Somatic Symptom and Related Disorders
Illness Anxiety Disorder
Illness Anxiety Disorder is persistent preoccupation with the idea that a serious illness exists or will occur, even though physical symptoms are absent or mild. Worry does not steadily decrease after medical reassurance and takes up considerable time and energy.
A diagnosis does not mean that "there is nothing". Actual illness or increased medical risk may co-occur; then it is assessed whether the concern is clearly disproportionate. New or changing symptoms need appropriate medical evaluation, without fueling an endless cycle of tests.
What Is Illness Anxiety Disorder?
Some people repeatedly check their bodies and seek reassurance, while others avoid medical care because they fear what might be found.
Key Features and Signs
The pattern may be the care-seeking type or the care-avoidant type:
- Persistent belief or fear that a serious illness exists, despite mild or absent physical symptoms.
- High health anxiety that is easily triggered by news, stories of others, or normal sensations.
- Frequent body checking, pulse measurement or seeking reassurance from family and professionals.
- Repetitive searching for information on the internet, which provides temporary relief but may maintain anxiety.
- Avoiding medical examinations, hospitals, exercise or contact with patients due to fear.
- Shifting concern from one possible disease to another over time.
How It Is Diagnosed
The assessment combines adequate medical screening with examination of mindset, safety behaviours, duration and functional impact.
- There is persistent preoccupation with having or acquiring a serious illness, while physical symptoms are absent or mild.
- When a medical condition or a genuine risk is present, the preoccupation is clearly excessive or disproportionate to the actual situation.
- Health anxiety is high and is accompanied by excessive health-related behaviour or maladaptive avoidance. DSM-5-TR specifies care-seeking type when medical care is frequently used and care-avoidant type when medical care is rarely used.
- The preoccupation persists for at least 6 months, although the specific disease the person fears may change.
- The presentation is not better explained by Somatic Symptom Disorder, Panic Disorder, Generalized Anxiety Disorder, Obsessive-Compulsive Disorder, Delusional Disorder, or another condition.
How It Can Affect Daily Life
Preoccupation can take up hours, affect work, sleep, relationships and finances, and lead to frequent visits or, conversely, dangerous avoidance of care. Reassurance usually brings temporary relief, and then new doubt sets in. Those around you may tire or dismiss the concern, but the discomfort is real and needs consistent, non-judgemental care.
Causes and Risk Factors
There is no single cause. Previous serious illness, illness of a loved one, bereavement, heightened attention to bodily sensations, difficulty tolerating uncertainty, and general anxiety vulnerability may interact. Access to online information is not considered a cause in itself. In some people, however, the repetitive searching and comparison of symptoms act as behaviours that perpetuate the stress cycle.
Similar or Co-occurring Conditions
The intensity of the physical symptoms and the focus of concern help distinguish:
- In somatic symptom disorder there are one or more bothersome physical symptoms and a disproportionate response to them.
- In Obsessive-Compulsive Disorder health fears may take the form of obsessions and be accompanied by compulsions with specific rules.
- In panic disorder the fear often focuses on the consequences of the attacks, such as a heart attack, rather than an ongoing belief of illness.
- In delusional disorder the belief may be firm and leave no room for doubt.
- An actual medical condition may co-occur and is not excluded because there is a health concern.
Treatment and Support
Care balances medical safety with reducing stress-maintaining behaviours.
- Regularly scheduled appointments with a clinician can reduce fragmented emergency visits and provide consistent follow-up.
- Cognitive-behavioural therapy helps to re-examine catastrophic interpretations, tolerate uncertainty, and reduce checks and reassurance seeking.
- Online searching, self-monitoring, and avoidance are changed gradually according to a specific plan, without dismissing genuine medical findings.
- If depression or another anxiety disorder is present, appropriate psychological or medical treatment is discussed.
When to Seek Help
Get help when the health concern persists for months, takes up a large part of the day, leads to repeated tests or avoidance of needed care, and affects relationships or work. New, severe, or significantly changing symptoms—such as chest pain, fainting, bleeding, or neurological deficit—need appropriate emergency medical evaluation.
Frequently Asked Questions
Can I have a medical illness and illness anxiety at the same time?
Yes. A medical condition or elevated risk can be present. The clinician assesses whether the preoccupation and anxiety are clearly disproportionate to that situation.
Do medical exams stop anxiety?
They can rule out specific problems, but repeated tests without a new indication often provide only temporary relief. A plan is needed for both the medical follow-up and the stress cycle.
Is the internet the cause of health anxiety?
Not by itself. Repetitive seeking may maintain anxiety in some people, but the disorder is multifactorial and not explained by a single behaviour.