OCD and Health Anxiety

by Ambro freedigitalphotos.net

by Ambro freedigitalphotos.net

Health anxiety (also known as hypochondria or hypochondriasis) is defined by 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 like OCD doesn’t it? Obsessions are health related and compulsions revolve around some type of reassurance and/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 DSM-5, however, OCD belongs to the obsessive-compulsive and related disorders category, while 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 this informative and comprehensive 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 front line treatment for OCD also helps those with health anxiety. To me, it doesn’t matter how OCD and hypochondriasis are classified in the DSM-5, 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 and/or OCD 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.

If you 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, by using exposure and response prevention (ERP) therapy, will help you learn to accept the uncertainty of life.







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7 Responses to OCD and Health Anxiety

  1. They do sound similar, but as you said, people with OCD tend to know what they fear is irrational, but can’t seem to stop themselves from worrying. A lot of symptoms around anxiety overlap; paranoia and most anxiety. But the major difference is whether or not you know the likeliness.

    I am diagnosed with several anxiety disorders, including OCD, but know that my rituals will not prevent my intrusive thoughts from becoming reality. Yet I can’t bring myself to stop; this is what differentiates me from someone with health anxiety or paranoia.

    • Thanks so much for sharing. I think the fact that those with OCD typically know their obsessions and compulsions make no sense can make the disorder even more tormenting. You know there’s no rhyme or reason, but you can’t stop. I can’t begin to imagine what that feels like. I appreciate your insight.

  2. expwoman says:

    Thank you for writing about this. Reading an essay about how compulsive checking of body symptoms could be OCD was crucial for me getting treatment. Hypochondria had never seemed to fit me when it was described as being “convinced” of having an illness ~ it was more the fear that I “might” have an illness.

  3. Darque says:

    Thank you for sharing this article.

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