Hypochondria Is More Than Just a Fear of Getting Sick — It Can Be Debilitating

Lewis Capaldi's new Netflix documentary "How I'm Feeling Now" is drawing attention to a series of health conditions, including Tourette syndrome and hypochondria. The singer-songwriter said that being in the entertainment industry has at times even exacerbated these conditions.

"The pressure of the job is the problem. The mammoth tours of enormous venues. The expectations upon me. That's surely anxiety-inducing for anybody, never mind a huge hypochondriac like myself," Capaldi told The Sunday Times in an interview ahead of the documentary's release.

Capaldi has spoken out in the past about having hypochondria, aka illness anxiety disorder. Last year, the 26-year-old shared on the "Diary of a CEO" podcast that he often leans on his mom when he has symptoms of the disorder. "I phone her and I say, 'Mum, I've got a headache, I'm dizzy, I think I've got a brain tumor or something,' she'll be like, 'Shut the f*ck up, you're fine. Take some paracetamol and go to bed,'" he said.

Capaldi even said he had to cancel one show over fears something was wrong with his health. Capaldi's candidness raises a lot of questions about hypochondria, including what causes it and how to spot the signs. Here's what you need to know.

Hypochondria is known medically as illness anxiety disorder. It's a mental health condition that's marked by a preoccupation that physical symptoms are signs of a serious illness, even when there is no medical evidence to suggest that someone is sick, according to the National Library of Medicine.

"Most people have times when they might be worried about a symptom in their body and, in the case of phantom symptoms, they go away. A person struggling with illness anxiety disorder has a really difficult time getting reassurance that they're OK," says psychologist Lily Brown, PhD, the director of research at the Center For the Treatment and Study of Anxiety at the University of Pennsylvania.

People with hypochondria have "excessive worry" that they're sick or developing a serious medical condition, says Hillary Ammon, PsyD, a clinical psychologist at the Center For Anxiety & Women's Emotional Wellness. They may see doctor after doctor trying to get a diagnosis or avoid interaction with the medical community altogether "because they're afraid of actually finding out a diagnosis," says Thea Gallagher, PsyD, a clinical assistant professor at NYU Langone Health and a cohost of the "Mind in View" podcast.

There are a lot of possible symptoms someone can have with illness anxiety disorder.

"A typical presentation is someone who repeatedly goes to the doctor and gets several opinions," Dr. Brown says. "They might need to take a lot of time off work and have a functional impairment because it's hard for them to think about things other than what might be wrong with their body."

People with hypochondria will spend a lot of time looking up their symptoms online and become so preoccupied with their health that "it gets in the way of other things they care about," Dr. Brown says.

"A good indicator that your anxiety is teetering towards problematic is if your worries are interfering with your daily life," Dr. Ammon says. "For example, you may be caught up in worry spirals about the illness, making it difficult to complete daily tasks or focus on work. You may be engaging in avoidance behaviors that are preventing you from performing daily tasks or hobbies you previously enjoyed."

For example, someone with hypochondria who is scared of Lyme disease may avoid walking in grassy or wooded areas, scan their body repeatedly, and do self-exams on a daily basis, she says. "People with illness anxiety disorder may engage in safety behaviors, such as seeking reassurance from loved ones or performing tasks that give them a sense of control related to their worries," Dr. Ammon explains.

Dr. Gallagher stresses that having illness anxiety disorder is different from seeking a second opinion when you're not satisfied with your medical care. A good sign that you may have illness anxiety disorder (versus being brushed off by a doctor and wanting another opinion) is if you keep pursuing a diagnosis, even when medical testing has determined you're fine. "You need to follow the science," Dr. Gallagher says. "When you start getting that third or fourth opinion and now you think you have another health condition and another health condition, it's become like a compulsion."

The cause of hypochondria isn't known, but Dr. Gallagher says there are a few factors that may play a role in whether someone develops the condition. Those include having trouble tolerating uncertainty and discomfort, having family members who are preoccupied with their own health or your health, or having past experience with a serious health issue, she says.

People with a history of physical or sexual abuse are also more likely to have hypochondria, but that doesn't mean everyone with illness anxiety disorder has a history of abuse, the National Library of Medicine says.

Ultimately, developing illness anxiety disorder is due to "a combination of genetic and environmental factors," Dr. Gallagher says.

A person is usually only diagnosed with illness anxiety disorder once all medical conditions have been ruled out, Dr. Ammon says. If your test results continue to come back normal and your medical provider has no medical concerns, but you are still experiencing excessive worry, exposure therapy may be recommended, she says.

That involves exposing yourself to thoughts or situations that scare you. "Through exposure therapy, people typically learn that the feared illness they are concerned about may not be as likely as they once believed and to better tolerate the distress associated with anxiety and uncertainty," says Dr. Ammon.

In some cases, antianxiety medications like selective serotonin reuptake inhibitors may also be helpful, in conjunction with therapy, she says.

Experts stress that being treated for illness anxiety disorder isn't something that will magically make symptoms go away — but it can help. "The possibility of developing a serious medical condition will always be there. There's always a chance," Dr. Ammon says. "Through exposure therapy, people learn to better tolerate the uncertainty of developing a serious illness, as well as examine the likelihood of their fears being true."