Do I Have Illness Anxiety Disorder?

Obsessive behavior and illness anxiety disorder

It is pretty likely that we know someone who has always been a little “squeamish” about personal contact. It might be because they were afraid of germs. Or of being exposed to a contagious condition. In Vancouver, I always saw a lot of Asian people wearing masks outside on a daily basis.

After university, I worked with a woman who used to bring her own pens to work. She couldn’t bear the thought of using a pen that another person had held. Right away she sanitized her hands at her desk after shaking someone’s hand. And she always used her sleeve to open the washroom doors. She used to talk a lot about her latest “symptom” of an undiagnosed but serious illness over lunch or coffee.

With the way our world has changed because of Covid-19, her behavior no longer feels that out of place. Perhaps I even feel a little like she was ahead of the crowd when it comes to personal safety. Yet for many people, “cleanliness rituals” and health preoccupations are not a fad. They may not even be strictly related to Covid-19.

Their general fears about their health were there long before the pandemic hit. And the mindset will remain long after the face shields are retired. What if your worrying about health is more than just a smart defence? Is there a point where we can be too preoccupied with our health?

Illness anxiety disorder is when worrying about your health becomes something that occupies more of your time than it needs to. It’s a persistent fear of having some kind of serious illness or health condition. Illness anxiety disorder can suck the energy right out of you. You spend days worrying about your health, going from doctor to doctor to find an answer.

It used to be referred to as hypochondriasis, but the medical community decided to change it to some more non-judgmental terms. Basically, someone who deals with this type of anxiety is always hyper-conscious of their body. They often interpret any body signals as a cause for concern or a symptom of a grave or serious illness.

We may have a very narrow understanding of what a person with illness anxiety disorder looks like. We have all seen the character in sitcoms who won’t touch any door handles. In reality, this type of anxiety can be much more complex and varied. Many individuals with illness anxiety disorder are actually more occupied with what is already happening in their body, rather than protecting it from germs.

They may believe that their headache is, in fact, the early stage of a brain tumor. Or that their cough is a sign of lung cancer. Those thoughts will be very intrusive and take over their daily routine. Since this is a condition, the process is not voluntary. Illness anxiety disorder is similar to obsessive compulsive disorder and some professionals see the two as related.

Whereas people used to just be lumped in under “hypochondriasis”, the medical community now distinguishes between two types of disorders. It is generally accepted that if a person complains about physical symptoms, they would likely be diagnosed with somatic symptom disorder. Whereas people who complain about mild or no physical symptoms would be diagnosed with illness anxiety disorder.

This makes a distinction between people who are preoccupied with and experiencing physical symptoms. As opposed to people who are more consumed by the fear over developing a grave or terminal illness

It is important to note that often people with either disorder have been gravely ill in the past. A traumatic event like that can lay the foundation for illness anxiety disorder, for example. It is common for illness anxiety disorder to start in the late teenage years. But, it can really start at any age. Symptoms can be made worse or even triggered by a traumatic event like losing a loved one.

Much like with OCD (obsessive compulsive disorder), the person does not choose to focus on their health. This is a mental health condition and usually needs mental health support rather than urgent medical care. Since people with illness anxiety disorder tend to visit their doctor often, it is usually their doctor who begins to suspect a mental health condition.

So what kind of symptoms does a person with Health Anxiety display? There is a broad range, but there are certain underlying themes that tend to be common among most people affected.

People who suffer from illness anxiety disorder most often have two things in common. They generally exaggerate the danger of certain health situations. And they misunderstand normal bodily functions. These two things can make any health situation feel worse and cause a lot of anxiety in the process.

Much of the anxiety around health is built up and perpetuated by intrusive thoughts. This includes thinking that certain health conditions are more common and more easily contracted than they actually are. For example, if there is an Ebola outbreak in Africa, it isn’t likely that a person living in rural Arkansas shows symptoms of it that same day.

A person with illness anxiety disorder may become convinced that they have or will contract Ebola. Even if the risk is extremely minimal and they have not been exposed. Similarly, just because someone in your family has died of throat cancer doesn’t mean that it is inevitably going to kill you too. The risk associated with this is actually not that straight forward.

Another way that illness anxiety disorder may overwhelm an individual is through misinterpreting normal bodily functions as symptoms of illness. A noisy belly rumble, or a normal mole may have them convinced that this is the symptom of a serious illness. Admittedly, it can be hard to decipher all the strange and wonderful things the human body does. We all have some strange marks and some funny noises sometimes. It’s when these harmless signs seem like the definite symptoms of illness every time that the anxiety is perhaps unwarranted.

Another common habit that fuels illness anxiety disorder is researching health issues online to an extreme. Without a doctor’s insight, medical information can be difficult to understand fully. And symptom lists can be far too simplified to provide the needed context for a diagnosis.

Individuals with illness anxiety disorder may spend an excessive amount of time online obsessing over what a mild symptom may “mean”. While extra information and research online can be helpful to an extent, it is best to have a medical doctor’s opinion and tests in order to give context to the overwhelming information online.

It is a hallmark of illness anxiety disorder to continue to believe you have a specific illness even after tests confirm that you do not. This is where the anxiety can take control and outweigh “reasonable” concern over illness. 

This can become especially difficult when your doctor has run all reasonable tests they could think of. At some point they may get frustrated because there is no reason for concern. And you may get just as upset and decide to seek a second, fifth, or tenth opinion. Understanding that illness anxiety disorder is a mental health condition is vital at that point.

In the wake of the Covid-19 pandemic, we have all become a little more aware of our health and our body’s signals. We are constantly being reminded of contagion and safety wherever we look in order to keep us safe. It’s when these thoughts start to take over all your time, interfere with work or relationships, or cause you excessive anxiety that you may be dealing with illness anxiety disorder.

Ask yourself how many of your latest health “suspicions” were actually confirmed with tests. And if this shows a pattern of unnecessary worry. If you see one dedicated doctor, they may already have a suspicion of this disorder before you come to realize you are suffering from it. The key is not to get offended if your doctor has a conversation with you about the possibility of this disorder. They are just trying to help you find a way to cope with it.

Most individuals will persist down the line of thinking that they need medical care, when in reality they need mental health care to address this issue. Treating the anxiety should result in the person being able to worry only about credible health threats. And spend more time feeling healthy (or at least not on the brink of a terminal illness). It’s important to be honest with yourself and your doctor in order to find the right solution for you.

For most cases of illness anxiety disorder the likelihood of recovery is actually quite good. This, of course, depends on whether the person receives the right kind of support and treatment they need. This is why it is important that your doctor refers you to a mental health professional. Once they have repeatedly run tests and reassured you, they should begin to suspect an underlying mental health condition.

As a starting point, your mental health professional may opt for medication. Since illness anxiety disorder is similar to OCD, medication for OCD may be prescribed. There are certain medications that work well for both OCD and illness anxiety disorder. Your doctor may also try antidepressants to help ease your anxiety.

Often, illness anxiety disorder presents with other mental health disorders at the same time. It’s possible for illness anxiety disorder to occur in conjunction with depression, schizophrenia, or somatization disorder. Your doctor may need to do some tests to find out. The treatment plan will then consider all mental health disorders and how to best address them.

There are also certain types of therapy that work well for this type of disorder. Your doctor might suggest cognitive behavioral therapy, for example. In certain cases therapy can be very successful and provide techniques on how to cope with your anxiety. Although curing illness anxiety disorder can be a lengthy process, you can definitely learn to manage it in the meantime.

Illness anxiety disorder can be an extremely frustrating experience. Not only do you experience anxiety around your health, it is also possible that your doctor hasn’t diagnosed you with something that is real. It is definitely possible that you feel symptoms that are difficult to diagnose. Or that your doctor hasn’t done their due diligence to really rule out a certain illness.

Having said that, diagnosing illness can be a very complex process. Often patients do need to advocate for themselves in order to find answers and not be brushed off. Health anxiety in this scenario would be well warranted and is actually a signal that there is still an underlying problem that needs to be addressed.

But if you find yourself in that situation often, with different conditions at different times, you may be dealing with illness anxiety disorder. As difficult as it may be, you will need to seek help from a mental health professional rather than a medical doctor at that point. Since you are suffering from the disorder, it may be impossible to make that call on your own.

As long as you stick with the same doctor, she or he should begin to understand what is happening and refer you. At the same time, you deserve to be treated professionally and with respect. Even if your doctor repeatedly comes up with nothing on their tests, they should not be rude, dismissive, or refuse to give you appointments.

Understand that seeking treatment for illness anxiety disorder can be scary, but you deserve to thrive fully and without constant fear of being terminally ill.