Managing Health Anxiety in Adults
Most people worry about their health from time to time. A lingering cough, an unusual headache, or a new mole can naturally raise concerns, especially when symptoms are unexplained.
For some people, however, those worries persist even when medical evaluations find no serious underlying condition. They may repeatedly search the internet for answers, check their body for signs of illness, or seek reassurance from doctors and loved ones.
Health anxiety can start to dominate a person’s thoughts and behaviors, says Dr. Jess Del Re, a core faculty member with Counseling@Northwestern at The Family Institute at Northwestern University. “Counselors might see the individual staying up late ruminating, worries interfering with other responsibilities (e.g., attending work, engaging in relationships), or a person struggling to see anything outside of a particular perspective,” Del Re says.
Fortunately, health anxiety is treatable. Counseling can help people respond differently and reduce the behaviors that keep anxiety going. This article explores what health anxiety is, common symptoms, strategies for managing it, available treatment options, and when to seek professional support.
Key Takeaways
- Health anxiety is more than occasional worry. Persistent fears about having or developing a serious illness can interfere with daily life, even after medical evaluations find no serious condition.
- The cycle of health anxiety can be interrupted. Strategies such as recognizing health anxiety thoughts, delaying reassurance-seeking, and working with a mental health professional can help people become more comfortable with uncertainty.
- Effective treatment is available. Cognitive behavioral therapy is the primary treatment for illness anxiety disorder, and some people may also benefit from medication or other therapeutic approaches.
What Is Health Anxiety?
Health anxiety is persistent worry about having or developing a serious illness, even when there is little or no medical evidence of a serious condition. Paying attention to changes in your body and seeking medical care when something feels wrong can be beneficial; health anxiety goes beyond typical concern. For people experiencing health anxiety, fear often persists or returns instead of easing after symptoms improve or a healthcare provider’s assessment.
Although “health anxiety” is the term most people use, the clinical diagnosis for severe, ongoing health anxiety is illness anxiety disorder. People with this condition may:
- become preoccupied with the possibility of serious illness, even with minor physical symptoms.
- experience health anxiety that causes distress but does not meet the full criteria for illness anxiety disorder.
Health anxiety exists on a spectrum, ranging from occasional worry to anxiety that significantly interferes with daily life.
Terminology Matters
You may also hear the term “hypochondriac” or “hypochondria,” which means having an excessive fear of illness. While these terms were once used in medical settings, they are now considered outdated and can carry a negative stigma.
Understanding the Cycle of Health Anxiety
Health anxiety follows a typical pattern: a physical sensation may trigger catastrophic thoughts, leading to anxiety and reassurance-seeking behaviors that provide only temporary relief before the cycle begins again.
The Health Anxiety Cycle
| Step | Example |
|---|---|
Trigger | A headache develops. |
Irrational thinking | Thoughts occur like “What if this is a brain tumor?” instead of “Maybe I didn’t drink enough water” or “I’m stressed.” |
Anxiety | Fear and symptoms like racing heartbeat and quickened breathing increase. |
Reassurance seeking | The individual may search the internet for symptoms, check their body, or schedule doctor visits. |
Temporary relief | Finding a less serious explanation or receiving normal test results may provide short-term relief. |
Return of doubt | Because complete certainty is impossible, the brain continues searching for danger with thoughts like “What if they missed something?” |
Understanding how health anxiety works is an important first step. The next step is learning practical strategies to interrupt the cycle of anxious thoughts and behaviors.
3 Strategies to Interrupt the Health Anxiety Pattern
Because health anxiety often develops over time, changing the thoughts and behaviors that maintain it can be a gradual process. As Del Re explains, “It’s important to normalize with clients that changing these core beliefs and reducing illness anxiety disorder long-term does take time.”
Rather than trying to convince someone with health anxiety that nothing is wrong, the goal is to shift the patterns that keep an anxiety response going. By recognizing and responding differently to the thoughts and behaviors that reinforce the cycle, a person can gradually become more comfortable with uncertainty and reduce the urge to seek reassurance.
The following evidence-based strategies can help people manage health-related worries that begin to interfere with daily life. While these techniques are not a substitute for professional treatment, they can complement counseling and help individuals develop healthier responses to uncertainty.
1. Notice the Process, Not Just Symptoms
One of the first steps in interrupting the health anxiety cycle is recognizing when you’re experiencing it. For example, Del Re encourages clients to pause and identify the response they are having.
“If a client is noticing a headache, instead of jumping to a brain tumor, I would encourage the individual to name the process: ‘I am having a health anxiety thought right now’,” she says. “This validates that the individual is experiencing something, but offers focus on the process versus staying in the symptom cycle.”
Saying this out loud helps the brain distinguish it from a real threat, she says. This simple shift can help you pause before reacting and begin breaking the health anxiety cycle.
2. Delay Fact-Finding Behaviors
This strategy involves intentionally waiting before researching a symptom or looking for immediate answers. Del Re says this technique “allows the individual to be present with the experience without immediately trying to ‘fix’ the problem.”
With practice, delaying these behaviors can help reduce the urge to seek immediate certainty and build greater comfort with uncertainty.
3. Using Grounding to Return to the Present
Becoming aware of your body in the moment and your surroundings can be a helpful grounding intervention, according to Del Re.
One effective approach is to become aware of what your five senses are experiencing or identify categories in the environment. Del Re provides one example: “Tell me all the green items you see in the room or how many plants you can see in my zoom screen.”
Redirecting your attention to what is happening around you can help calm your nervous system so you can respond thoughtfully rather than react automatically. In addition to grounding, tools like stress mapping can help individuals identify specific triggers that ignite health anxiety thoughts before they escalate.
Learn More about the Counseling Profession
Understanding Health Anxiety Symptoms
What Health Anxiety Looks Like
Health anxiety can affect more than someone’s thoughts. It can also influence their daily routines, relationships, and decisions about seeking medical care. Depending on the individual, health anxiety may look like:
- Spending hours ruminating about the possibility of a serious illness.
- Frequently Googling symptoms or reading about rare or life-threatening conditions.
- Repeatedly checking the body for changes, such as skin lesions, lumps, or hair loss.
- Becoming so preoccupied with physical symptoms that it interferes with work, relationships, daily activities, or enjoyment of life.
- Seeking answers from healthcare providers, loved ones, or repeated medical testing.
- Avoiding medical appointments because of fear that a serious diagnosis will be confirmed.
In addition to these behaviors, health anxiety often involves recurring thought patterns and internal dialogue.
What Health Anxiety Sounds Like
People experiencing health anxiety may find themselves thinking:
- “This doesn’t seem normal.”
- “I need to figure out what’s causing this.”
- “What if this is more serious than my doctor thinks?”
- “Something still doesn’t feel right.”
- “I don’t think they found everything.”
These thought patterns are often accompanied by intense emotional and physical reactions.
What Health Anxiety Feels Like
Someone experiencing health anxiety may feel:
- Persistent fear or preoccupation with developing a major illness.
- Significant distress, even after medical evaluations have ruled out serious conditions.
- Physical sensations that are uncomfortable or concerning but not necessarily a sign of a serious illness.
- Increasing anxiety after checking symptoms online or looking for answers.
- Overwhelmed by catastrophic thoughts about what their symptoms might mean.
Although anyone can experience health anxiety, certain factors may increase the likelihood of developing it.
Who Is at Risk for Health Anxiety?
According to the Association for Behavioral and Cognitive Therapies (ABCT), health anxiety may be linked to a variety of psychological and medical conditions. It may be more common among people who:
- Have another anxiety disorder or mental health condition, such as generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), panic disorder, depression, and somatic symptom disorder.
- Experienced a serious illness during childhood or witnessed a family member cope with a significant medical condition.
- Frequently search for health information online to feel better about symptoms they’re experiencing.
- Live with a chronic medical condition, such as diabetes or cardiovascular disease.
It’s important to distinguish between appropriate health concerns and health anxiety. People living with chronic conditions often have legitimate reasons to monitor symptoms, attend follow-up appointments, or watch for signs that a condition is worsening.
Other Conditions Similar to Health Anxiety
Illness anxiety disorder shares symptoms with other mental health conditions, which can make it difficult to recognize. While only a qualified mental health professional can make a diagnosis, understanding some key differences may help clarify why treatment approaches can vary.
Health Anxiety vs. OCD
Del Re identifies several differences between health anxiety and obsessive-compulsive disorder (OCD).
| Dimension | Health Anxiety | OCD |
|---|---|---|
Trigger | Physical symptoms or normal bodily sensations interpreted as signs of serious illness | Intrusive, unwanted thoughts about feared outcomes, which may or may not involve health |
Behaviors | Researching symptoms, checking the body, or repeatedly seeking medical reassurance to reduce uncertainty | Compulsive behaviors like repetitive handwashing, checking locks or appliances, or other rituals to temporarily relieve anxiety and prevent a feared outcome |
Function of behavior | Reduce uncertainty about health | Temporarily relieve anxiety and prevent a feared outcome |
Health Anxiety vs. Somatic Symptom Disorder
Health anxiety and somatic symptom disorder share many similarities. Both involve excessive concern about health and can interfere with daily life.
Traditionally, the difference has been the focus of the distress. Illness anxiety disorder is characterized by a persistent fear of having or developing a serious illness despite few or mild physical symptoms. Somatic symptom disorder involves one or more distressing physical symptoms that become the focus of excessive thoughts, feelings, or behaviors.
Because these conditions overlap, it can be challenging to tell them apart without a professional evaluation. Recent research suggests the differences between them may be smaller than previously thought, and researchers continue to study how distinct the diagnoses are.
Treatment for Health Anxiety
Using CBT to Treat Health Anxiety
Cognitive behavioral therapy (CBT) is considered the first-line treatment for illness anxiety disorder and can help people recognize and change thought patterns and behaviors that contribute to health anxiety.
According to Del Re, CBT doesn’t involve convincing someone that their health concerns are unfounded. Instead, it might center on accepting multiple perspectives, reducing assumptions or misinterpretations of symptoms, and building the ability to accept ambiguity. The goal is to stay aware of changes in your health without automatically jumping to catastrophic conclusions.
As Del Re explains, the goal isn’t to eliminate uncertainty—something that’s impossible in health and in life—but to build confidence in responding to it in healthier ways.
“Individuals with illness anxiety disorder try to convince themselves they are healthy by attempting to gather 100% certainty, but when building comfort with ambiguity it’s normalized that individuals might not know everything at 100% certainty, but they know what they know,” she says.
“This might sound like an ‘and statement’: ‘I cannot know with 100% certainty AND I know that I went through testing that came back normal.’”
Narrative Therapy and Health Anxiety
Del Re also recommends narrative therapy for health anxiety, particularly for people who have lived with it for many years. A therapist may support a person in changing the way they talk about their experience so that they move toward thinking of themselves as separate from their worry.
“This might sound like ‘health anxiety is showing up right now’ versus ‘I’m anxious about my health,’” Del Re says.
Other steps may be exploring questions like “How does health anxiety affect your relationships?” or “When does it feel the strongest?” The goal is to help a person shift their story, changing the way they understand their experiences and reducing the influence health anxiety has on their lives.
Antidepressants
While cognitive behavioral therapy is typically the first-line treatment for health anxiety, medication may also help some people. Selective serotonin reuptake inhibitors (SSRIs), a type of antidepressant, may be recommended when symptoms are severe or occur alongside depression or another anxiety disorder. A mental health professional or primary care provider can help determine whether medication, psychotherapy, or a combination of both is the most appropriate treatment.
How to Support Someone with Health Anxiety
When supporting someone who has health anxiety, Del Re recommends validating their experience without reinforcing their fears about their symptoms.
Acknowledge that their anxiety feels real while encouraging healthier ways of coping. For example, you might say, “I can see that this is really worrying you,” rather than focusing on whether you think they are seriously ill.
Supporting someone with health anxiety can be challenging. Family members and loved ones may spend significant time providing emotional support or accompanying someone to medical appointments. Over time, this can contribute to stress and caregiver fatigue. Setting healthy boundaries, prioritizing your own well-being, and learning about topics such as secondary trauma may also be helpful for those who regularly support someone experiencing ongoing mental health challenges.
If health anxiety is affecting your loved one’s daily life, relationships, or well-being, encourage them to seek help from a mental health professional. With appropriate treatment, many people learn to manage health anxiety more effectively and reduce its impact on their lives.
When to Seek Professional Help
Occasional worries about your health are a normal part of life. However, if health anxiety is interfering with your relationships, work, or daily activities, or you find yourself repeatedly seeking reassurance or avoiding medical care because of fear, it may be time to seek support from a mental health professional.
Effective treatments such as cognitive behavioral therapy can help many people better manage health anxiety, reduce distress, and improve their quality of life. Taking the first step to seek help is an important part of improving your mental well-being.
Interested in helping others manage anxiety and other mental health concerns? Learn more about the Northwestern Online Master in Counseling program.
Created by Counseling@Northwestern, the online Master of Arts in Counseling Program from The Family Institute at Northwestern University.