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What is Illness Anxiety Disorder?

December 24, 2019


Hello, this is Dr. Grande. Today’s question is what is Illness Anxiety Disorder If you find this video to be interesting or helpful, please like it and subscribe to my channel. That way you won’t miss any new videos. Now when we talk about illness anxiety disorder, we talk about a mental disorder where an individual is preoccupied with concern about having a serious illness and this is an interesting disorder because it’s fairly similar to Obsessive Compulsive Disorder and there’s even a debate in a mental health community About whether or not Illness Anxiety disorder is really just a variant of OCD So when we look at the criteria for Illness Anxiety Disorder there’s another interesting feature a lot of mental disorders in the DSM have a symptom criteria section and Then other criteria so there may be Nine symptoms in the symptom criteria section and somebody might have to meet four or five of those symptoms to qualify For that criterion and then there are other criteria that have to qualify for as well With illness anxiety disorder all of the different criteria are required There is no section in the DSM with illness anxiety disorder That has a number of symptoms where somebody only has to meet a certain Number less than that for the diagnosis. For example if we consider Borderline Personality Disorder that disorder has nine symptoms in the symptom criteria But an individual only needs to have five of those to qualify for that diagnosis So again with Illness Anxiety Disorder, all the symptoms are required. So the first symptom is a preoccupation with having or acquiring a serious illness now the DSM doesn’t specifically say that this would be a mental disorder or a medical disorder but most of the time we interpret this as relating to a possible medical disorder a concern over having or getting a medical disorder because we usually conceptualize this first criterion as being related to medical disorders this brings up an important point in terms of the distinction between a talk therapist and a physician For example, I have a PhD in counselor education and supervision and I’m a licensed counselor I’m not a physician and most talk therapists are not physicians either. So with this particular diagnosis of illness anxiety disorder as a talk therapist you would be working with somebody who has complaints or concerns about a medical disorder. So it’s important to make the referral to a physician so that you know if they in fact have the disorder or don’t That’s an important element in terms of the mental health treatment to know if that medical disorder is really there or not. Now, of course a lot of times when we treat individuals with Illness Anxiety Disorder, they have been referred by a physician and we already have the information that shows that they did not qualify for a diagnosis of any type of medical disorder at least not the medical disorder that they’re worried about. The second criterion is that there are little or no somatic symptoms. So there’s another disorder which is difficult to differentiate from Illness Anxiety Disorder called Somatic Symptom Disorder and I have another video that discusses these two disorders together. With Illness Anxiety Disorder there can be mild somatic symptoms but that’s really not the emphasis as the symptom criterion suggests the anxiety is not coming primarily from physical sensations of the person’s having but rather the meaning or significance of having the illness that they’re worried about having. The third symptom criterion is the individual is experiencing a high level anxiety about health-related concerns. The fourth is that there’s excessive health-related behavior like checking or maladaptive avoidance, so a lot of times we think of this disorder and compare it to OCD, it’s this particular symptom criterion that makes it difficult to distinguish the two because that health-related behavior as I mentioned oftentimes involves checking and of course OCD oftentimes involves checking. The fifth symptom criteria is that the disturbance has been present for six months. but the illness that the person is worried about can change in that time. So a lot of times we think of Illness Anxiety Disorder, we think of one particular illness that the person is worried about having or acquiring. But sometimes with this disorder if they have evidence that shows that they don’t have a particular medical disorder they were worried about, Then they might develop a fear about another potential medical disorder. So the illness can change but the disturbance would be present for at least six months and The sixth symptom criterion is that this disturbance is not better explained by another mental disorder and there’s a number of mental disorders listed in the DSM as examples. One of them is OCD. Again, emphasizing this difficult differentiation between illness anxiety disorder and OCD It’s important to note here as well that somebody can have Obsessive Compulsive Disorder and Illness Anxiety Disorder at the same time These can be comorbid and oftentimes they are comorbid. This six symptom criterion that not better explained by another mental disorder criterion doesn’t mean that the two can’t co-occur. It just means that if you’re looking at a presentation that you think is Illness Anxiety Disorder and the symptoms are in fact better explained by OCD then you would consider OCD over illness anxiety disorder. This can certainly become confusing but the term not better explained doesn’t mean that the two are mutually exclusive, that the two disorders cannot co-occur. Now it’s also important to note that with illness anxiety disorder. There are two subtypes These are not specifiers but rather subtypes So an individual would have to have one and only one of these subtypes There’s the care-seeking type and the care-avoiding type. So an individual with Illness Anxiety Disorder would have to be categorized as one of these two types, they could not be assigned both types. Some other interesting associated characteristics with Illness Anxiety Disorder include that there’s usually not a desire for perfectionism with this disorder like we would see with OCD and also, in terms of what medical disorder or serious illness somebody’s worried about it’s oftentimes not a communicable illness so the concern would more likely be over a medical disorder like cancer or heart disease as opposed to influenza. Now in terms of the treatment for Illness Anxiety Disorder, we don’t have a lot of research on the treatment effectiveness for illness anxiety disorder specifically, but generally we believe that mental health talk therapy is somewhat effective in relieving the symptoms of Illness Anxiety Disorder. I hope you found this description of Illness Anxiety Disorder to be interesting. Thanks for watching.

32 Comments

  • Reply Alex Says Hi June 7, 2018 at 1:14 am

    Can you do a video on the similarities between schizotypal vs borderline personality disorder please?

    P. S: I like the videos, keep making more please.

  • Reply Johnny Johnston June 7, 2018 at 4:24 am

    Wouldn't that be the same thing as hyperchondria?

  • Reply All I do Is Cry June 7, 2018 at 2:45 pm

    I have this.. Every day Im "scanning" my own body.. "how do I feel now, what is this sensation".. Every day I think about death and dying. Its exhausting. Its terrifying. My mother has severe OCD. I have never been diagnosed with ocd myself.

  • Reply Karen Lewis August 25, 2018 at 12:20 am

    Thanks – very interesting. Are there any other treatment out there other than talk therapy. Does stress management n proper diet plays an important role

  • Reply Virginia Murrey September 1, 2018 at 7:02 pm

    Interesting video, I enjoyed watching this along with the other videos concerning anxiety. Each video relates to each other and offers important relevant information.

  • Reply Veronica Betz September 10, 2018 at 3:32 am

    This is a very interesting video and complex disorder. Back in the day the term hypochondriac was used for someone with similar symptoms.

  • Reply John Harris Jr September 12, 2018 at 12:20 am

    Wow you have to have all the symptoms to get this diagnosis. It sounds like it relates to OCD. Illness anxiety disorder has two sub types the care-seeking type and the care- avoidant type. It has to be either or it can't be both

  • Reply Andrea Nichols September 13, 2018 at 12:00 am

    First disorder where I am hearing if a person doesn't exhibit all of the symptoms they cannot receive the diagnosis.

  • Reply Wanda Mixon September 13, 2018 at 3:18 am

    It is interesting that all symptoms are necessary to meet the criteria for the disorder. While I understand the categorical debate, I wonder the reasoning for what makes this disorder an exception to the rule.

  • Reply Kelly Harp September 13, 2018 at 3:44 am

    This sounds like the one disorder where a person thinks they have all these medical ailments, hypochondria is it? I have never heard of this one and it is very intriguing to know that to be qualified as having this you have to meet all of the criteria and not just some like most of the other disorders.

  • Reply Joe Dirt September 13, 2018 at 6:05 am

    I can see this being a sub type of OCD. This seems like an obsession where someone has magical thoughts about something irrational.

  • Reply TSBCMHC20 September 13, 2018 at 2:34 pm

    Yet another example why the medical field and the mental health field need to collaborate more. It is also interesting that this disorder requires all criteria to be present and that a disturbance needs to be present for 6 months.

  • Reply rbells2018 September 13, 2018 at 6:55 pm

    It's interesting that obsessive compulsive disorder and illness anxiety disorder can be comorbid. I think that it's also interesting that although it seems to be very similiar to OCD, it does not have the perfectionist component to it.

  • Reply kiki Xiong September 13, 2018 at 8:03 pm

    It’s an interesting disorder and I can see how it is similar to OCD. I’m interest in seeing real cases also the measurement for diagnosing.

  • Reply Suz Gen September 17, 2018 at 12:59 am

    This is interesting that if a person has the illness anxiety disorder to be referred to a physician. I am guessing that once the physician rules out any illness, it would be expected for them to refer them back to the talk therapist. I wasn't clear if the client would be working with both the talk therapist and physician.

  • Reply Adam Browne September 17, 2018 at 3:26 pm

    I thought it was very interesting that for an individual to qualify for Illness Anxiety disorder, they must meet all of the symptom requirements whereas other disorders the client only needs to meet a certain number of symptoms. I also thought it was interesting that the client needs to be referred to a physician to ensure that they have a medical condition before they can be diagnosed. To me this seems like a heavy burden on all parties involved (client, therapist, and physician) because of the amount of communication required to handle this.

  • Reply Jill Beck September 17, 2018 at 5:26 pm

    Very subtle distinctions between many of the disorders. Good thing there's a manual.

  • Reply Angelina Stanton December 3, 2018 at 11:09 pm

    This video was very helpful in explaining Illness Anxiety Disorder and showing how some OCD traits, like perfectionism, are not a symptom of this disorder. I think it can be tricky to differentiate this disorder from Somatic Symptom Disorder.

  • Reply Jackie Sorrells December 12, 2018 at 2:24 pm

    It is important to consider a holistic approach to treatment including life style, stress, etc…

  • Reply Brittany Ledwell February 11, 2019 at 1:32 pm

    As soon as you said “9 symptoms” I KNEW you were going to mention BPD… I watch too many videos

  • Reply Sara K. February 19, 2019 at 7:44 am

    Doesn’t GAD have the same symptoms ?

  • Reply SYED JAFFER IMAM February 27, 2019 at 7:50 am

    I just shift illness once i confirmed I don't have this one. If i am sure i am not going to get any serious illness not going to die anysoon i feel relaxed n happy.
    My health anxiety has all the symptoms of severe anxiety.

    I have started exercise and meditation hopefully it will work soon.

  • Reply This black girl Over here March 27, 2019 at 6:09 am

    It’s called Health Anxiety Disorder, not Illness Anxiety Disorder.

  • Reply This black girl Over here March 27, 2019 at 6:12 am

    I need YouTubers to start showing their DEGREES.

  • Reply Deffi Triyani April 9, 2019 at 9:44 am

    this video i know what illness anxiety and thank you for videoo

  • Reply Kathleen Mulcahy June 11, 2019 at 12:29 am

    I would really love to see a video on Borderline Personality disorder and comorbidity with actual physical illness, as I've seen a study or two that said that this could be somewhat likely (i.e. I have many physical illnesses and BPD and I've encountered others like this as well). Also, if you want to include BPD and somatic illness, that could be interesting. I know there have been studies done on how ppl with BPD experience self inflicted pain vs. other types of pain, so the topic always interests me. Looking forward to this! Thanks!
    Kathleen

  • Reply Wyatt Bunnell July 16, 2019 at 6:36 pm

    I have this some times then if I learn about a new illness mental or physical for some reason I think I have it so

  • Reply Nishant Shah August 7, 2019 at 6:30 am

    Does anxiety causes aphantasia?

  • Reply JIN'S SHOULDERS October 3, 2019 at 1:05 am

    I thought I was just alone.. now I think I have this.. every single day, I cant even concentrate in school. I spend late nights searching for symptoms of anything ranging from cancer, to parasites, to diseases. I get severe anxiety if my stomach hurts or I feel weird in the slightest… I've been dealing with this for longer than I can remember and i and slowly breaking down. What should I do? I dont think I can tell my family. I dont think they will believe me…. and if I go to a doctor, or look it up online, I find out I am fine and then I start fearing another illness right after… and eventually, I start fearing the illness I was fearing before… sometimes I fear more than one illness at a time….can anyone relate or help my situation?

  • Reply Yadel Manguera October 13, 2019 at 12:25 pm

    I will just share, coz i have this anxiety too, since my father died in cancer, this anxiety sickness suddenly occur because im afraid that i also have cancer too bcoz im the only child and my mother is 65 years old, im afraid if i die earlier than my mother what will she do? shes old no one will take care of her since im a only child, thats why i have this illness anxiety disorder, pls help me doc.

  • Reply nathan koehler November 19, 2019 at 9:58 pm

    What would it look like in someone who has illness anxiety regarding worrying about mental health?

  • Reply Mike Corazza November 28, 2019 at 9:06 pm

    Hi Dr. Grande. What if the illness we feel is the fear we're going to develop a more serious mental/psychiatric illness? For example, I've been diagnosed with GAD, depression, possibly hypochondria. I've often feared my heart, but I've had a heart issue in the past. Secondly, I have a constant fear I'm going to going to go "crazy", more specifically, go into a state of psychosis, and possibly develop Schizophrenia. I don't know if it's a/the cause but in my 20's, after some heart palpitations, I started to become more nervous it would happen again and developed anxiety issues ie: fear in public places, being in lines, feeling trapped etc. I didn't understand then what I do now but I got better through exposure therapy (didn't realize what it was called but was doing it naturally). It got to the point of very minor anxiety for many years and not really even an issue. I'm now 41, and about a year ago woke up with heart palps again, worried about my heart all over again, and the past year has been up and down with issues/symptoms, fear, racing thoughts. However the past month/weeks the fear and feelings are so intense that I'm scared all day, every day, afraid of the smallest things, can't handle stress, can't concentrate, feel this nervous tension, skin crawling almost and can't stay still, feel I'm literally going to go crazy. Like it literally feels my brain is going to melt, I'm going to perhaps pass out, wake up unconscious and not know who I am, wake up in institution etc. Biggest reason I worry about psychosis/schizophrenia specifcally? I have an older brother with it. He was diagnosed in his early 20's – he's now 48. Anyways, I've seen a psychologist for the past year, and he thinks I'm being neurotic, but I can't shake this intense fear of psychosis. I've watched so many of your videos of schizophrenia, schizotypal, etc…. I don't connect many things but the one thing that stands out everything I did in my 20's to get over this isn't working. You mentioned the more a person goes into social situations and feels worse, could be a sign. I keep telling my psychologist I feel worse and worse every time, come out of the situation and feel even more anxiety/fear/worry. My mind is racing, I'm now having terrible sleep patterns, this is spiralling out of control and my wife feels she's losing her husband 🙁 Any info appreciated – love your videos. Ps – I wonder if this intense feeling I have that lasts hours all day is mania but I find it hard to understand, even after watching videos. I'm extremely, extremely depressed 🙁 . I don't expect you to diagnose me by the way – just wanted to vent to somebody who hopefully understands.

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