Health Anxiety Disorder Management

Health anxiety disorder, also called illness anxiety disorder or hypochondriasis, is a condition wherein patients worry excessively about their health. These patients may have many other diagnostic categories such as obsessive compulsive disorder (OCD), generalized anxiety disorder (GAS), and depression.

The patients may also experience other disorders, such as somatization disorder, a condition where anxious individuals manifest physical symptoms. They also have hypochondriasis, which is a condition characterized by the person’s disposition to respond to physical symptoms, due to imagining the worst possible scenario or illness.

Image Credit: Chinnapong / Shutterstock
Image Credit: Chinnapong / Shutterstock

Health Anxiety Signs and Symptoms

Health anxiety patients may become worried about their health by knowing someone else with the disease, reading articles or searching online about certain diseases, and things they notice in their body, including physical symptoms.

The common symptoms of the condition include worrying that the patient has a serious disease, misinterpreting physical or mental symptoms, and continuing to worry even if they’re given reassurance by a health care provider.

Also, patients may feel anxious and distressed because of overthinking. They often have impaired ability to work or interact socially. The patients also visit their doctor many times a year, more than the usual, and in some cases, they visit many doctors.

Lastly, patients with health anxiety may undergo a series of laboratory and diagnostic tests that are not warranted. The patients may also repeatedly seek reassurance about their life and develop unhelpful behaviors like resting excessively, taking drugs that are not needed, and avoiding exercise or physical activity.

Health Anxiety Disorder Diagnosis and Treatment

The goal of treatment is to improve the patient’s symptoms. Moreover, managing health anxiety disorder is important to improve the patient’s quality of life and ability to function normally.

To land at a health anxiety disorder diagnosis, the doctor will perform a comprehensive physical examination to rule out any health conditions. If the patient is generally healthy, the doctor may refer him or her to a mental health professional.

The mental health professional will perform a psychological evaluation. From there, management for the condition can be provided.

In order to diagnose the condition, it will be based on criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). The criteria include:

  • The patient has a preoccupation with having or getting a severe disease.
  • The patient has no or just minimal somatic symptoms.
  • The patient feels extremely anxious about health and can feel worried easily about personal health issues.
  • The patient persistently consults doctors for reassurance, or in other cases, avoids doctor appointments.
  • The patient feels worried about an illness for more than six months.
  • The symptoms are not better accounted for by another mental health disorder.

Psychotherapy

Psychotherapy, also known as talk therapy, can be an effective way to manage health anxiety disorder. The condition is due to the physical sensations associated with psychological distress and health anxiety. Hence, the most common management is through cognitive behavioral therapy (CBT). It provides the skills needed to manage the disorder.

CBT can be provided as a group or individually. There are two types of CBT that can help, Exposure and Response Prevention (ERP) and Cognitive Restructuring.

These can help the patient:

  • Identify the belief and fears about having a serious illness.
  • Learn other ways to view the body sensations, by changing negative and unhelpful thoughts.
  • Become more aware of the worries that can affect behavior.
  • Learn coping skills to handle stress and anxiety.
  • Improve the ability to function normally.
  • Learn to stop avoiding activities due to physical sensations.
  • Deal with other mental health issues such as depression, generalized anxiety disorder, and obsessive-compulsive behavior.

Medication

Some patients may need more than just psychotherapy to feel better. In those cases, the doctor may recommend taking medications.

Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), are prescribed for this condition.

Health anxiety disorder is a long-term medical condition. People may experience varied severity, depending on their coping skills and disease management. Seeking help and complying with their treatment plan can reduce the symptoms and improve daily functioning.

Last Updated: Feb 26, 2019

Angela Betsaida B. Laguipo

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Angela Betsaida B. Laguipo

Angela is a nurse by profession and a writer by heart. She graduated with honors (Cum Laude) for her Bachelor of Nursing degree at the University of Baguio, Philippines. She recently completed a Master's Degree where she specialized in Maternal and Child Nursing and is now working as a clinical instructor and educator in the School of Nursing at the University of Baguio.

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Comments

  1. Peter George Peter George Australia says:

    Once again the drop-out rates of CBT are ignored (see papers by Prof. Ephrem Fernandez, a CBT expert). Cognitive re-construction is a necessary but not sufficient approach to the resolution of Health Anxiety and should certainly not be attempted in the first sessions; that is a recipe for rapid dis-embarcation of the Patient from psychotherapy.

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