You've probably heard someone at some stage be described as a hypochondriac, suggesting they are always worried about their health or believe they are showing symptoms of some ailment or illness. It is often used as a joke – "Stop being such a hypochondriac!" – but for those who understand the condition, there's not much to joke about. In fact, because of common derogatory usage, the word 'hypochondriac' has now largely fallen out of use in the medical community and has been replaced with the broader and more neutral term 'health anxiety'.
Other than that, what do we really know about health anxiety and those it affects? The condition, which sits within the obsessive-compulsive disorder (OCD) spectrum, convinces sufferers that harmless physical symptoms are indicators of serious disease or a severe medical condition. In 2016, the British Medical Journal called health anxiety a "silent, disabling epidemic" and in 2019, health anxiety was the third highest presentation of anxiety via Anxiety UK’s national helpline, after generalised anxiety disorder and mixed anxiety and depression.
Research confirms the growing numbers, with a study by Imperial College London determining that 19.8% of UK hospital patients surveyed were suffering with significant health anxiety. And though there are no specific statistics on an increase in health anxiety during the pandemic, we can assume that there has been one, based on the dramatic increase of anxiety in general. While the reasons behind the increasing rates remain unclear, one theory suggests that easy access to medical information websites could be a contributing factor. Known as 'cyberchondria', experts believe that self-diagnosis is having a significant impact on anxiety and stress levels.
Nicky Lidbetter, CEO of Anxiety UK, explains: "The internet now holds a vast array of information; this could help to explain the rise in health anxiety as people with this condition have access to this information at all times. This information often gives the worst-case scenario for the symptoms provided and therefore reinforces the cycle of health anxiety and increases the physical and psychological symptoms of their anxiety.
"For most, when experiencing a new physical health symptom, a short trip to the doctor results typically in being provided with a clear answer and a way forward as to the issue faced. However, for individuals with health anxiety, their anxiety leads them to believe there are further issues at play and so the cycle of anxiety continues."
While the stigma attached to more common mental health issues has lessened in recent years, health anxiety remains taboo, according to Jessica Ellis, a 23-year-old NHS worker who has suffered with the condition for the past three years. Here she describes her journey to diagnosis, the difficulties of living with health anxiety, and how we can better understand those dealing with mental health issues.
"I always disliked the term 'hypochondria' because it gives the idea that a person is just being dramatic or attention-seeking, when in fact they are suffering from a serious mental illness. I’ve suffered from general anxiety disorder and OCD tendencies for as long as I can remember but it eventually manifested into health anxiety when I noticed I was urinating a lot more than normal. I googled my symptoms and it said that the main cause was likely a urinary tract infection or diabetes.
I was tested for both and both tests came back clear, but a few weeks later I was scrolling on Facebook and one of those awful, scaremongering articles popped up: "Ovarian Cancer – The Silent Killer." It listed the main symptoms of ovarian cancer that people often ignore and the third one on the list was frequent urination. Over the next few days I began to develop every other symptom on the list – stomach pain, bloating, pelvis pain, change in bowel habits – and the frequent urination became worse than ever.
I ended up going to the doctor's three times in the space of two weeks, each time hysterical and begging for examinations and scans, only to be told that it was caused by anxiety and I was too young for it to be anything sinister. From that point on I spent every spare moment I had reading up about ovarian cancer, reading articles about girls the same age as me who were dismissed by doctors, only to be diagnosed too late for treatment. I was completely terrified. Thankfully I work for the NHS and a consultant arranged for me to have a 'peace of mind' scan, which told me everything was totally fine. Straight after having the scan, all the symptoms stopped but sadly the anxiety continued, jumping from illness to illness, with very little respite.
Over the last three years I have convinced myself that I have ovarian cancer, breast cancer, leukaemia, nasal cancer and lymphoma.
Over the last three years I have fully convinced myself that I have ovarian cancer, breast cancer, leukaemia, nasal cancer and lymphoma. Every morning I mentally scan my whole body, checking for any slight pain or new sensation, then check for any lumps or bumps or marks on my skin. Trust me, if you go looking for these things you will find something. Last year while checking myself over I noticed a lump under my jaw, which part of me knew had probably always been there. I completely freaked out and was 100% certain I had lymphoma.
I poked and prodded at it for weeks, to the point my skin was bruised. I finally plucked up the courage to see a doctor, who told me they couldn't feel anything. Initially this gave me reassurance but a few days later the 'what if' voice started to creep back in. What if they missed something? What if they weren't feeling in the right place? Not trusting doctors is one of the hardest parts of having health anxiety because it makes it almost impossible to feel reassured about anything.
Because of this I find myself constantly seeking reassurance from my loved ones, which I'm sure can become annoying after a while. I also use the internet but for health anxiety sufferers the online world is a double-edged sword. On one hand, if you google pretty much any symptom, cancer will come up as one of the possible causes. The information is always so vague and not person-specific, which can often make my anxiety worse. On the other hand, I have also found information online has helped me to better understand my condition. The internet has allowed me to get in touch with support groups and forums for health anxiety sufferers, which has made me realise it's a much more common issue than people think.
Even knowing this, I often try and play down my health anxiety when discussing it with those outside my inner circle because I'm always so nervous of their reactions. People often don't understand and will unknowingly make unhelpful comments, such as 'everyone worries about their health' or 'you just have to live in the now and not worry about stuff like that'. I tend to try and make a joke about it and laugh at myself because it’s embarrassing to admit how much of a hold this has over me.
When it comes to the public perception of health anxiety, I wish people knew that this is a crippling mental illness. It's not an attention-seeking strategy.
Treatment options for those with health anxiety remain pretty limited. I tried taking sertraline but ended up stopping as it made me feel very low. At the moment I take propranolol, which is a type of beta-blocker, to help with the physical side of anxiety, such as rapid heartbeat. It doesn't really do anything to help with the obsessive thoughts, though. I’m currently waiting for a consultation with the NHS wellbeing service but due to services being so underfunded and stretched, I will probably end up seeking private therapy.
When it comes to the public perception of health anxiety, I wish people knew that this is a crippling mental illness. It's not an attention-seeking strategy. I'm not deliberately being a drama queen. I know everybody worries about their health from time to time and nobody wants to get ill, but for someone with health anxiety that fear completely takes over and stops you from living your life. It's a vicious cycle and it's so hard to break free from it. Just because you don't understand something, it doesn't mean it's not a real thing for many people."