What is Illness Anxiety Disorder?
In Illness Anxiety Disorder (IAD), previously known as hypochondriasis, the individual develops an excessive worry about any physical or psychological symptoms experienced albeit in the absence of a diagnosed health condition. The anxiety experienced is so pervasive that it interferes with the individual’s ability to function adequately and it’s often self-limiting as the individual modifies his lifestyle and the range of activities he engages in. In the majority of cases, the anxiety comes from a misinterpretation of the symptoms experienced and is not confirmed upon extensive medical check-ups. In some cases, there is an actual illness but this is minor and can be easily treated. The anxiety might extend to the health of family members and that of the other people. The apprehension towards medical conditions spreading in other parts of the world is also commonly observed.
Diagnostic criteria for Illness Anxiety Disorder
According to the fifth edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM – V), the criteria for an individual to be diagnosed with Illness Anxiety Disorder are the following:
1. Worry that one is or will be affected by a serious illness.
2. Absence of physical symptoms or only mild physical symptoms are present, such as unusual sweating (diaphoresis) or abnormally rapid heart beat (tachycardia).
3. In the presence of an actual health condition, e.g. a benign cyst, or if the individual is at high-risk of developing a health condition, e.g. cancer, but no indicators of the feared condition have been found, the anxiety experienced by the individual is disproportionate compared to reality.
4. The individual is over-alerted to any changes in their health or unusual symptoms.
5. The individual carries out frequent self-checks (e.g. temperature or blood pressure) to detect any signs of illness.
6. The individual’s anxiety about being diagnosed with an illness might deter him from going to a doctor to get checked.
7. This anxiety about one’s health has been present for at least six months, even though the cause of anxiety itself might shift e.g., fear of heart disease might be replaced by fear of a tumour.
8. The anxiety and cannot be better explained by another mental disorder, such as Generalised Anxiety Disorder (GAD), as health anxiety might be one of the many sources of anxiety, not the primary or only source of anxiety.
Individuals diagnosed can be classified as belonging to one of two types:
1. Care-seeking type: The individual frequently goes to the doctor with health concerns and symptoms seeking thorough health assessment with the use of invasive diagnostic procedures.
2. Care-avoidant type: The individual is anxious about going to the doctor out of fear of the dreaded diagnosis.
Some of the other diagnostic characteristics displayed by individuals with IAD are:
– having an exaggerated reaction to minor injuries;
– not being responsive to the reassurance of health providers;
– engaging in self-pity thus gaining the attention and sympathy of others;
– making tragic statements about one’s health which often causes discomfort in others and results in isolation;
– amplifying the impact of actual disorders;
What are the risk factors for Illness Anxiety Disorder?
Three major risk factors for the development of IAD have been identified:
1. having a family or personal history of chronic illness, in which cases the fear is born out of a reality close to home;
2. having a first degree relative with IAD might lead the individual to develop IAD via observational learning;
3. having diminished faith in the medical profession due to personal experience.
IAD is ofter triggered by a major stressor or it develops in some adult individuals who were abused in childhood thus indicating that risk factors alone only partly explain the development of this disorder.
How can you fight Illness Anxiety Disorder?
Once developed, IAD is in some cases a lifelong disorder. Therefore, it is important to develop strategies to cope with it. IAD can be treated with both psychological therapies and medication. Cognitive behavioural therapy (CBT) has proved to be one of the most effective psychological therapies as it tackles the irrational health beliefs held by the patient. The irrational beliefs can be so strong that the person affected struggles to believe that he has a mental disorder rather than a physical one. This is why most of the psychological therapies will involve helping the individual come to terms with their actual diagnosis as well as relaxation techniques. Anti-anxiety reducing drugs, such as SSRIs (selective serotonin re-uptake inhibitors), can also be used to reduce the symptoms associated with the disorder thus providing effective relief in the affected person. However, drugs have several side-effects. Indeed, a combination of medication and psychological therapies is the best option.
If you have experienced pervasive worry about your health for the past 6 months or longer you should seek the advise of a doctor.