Health anxiety: signs, what keeps it going and what helps

Health anxiety is when you spend so much time worrying that you are ill, or about to become ill, that it starts to take over your life. The NHS describes signs such as frequently checking your body, repeatedly seeking reassurance, and worrying that doctors or tests have missed something. It is kept going by a cycle of worry, checking and short-lived relief, and it is very treatable, with cognitive behavioural therapy (CBT) having good evidence behind it.

Key points

• Health anxiety is sometimes called hypochondria. It is a genuine and distressing problem, not “making a fuss”.
• Common signs include body checking, reassurance-seeking, searching symptoms online and avoiding anything to do with illness.
• Checking and reassurance bring short-term relief but tend to keep the worry going.
• Anxiety itself causes physical sensations, such as a racing heart or headaches, which can be mistaken for illness.
• Talking therapy, particularly CBT, can help. In England you can refer yourself to NHS Talking Therapies.
• New or changing physical symptoms should still be checked by your GP.

What is health anxiety?

Most people worry about their health from time to time, especially after a scare or when someone close to them is unwell. Health anxiety is different in how much space the worry takes up. It can feel constant, it is hard to set aside even after a doctor has found nothing wrong, and it starts to affect your work, relationships and ability to enjoy things.

The NHS notes that health anxiety is related to obsessive-compulsive disorder (OCD), and Anxiety UK describes it as often grouped with OCD. The worry can focus on any illness. Anxiety UK gives cancer as a common example, and notes that harmless bodily sensations are often read as signs of serious disease, such as chest tightness being taken as a heart attack.

What are the signs of health anxiety?

The NHS lists signs including:

• Constant worry about your health.
• Frequently checking your body for signs of illness, such as lumps, tingling or pain.
• Repeatedly asking other people for reassurance that you are not ill.
• Worrying that your doctor or medical tests have missed something.
• Spending a lot of time reading health information online or in the media.
• Avoiding anything related to serious illness, such as medical TV programmes.
• Acting as if you are ill, for example avoiding physical activity.

Anxiety UK adds that reassurance from doctors, family or friends often does not feel believable for long. You might feel calmer after an appointment, only for the doubt to creep back hours or days later.

Why do I feel physical symptoms?

Anxiety is a whole-body response. When you feel threatened, your body prepares to deal with danger, and the NHS lists physical signs of anxiety such as a noticeable or unusual heartbeat, feeling tense, feeling lightheaded or dizzy, and stomach problems. The NHS also points out that anxiety symptoms such as headaches or a racing heartbeat can themselves be mistaken for signs of illness.

This can create a confusing loop: you notice a sensation, worry about it, the worry produces more sensations, and these seem to confirm the fear. NHS self-help guidance describes how focusing attention on your body can make harmless sensations feel more alarming.

None of this means your symptoms are “all in your head” or should be ignored. If you have a new, persistent or changing physical symptom, it is right to see your GP. Part of recovering from health anxiety is finding a balance between sensible medical care and repeated checking that no longer helps.

What keeps health anxiety going?

NHS self-help materials describe health anxiety as a vicious cycle. Something triggers a worry, such as a twinge, a news story or someone else’s illness. Your attention turns to your body, harmless sensations feel alarming, and catastrophic thoughts follow (“What if this is cancer?”). Anxiety rises, and you respond in ways that bring quick relief:

• Checking your body, pulse, skin or a particular spot.
• Seeking reassurance from family, friends or doctors.
• Searching symptoms online, which often turns up the most frightening possibilities.
• Avoiding exercise, medical programmes, hospitals or conversations about illness.

Each of these makes sense in the moment, and each eases the anxiety for a while. But the relief does not last. Because no check or test can offer complete certainty, the doubt returns, often with a new question, and the urge to check or ask again comes back. Over time, these habits can strengthen the worry rather than settle it.

What might make someone more prone to health anxiety?

There is rarely one cause. NHS self-help guidance mentions possible influences such as:

• Having had a serious illness or health scare in the past.
• Illness or death in the family, especially if early signs were missed.
• Stressful periods, which bring their own physical symptoms.
• Growing up with someone who worried a great deal about health.
• Health stories in the media, or noticing ordinary body sensations at an anxious time.

For some people, health anxiety also links to grief, earlier frightening experiences, or a more general tendency to anxiety. The same guidance notes that severe health anxiety can sometimes go with low mood, so if you are also feeling very low, it is worth telling your GP.

What can I do to help myself?

The NHS suggests some practical steps, which many people find helpful to try gradually:

1. Keep a diary of how often you check your body, ask for reassurance or look up health information, then try to reduce these little by little over a week.
2. Write down your worries in one column and a more balanced view in another.
3. Delay or redirect the urge to check, for example by going for a walk or calling a friend.
4. Gradually return to things you have been avoiding, such as exercise or socialising.
5. Try breathing or relaxation exercises. A short breathing exercise can help when anxiety spikes.

It can also help to agree with the people close to you how they will respond when you ask for reassurance, so that they can support you kindly without getting pulled into the cycle.

What treatment is available?

The NHS advises seeing a GP if health worries are stopping you from living a normal life and self-help is not working. A GP may refer you for a talking therapy such as CBT, or offer medicine for anxiety. In England you can also refer yourself directly to NHS Talking Therapies without seeing your GP first.

Research supports CBT for health anxiety. A 2017 systematic review and meta-analysis of randomised controlled trials found CBT had a large effect compared with control conditions, and that the benefits were still present at 6 and 12 months. A large NHS-funded trial in hospital clinics also found that a short course of CBT for health anxiety helped, with benefits lasting over several years.

CBT for health anxiety usually involves understanding your own cycle, testing out worrying predictions, and gradually reducing checking, reassurance-seeking and avoidance. Medication is something to discuss with your GP.

How therapy with me can help

As an integrative psychotherapist registered with the BACP, I work with adults experiencing anxiety in many forms, including persistent worry about health. Alongside CBT-informed ideas about the cycle of checking and reassurance, we can also explore what the worry might be connected to, such as past illness, loss or a sense of needing to stay in control, using person-centred and psychodynamic approaches. If you are also struggling with panic attacks, that is something we can work on too. Sessions are in Farringdon, Central London, or online, in English or Turkish.

If you are in crisis, call 999, go to A&E, call NHS 111, or contact Samaritans on 116 123 (free, 24/7).

If worry about your health is taking up more of your life than you would like, you are welcome to get in touch to arrange an initial consultation. We can talk about what has been happening and whether working together feels right for you.