Health anxiety
Persistent preoccupation with having or developing a serious illness, with misinterpretation of normal sensations, repeated checking and reassurance-seeking that brings only brief relief. It can coexist with real illness; the problem is the anxiety's size, persistence and grip.
What drives it
Checking, searching and seeking reassurance relieve uncertainty for a short time and so get reinforced, while attention to the body amplifies sensations and seems to confirm the fear.
How it shows
Work
Frequent medical appointments, searching symptoms online between meetings, anxious questions about colleagues' illnesses, avoidance of hospitals or news about disease, distraction by bodily sensations. 'Does this look normal to you?'
Relationships
Repeated requests for reassurance from a partner, checking moles or lymph nodes, distress after reading about a celebrity's diagnosis, conflict when a partner stops reassuring. Some avoid doctors entirely for fear of what they might hear.
Self
A normal twinge sets off a chain of 'what if it's…', you check and search, feel better for a few hours after a clear test, then doubt the test. Your body feels like a source of threat.
What tells it apart
Somatisation: Somatisation is distress expressed as bodily symptoms, often without the person linking them to emotion; health anxiety is fear about what symptoms mean, and the focus is the feared diagnosis rather than the symptom itself.
Panic: Panic is a sudden acute alarm about immediate catastrophe; health anxiety is a chronic, slower preoccupation with illness that drives checking and appointments over weeks and months.
Vulnerability to harm or illness schema: The vulnerability schema is a broad belief that catastrophe (illness, crime, financial ruin) is imminent; health anxiety is focused on the body and has a specific cycle of checking and reassurance.
A test
Real illness and health anxiety can coexist, so new, persistent or worsening symptoms (weight loss, bleeding, lumps, night sweats, pain that wakes them) still need proper medical review; once that is done, if fear survives normal results and reassurance lasts hours rather than weeks, suggest psychological assessment, as CBT for health anxiety works well.
Questions to carry
- Once proper medical checks are done, how long does the reassurance last before the fear comes back?
- Which sensation in my body do I keep checking, and what does checking give me for an hour?
How strong the research is
strong
Where it comes from
Hypochondriasis as a concept since antiquity; cognitive model by Paul Salkovskis and Hilary Warwick, 1986; replaced in DSM-5, 2013, by illness anxiety disorder and somatic symptom disorder