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We all worry and become preoccupied about our health from time to time. However, when the concern becoming chronic or interferes with life, it might be considered problematic. There are several disorders that are defined by excessive anxiety related to bodily symptoms or fear of an illness or condition. For adults with these disorders there is a preoccupation with one or more bodily symptoms/sensations, having or getting a serious illness or condition. Benign sensations are often misinterpreted as evidence for illness, and consequently the individual is easily alarmed about their health.
Typical behaviors associated with fear of illness include excessive body checking to ensure they aren't sick, such as frequent visits to medical professionals, use of home devices (e.g. a blood pressure machine or thermometer), seeking reassurance from others or online resources. Alternatively, the person with illness anxiety may avoid medical attention completely due to fear of what may be discovered. Even when the individual does have an illness or condition, the degree of worry and related checking behaviours are far more extreme and time consuming than would be expected given the situation. Although many people may worry about health and general wellness on occasion, for adults with health-related anxiety disorders this worry is excessive, ongoing, uncontrollable, physically draining, and has a significant negative impact on quality of life of the person and their family and loved ones.
Fear or fact seeking: Chronic medical conditions and worry
While adults with health anxiety disorders do not always have a medical condition, some do. If you have a chronic medical condition such as asthma, food allergies, diabetes, or other conditions, you can also have illness anxiety. But how do you tell what is reasonable worry that can understandably occur with a life-threatening allergy to peanuts or other serious illnesses, versus whether you might have illness anxiety? To make this determination it is recommended you seek an assessment by a medical or mental health professional. However, you can contribute to that assessment by starting to observe whether your behaviours are a result of fear or fact seeking. Adults with excessive anxiety about their medical condition are ruled by fear. Fear tells you not to go on a trip because your medical condition might flare up, or it convinces you to stay home sick from work because your coworker might not be able to help. Fear bosses you about daily even when others have provided information to calm your worry, many, many times, or have explained to you why your behaviours are unnecessary. This includes multiple visits to medical professionals who have all provided medical clearance to engage in a specific activity. In fact, you know fear is in charge when you seem to be asking for the same information repeatedly, but you never quite feel satisfied. Fact seeking on the other hand allows an individual with a chronic condition to understand the dos and don'ts to managing and living with that condition. If this applies to you, you may have some worry about how to cope with your illness or condition, however, you have sought out relevant facts that make you feel confident you can cope and thrive. It can include identifying community members who will help when you need additional help (e.g. a friend who knows where your asthma inhaler is if you cannot reach it), and taking reasonable precautions outlined by your doctor to ensure your condition remains stable. As a result, you are able to engage in your daily life with minimal disruption and if you do experience small doses of worry, it creates minor interference.
Examples of thinking associated with illness anxiety
Thoughts (and noticing how these thoughts quickly escalate into the worst possible outcome)
What if my cold turns into pneumonia and I die?
I've had three headaches this year. I'm sure I have a brain tumor!
What if that pain means I have cancer?
Examples of disqualifying the positive or negating a reassuring response
- I don't think my doctor is qualified enough
No one understands me
Nonspecific physical sensations that can trigger health worries
Irritability
Tired or fatigue
Muscle pains
Headaches
Stomachaches
Emotions associated with being caught in the cycle of illness anxiety
Anxiety/worry
Sadness
Anger
Frustration
Guilt
Behaviours associated with illness anxiety
Avoiding going places or doing things for fear help may be hard to find
Difficulty falling or staying asleep, or disturbed/interrupted sleep
Excessive body checking/scanning
Reassurance seeking
Researching illness and treatments
Work absenteeism (i.e. excessive missed days of work)
Common situations or affected areas
Work absenteeism
Frequent trips to medical professionals
Inability to participate and enjoy recreational activities and activities due to trying to prevent exposure to perceived germs or illnesses
General decline in quality of life—less involved in activities, poor relationships, limited interests, time spent worrying
Unusual or overly focused interests—frequent research of medical illnesses and treatments, becoming an expert on identifying diseases, etc.
Strained relationships as others may get frustrated in talking about health fears
Ms. Sangara's story
Ms. Sangara is a 34-year-old high school teacher with a passion for softball, who happens to have a mild case of asthma. Fortunately, Ms. Sangara only needs to use her inhaler during softball season and in the wet winter months. However, she worries about her asthma most days, especially when she is physically active and throughout the winter. As a result, she goes to her doctor almost monthly, and Ms. Sangara's fiancé is convinced that her worry actually causes at least some of her asthma attacks. Since she was young, Ms. Sangara's parents provided her with ongoing reassurance that her body is strong enough to cope, and that should her respiratory system weaken, help will be available. Yet her worry has only increased. Ms. Sangara is hyper-focused on vague sensations and pain she claims to feel in her lungs and throat. She constantly asks her fiancé for his opinion about her sensations, and she always carries multiple inhalers with her. She refuses to participate in any sports aside form softball despite her teammates encouraging her to try other sports as she clearly has an athletic gift, as she is fearful that unnecessary exertion will compromise her health. Although Ms. Sangara agrees that some of her safety measures might be a bit "over the top," she is reluctant to give up anything, convinced that were she to do so it might be the very thing that could have saved her life.
My Anxiety Plan for health anxiety
The following strategies are designed for you to use as you begin to tackle health anxiety. These strategies are best used for adults with mild-moderate signs of this type of anxiety. For individuals with more severe symptoms or who have been diagnosed with a health-related anxiety disorder, we recommend treatment with a mental health professional, although MAP strategies can be used at home to support your therapy work.
Step 1. Helping you become an expert on anxiety
This is an important first step, as the information outlined in this step can help you understand what is happening when you experience anxiety. Learning that the worries and physical feelings you are experiencing have a name -anxiety- and that millions of other people also have anxiety, can be a great relief. To become an expert on anxiety you will want to read about the facts and learn important information. In addition, you might find it helpful to start to track your own symptoms to better understand the physical, cognitive, and behavioural parts to your type of anxiety and how this affects you. Please view the following links: ABC's of Anxiety: Understanding How Anxiety Works & Anxiety 101: What You Need to Know About Anxiety & Anxiety 102: More Facts & Fight-Flight-Freeze & When Anxiety Becomes a Problem: What’s Normal and What's Not.
Step 2: Learning the facts about health anxiety
Reading about the information outlined on the health anxiety main page can help you feel less afraid of what is happening to you. After all, knowledge is power.
The following list includes some facts and highlights common symptoms of health-related anxiety disorders:
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We all get anxious and become preoccupied from time-to-time with our health. However, if the anxiety becomes chronic and/or interferes with how life is lived, it may be a disorder. There are several disorders that are defined by excessive anxiety related to somatic symptoms or an illness or condition. For adults with these disorders there is a preoccupation with one or more somatic symptoms or having or getting a serious illness or condition.
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People with illness anxiety worry excessively and uncontrollably about their health, physical sensations, and/or specific medical conditions, often catastrophizing minor events. For example, they misinterpret a headache as a sign of a brain tumor or believe that a minor cut can become infected resulting in amputation.
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People with health anxiety can have a diagnosed medical condition such as diabetes, asthma, hypertension, and other illnesses. However, they differ from others diagnosed with that same disorder or condition in that they are so focused on their symptoms and wellbeing that their daily life functioning is severely impacted, far more so then their condition would warrant. It can reduce their work productivity or attendance, limit social interactions, and reduce quality of life.
Step 3: Creating your health anxiety MAP
The best way to help deal with health-related anxiety, is to have access to tools that can evaluate and challenge your worries and change your problem behaviours. These tools are intended to increase your ability to tolerate anxiety, rather than to eliminate anxiety. Anxiety exists everywhere, and therefore it is an illusion to believe we can eliminate the source and experience of anxiety. It is far more effective to have tools to tolerate and cope, rather than to control and escape. For health anxiety, you might want to use any or all of the following tools to create your MAP: My Anxiety Plan. These tools are listed in a recommended order, although proceeding in this order will depend on your needs and interests. There are many effective tools in this section from which you can chose that will provide you with much needed relief from your worry.
Final point: Although increased knowledge and the many tools available on this website can be very effective in helping you to manage your health anxiety, sometimes it is not enough. Some adults have very severe anxiety, and despite all their best efforts, they might still be struggling daily with anxiety symptoms. If this is the case for you, we recommend you seek professional help through a consultation session with your family doctor, psychiatrist, or a psychologist/mental health worker.
About the author
Anxiety Canada promotes awareness of anxiety disorders and increases access to proven resources. Visit www.anxietycanada.com.
Thank you to Anxiety Canada Scientific Advisory Committee member Dr. Maureen Whittal for revising this resource in 2024.
