Health Anxiety

Health anxiety is characterized by an excessive preoccupation with the belief that one has, or is in danger of developing, a serious illness. This preoccupation can be debilitating, leading individuals to frequently seek medical reassurance, undergo numerous medical tests, and experience significant distress.

Health anxiety involves an intense fear and worry about one’s health, often without significant physical symptoms. People with health anxiety might interpret normal bodily sensations as signs of severe illness, leading to constant checking, researching symptoms online (often referred to as "cyberchondria"), and seeking medical advice. This anxiety persists despite reassurances from healthcare professionals and negative test results.

Differences Between Health Anxiety and Hypochondriasis

While health anxiety and hypochondriasis are closely related, they are not synonymous. Hypochondriasis, historically a specific diagnosis in the DSM-IV, has evolved in the DSM-5 into two categories: somatic symptom disorder (SSD) and illness anxiety disorder (IAD). Health anxiety is more aligned with illness anxiety disorder, where the predominant concern is the fear of illness rather than the presence of somatic symptoms.

Here’s a breakdown of the differences:

1. Somatic Symptom Disorder (SSD):

   • Involves significant focus on physical symptoms (e.g., pain, fatigue).

   • The anxiety and behaviors are primarily driven by the physical symptoms.

   • The individual’s concern about their health is disproportionate to the actual physical condition.

2. Illness Anxiety Disorder (IAD):

   • Involves a preoccupation with having or acquiring a serious illness.

   • Minimal to no physical symptoms are present.

   • The focus is on the anxiety about the possibility of illness rather than the physical symptoms themselves.

Is Health Anxiety a Form of OCD?

While health anxiety and OCD share similarities, they are distinct disorders. Health anxiety is not classified as a subtype of OCD, but it can be considered on the obsessive-compulsive spectrum due to the overlapping nature of obsessive thoughts and compulsive behaviors. However, the primary focus of health anxiety is specifically on health-related fears, which is not necessarily the case in OCD. For some the focus is on physical health concerns while for others they can be focused on having a psychotic episode, developing a severe psychiatric disorder or 'going crazy'.

Health anxiety shares some characteristics with OCD, and could perhaps be thought of as a subtype of OCD, as it involves obsessive thoughts and compulsive behaviors. In health anxiety the obsessions revolve around fears of developing an illness or health issue, and compulsions include repetitive unnecessary health checks (eg. blood tests, blood pressure, scans etc), seeking reassurance from doctors, excessive research of health concerns and avoiding certain food/activities perceived as risky.