In short
Health anxiety is persistent, distressing worry about having or developing a serious illness, even when symptoms are mild or tests are clear. It used to be called hypochondria. It affects about 1 in 18 Australians at some point. Repeated checking, searching symptoms online and seeking reassurance bring short relief and keep the worry going. Cognitive behavioural therapy is the main treatment, and about two in three people respond to it.
On this page
What is health anxiety?
Health anxiety is a type of anxiety disorder in which a person worries often about their health, even when nothing is seriously wrong. It is also known as hypochondria or hypochondriasis.1
Worrying about your health now and then is normal. With health anxiety, a person becomes very worried that they are seriously ill, or about to become so, even with only mild symptoms.1
It takes two forms. Some people have a medical condition that they keep worrying about. Others are physically healthy and have an overwhelming fear about their future health.1 In both, the distress is real, and it can make everyday life hard.1
How common is it?
An Australian national survey found that health anxiety affects about 5.7 per cent of people at some point in their lives, and that 3.4 per cent met the criteria at the time they were interviewed. It was linked with more distress, more disability and more use of health services.2
Want to talk it through?
Talk it through with an Australian doctor online. No referral needed.
Signs of health anxiety
- Seeing a doctor often, without feeling reassured when told you are healthy1
- Spending hours online researching symptoms1
- Talking about health a lot with friends and family1
- Trouble at home, at work or socially because of health worries1
Some people go the other way and avoid doctors, tests and anything to do with illness, because the fear of what might be found is too much.
What causes it?
It is not clear why some people develop it. Several things are likely to play a part:1
- A family history of anxiety disorders
- Earlier major stress, illness or a death in the family
- A tendency to worry
- A history of childhood neglect or abuse, serious physical illness or other mental health problems
Why checking makes it worse
The things people do to feel safer are the things that keep health anxiety going. Checking your body, asking for reassurance and looking up symptoms each bring a few minutes of relief. Then the doubt returns, and the urge to check is stronger than before.
Searching online is a particular trap. Reading about diseases on the internet is a recognised trigger for episodes of anxiety.1 A pooled analysis of 20 studies with 7,373 participants found that the more health anxiety people had, the more they searched for health information online, and that health anxiety was strongly linked with searching that escalates and causes distress.3
Treatment
Cognitive behavioural therapy
Cognitive behavioural therapy (CBT) is the treatment with the most evidence. It works on how you interpret body sensations and helps you cut back the checking and reassurance-seeking in steps.
- Across 19 randomised trials, CBT had a moderate to large effect on health anxiety. About 66 per cent of people responded and 48 per cent recovered, and the gains largely held 12 to 18 months later.4
- Online CBT worked about as well as face-to-face CBT.4
- In a trial of 444 hospital outpatients with health anxiety, those given CBT improved more than those given standard care, and the benefit lasted two years. Twice as many reached normal levels of health anxiety at one year.5
Clear information
A clear and honest explanation from a doctor of what is and is not causing your symptoms, with self-help resources, is part of treatment.1
Medicines
Antidepressant medicines can help reduce the anxiety.1
The basics
Exercise, sleep and a healthy diet help reduce stress and anxiety.1
Working with your doctor
Health anxiety does not mean your symptoms are imagined, and it does not mean you should stop seeing doctors. People with health anxiety get sick like anyone else. What helps is a steady arrangement with one GP you trust:
- See the same doctor, so someone knows your history and what has already been checked
- Agree on which symptoms need a prompt visit and which can wait
- Book regular reviews in place of urgent visits when worry spikes
- Ask about a mental health treatment plan1
When to see a doctor
If you think you have health anxiety and it is affecting your day-to-day life, it is important to seek help. Your doctor is a good place to start.1
- Health worries take up much of your day
- Reassurance and clear test results do not settle the worry for long
- You are avoiding medical care you need
- You feel low or hopeless
If you are having thoughts of suicide or self-harm, call Lifeline on 13 11 14. In an emergency, call 000.
See also generalised anxiety disorder, anxiety chest pain and how to stop overthinking.
Next step: talk to a doctor
Answer a few quick questions and you’ll get an email about your eligibility. A consultation doesn’t guarantee any particular treatment.
References
- healthdirect. Hypochondria.
- Sunderland M, Newby JM, Andrews G. Health anxiety in Australia: prevalence, comorbidity, disability and service use. Br J Psychiatry. 2013;202(1):56-61.
- McMullan RD, Berle D, Arnáez S, et al. The relationships between health anxiety, online health information seeking, and cyberchondria: Systematic review and meta-analysis. J Affect Disord. 2019;245:270-278.
- Axelsson E, Hedman-Lagerlöf E. Cognitive behavior therapy for health anxiety: systematic review and meta-analysis of clinical efficacy and health economic outcomes. Expert Rev Pharmacoecon Outcomes Res. 2019;19(6):663-676.
- Tyrer P, Cooper S, Salkovskis P, et al. Clinical and cost-effectiveness of cognitive behaviour therapy for health anxiety in medical patients: a multicentre randomised controlled trial. Lancet. 2014;383(9913):219-25.
This guide is general information, not medical advice. It doesn’t replace a consultation with a doctor who knows your history. In an emergency, call 000.