Illness and Anxiety Disorder: Symptoms, Causes, and Treatment

Are you concerned about your health all the time? Do you often go to many physicians to get reassurance about your symptoms? Do you insist on being scanned and having blood tests done on a regular basis?

In such scenario, it is possible that you have an illness anxiety disorder (IAD). The medical community recognizes it as a psychiatric problem that requires a different diagnosis than other mental health ⁽¹⁾ issues. Excessive and ongoing concern for one’s health and an irrational fear of having or acquiring a major medical ⁽²⁾ illness are among its defining characteristics. It causes compulsive behaviors that make it difficult for victims to go about their daily lives regularly.

Let’s examine the characteristics of anxiety disorders ⁽³⁾ in greater detail.

The illness-anxiety disorder’s history

The original name for the illness anxiety disorder was hypochondriasis. Greek doctors were the first to use the word “hypochondria” in traditional medicine. Thus, the Greek term “hypochondrios,” which means “under cartilage,” is where the name hypochondrium originates. The word refers, in essence, to the areas of the body between the navel and the ribs.

Why is it the case? Back then, hypochondria was thought to be a medical ailment that started in the stomach and moved up to the brain, where it resulted in psychological issues. Furthermore, until recently, the term “illness without a specific cause” was associated with hypochondriasis.

The most recent version of the Diagnostic and Statistical Manual (DSM-5) completely rejected the name “hypochondriasis” due to its perceived disparaging nature. Instead, a new label called “illness anxiety disorder” was added. Health anxiety and disease anxiety are currently classified as “somatic symptom and related disorders” in the DSM-5. This psychological disease is one of the most difficult to identify and treat because its symptoms are similar to and overlap with those of other mental health ⁽⁴⁾ conditions, including OCD and generalized anxiety..

What Are Illness Anxiety Disorder’s Causes and Risk Factors?

Although the precise causation of anxiety disorders ⁽⁵⁾ is unknown, several risk factors have been shown to be plausible contributors to the condition.

• Oversensitivity to bodily sensations: Some individuals have increased sensitivity to the body’s typical physiological feelings, which they may interpret as a red flag for a potentially dangerous condition. These symptoms often manifest as heart palpitations, sneezing, profuse perspiration, and stomach discomfort.
• Family influences: Parents who are cautious about their own or their children’s health are more likely to counteract health concerns in younger generations. A history of child maltreatment is also associated with a higher risk.
• Past sickness experiences: People are more likely to become sensitive about their health if they have had a terrible medical encounter in the past or if they have seen a loved one struggle with a major disease.
• Stress and other anxiety disorders: An increased risk ⁽⁶⁾ of developing IAD is associated with the presence of certain phobias, personality disorders, and anxiety disorders. Persistently high stress levels can represent a risk factor.
• Overindulgence in health-related material: If you read or watch too much online medical content, you may be more susceptible to health anxiety. Students studying medicine are especially prone to this.

Illness Anxiety Disorder: How Common Is It?

We approximate the prevalence of IAD, a relatively recent medical diagnosis, using historical data on hypochondriasis. The following are significant epidemiological data on anxiety disorders:

• There is a 25% likelihood that a patient with a history of hypochondriasis will also be diagnosed with an anxiety condition.
• In a clinical context, the prevalence of IAD is around 0.75%, compared to 0.1% in the general population.
• Adults and adolescents between the ages ⁽⁷⁾ of 25 and 35 are more susceptible to IAD.
• As people age, IAD often becomes worse.
• Men and women with no gender predilection experience IAD at the same rates.
• Individuals with lower incomes and educational levels are more likely to develop IAD.

Has the risk of illness anxiety disorder increased due to the COVID-19 pandemic?

Undoubtedly, there is a positive correlation between Covid-19 and sickness anxiety disorder. People with health concerns now find it more difficult to manage ⁽⁸⁾ their symptoms as a result of the coronavirus epidemic. Since the epidemic, there has been a 25% rise in mental health problems such as anxiety and depression, according to WHO. The main causes of this increase include social isolation, being afraid of being sick, having money issues, and having seen a loved one die.

What Indicates a Sickness Anxiety Disorder?

The main feature of anxiety disorder symptoms ⁽⁹⁾ is the belief that one has a significant medical issue even when there are no physical symptoms or just mild ones. These might include a little rash, a slight bruise, or moderate soreness.

The following behaviors are indicative of someone who is experiencing health anxiety:

• Believing that one already has or is susceptible to developing a significant medical condition
• An inordinate amount of concern for little symptoms, such as coughing or itching
• Thinking that anything major may be behind a routine bodily function, such as gastric passage
• Constantly searching the internet for information on the origins and manifestations of various illnesses
• Monitoring vital signs including blood pressure ⁽¹⁰⁾ and temperature, on a regular basis
• Being anxious about contracting a disease that runs in the family
• Discussing the symptoms with loved ones and friends and getting their confirmation
• Scheduling frequent medical appointments or forgoing them entirely
• Requesting testing from many hospitals and laboratories and not trusting the medical reports
• Ignoring the advice of the physician and taking no comfort from their observations
• Staying away from certain individuals, events, and locations out of concern that they may get unwell.

Which Illness Anxiety Disorder Types Are There?

We classify IAD into two types based on the patient’s behavior and reaction:

• Care-seeking type: People often go to hospitals for routine examinations and treatments and consult various experts on their health.
• Care-avoiding type: People avoid or utilize healthcare seldom because they worry that their health issues will be dismissed as illogical and unimportant.

How is a diagnosis of illness anxiety disorder made?

To diagnose anxiety, one must first rule out the patient’s most concerning medical symptoms or disorders. Afterwards, medical practitioners conduct a comprehensive psychological assessment to pinpoint any underlying issues or coexisting disorders that might be influencing the problem. Medical practitioners use the DSM-5 criterion to diagnose health anxiety. A person must possess the following traits to meet the DSM-5 criteria for a sickness anxiety disorder:

1. Fixated on the idea of developing a major disease
2. Lack of outward signs and symptoms
3. Exaggerated concern for one’s own health
4. Repetitive and compulsive actions linked to health
5. A minimum of six months’ worth of symptoms
6. Symptoms that other mental health ⁽¹¹⁾ disorders are a better fit for

A diagnostic instrument called “The Health Preoccupation Diagnostic Interview”. has also been developed by researchers to help with the diagnosis of somatic symptom disorder and health anxiety. The degree of sickness anxiety disorder may also be assessed using a self-assessed “Health Anxiety Inventory“ ⁽¹²⁾ scale test. Furthermore, someone might still be diagnosed with IAD even if they have a medical condition ; their concerns about it are unwarranted.

What Is the Treatment for Illness Anxiety Disorder?

Various methods for treating anxiety disorders include

Psychoanalysis

The preferred and scientifically confirmed ⁽¹³⁾  treatment for health anxiety is therapy. Cognitive-behavioral therapy (CBT) is the most used therapeutic approach for this goal. It assists in determining the patients’ problematic beliefs and attempts to address such beliefs using techniques for behavioral change. In situations of health anxiety, CBT also assists patients in distinguishing between normal and abnormal bodily feelings.

In addition to cognitive behavioral therapy, alternative treatments for IAD may include exposure therapy and acceptance and commitment therapy.

Drugs

Taking antidepressant ⁽¹⁴⁾ drugs is the second line of treatment for IAD. The most often recommended pharmacological medications for symptom remission are newer antidepressants such as selective serotonin reuptake inhibitors (SSRIs) ⁽¹⁵⁾ and serotonin-norepinephrine reuptake inhibitors (SNRIs). These medications often take four to six weeks to start working and have the expected therapeutic benefits. Patients may need to take the drugs for six to twelve months as maintenance therapy in the event that they have a favorable response.

Approach to Lifestyle Treatment

For the therapy of sickness anxiety disorder, a lifestyle treatment plan ⁽¹⁶⁾ can be the best choice. It aims to reduce health anxiety through motivation by addressing the lifestyle factors that lead to the illness. Patients are required to take an active role in their care and modify their lifestyle significantly to follow the prescribed course of treatment. With the help of a mental health ⁽¹⁷⁾ professional, this approach places a strong emphasis on motivational interviewing and may do away with the need for medicine to treat symptoms.

Techniques for Self-Management

Using various coping mechanisms in conjunction with medical care might hasten healing and reduce symptom recurrence.

• Record the symptoms you experience. Note what makes you feel more anxious about your health, and let the doctor know what triggers you. Keeping a notebook, diary, or even a health app might help with this.
• Take some time to educate yourself on the functioning of regular bodily sensations and how they vary from aberrant ones.
• Play sports or other enjoyable and healthful activities to divert your mind from bothersome concerns about your well-being.
• Take more time offline, away from the internet, in nature and with loved ones to avoid absorbing needless medical information.
• To help you relax, try yoga, mindfulness, breathing exercises, and other methods.
• Regular exercise helps let go of stored worries.
• Establish a regular sleep ⁽¹⁸⁾ routine that includes at least 6–8 hours of restful sleep each day.
• Eat a diet rich in fruits and vegetables and low in sugary foods.
• Quit smoking, using illegal drugs, and drinking less alcohol. ⁽¹⁹⁾
• Look for and take part in events at nearby anxiety support groups.
• If your concerns about your health are excessive, always seek the advice of a medical expert ⁽²⁰⁾. They are most suited to advise you.
• A Follow your treatment plan and speak up if you have any worries.

What Consequences Can Untreated IAD Cause?

Health anxiety may lead to several issues and exponential misery if left untreated:

• The higher cost as a result of needless hospital stays
• Reduced socialization and isolation risk
• Issues in your relationships ⁽²¹⁾ with your family and friends
• inability to focus and decreased output in the workplace and in the classroom
• higher likelihood of experiencing further mental health problems ⁽²²⁾

What Is the Duration of Illness Anxiety Disorder?

The length of anxiety disorders varies from person to person and cannot be prescribed. Episodes of health worry may recur in cycles with no discernible pattern. Undiagnosed and untreated mental health issues often worsen over time ⁽²³⁾.

Can Panic Attacks Be Caused by Illness Anxiety Disorder?

Yes, panic episodes ⁽²⁴⁾ are prevalent among those who suffer from an anxiety condition. When the underlying cause is treated, these assaults usually stop.

What Separates Illness Anxiety Disorder from Other Mental Health Issues?

IAD is a distinct mental illness. However, people often confuse it with other psychiatric disorders that share certain characteristics. Health anxiety is associated with the following list of comorbid conditions:

• Distinguishing between Somatic Symptom Disorder (SSD) and Illness Anxiety Disorder: Individuals with SSD have physical symptoms that cause them to experience excessive anxiety related to their health and the potential for developing a major medical condition. On the other hand, anxiety disorders often don’t cause any physical symptoms ⁽²⁵⁾ in their sufferers.
• Obsessive-compulsive disorder (OCD) vs. illness anxiety disorder (IAD): In contrast to illness anxiety disorder, when a person solely concentrates on health-related concerns, ⁽²⁶⁾ they experience intrusive thoughts and repetitive actions in other areas of their life. Therefore, people often perceive health anxiety as a specific form of OCD.
• Differences between Generalized Anxiety Disorder (GAD) and Illness Anxiety Disorder (IAD): GAD is characterized by anxiety ⁽²⁷⁾ and worry in all facets of life, while IAD instills anxieties related to health and illnesses.
• Body Dysmorphic Disorder (BDD) vs. Illness Anxiety Disorder: BDD sufferers worry that certain physical characteristics make them seem unattractive. But with IAD, actual symptoms—rather than outward appearance—are the real issues.
• Delusional Disorder vs. Illness Anxiety Disorder: Individuals with delusional disorder have one or more persistent delusions that they are unable to shake. Patients with IAD, on the other hand, are open to the possibility that their symptoms could not really exist.
• Conversion disorder vs. sickness anxiety disorder: Unlike illness anxiety disorder, conversion disorder patients really experience physical symptoms in the absence of a known cause. ⁽²⁸⁾
• Factitious Disorder vs. Illness Anxiety Disorder: In factitious disorder, patients fabricate symptoms to acquire a diagnosis and attention from a physician. On the other hand, those who have sickness anxiety disorder are convinced that they have a medical problem. ⁽²⁹⁾

Last Remarks

Anxiety disorder related ⁽³⁰⁾ to illness is among the most intricate psychiatric diseases. It is difficult to treat and worsens over time if appropriate medical care is not received. People who have IAD are obsessed with the idea that they have a severe disease yet don’t have any physical symptoms. The best treatments for health anxiety are lifestyle medicine, medication, and therapy.

Lillie’s Friends’ mental health specialists are qualified experts who offer precise online evaluation and treatment for psychological issues such as illness anxiety disorder. They create a treatment plan to address each patient’s unique needs, both big and small. Please schedule an online appointment at your earliest convenience to discover how your quality of life has improved.