Health Anxiety (Illness Anxiety): When You Can't Stop Googling Symptoms

What is health anxiety and what causes it? Learn about its symptoms, the cycle of searching symptoms online and how it is approached in therapy.

If a small headache you notice at midnight turns, within minutes, into a search for "brain tumour symptoms", you are not alone. Health anxiety, known in everyday speech as "illness anxiety" (in Turkish, hastalık hastalığı, literally "the illness of illness"), shows itself as a person interpreting ordinary sensations in their body as signs of a serious disease and not being able to shake that thought easily. Although medical examinations, test results and loved ones saying "there's nothing wrong with you" bring short-lived relief, the anxiety very often flares up again. In this article I will try to explain in plain language what health anxiety is, the symptoms with which it appears, why it develops and how it is approached in therapy.

What Is Health Anxiety?

Health anxiety is a condition that today is considered in the medical literature mostly as "illness anxiety disorder" or, under its general name, "health anxiety". The term "hypochondria", used in the past, has been replaced among specialists by more neutral expressions because it gradually took on a stigmatising meaning. This is because a person experiencing this is not "making up an illness" or "putting it on"; they are genuinely struggling with intense and exhausting anxiety.

At the core of health anxiety lies difficulty tolerating uncertainty. Our body produces countless sensations during the day: the heart rhythm changes, muscles twitch, the stomach rumbles, the head aches from time to time. Most of us pass these sensations by without noticing. A person with health anxiety, on the other hand, monitors these sensations closely, magnifies them and tends to explain them with the worst possibility.

It is important to make a distinction here: worrying about a real health problem, having regular check-ups and taking care of your body are healthy behaviours. The problem begins when the anxiety becomes disproportionate, clearly restricts daily life and the search for reassurance never ends.

What Are the Symptoms of Health Anxiety?

Health anxiety does not look the same in every person. Some go from doctor to doctor constantly, while others, on the contrary, never go to hospital for fear of receiving bad news. Even so, some common signs are as follows:

• Constant body checking: Taking your pulse, examining moles, feeling the lymph nodes in your neck, checking your blood pressure many times a day.
• Searching for symptoms online: Turning to search engines, forums or health videos on social media as soon as you notice a sensation.
• Seeking reassurance: Asking a partner, mother or friends again and again, "Do you think this is normal?"
• Changing doctors: Turning to another doctor or another test even though one doctor has said "there's no problem".
• Avoidance: Staying away from news about illnesses, TV series and hospital visits.
• Physical anxiety symptoms: Symptoms that come from the anxiety itself, such as palpitations, a feeling of breathlessness, nausea and muscle tension. Unfortunately, these symptoms also feed the thought "so I really am ill".
• Mental preoccupation: Thinking about the possibility of illness for long hours of the day, being unable to focus on work or conversation.

Experiencing some of these symptoms from time to time does not on its own amount to a diagnosis. What is decisive is how often these behaviours occur, how much time they take and how much they narrow your life.

Cyberchondria: The Trap of Searching Symptoms Online

In recent years a concept called "cyberchondria" has often been talked about. Searching for symptoms on the internet, although it gives a sense of control in the short term, tends to increase anxiety in the long term. There are several reasons for this. Search results often list rare but serious illnesses as well; the anxious mind gets stuck on the most frightening option on the list. In addition, each search raises a new question, and a person can move from page to page for hours.

Suppose you felt a slight numbness in your arm. The search engine will show you many ordinary explanations, from a trapped nerve to lying in the wrong position in your sleep, alongside more serious conditions. An anxious mind passes over the ordinary explanations, saying "I'm fooling myself", and turns its attention to the worst possibility. In this way a feeling of numbness can turn into a sleepless night.

What Causes Health Anxiety?

Health anxiety does not have a single cause. Usually several factors come together:

• Past experiences: Having had a serious illness in childhood, having cared for a seriously ill relative or having lost a loved one unexpectedly can sharpen the perception of danger concerning the body.
• Attitudes learned in the family: Growing up with parents who were very anxious about health, or in an environment where every cough was met as a major danger, can lead to this outlook being learned.
• Intolerance of uncertainty: The need to "know for certain" is one of the strongest thought patterns feeding health anxiety.
• Stressful periods of life: In periods such as a change of job, a house move, financial difficulties or relationship problems, anxiety can show itself by turning towards the body.
• Personal tendencies: Being prone to anxiety in general, or having other anxiety problems, can also create risk. For more information on this, you can look at the article on anxiety symptoms.

The cognitive behavioural approach treats health anxiety as a cycle: a bodily sensation is noticed, interpreted catastrophically, anxiety rises, the anxiety produces new bodily symptoms, the person resorts to checking and reassurance behaviours, short-term relief comes and this relief sets up the next round of the cycle. Understanding the cycle is the first step towards getting out of it.

How Does Health Anxiety Affect Daily Life?

Health anxiety is not just a mental burden; it can also have marked effects on work, relationships and family life. Taking frequent time off, losing concentration in work meetings, tension caused by a partner's "again?" reaction and the guilt that comes from constantly asking for reassurance are only a few of these.

In Turkey, the marks left by the pandemic period are still felt. In those years we lived together through an environment in which every cough and every fever created fear. For many people, constantly following health news turned into a habit. In addition, health content of uncertain accuracy spreading on social media, stories of the "a friend's cousin started out just like this" kind and illness stories that often feature in family conversations can add to the burden of people prone to anxiety.

Although the support provided by the extended family structure is very valuable, there are times when the anxious approach of older family members can also feed the reassurance cycle. Suppose you ring your mother with every headache and see that she worries along with you. In this case the anxiety can become the shared agenda of two people.

What Can You Do to Cope with Health Anxiety?

The suggestions below are steps that can help you manage health anxiety and that you can try on your own. Each one shows its effect when applied in a small but consistent way.

Gradually reduce checking and searching behaviours

For a few days, note how many times a day you check your pulse or blood pressure and how many times you search for symptoms. Then, rather than suddenly bringing this number down to zero, aim to reduce it gradually. When the urge to search comes, giving yourself a fifteen-minute delay can let you notice that the urge weakens over time.

Work on the habit of seeking reassurance together with your loved ones

Asking your loved ones for reassurance is a natural need, but when it is constantly repeated it feeds anxiety. You can have an open conversation with your partner or family and try to notice this cycle together. What helps more is not their turning you away, but a compassionate response such as "It sounds like your anxiety is asking this, shall we wait a bit?"

Approach bodily sensations like a curious observer

When you notice a sensation, try describing it rather than interpreting it straight away: "There's a mild pressure on the left side of my chest, it's more noticeable right now, it was lighter a few minutes ago." This approach puts a small distance between you and the sensation and slows down the speed of the catastrophic interpretation.

Keep up regular, planned health check-ups

Coping with health anxiety does not mean neglecting your health. Planning regular check-ups with a family doctor you trust and making an agreement with yourself not to request new tests in between is a balanced way of caring for both your body and your mind.

Build habits that reduce the anxiety's effect on the body

Regular walking, breathing exercises, enough sleep and limiting caffeine can ease the physical symptoms that anxiety creates. Fewer palpitations and less muscle tension mean fewer sensations to interpret.

Set aside a specific time for worry

Trying to suppress health worries that come scattered through the day often doesn't work; a suppressed thought returns more often. Instead, you can set a "worry time" of about twenty minutes at the same hour every day. When a worry comes to mind during the day, you jot it down briefly on a piece of paper and postpone it to this time. When you look at your notes at the set time, you may notice that many of the worries have lost their power. This method is a practical way of limiting the anxiety's management of your day without ignoring it.

Limit content that feeds anxiety

Health videos that come up on social media, posts headed "never ignore this symptom" and forums where illness experiences are told are powerful triggers for an anxious mind. Muting or unfollowing such accounts for a while can open a breathing space for your mind. When you need reliable health information, it will be healthier to get it from your doctor.

When Should You Seek Professional Support for Health Anxiety?

If one or more of the following situations are familiar to you, you may consider talking to a mental health specialist:

• If health worries take up a significant part of your day,
• If medical examinations and tests give you only short-lived relief,
• If your work, school or family life is clearly affected by this anxiety,
• If you avoid going to hospital altogether because of the anxiety,
• If other difficulties such as sleeplessness, unhappiness or hopelessness accompany it.

An important note: if there is a bodily symptom that is new, getting worse or genuinely worrying you, you should see a doctor first. Psychological support does not replace medical assessment; it goes alongside it. As for whether medication is needed, the assessment of a psychiatrist is important.

How Is Health Anxiety Addressed in Therapy?

One of the approaches strongly supported by research in the treatment of health anxiety is cognitive behavioural therapy. This approach aims to explore together, and change step by step, the cycle of thoughts and behaviours that feeds the anxiety. If you are curious about the general framework of the approach, you can read the article on cognitive behavioural therapy.

The therapy process generally includes the following elements:

• Mapping the cycle: Which sensations trigger the anxiety, which thoughts come into play and which behaviours maintain the anxiety are identified together.
• Examining thoughts: The evidence for thoughts such as "this headache is definitely a sign of something serious", alternative explanations and probabilities are evaluated.
• Behavioural experiments: What happens when you stop checking for a while, or stop asking for reassurance, is tried out safely and in a planned way.
• Learning to live with uncertainty: Work is done on building a more flexible relationship with the fact that nothing in life is one hundred percent certain.
• Attention work: The aim is a more flexible use of attention that is constantly turned towards the body.

The aim is not to eliminate anxiety completely, but not to let it take the wheel of your life when it comes.

In therapy you are never told "there's nothing wrong with you, forget it". Your anxiety is taken seriously, an effort is made to understand your experience, and change is planned with respect for your pace. You can find more information about individual work on anxiety on the anxiety and panic page.

Frequently Asked Questions

Is health anxiety a real condition?

Yes. Health anxiety is a well-known form of anxiety defined in the field of mental health. People who experience it do not make up illness; they feel the anxiety genuinely and intensely. It is therefore important to approach it with understanding and to get support when needed.

Why does searching for symptoms online increase my anxiety?

Search results often include rare but frightening possibilities, and the anxious mind tends to focus on the worst option. Although it gives a sense of control in the short term, each search raises new questions. This is why gradually reducing searching behaviour does most people good.

Is health anxiety the same as a panic attack?

They are not the same thing, but they can accompany each other. In a panic attack there is a sudden and intense wave of fear, whereas in health anxiety a more continuous worry and preoccupation come to the fore. If you would like information about panic attacks, you can look at the article on panic attack symptoms.

Will I have to stop going to the doctor during therapy?

No. The aim of therapy is not for you to give up necessary medical check-ups, but to reduce the repeated and unsoothing consultations driven by anxiety. Setting up a planned check-up routine with your doctor supports the process. If your health anxiety is making your life difficult, knowing that it is possible to get support from a specialist can be a good start.

• #health anxiety
• #illness anxiety
• #anxiety
• #cognitive behavioural therapy

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Eda Erkan Alapala

Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.

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