Illness Anxiety Disorder also known as Hypochondriasis.

Illness anxiety disorder, previously known as ‘Hypochondriasis” or health anxiety disorder involves excessive worry about having a serious medical condition despite minimal or no evidence of illness. It is a treatable mental health condition, as per The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is the handbook used by healthcare professionals across the globe as the authoritative guide to diagnosing mental disorders.

Illness anxiety disorder can lead to frequent doctor visits and unnecessary medical tests. It is a long-term condition that can fluctuate in severity with age and level of stress. The main focus of the fear and worry in illness anxiety disorder is the uncomfortable or unusual physical sensation being an indication of a serious medical condition.

Symptoms of Illness Anxiety Disorder.

1. Excessive Worry: Persistent, intense worry about having a serious medical condition, despite medical reassurance from several professionals, family members, and friends. Individuals with illness anxiety disorder are constantly talking about their health and illnesses. They will avoid people, places, or activities for fear of health risks.

2. Frequent Health Checks: A person will see many medical professionals repeatedly to check for signs and symptoms, constantly seek reassurance from others, and obsessively may research medical conditions on the internet, despite all tests showing no signs of a real physical condition.

3. Misinterpretation of Bodily Sensations: Normal bodily sensations are misrepresented as evidence of a having a severe illness.

4. Avoidance of Medical Information: Individuals will avoid medical information or appointments due to fear of receiving a serious diagnosis. This makes it most frustrating for the family members.

5. Excessive Doctor Visits: On the other hand some people with an illness anxiety disorder will make frequent visits to healthcare professionals for reassurance, even when no medical issue is present.

6. Emotional Distress: The anxiety and preoccupation with symptoms cause significant emotional distress and impairment in daily functioning.

It’s important to note that a diagnosis of illness anxiety disorder is made by a qualified mental health professional based on a thorough assessment of symptoms and their impact on daily life. 

Family’s role:

Significant health anxiety can cause real distress for the person, and the family often feels a need to provide ongoing, constant reassurance. However, reassurance isn’t always helpful. Sometimes, it can make things worse. Put unnecessary stress on the other family members, and also lead to unhealthy dependence and worsening of the symptoms. Families can best support by encouraging their loved ones to consider seeking help through proper mental health professionals and learning ways to cope with illness anxiety disorder.

Treatment:

Treatment for illness anxiety disorder often involves a combination of approaches:

Psychotherapy or Talk Therapy:

Various forms of psychotherapies that can be extremely beneficial, and are a first line of treatment are: 

1. Cognitive-Behavioral Therapy (CBT): This type of therapy helps individuals identify and change negative thought patterns and behaviors related to health concerns. It aims to break the cycle between anxious thoughts and reassurance-seeking behaviors.

2. Exposure Therapy: Gradual exposure to feared situations or stimuli related to health concerns helps desensitize individuals and reduce anxiety.

3. Mindfulness-Based Therapies: Techniques such as mindfulness meditation can be beneficial in managing anxiety by promoting awareness of thoughts and sensations without judgment. 

4: Deep breathing, and whole body relaxation: Exercises that cause relaxation like taking long deep breaths, with long pauses in between, or whole body relaxation, meditation, walking, and exercise can help achieve a sense of control over our body and allay anxiety. 

Medications:

Medications called selective serotonin reuptake inhibitors or serotonin-norepinephrine reuptake inhibitors (SNRIs), are often used to alleviate anxiety and depressive symptoms.

Some commonly prescribed SSRI/SNRI are like sertraline, fluoxetine, escitalopram, duloxetine, venlafaxine, paroxetine etc are used.

  Benzodiazepines or antianxiety medications are usually avoided due to the chronicity of this condition, and the high potential for tolerance, dependence, and abuse. However, in certain cases where the severity of symptoms can cause substantial impairment in work, school, and relationships, low doses of Benzodiazepines or antianxiety medicines can be used for a short period, like the first 2 to 3 months until the SSRI/SNRI take effects.

  Some other antianxiety medications that do not cause tolerance, or dependence, like Hydroxyzine, propranolol, buspirone, etc can also be used‌ on as needed basis.

Your psychiatrist or medical provider may also use short-term sleeping aids if sleep is substantially impaired. Some commonly prescribed sleep medicines are Trazodone, melatonin, hydroxyzine, diphenhydramine, etc. 

Psychoeducation:

Educating individuals suffering from Illness anxiety disorder about the nature of anxiety and the impact of cognitive distortions can empower them to better manage their health concerns.  When medical practitioners provide mindful listening, supportive counseling, and motivational interviewing, which is asking open-ended questions to the patients, and allowing them to vent the discomfort they are experiencing in a non-judgemental manner, it can be crucial in addressing the emotional impact of illness anxiety disorder. 

Showing empathy, along with offering choices can help build that trust with the patients, thus alleviating the fears, reducing the emotional burden and slowly leading to slow remission of this condition. 

Collaborative Care:

 Coordinating care between mental health professionals and primary care physicians can provide a comprehensive approach to addressing both mental and physical health concerns. 

Stress management:

Since the severity and symptoms of illness anxiety disorder are directly proportional to the level of stress one faces in life. Hence learning ways to manage stress, can substantially decrease the severity of symptoms as well as prevent future episodes of this condition. 

Exercise, proper eating, staying hydrated, exercise, yoga, taking time off, frequent breaks, developing a hobby, volunteering, and making healthy social connections are some ways to manage stress effectively.

Treatment success varies among individuals, and a tailored approach based on the severity of symptoms and individual needs is essential. If you or someone you know is experiencing symptoms of illness anxiety disorder, seeking professional help is recommended. The average duration of an episode of Illness anxiety disorder is usually 6 months, but it can be shortened with early and proper treatment. Hence leading to a happy and productive life.