Hypochondria (health anxiety): meaning, signs and how CBT helps

A headache becomes a brain tumour. A twinge in your chest becomes a heart problem. You check your body, search your symptoms, ask for reassurance and book another appointment, and the relief never lasts.

People sometimes call this being a “hypochondriac”. Today, most doctors call it health anxiety, and it’s very treatable.

What does hypochondriac mean?

“Hypochondriac” describes someone who worries excessively about having a serious illness. The word has picked up a dismissive tone, as if people are making it up. But the anxiety is real and often very distressing, which is why health anxiety is the preferred term. Doctors may diagnose it as illness anxiety disorder, or somatic symptom disorder when physical symptoms are a big part of it. Our post on illness anxiety vs somatic symptom disorder explains the difference.

The NHS describes health anxiety as spending so much time worrying you’re ill, or going to get ill, that it starts to take over your life. It also notes that health anxiety is related to OCD.

Signs of health anxiety

The NHS says you may have health anxiety if you:

• constantly worry about your health
• frequently check your body for signs of illness, like lumps, tingling or pain
• are always asking people for reassurance that you’re not ill
• worry that a doctor or medical tests may have missed something
• obsessively look at health information online or in the media
• avoid anything to do with serious illness, like medical TV programmes
• act as if you were ill, for example avoiding physical activity

Why it keeps going

1. You notice a sensation, like a headache or a skipped heartbeat.
2. You fear the worst.
3. Anxiety causes more sensations, like a racing heart, tension or tingling.
4. You check, search or seek reassurance, and feel relief for a while.
5. The doubt returns, often with a new symptom, and the cycle repeats.

Anxiety itself causes real physical symptoms, which can feel like proof that something is wrong. Googling usually makes it worse, because search results highlight the scariest possibilities.

Treatment that works

Cognitive behavioural therapy (CBT) is very effective for health anxiety. A review of studies found a large effect for CBT compared with control conditions, lasting at 6 and 12 months. CBT helps you:

• understand how anxiety creates and amplifies symptoms
• gradually reduce checking, googling and reassurance-seeking
• test your fears and build more balanced thoughts
• return to activities you’ve been avoiding

Some people are also helped by medicine, usually an SSRI.

Self-help from the NHS

• Keep a diary of how often you check your body, seek reassurance or look up health information, and gradually reduce it.
• Challenge your thoughts: write the health worry in one column and a more balanced thought in another.
• Keep busy when the urge to check arrives: go for a walk or call a friend.
• Get back to normal activities you’ve been avoiding.

Getting checked without feeding the cycle

Health anxiety doesn’t protect you from real illness, so new, different or severe symptoms should still be checked. It can help to agree a plan with one doctor: regular check-ins rather than urgent appointments for every worry, and an agreed list of symptoms that do need prompt attention.

When to get help

Talk to a doctor if worry about your health is taking up a lot of your time, affecting your work or relationships, or you’re constantly checking and seeking reassurance. If you’re having thoughts of ending your life, call or text 988 (US) now.

Frequently asked questions

What is the definition of a hypochondriac?

A hypochondriac is someone who worries excessively that they have, or will get, a serious illness. Doctors now usually call this health anxiety, or illness anxiety disorder.

Is hypochondria a mental illness?

Health anxiety is a recognised mental health condition, related to OCD and anxiety disorders. It’s very treatable.

Can health anxiety cause real symptoms?

Yes. Anxiety causes real physical symptoms like a racing heart, headaches, tingling, dizziness and stomach problems, which can feel like signs of illness.

How do I stop googling my symptoms?

Notice the urge, delay it, and do something else for 20 minutes. Gradually reduce how often you search. Each time you resist, the urge gets weaker. CBT can help if it’s hard to do alone.

How Breatheasy can help

When a health worry brings a wave of panic and an urge to check or search, Breatheasy can help you ride it out. Tap “I’m feeling anxious” and Luma walks you through slow breathing and grounding, which calms the anxiety that creates many of the symptoms. The “Ride out an urge” tool helps you resist checking or googling, and Luma is designed not to get pulled into endless reassurance. Breatheasy is coming soon to iPhone and Android.

Sources

• Health anxiety, NHS
• Cognitive behaviour therapy for health anxiety: a systematic review and meta-analysis, Cooper and others, Behavioural and Cognitive Psychotherapy, 2017
• Obsessive compulsive disorder (OCD), NHS