“WebMD on Steroids”: Understanding Health Anxiety

Dr. Moses Appel (Edited by Matthew Shields)

Leah was brushing her teeth before bed when she felt a dull ache in her jaw. Almost

instantly, her thoughts shifted: What if this is oral cancer? What if no one notices until it’s too late? She pressed her gums, traced her teeth with her tongue, and then sat on her couch, phone in hand, typing “jaw pain serious illness” into Google for the tenth time. When she finally crawled into bed, she was exhausted yet wired, her mind running laps. Even after booking a dentist appointment, the relief barely lasted until morning. Then, a skipped heartbeat became the new star of the show. For Leah, ordinary sensations rarely stay ordinary. They turn into plot twists in a drama her brain insists on writing. Leah’s experience is a classic example of health anxiety, once called hypochondriasis and now formally diagnosed in the DSM-5 as Illness Anxiety Disorder (American Psychiatric Association, 2013).

What Is Health Anxiety?

Health anxiety is not about being dramatic or “just worrying too much.” It is a recognized mental health condition in which ordinary body changes feel like danger signals. A stomach rumble gets mistaken for an ulcer. A skipped heartbeat becomes a possible heart condition. The mind jumps ahead to the worst-case scenario with remarkable speed. If you’ve ever promised yourself you wouldn’t Google symptoms again, only to find yourself at 2 a.m. scrolling through WebMD like it’s your personal horror novel, you know the feeling.

People with health anxiety often find themselves:

- Checking their body for lumps or marks.

- Googling symptoms at 2 a.m., even though they swore off WebMD the night before.

- Seeking reassurance from doctors, family, or friends.

- Avoiding hospitals or health shows, because even hearing about illness can set off the spiral.

Two Subtypes of Illness Anxiety

Clinicians often describe two broad patterns:

- Care-seeking type: frequent doctor visits, repeated tests, and constant reassurance-

seeking.

- Care-avoidant type: avoiding doctors, hospitals, or even medical information for fear of discovering something terrible. Both patterns are fueled by the same core worry: What if I’m seriously ill and no one notices until it’s too late?

DSM-5 Criteria for Illness Anxiety Disorder

According to the DSM-5, the diagnosis requires:

1. Persistent worry about having or developing a serious illness.

2. Few or mild physical symptoms; if a real medical condition is present, the worry is out of proportion.

3. Heightened anxiety about health and being easily alarmed about health status.

4. Either repeated health-related behaviors (like checking or reassurance seeking) or

avoidance.

5. Symptoms lasting at least six months, though the specific feared illness may change.

6. Not better explained by another condition such as OCD or generalized anxiety disorder.

Illness Anxiety Disorder vs. Somatic Symptom Disorder

Both Illness Anxiety Disorder (IAD) and Somatic Symptom Disorder (SSD) involve high

anxiety about health, but the role of symptoms sets them apart:

- Somatic Symptom Disorder involves real, persistent, and distressing physical symptoms (such as chronic pain or fatigue) that significantly disrupt life. Even when medical tests show nothing dangerous, the symptoms remain, and so does the worry.

- Illness Anxiety Disorder, in contrast, is defined by minimal or no physical symptoms at all. The anxiety centers on the possibility of hidden or future illness.

The Cycle of Health Anxiety

For people with Illness Anxiety Disorder, the cycle often begins with worry itself: What if I get sick? What if my body is hiding something? Even in the absence of symptoms, the thought snowballs into hours of scanning, Googling, and seeking reassurance. Other times, a very mild or fleeting sensation (a jaw ache, a skipped heartbeat, a twinge in the stomach) is misinterpreted as a sign of something serious. These minimal, or nonexistent, symptoms take on catastrophic meaning, and the fear becomes overwhelming.

The loop in IAD often looks like this:

1. Health-related worry arises (with or without a body sensation).

2. Thoughts quickly jump to worst-case scenarios.

3. Anxiety builds, often leading to hypervigilance and monitoring.

4. Checking, Googling, or reassurance-seeking offers temporary relief.

5. The relief fades, and the cycle starts again.

By contrast, in Somatic Symptom Disorder (SSD), the symptoms themselves are more

disruptive from the start. Rather than fleeting aches, the person may face ongoing stomach pain or fatigue that lingers for months, resists medical explanation, and disrupts work and family life. Even after reassurance, the symptoms, and the fear they cause, remain.

This also distinguishes health anxiety from panic attacks. Panic is dominated by a sudden surge of intense physical symptoms. Health anxiety, by contrast, is driven more by interpretation and meaning, a false alarm system convincing the mind that danger is near even when the body is not in crisis.

Treatment and Recovery Approaches

The encouraging news: health anxiety is treatable.

I often start with Cognitive Behavioral Therapy (CBT), which helps people recognize when their thoughts are running away with them and teaches new ways of responding. One practical step is reducing reassurance-seeking, scaling back those 2 a.m. Google marathons. Watching someone discover they can sit with uncertainty without spiraling is one of the most rewarding parts of my work.

A core CBT skill is cognitive restructuring, learning to catch unhelpful thought patterns and replace them with more balanced ones. One common distortion is catastrophizing, or jumping straight to the worst-case scenario. Instead of assuming “This flutter means something’s wrong with my heart,” patients learn to generate other explanations: “This could just be normal, or maybe I had too much coffee.” When someone tells me, “I felt my heart flutter and for the first time I thought, ‘There’s my quirky heart again,’” it’s a moment worth celebrating.

Another tool is exposure to feared information. Rather than avoiding it, patients practice confronting it in a structured way. For instance, someone might read a story about a person who ignored a symptom and later received a serious diagnosis. The goal isn’t to dismiss the story but to learn how to sit with the anxiety it provokes without falling back on compulsive Googling or checking. These exercises build resilience and shrink the power of catastrophic thinking. It’s a bit like watching a scary movie for the second or third time; it doesn’t hit as hard once your brain knows what to expect.

Finally, medication can sometimes play a supporting role. SSRIs and SNRIs may lower the intensity of anxiety, creating space for therapy to work.

Leah’s Story, Revisited

Leah’s late-night Googling and racing thoughts may sound familiar. What began with a simple jaw ache turned into a night of spirals, fleeting reassurance, and renewed worry in the morning. This is Illness Anxiety Disorder in action: minimal symptoms, but overwhelming fear of hidden illness.

The good news is that cycles can be broken. With CBT, cognitive restructuring, exposures, and sometimes medication, people can learn to live with uncertainty, notice their body’s quirks, and stop turning every sensation into a story of disaster. And yes, life really can feel lighter once the brain learns it doesn’t have to script medical thrillers out of every ache and pain.

Disclaimer: All characters and scenarios in this post are entirely fictional. This content is intended for informational purposes only and is not a substitute for professional therapy or treatment from a licensed mental health provider. To contact Dr. Appel, please email office@ADOPsychologyCenter.com.