Health Anxiety in Children: It’s Real and Needs Our Attention

Picture 11-year-old Joseph. His grandfather recently passed away after a long bout of cancer. Unfortunately, it was not without pain and suffering, for which Joseph got a front row seat. Now, months after his grandfather’s passing, he has started to complain of body pains to his parents, his siblings and even teachers at school. His parents have taken him to his pediatrician several times but tests have shown that Joseph is perfectly healthy. But Joseph continues to complain and shares fears of his pains being a disease that could kill him.

Joseph is likely suffering from a common condition present in many people—once referred to as hypochondria, the more current term is “health anxiety,” and it can afflict children as much as adults.

Someone with health anxiety “lives with the fear that they have a serious but undiagnosed medical condition, even though diagnostic tests show there is nothing wrong with them,” said the Children’s Center for Psychiatry, Psychology and Related Services.

A new study conducted by Aarhus University and the Child and Adolescent Psychiatric Department found that health anxiety in children and adolescents can be a common occurrence. It also found that “children with recognized physical illness at the age of 11 have a particular increased risk of developing symptoms of health anxiety later in adolescence.” This information matches what we already know about health anxiety—that either a personal health occurrence or one in a close family member or friend can trigger the condition.

“Someone may develop health anxiety after becoming sensitized to health information or it may develop as an anxiety spontaneously,” said Lauren Soberon, Ph.D., a local licensed clinical psychologist with a private practice in Haile Village. For most parents, hearing a child express a symptom of illness triggers immediate worry and concern and experts advise parents not to ignore those feelings.

“Some anxiety symptoms can manifest very physiologically, which is often referred to as psychosomatic symptoms. They are very real but mediated by stress/anxiety and not other medical causes,” Soberon said. “However, physiologic symptoms should never just be ignored. Parents should take symptom complaints seriously and seek medical evaluation to rule out medical causes of symptoms. Once medical illnesses are ruled out and if symptoms persist, this may suggest more of a psychosomatic presentation.”

According to the Child Mind Institute, many times children with health anxiety may correlate a common everyday symptom with a more serious condition. For example, a child may think a simple headache (which could be caused by hormones or mild dehydration) means they have a brain tumor. Or a child may think a bruised knee equals hemophilia. They may seek out health information obsessively on the internet or ask questions frequently about health conditions.

It is important for parents to understand that even if their child isn’t experiencing true physical conditions, they are still suffering with real symptoms of anxiety and unrest, said the Child Health Institute. If left untreated, like any mental condition, symptoms can poorly affect a child’s overall health.

“Untreated health anxiety could potentially spiral into a more severe anxiety or mood disorder. For example, a person could become health-obsessed and begin washing their hands compulsively as an attempt to maintain health. Over time this could become a ritual tied to the need to create relief from their anxiety, consistent with obsessive compulsive disorder. Another example might be a person whose anxiety over their health lends them to isolating, staying home, withdrawing from society and relationships and becoming depressed, consistent with a major depressive disorder,” Soberon said. “Realistically, any untreated significant mental health symptom has the potential to develop into a more severe mental health symptom or disorder.”

These past 18 months have definitely sparked nervousness about health and sickness for everyone. COVID-19 anxiety has been reported in many adults, and this type of worry can spread to children in the family.

“With COVID, there has been a large amount of health information in our daily life, children have likely been overexposed to potentially alarming health information that they may not really understand. There is certainly the potential to become sensitized to health information in the context of the COVID crisis. Parents should be sensitive to the amount of health information they are discussing or viewing and should ensure that any information provided to children is age- appropriate. Giving children the opportunity to ask questions about health information they have heard also provides the chance for parents to reduce any misconceptions that might be anxiety provoking,” Soberon said.

Cognitive behavioral therapy (CBT) remains the recommended treatment for children who may be suffering from health anxiety. In this type of therapy, the child is taught to recognize the false beliefs that trigger their anxiety and teaches them coping skills to help them manage it, said the Children’s Center for Psychiatry, Psychology and Related Services.

“CBT works to reduce cognitive distortions (errors in thinking) and enhance appropriate behaviors and decision making. In the context of health anxiety in children, CBT can be effective in clarifying misinformation about health risk, reducing bodily hypervigilance and somatic symptoms through relaxation and stress management strategies and minimizing the burden that fears about health have created in a child’s life,” Soberon said.

Possible Symptoms of Hypochondria or Health Anxiety in Children
(from the Children’s Center for Psychiatry, Psychology and Related Services)

Regularly checking themselves for any sign of illness
Telling a parent or loved one about a new physical complaint almost every day
Fearing that anything from a runny nose to a gurgle in their gut is the sign of a serious illness
Frequently asking their parent to take them to the doctor
Asking to have their temperature taken daily (or more than once per day)
Talking excessively about their health Happily wearing bandages like badges of honor, has one on almost constantly
May focus excessively on things most children typically don’t: a certain disease (example: cancer) or a certain body part (example: worrying about a brain tumor if they have a headache)
Having frequent pains or finds lumps that no one else can feel
Fearing being around people who are sick