Diagnosis

To determine a diagnosis, you'll likely have a physical exam and any tests your primary care provider recommends. Your provider can help determine if you have any medical conditions that require treatment and set limits on lab testing, imaging and referrals to specialists.

Your primary care provider may also refer you to a mental health professional. He or she may:

  • Conduct a psychological evaluation to talk about your symptoms, stressful situations, family history, fears or concerns, and ways that your anxiety is negatively affecting your life
  • Have you fill out a psychological self-assessment or questionnaire
  • Ask you about alcohol, drug or other substance use
  • Determine whether your illness preoccupation is better explained by another mental disorder, such as somatic symptom disorder or generalized anxiety disorder.

Treatment

The goal of treatment is to help you manage anxiety about your health and improve your ability to function in daily life. Psychotherapy — also called talk therapy — can be helpful for illness anxiety disorder. Sometimes medications may be added.

Psychotherapy

Because physical sensations can be related to emotional distress and health anxiety, psychotherapy — particularly cognitive behavioral therapy (CBT) — can be an effective treatment. CBT helps you learn skills to manage illness anxiety disorder and find different ways to manage your worries other than excessive medical testing or avoidance of medical care.

CBT can help you:

  • Identify your fears and beliefs about having a serious medical disease
  • Learn alternate ways to view your body sensations by working to change unhelpful thoughts
  • Become more aware of how your worries affect you and your behavior
  • Change the way you respond to your body sensations and symptoms
  • Learn skills to cope with and tolerate anxiety and stress
  • Reduce avoidance of situations and activities due to physical sensations
  • Reduce behaviors of frequently checking your body for signs of illness and repeatedly seeking reassurance
  • Improve daily functioning at home, at work, in relationships and in social situations
  • Address other mental health disorders, such as depression

Other therapies such as behavioral stress management and exposure therapy also may be helpful.

Medications

Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), may help treat illness anxiety disorder. Medications to treat mood or anxiety disorders, if present, also may help.

Talk with your doctor about medication options and the possible side effects and risks.

Lifestyle and home remedies

In addition to profession treatment for illness anxiety disorder, these self-care steps can help:

  • Work with your provider. Work with your primary care provider or mental health professional to determine a regular schedule for visits to discuss your concerns and build a trusting relationship. Discuss setting reasonable limits on tests, evaluations and specialist referrals. Avoid seeking advice from multiple doctors or emergency room visits that can make your care harder to coordinate and may subject you to duplicate testing.
  • Practice stress management and relaxation techniques. Learning stress management and relaxation methods, such as progressive muscle relaxation, may help reduce anxiety.
  • Get physically active. A graduated activity program may have a calming effect on your mood, reduce your anxiety and help improve your physical functioning.
  • Participate in activities. Staying involved in your work, as well as social and family activities, can provide you with support.
  • Avoid alcohol and recreational drugs. Substance use can make your care more difficult. Talk to your primary care provider if you need help quitting.
  • Avoid searching the internet for possible diseases. The vast amount of health information that may or may not be related to your situation can cause confusion and anxiety. If you have symptoms that concern you, talk to your primary care provider at your next scheduled appointment.

Preparing for your appointment

In addition to your medical evaluation, your primary care provider may refer you to a mental health professional, such as a psychiatrist or psychologist, for evaluation and treatment.

Here's some information to help you prepare for your appointment and what to expect from your primary care provider or mental health professional.

What you can do

  • Your symptoms, including when they first occurred, how they impact your daily life and what you do to try to manage them
  • Key personal information, including traumatic events in your past and any stressful major events
  • Medical information, including other physical or mental health conditions that you have
  • Medications, vitamins, herbs and other supplements you take and the dosages
  • Questions to ask your doctor

Ask a trusted family member or friend to go with you to your appointment, if possible, to lend support and help you remember information.

Questions to ask your mental health professional may include:

  • Do I have illness anxiety disorder?
  • What treatment approach do you recommend?
  • Would therapy be helpful in my case?
  • If you're recommending therapy, how often will I need it and for how long?
  • If you're recommending medications, are there any possible side effects?
  • For how long will I need to take medication?
  • How will you monitor whether my treatment is working?
  • Are there any self-care steps I can take to help manage my condition?
  • Are there any brochures or other printed material that I can have? What websites do you recommend?

Don't hesitate to ask any other questions during your appointment.

What to expect from your doctor

Your primary care provider or mental health professional may ask:

  • What are your symptoms, and when did they first occur?
  • How do your symptoms affect your life, such as at school, at work and in personal relationships?
  • Have you or any of your close relatives been diagnosed with a mental health disorder?
  • Have you been diagnosed with any medical conditions?
  • Do you use alcohol or recreational drugs? How often?
  • Do you get regular physical activity?

Your primary care provider or mental health professional will ask additional questions based on your responses, symptoms and needs. Preparing and anticipating questions will help you make the most of your appointment time.

June 06, 2018
References
  1. Illness anxiety disorder. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. https://dsm.psychiatryonline.org. Accessed April 16, 2018.
  2. Highlights of changes from DSM-IV to DSM-5. https://dsm.psychiatryonline.org/doi/full/10.1176/appi.books.9780890425596.changes#x27321.2817768. Accessed April 16, 2018.
  3. Illness anxiety disorder. Merck Manual Professional Version. http://www.merckmanuals.com/professional/psychiatric-disorders/somatic-symptom-and-related-disorders/illness-anxiety-disorder. Accessed April 16, 2018.
  4. Levenson JL. Illness anxiety disorder: Epidemiology, clinical presentation, assessment, and diagnosis. https://www.uptodate.com/contents/search. Accessed April 16, 2018.
  5. Levenson JL. Illness anxiety disorder: Treatment and prognosis. https://www.uptodate.com/contents/search. Accessed April 16, 2018.
  6. Newby JM, et al. DSM-5 illness anxiety disorder and somatic symptom disorder: Comorbidity, correlates, and overlap with DSM-IV hypochondriasis. Journal of Psychosomatic Research. 2017;101:31.
  7. Fallon BA, et al. A randomized controlled trial of medication and cognitive-behavioral therapy for hypochondriasis. American Journal of Psychiatry. 2017;174:756.
  8. Te Poel F, et al. The curious case of cyberchondria: A longitudinal study of the reciprocal relationship between health anxiety and online health information seeking. Journal of Anxiety Disorders. 2016;43:32.
  9. Anxiety disorders. National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml#part_145338. Accessed April 17, 2018.
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Illness anxiety disorder