ANXIETY DISORDERS
Health anxiety
The tests say everything is fine, and the relief lasts two days.
The tests say everything is fine. But every symptom makes me think of the worst possible illness.
Health anxiety: when the body becomes something to police
Everyone notices their own symptoms. The difference is what happens after noticing.
In health anxiety a bodily sensation doesn't stay a sensation: it immediately becomes a diagnostic hypothesis, and the hypothesis always leans toward the worst available explanation.
A headache isn't a headache. An irregular heartbeat isn't an irregular heartbeat. Every signal gets read as the possible beginning of something serious, and from there the checking starts.
The central point is this: the body produces sensations constantly. Anyone monitoring will always find some. Not because they're less well than anyone else, but because they're looking.
Why reassurance doesn't hold
A clear test result should close the question. It doesn't, and that confuses both the person living it and everyone around them.
The relief does arrive, and it's real. But it's short: a few hours, a few days. Then a doubt returns — what if they looked at the wrong thing, what if it's too early to show, what if that borderline value means something.
The reason is that reassurance answers the wrong question. The question isn't "am I ill?". It's "can I be certain I'm not?". And no test can answer that, because absolute certainty doesn't exist in medicine.
So every reassurance teaches one thing only: that being calm requires a check. And next time it will require another.
Checking: searching online, examining, measuring
The checks take different forms and all share the same structure.
Searching symptoms online. Repeatedly examining the same area. Taking blood pressure or pulse several times a day. Asking family whether you look pale. Comparing a photo from today with one from six months ago. Booking appointments, or postponing them out of fear of what they'd say.
Each of these lowers anxiety for a few minutes and raises it straight afterwards, because none can produce the certainty being sought.
Online searching deserves a note of its own: it's built to show matches, not to weigh them. Searching a symptom always returns the worst diagnosis that includes it, alongside the others.
Hypochondria and anxiety
"Hypochondria" is the traditional term, and it's still what many people use to describe themselves. Current diagnostic manuals have changed the category's name, but the picture is the same: persistent health worry, out of proportion to medical findings, with checking behaviours or, at the opposite extreme, total avoidance of medicine.
It's an anxiety disorder and behaves like one: an alarm that fires, an interpretation that feeds it, and strategies that maintain it while appearing to reduce it.
When to speak to a doctor instead
This needs saying plainly, and it's why this page takes no position on any reader's symptoms: medical assessment comes first.
Psychological work isn't there to establish whether a symptom has a physical cause — that isn't within my competence and never will be. It's for when the investigations have been done, the clinical assessment exists, and the worry continues anyway.
If the investigations haven't been done, that's the first step.
Health anxiety therapy in English in Milan and Monza
I'm an Italian psychologist and psychotherapist, registered with the Order of Psychologists of Lombardy, working in English and Italian, in two practices in Milan, in Monza, in Cernusco sul Naviglio, and online.
Health anxiety is often harder abroad. An unfamiliar health system, uncertainty about whether you've been understood in a second language, results explained in terminology you can't fully weigh, and no GP who has known you for twenty years — all of it makes reassurance thinner and doubt easier. That's worth naming rather than treating as background.
The first session is about reconstructing the picture: how long, which symptoms, which investigations have already been done, and what you do when the worry arrives.
The work then concerns three things: reducing the role of checking, changing how bodily sensations get interpreted, and building tolerance of uncertainty — which is the real knot, because the certainty being sought isn't available.
When it makes sense to ask for help
— How much of my day goes into checking how I am?
— How long does the relief after a test last?
— Have I searched symptoms online in the last week?
— Do I avoid doctors, or seek them more than necessary?
Frequently asked questions
Because reassurance answers a different question from the one being asked. A test says what wasn't there at that moment; it can't give the absolute certainty being sought, and that search is the mechanism the work addresses.
In everyday use, yes. "Hypochondria" is the older term; current classifications use different names but describe the same pattern.
That isn't my decision to make, and it doesn't concern check-ups your doctor has prescribed. It concerns checks done to lower anxiety, which are a different thing and are addressed gradually.
Dr. Giuseppe Iannone — Psychotherapist
FIRST STEP