Illness Anxiety

Diagnostic Criteria: Illness Anxiety Disorder  300.7 (F45.21)

You scan your body and notice your chest feels tight, and your heart rate increases. You wonder if you are having a heart attack. Its hard to breathe as well. But when you get advice from your doctor, they assure you your heart is in the fittest of health. Somehow that doesn’t feel reassuring. Maybe you are convinced that your body is weak and vulnerable? You constantly seek reassurance and check your body for signs of illness.
 
You have a headache. It’s the third one this week, and you’re convinced you must have a brain tumor. Your doctor sends you for a scan, which shows nothing, so you get a second opinion. Still nothing. The doctors all reassure you there are no signs or other symptoms related to a brain tumor, but somehow the worry persists. Maybe a relative or friend had a brain tumor, so you tell yourself its possible that its happening to you too, and no one has found it yet.

If you experience some of these issues, you may be showing the clinical signs of illness anxiety disorder. In the recent months of the Sydney lockdown (where I am located, and may be the same for other areas in lockdown), I’ve noticed an increase in clients presenting with health anxiety issues. Unsurprisingly, the emergency of the Delta Covid-19 variant seems to be playing a role in this particular mental health condition. This blog post aims to outline what illness anxiety is (as defined by the American Psychiatric Association using the DSM-v diagnostic criteria), and what evidence-based treatment exists.
 
For those with illness anxiety, there will often be an experience a heightened fear of acquiring a severe medical illness. This fear exists often despite contrary medical advice, evidence, and information. These fearful thoughts are usually triggered by environmental feedback, or a misinterpretation of bodily sensations and may look like:

• You overestimate that you have the disease
• You overestimate the severity of the disease
• You perceive negative consequences and difficulties when faced with a health issues
• You believe there to be limited availability of care for your health issues.
• Your ambiguous symptoms are interpreted as catastrophic, potentially fatal
• You have a belief that serious illnesses are highly prevalent
• You generally define good health as being symptom free
• You experience frequent intrusive thoughts and images related to past illnesses of yourself or loved ones
• This impacts on daily functioning due to distressing thoughts

The good news is this particular brand of anxiety is treatable. Evidence suggests that psychoeducation (speak to your psychologist about this), emotional regulation strategies, exposure and response prevention, stress management strategies, cognitive behavioral therapy, and some pharmacotherapies can all provide great treatment outcomes. If you are one of the 74% of people who would prefer a cognitive psychology-based approach over a medication-based approach, then finding a good therapist experienced in administering cognitive behavioral therapy may be the way for you.
 

References:
 
American Psychiatric Association. (2013). Cautionary statement for forensic use of DSM-5. In Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
 
Asmundson, G., Abramowitz, J.S., Richter, A.A., & Whedon, M. (2010). Health anxiety: Current perspectives and future directions. Current Psychiatry Reports, 12(1), 306-312. Springer Publishing

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