What it is
Illness Anxiety Disorder (IAD), often called health anxiety, involves persistent worry about having or developing a serious disease despite minimal or no symptoms and reassuring medical evaluations. People may frequently seek medical checks or, alternatively, avoid doctors altogether due to fear. It’s treatable.
IAD differs from being health-conscious: the worry is excessive, persistent (6+ months), and interferes with life.
Common signs and symptoms
- Preoccupation with serious illness (e.g., cancer, ALS, heart disease) despite benign findings
- Misinterpreting normal sensations (heartbeat, twitches, gas) as dangerous
- Reassurance seeking: repeated online searches, doctor visits, tests, asking loved ones
- Safety behaviors: repeated body checks (moles, lymph nodes), avoiding exercise for fear of heart issues
- Avoidance: healthcare avoidance due to fear of a bad diagnosis
- Distress and impairment: lost time, reduced quality of life, strained relationships
Why it happens
- Attention and interpretation biases: scanning the body and assuming worst-case explanations
- Anxiety physiology: anxiety sensations (palpitations, dizziness) are misread as illness
- Reassurance traps: brief relief after tests increases the cycle of worry and checking
- Health experiences: past illness in self/family or traumatic medical events can sensitize worry
What helps
- Cognitive Behavioral Therapy (CBT) for health anxiety
- Re-label catastrophic thoughts; test balanced explanations
- Reduce reassurance/checking gradually; planned “reassurance-free” periods
- Exposure to feared sensations/information (e.g., reading about symptoms) without checking or escape
- Acceptance and Commitment Therapy (ACT)
- Shift focus toward values-based actions while allowing uncertainty
- Medical partnership
- Agree on a reasonable follow-up schedule instead of repeated urgent visits
- Learn when evaluation is actually indicated vs. when anxiety is driving checks
- Lifestyle
- Limit health-related internet searches; set specific times if needed
- Sleep, exercise, and stress tools to reduce baseline arousal
When to seek help now
- Daily life is dominated by health worries or checking/avoidance
- Repeated tests without relief or avoidance of necessary medical care
- Thoughts of self-harm or not wanting to live (seek urgent help)
How to talk to a clinician
- “I’m preoccupied with having a serious illness despite normal exams. I’d like CBT for health anxiety and a structured follow-up plan to avoid excessive testing.”
Outlook
With CBT/ACT and a collaborative medical plan, most people significantly reduce worry and checking, regaining time and peace of mind.
Resources for readers in the USA
- Immediate help: 988 Suicide & Crisis Lifeline (call/text 988); Crisis Text Line (text HOME to 741741)
- Find care: Psychology Today (filter for health anxiety/CBT/ACT); FindTreatment.gov; NAMI HelpLine (nami.org/help)
- Self-help: Anxiety and Depression Association of America (adaa.org) resources on health anxiety
- Low-cost/community: Open Path Collective; Community Health Centers (findahealthcenter.hrsa.gov); 211
- Insurance tips: Verify in-network therapy, telehealth, session limits, prior authorization; copay/coinsurance, deductible, out-of-pocket max; note rep name/date/reference number
- Work/school supports: ADA accommodations if substantially limiting; EAP; campus counseling
- Urgent options besides ER: Mobile Crisis via 988 (where available), behavioral urgent care
Disclaimer: Educational information, not a diagnosis. If in crisis, use the resources above.