What Is Illness Anxiety Disorder?

Illness anxiety disorder (IAD) is a mental health condition in which an individual worries excessively about having a severe illness (or contracting one). Patients with this condition may have no physical symptoms of an acuteÂillness or may be under the belief that minor symptoms or normal sensations in the body are symptoms of a critical disease. This can apply even if a medical exam indicates otherwise.

Excessive anxiety like this can cause intense distress, which may become debilitating. Thus, it is essential to understand the signs of illness anxiety disorder as well as how to treat this condition. Life does not have to be filled with worrying about potential illness.

Relation To Hypochondria

The first important thing to discuss is IAD's connection to hypochondria. Hypochondria is a popular term many people use to describe those who are more concerned about their health and the idea they have serious medical conditions than the general population. However, hypochondria is no longer a recognized diagnosis of the American Psychiatric Association's fifth edition of The Diagnostic and Statistical Manual of Mental Disorders.

Instead of hypochondria, patients who meet certain criteria would receive one of two diagnoses. The first, evidently, is IAD, specifically when no physical symptoms are present, or they are quite mild in severity. The second diagnosis patients may receive is Somatic symptom disorder (SSD), often if there are multiple or significant physical symptoms. For full details on SSD, check out What Is Somatic Symptom Disorder?

Signs And Symptoms

Illness anxiety disorder signs and symptoms come in a variety of different feelings and behaviors and vary among individuals. However, the accepted symptoms include believing normal changes of body sensations as signs of a serious illness, exaggerating the severity of health issues seen in the news including the potential of being affected, continually researching symptoms and conditions (often being compelled to do so), and not believing a doctor's diagnosis.

Another potential symptom is thinking physical signs of anxiety indicate a critical illness, although this is most often associated with SSD instead. These symptoms often negatively influence personal and professional relationships. Of course, it is also important to note individuals with a specific medical condition can experience IAD regarding the severity of their diagnosis, adding symptoms of anxiety to the already preexisting symptoms of their condition.

Causes And Risk Factors

Unfortunately, the precise cause of IAD is not clear. Individuals can develop IAD in a variety of ways and for a variety of reasons, often unique to them. With this in mind, however, there are a few general factors that increase the risk of developing IAD. These reasons include undergoing a significant life upheaval or stressful event, such as losing a family member due to illness, having a history of childhood illnesses, and having a history of abuse or neglect, which is often suffered as a child. Other reasons include not understanding the meaning of body sensations, thus researching about everything, having relatives who worried a lot about their health, and having a worrisome personality.

Given IAD is a recognized diagnosis under The Diagnostic and Statistical Manual Of Mental Disorders, Fifth Edition (DSM-5), possessing another mental illness (such as generalized anxiety disorder, obsessive-compulsive disorder, and post-traumatic stress disorder) can significantly raise the risk of developing IAD.

Steps To Diagnosis

The first step in determining an accurate diagnosis is for individuals to visit their primary care physician, who will conduct a physical exam and other tests, as well as ask a series of questions, to get familiar with the situation at hand. They can help determine if the patient has a physical medical condition that requires treatment. In cases where they suspect IAD or another mental illness, they will often refer patients to a mental health professional, such as a psychiatrist.

The mental health professional will have patients fill out an initial self-assessment or questionnaire about their psychological well-being. They will then use this information and conduct a thorough psychological evaluation. This evaluation will include discussing symptoms, if there are stressful situations in the patient’s life, family history, talking about drug or alcohol use, and any other issues affecting the patient’s wellbeing. It is important for individuals to openly express their issues to the mental health professional about what exactly they are experiencing and the severity of the situation to receive an accurate diagnosis.

Diagnosis Criteria

Criteria for a diagnosis of IAD from the DSM-5 highlights being excessively concerned about having or contracting a serious illness, becoming easily alarmed about personal health, and having no physical symptoms (or quite mild ones). Other criteria include exhibiting excessive behaviors related to health, such as continually researching symptoms or checking the body for signs of illness or avoiding medical appointments for fear of a serious diagnosis. If the patient in question does have a physical illness, the DSM-5 states that the thoughts about the illness and the severity can be excessive (worrying is normal with an existing illness).

Furthermore, the excessive worry and symptoms must endure at least six months, even if the illness the individual is worried about has changed during these six months, to receive an IAD diagnosis. Finally, the individual's symptoms must not be better explained by another mental illness, such as panic disorder, generalized anxiety disorder, or somatic symptom disorder.

Medical Treatment

One of the most popular forms of medical treatment for IAD is cognitive behavioral therapy (CBT), which is a type of psychotherapy (talk therapy). Individuals can undergo CBT privately or in a group setting. CBT can specifically help develop awareness of how these fears are affecting individuals and their behavior, and identify the specific worries about having (or contracting) a serious physical illness. With this increased awareness, CBT seeks to help patients develop strategies such as learning alternative ways to view and respond to body sensations, learning skills to tolerate stress and anxiety better, improving normal function, and reducing the frequency of checking the body for signs of illness. CBT will also address other potential mental illnesses, should they be present.

In certain cases, doctors might recommend medication to help alleviate IAD and its symptoms. Some selective serotonin reuptake inhibitors, which are commonly used as antidepressants, may help treat IAD. Other options for medications include those for other anxiety disorders or obsessive-compulsive disorder. It is important to discuss these medications and the potential side effects accompanying them with a physician.

Lifestyle Treatment

Lifestyle adjustments to treat IAD often occur in conjunction with formal medical treatment. One popular recommendation is to engage in regular exercise, at this helps to not only boost physical fitness but also lower stress and feelings of anxiety. The standard recommendation is to get thirty minutes of moderate physical activity, five times a week. Developing and implementing stress management techniques is also essential. Some patients report engaging in mindful breathing each day, even when they are not bothered by their symptoms, can help manage their IAD.

Patients should also avoid consuming alcohol and recreational drugs, as these can make symptoms of IAD worse. Patients should also avoid going to multiple doctors unless specifically referred to a specialist, as this makes treatment harder to coordinate and may mean undergoing the same tests. Emergency room visits should be reserved for crises, and when they do occur, the intake nurses should be thoroughly informed of the situation and the patient's mental health care provider should be notified. Finally, all patients with IAD should avoid conducting research, online or otherwise, about potential symptoms and diseases. Instead, they should make a note of what is concerning them and discuss those at their next scheduled appointment.

Potential Complications

Swift, effective treatment is important for patients with IAD because, beyond the excessive distressing thoughts about contracting or having a serious illness, there are numerous complications associated with this condition. Some individuals with IAD, for instance, may experience suicidal thoughts, particularly if their IAD is connected to clinical depression. Other complications of IAD include expensive medical bills stemming from the overuse of medical services, an increased risk of complications from medical tests, problems in personal and professional relationships, as well as unemployment or disability. As such, it is important to seek professional assistance when excessive worry hits. This applies even if the formal diagnosis points to a condition other than IAD.