OCD and Health Anxiety

Health anxiety (also known as hypochondria or hypochondriasis) is defined as a preoccupation with, and persistent fear of, severe illness. Despite medical attention and reassurance, people with health anxiety either believe they already have a devastating illness or are in imminent danger of catching one. Seeking reassurance from doctors or the Internet might provide temporary relief, but the fear of illness returns. Symptoms must last a minimum of six months and interfere with daily living for a diagnosis to be made.

Sounds a lot like obsessive-compulsive disorder, doesn’t it? Obsessions are health-related and compulsions revolve around some type of reassurance or compulsive checking. Fear of contamination is a common obsession for those with OCD, and it’s easy to connect this obsession to the fear of contracting a disease.

According to the Diagnostic and Statistical Manual-V, which mental health professionals use to make diagnoses, OCD belongs to the obsessive-compulsive and related disorders category. Health anxiety is listed as either a somatic symptom disorder or illness anxiety disorder, depending on the specific symptoms displayed.

While there can be overlapping symptoms between the two disorders, and it’s also possible for someone to be diagnosed with both OCD and health anxiety, they are defined as separate disorders. It’s interesting to note that those with OCD typically have better insight into their disorder than those with health anxiety, who truly believe they have a serious illness.

In an article by Dr. Jonathan Abramowitz, he discusses OCD and hypochondriasis in detail. In examining the relationship between the two, he says:

In my mind, hypochondriasis is a form of OCD. In fact, as I describe below, I tend to use the same treatment techniques as I would use to help someone with OCD.

Dr. Abramowitz goes on to discuss in detail the treatment for hypochondriasis, and you guessed it, it involves exposure and response prevention (ERP) therapy. This frontline treatment for OCD also helps those with health anxiety. To me, it doesn’t matter how OCD and hypochondriasis are classified in the DSM-V, as long as those who suffer from these disorders get the appropriate help.

Once again, we see how the need for certainty propels these illnesses forward. Think you have a brain tumor? For most of us, a negative MRI and a clean bill of health from our doctors would be enough to put us at ease. But even though those with health anxiety or obsessive-compulsive disorder might feel a fleeting sense of relief after receiving this good news, chances are they will soon ask, “But how can I be completely sure…?” And since we can’t be completely sure of anything, the vicious cycle begins. Perhaps the dizziness you are feeling is from that brain tumor nobody can find, and not from the bad head cold you’ve been fighting. It’s not hard to see how this mindset can negatively affect all aspects of your life – work, school, and home.

If you are or a loved one is living a life consumed by unwarranted worry about your health, I hope you’ll try to find a qualified therapist who can give you a proper diagnosis and help you get started on the right therapy. We all need to accept the uncertainty of life and the sooner we do, the less precious time will be wasted worrying about the “what ifs.”

Therapy Anxiety image via Shutterstock.