Health Anxiety: A Care Staff Guide to Recognising and Responding

Everyone worries about their health from time to time. For some people, the worry grows until it takes over. They check their bodies repeatedly, search for symptoms, seek reassurance from every professional they meet and still cannot settle. For staff, it can be hard to know how to respond, because the worry is real, and sometimes the person really does have a physical problem. This guide explains health anxiety and how to support people with it.

What is health anxiety?

The NHS describes health anxiety as spending so much time worrying that you are ill, or going to get ill, that it starts to take over your life. It notes that health anxiety is related to obsessive compulsive disorder, and our guide to OCD and body dysmorphic disorder explains the overlap in thoughts, checking and avoidance. It is not the same as pretending, and it is not a character flaw.

Signs to look for

The NHS lists the following signs of health anxiety:

• constantly worrying about your health
• frequently checking your body for lumps, tingling or pain
• repeatedly seeking reassurance that you are not ill
• worrying that a doctor or test has missed something
• obsessively reading health information online or in the media
• avoiding anything to do with serious illness, such as medical programmes on television
• acting as if you are ill, for example avoiding physical activity

The NHS also points out that anxiety itself can cause symptoms such as headaches or a racing heartbeat, which a person may then mistake for signs of illness. That can set off a cycle: worry causes sensations, the sensations feed more worry.

Why reassurance does not last

Reassurance feels like the obvious response, but it usually works only briefly. Repeated checks and repeated reassurance can keep the worry alive, because the person never learns that they can tolerate uncertainty. The NHS self-help advice reflects this by encouraging people to keep a diary of how often they check their body, seek reassurance or read health information, and to reduce these behaviours gradually over a week.

Do not dismiss real symptoms

A person with health anxiety can still become physically ill. Any new or worsening symptom should be taken seriously, recorded and passed to the right clinician in the usual way. The goal is not to say that nothing is wrong, but to respond consistently and calmly, without escalating every worry into an emergency. If you are unsure, follow your organisation's escalation procedure and ask the nurse or GP. Where long-term physical symptoms are part of the picture, our guide to chronic primary pain shows how NICE emphasises believing the person while focusing on living well.

How to respond day to day

• Listen first. Let the person describe what worries them, then acknowledge that it feels frightening.
• Agree a consistent plan. The team might agree when symptoms are reviewed, who the person speaks to, and what happens if they are worried between reviews.
• Avoid long reassurance sessions. Gently refocus on what the person values doing, using a short, kind and consistent response.
• Encourage normal activity. The NHS advises gradually returning to things the person has avoided, such as sport or socialising.
• Use distraction. A walk, a call to a friend or another activity can help when the urge to check strikes.

Recording and care planning

Write down what worries the person raises, what you did in response and how they felt afterwards, using neutral, factual language. Avoid labels such as attention-seeking. Review the pattern with the clinical team, so you can see whether worries are changing, whether a new physical symptom needs assessment, and whether the plan for responding is helping. Share the plan with night and agency staff so everyone answers in the same calm, consistent way.

What help is available?

The NHS advises seeing a GP if health worries are stopping you living a normal life or self-help is not working. A GP may refer people for a talking therapy, most often cognitive behavioural therapy (CBT), or offer medicine for anxiety. People in England can also self-refer to NHS talking therapies without a GP referral. Charities such as Mind and Anxiety UK may offer lower-cost sessions, and the BABCP and British Psychological Society directories list accredited therapists.

Looking after yourself

Responding to repeated worries is tiring. Share the load, agree consistent responses with colleagues, and ask for supervision if you find yourself becoming frustrated. Learnsignal's CPD library can help you plan learning around mental health and communication.

Frequently asked questions

Is health anxiety the same as hypochondria? It is the term the NHS uses today for persistent, disruptive worry about illness, and it is better understood as an anxiety problem than a character trait.

Should we keep reassuring the person? Brief, kind responses help, but repeated reassurance tends to keep the worry going. Follow the plan agreed with the clinical team.

What treatment works? According to the NHS, talking therapy, most often CBT, and sometimes medicine for anxiety.