Health anxiety is a persistent fear of having or developing a serious illness, which carries on despite normal test results and medical reassurance. The older word for it is hypochondria. Two behaviours keep it going: checking, including online symptom searching, and reassurance seeking, including repeat GP visits.
Key points
- Health anxiety is a persistent fear of serious illness that continues after tests come back clear.
- Hypochondria is the older name; ICD-11 calls it hypochondriasis and groups it with obsessive-compulsive and related disorders.
- Two behaviours keep it going: checking, including online symptom searching, and reassurance seeking, including repeat GP visits.
- Reassurance relieves anxiety briefly, then the relief fades and the urge to ask returns stronger.
- CBT adapted for health anxiety has the strongest evidence. NICE has no guideline dedicated to it, so UK treatment rests on trial evidence.
Symptoms
- Persistent worry about having or catching a serious illness; reading ordinary sensations as signs of disease.
- Examining the body for lumps or changes, taking a pulse or temperature repeatedly, searching symptoms online for hours.
- Repeat GP appointments and requests for further tests; asking family to confirm nothing is wrong.
- Physical: fast heartbeat, chest tightness, dizziness, stomach upset and headaches, which are real and are read as evidence of disease.
Causes and risk factors
- Serious illness in childhood, or serious illness or death in the family.
- A frightening medical experience, such as a delayed or missed diagnosis.
- A general tendency to high anxiety, bereavement or heavy stress shortly before onset.
- Heavy internet use to interpret symptoms is a likely contributor, though not proven as cause.
Treatment
- CBT for health anxiety: mapping the sensation-interpretation-checking-relief cycle, testing feared interpretations, cutting down checking and reassurance seeking.
- Antidepressants, mainly SSRIs, are a second-line option after psychological therapy.
When to speak to a professional
- Worry about your health has lasted weeks and fills much of most days.
- Checking or symptom searching is affecting work, sleep or relationships.
- Repeated tests have come back normal and the relief no longer lasts.
- You are avoiding appointments or screening invitations because of what might be found.
If you need help now: Samaritans, call 116 123, free, 24/7. Shout, text SHOUT to 85258. NHS 111, then choose the mental health option. Call 999 if anyone is in immediate danger.