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Somatic symptom disorder

Illness anxiety disorder, sometimes called hypochondriasis or health anxiety, is worrying excessively that you are or may become seriously ill. You may have no physical symptoms. Or you may believe that normal body sensations or minor symptoms are signs of severe illness, even though a thorough medical exam doesn't reveal a serious medical condition.

You may experience extreme anxiety that body sensations, such as muscle twitching or fatigue, are associated with a specific, serious illness. This excessive anxiety — rather than the physical symptom itself — results in severe distress that can disrupt your life.

Illness anxiety disorder is a long-term condition that can fluctuate in severity. It may increase with age or during times of stress. But psychological counseling (psychotherapy) and sometimes medication can help ease your worries.


The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, no longer includes hypochondriasis — also called hypochondria — as a diagnosis. Instead, people previously diagnosed with hypochondriasis may be diagnosed as having illness anxiety disorder, in which the focus of the fear and worry is on uncomfortable or unusual physical sensations being an indication of a serious medical condition.

On the other hand, somatic symptom disorder — a related disorder — involves focusing on the disabling nature of physical symptoms, such as pain or dizziness, without the worry that these symptoms represent a specific illness.


Symptoms of illness anxiety disorder involve preoccupation with the idea that you're seriously ill, based on normal body sensations (such as a noisy stomach) or minor signs (such as a minor rash). Signs and symptoms may include:

  • Being preoccupied with having or getting a serious disease or health condition
  • Worrying that minor symptoms or body sensations mean you have a serious illness
  • Being easily alarmed about your health status
  • Finding little or no reassurance from doctor visits or negative test results
  • Worrying excessively about a specific medical condition or your risk of developing a medical condition because it runs in your family
  • Having so much distress about possible illnesses that it's hard for you to function
  • Repeatedly checking your body for signs of illness or disease
  • Frequently making medical appointments for reassurance — or avoiding medical care for fear of being diagnosed with a serious illness
  • Avoiding people, places or activities for fear of health risks
  • Constantly talking about your health and possible illnesses
  • Frequently searching the internet for causes of symptoms or possible illnesses

When to see a doctor

Because symptoms can be related to health problems, it's important to be evaluated by your primary care provider if this hasn't already been done. If your provider believes that you may have illness anxiety disorder, he or she may refer you to a mental health professional.

Caring for a loved one

Significant health anxiety can cause real distress for the person, and reassurance isn't always helpful. Sometimes, providing reassurance can make things worse. This can be frustrating and cause stress on families and relationships. Encourage your loved one to consider a mental health referral to learn ways to cope with illness anxiety disorder.


The exact cause of illness anxiety disorder isn't clear, but these factors may play a role:

  • Beliefs. You may have a difficult time tolerating uncertainty over uncomfortable or unusual body sensations. This could lead you to misinterpret that all body sensations are serious, so you search for evidence to confirm that you have a serious disease.
  • Family. You may be more likely to have health anxiety if you had parents who worried too much about their own health or your health.
  • Past experience. You may have had experience with serious illness in childhood, so physical sensations may be frightening to you.

Risk factors

Illness anxiety disorder usually begins in early or middle adulthood and may get worse with age. Often for older individuals, health-related anxiety may focus on the fear of losing their memory.

Risk factors for illness anxiety disorder may include:

  • A time of major life stress
  • Threat of a serious illness that turns out not to be serious
  • History of abuse as a child
  • A serious childhood illness or a parent with a serious illness
  • Personality traits, such as having a tendency toward being a worrier
  • Excessive health-related internet use


Illness anxiety disorder may be associated with:

  • Relationship or family problems because excessive worrying can frustrate others
  • Work-related performance problems or excessive absences
  • Problems functioning in daily life, possibly even resulting in disability
  • Financial problems due to excessive health care visits and medical bills
  • Having another mental health disorder, such as somatic symptom disorder, other anxiety disorders, depression or a personality disorder


Little is known about how to prevent illness anxiety disorder, but these suggestions may help.

  • If you have problems with anxiety, seek professional advice as soon as possible to help stop symptoms from getting worse and impairing your quality of life.
  • Learn to recognize when you're stressed and how this affects your body — and regularly practice stress management and relaxation techniques.
  • Stick with your treatment plan to help prevent relapses or worsening of symptoms.

April 19, 2021
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