Illness Anxiety Disorder DSM-5 300.7 (F45.21): Symptoms, Treatments

When people complain about pain, gripe that they are coming down with a cold or grieve about a major health problem–but there are no physical explanations for any of these conditions– they are sometimes called hypochondriacs. This title very often has a stigma attached and can be the subject of jokes. It is unfortunate, because many people suffer from this disorder and feel like they are not being taken seriously by others. In fact, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)* has removed the term hypochondriasis (the name of the disorder suffered by hypochondriacs) and updated it with the title of Illness Anxiety Disorder (IAD).

IAD is when a person has an excessive concern over his health when there is no proof of an existing illness. These individuals have serious concerns about their health.

*The DSM is published by the American Psychiatric Association, which lists all classifications of mental disorders.

Symptoms of IAD

• Preoccupation with thinking he is sick or is going to be.
• Lack of physical signs like sweating or accelerated heart rate.
• Thinks he has an illness or is at risk for having an illness, but has nothing to indicate the disease–the person will become anxious and concerned to the extent that it is unreasonable in the situation.
• The person is constantly concerned about his well-being, often feeling distraught about any changes to it.
• The person will repeatedly monitor himself for signs of sickness.
• Avoidance of going to the doctor for a check-up because of anxiousness about the findings of the health practitioner.
• The apprehension and obsession will have continued for a minimum of half a year. However, the anxiety may move to something else, such as a fear of a diabetes being replaced with the fear of a heart attack.
• The apprehension and obsession of being sick can’t be justified by another mental health problem.

Additional Signs and Symptoms of IAD (by the person’s clinician)

A doctor may be able to provide more information about the individual’s signs of showing IAD, including:

• An individual may often “need” medical care for specific things he’s worried about or grievances being unwell, as well as wanting to have diagnostic procedures.
• The patient will avoid getting medical care because of anxiety about a diagnosis.

Other Signs of IAD

People with IAD may:

• Frequently make dramatic statements about their health.
• Have self-pity.
• Exaggerate the effects real illnesses.
• Have dramatic responses and a preoccupation with insignificant injuries.
• Claim to have disorders that are not confirmed or one that continues for an unreasonable amount of time.
• Have a little reaction to being reassured by the doctor.
• Research the disease they imagine they have, which is referred to as “med student syndrome.” The person may base his belief of the sickness on incomplete knowledge or misunderstanding of the conditions he is studying. For example, Celiac disease or gluten-intolerance are genuine and verifiable medical conditions. Many individuals with IAD will self-diagnose themselves and adhere to a restrictive diet because they think they have the disorder.
• Overuse health care services and have extensive medical care, invasive diagnostic procedures and sometimes even unnecessary elective surgeries. They may like the attention and care they get by these highly-trained medical practitioners.

Individuals with IAD

After a thorough medical exam, possible testing and consultations with specialists without the result of any significant illnesses, the individual with IAD is distressed because the doctors may have misinterpreted an indication that the illness exists. When a condition is confirmed, it is usually not serious and is simple to take care of.

The individual may be worried about the health and possible diseases in other people. The person with IAD may react dramatically to news reports dealing with different types of illnesses, such as the Zika virus. In addition, the individual may extend his health anxiety to others in the family, as well as overreact to minor illnesses or injuries sustained by children.

People with IAD may limit the things they do, sometimes making up an illness that defines them. They may flourish from the time and care spent on them. Individuals with IAD may talk and grouse about their conditions to such excess that others become uncomfortable and, in time, avoid the person. As a result, the person with IAD has little social network and becomes isolated.

An ironic twist for an individual with the disorder is that if he becomes ill (verifiably), other people may ignore it because of past complaints. In addition, if the person is isolated, he may not have support for the illness. If the person is diagnosed with a mental illness, he is adamant it’s actually a health issue and feels that his concerns are not being taken seriously.

How Does IAD Begin?

Most times, IAD begins in early to mid-adulthood and is a lifelong illness. It may be triggered by a major stressor or a serious, but benign, threat to the person’s health. Child abuse or a severe sickness in childhood can trigger IAD in an adult.

Treatment of IAD

An individual with IAD may benefit from Mindful Cognitive Behavioral Therapy or Rational Emotive Behavioral Therapy to help learn strategies to respond appropriately to benign or obscure signals in the body.

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