Everyone worries about their health sometimes. A new lump, a parent's diagnosis or a frightening headline can send anyone to a search engine at midnight.
Health anxiety is different in degree. The worry does not settle when a test comes back clear, or it settles for a day and returns attached to something new. This article explains the terms clinicians use, the checking and reassurance cycle, what has been studied as treatment, and how to keep working with your doctor. Nothing here suggests your symptoms are imagined, and nothing here replaces a medical evaluation.
What is health anxiety?
Health anxiety is worry about illness that has grown large enough to crowd out the rest of life. The NHS, the United Kingdom's health service, puts it this way: "Health anxiety is when you spend so much time worrying you're ill, or going to get ill, that it starts to take over your life." It adds that health anxiety is related to obsessive compulsive disorder (OCD).
The definition is about the worry and what it costs. It is not a statement about whether a person is sick or well. "Health anxiety" is an everyday term, and clinicians use two more specific names.
What do clinicians call it?
The American Psychiatric Association describes two related diagnoses.
- Illness anxiety disorder, previously called hypochondriasis. "A person with this condition is preoccupied with having an illness or getting an illness." The association says a person with it generally does not experience physical symptoms.
- Somatic symptom disorder, which "is diagnosed when a person has a significant focus on physical symptoms, such as pain, weakness or shortness of breath, to a level that results in major distress and/or problems functioning."
The Merck Manual's professional edition places illness anxiety disorder under somatic symptom and related disorders, and the American Psychiatric Association describes it on its page about somatic symptom disorder. Neither diagnosis is in the anxiety disorders chapter of the diagnostic manual. Types of anxiety disorders explains how that chapter is organized.
Duration matters for both. The Merck Manual's professional edition says illness anxiety disorder is confirmed when fears and symptoms, if any, persist for 6 months or more despite reassurance after a thorough medical evaluation. MedlinePlus, from the National Library of Medicine, says that in somatic symptom disorder the reactions must persist for 6 months or more. Only a clinician can make either diagnosis.
Are the symptoms real?
Yes. MedlinePlus is direct about this: "A person with SSD is not faking their symptoms. Their pain and other symptoms are real." SSD is somatic symptom disorder.
Anxiety also produces sensations of its own. The NHS notes: "Anxiety itself can cause symptoms like headaches or a racing heartbeat, and you may mistake these for signs of illness." A racing heart brought on by anxiety is still a racing heart. Physical symptoms of anxiety covers what the body does and when to see a doctor.
Some symptoms are never ones to wait on. The American Heart Association says to call 911 if you have heart attack warning signs, which include chest discomfort and shortness of breath, with or without chest discomfort. A history of health anxiety does not change that. New, severe or unexplained chest pain or trouble breathing is a reason to call 911, not a reason to wonder whether it is anxiety.
What is the checking and reassurance cycle?
It is a loop in which the relief is real but brief. MedlinePlus describes people with illness anxiety disorder who "seek out reassurance from family, friends, or health care providers on a regular basis. They feel better for a short time and then begin to worry about the same symptoms or new symptoms."
The NHS lists signs of health anxiety that include:
- frequently checking your body for signs of illness, such as lumps, tingling or pain
- always asking people for reassurance that you are not ill
- obsessively looking at health information on the internet or in the media
Each of these makes sense as an attempt to feel safe. The trouble MedlinePlus describes is that the relief does not last, so the checking gets repeated. Noticing the loop is not the same as being told to ignore your body.
What has been studied as treatment?
Cognitive behavioral therapy (CBT) is the therapy with trial evidence in the sources used for this article. MedlinePlus says CBT "can help you deal with your symptoms." The Merck Manual's professional edition says treatment with selective serotonin reuptake inhibitors (SSRIs) "may be helpful, as may cognitive-behavioral therapy."
A 2014 trial published in The Lancet tested CBT in hospital medical clinics in the UK. It randomly assigned 444 patients aged 16 to 75 with excessive health anxiety to 5 to 10 sessions of adapted CBT or to standard care. At 1 year, health anxiety had improved more in the CBT group, and twice as many of those patients reached normal levels of health anxiety: 13.9% compared with 7.3%. Results were similar at 6 months and 2 years.
The limits matter. Fewer than 1 in 7 people in the CBT group reached normal levels. Social functioning and health-related quality of life did not differ significantly between the groups. The patients were hospital outpatients, and the comparison group received standard care with no matched time and attention. The sources used here include no trial of psychodynamic therapy for health anxiety, so this article cannot say how it compares.
Medication decisions are made with a prescriber. Therapy, medication or both explains how the two fit together.
How do you keep working with your doctor?
Stay in care, and keep it in one place where you can. MedlinePlus's guidance on illness anxiety disorder is: "It is important to have a supportive relationship with a provider. There should be only one primary care provider." It gives the reason: this helps avoid having too many tests and procedures, some of which may be harmful.
Nothing in that guidance says to stop seeing a doctor. The Merck Manual describes the diagnosis as one made after a thorough medical evaluation, not in place of one. New or different symptoms deserve to be assessed each time.
The NHS organizes its self-help advice for health anxiety under three headings: "Keep a diary," "Challenge your thoughts," and "Get back to normal activities." Its page gives the detail.
When might therapy be worth considering?
When worry about illness is taking more of your time, attention or relationships than you want it to. You do not need a diagnosis to ask.
Dr. Rabin offers anxiety therapy in Brookline and by secure telehealth across Massachusetts. Her approach is psychodynamic, attachment-based, trauma-informed and mindfulness-based. It looks at what drives the anxiety as well as how to respond to anxious thoughts and physical sensations in the moment. She also offers CBT. Therapy does not replace medical care, and she can coordinate with a prescriber.
Because the trial evidence described here is for CBT adapted to health anxiety, a fair question for any therapist is how they would work with it. You can ask Dr. Rabin on a free consultation of about 15 minutes, requested through the contact page, whether her approach fits what you are dealing with. Do I need therapy for anxiety? sets out other things to weigh.
Keep reading
Sources
- NHS, Health anxiety (page last reviewed 8 November 2023)
- American Psychiatric Association, What is Somatic Symptom Disorder? (physician review July 2024)
- Merck Manual Professional Edition (Dimsdale), Illness Anxiety Disorder (full review June 2026)
- MedlinePlus Medical Encyclopedia, Illness anxiety disorder (reviewed 7/17/2024)
- MedlinePlus Medical Encyclopedia, Somatic symptom disorder (reviewed 2/3/2025)
- Tyrer P, et al., Clinical and cost-effectiveness of cognitive behaviour therapy for health anxiety in medical patients, Lancet (2014)
- American Heart Association, Warning Signs of a Heart Attack (last reviewed December 12, 2024)
Last reviewed October 2026. This guide is general information, not medical advice or a diagnosis. If you are in crisis, call or text 988, or call 911 in an emergency.
