Understanding illness anxiety disorder and the risks of Dr. ChatGPT
February 25, 2026
Madeleine N. Fuselier, graduate student researcher in Clinical Psychology at UT Southwestern, also contributed to this story.
A sudden surge in heart rate, a lingering headache, an odd bout of stomach cramps – we all have moments when a new sensation sparks worry about what might be wrong. And as we observed during the pandemic, going out in public can be very stressful for people who are worried about catching germs and getting sick.
For people with illness anxiety disorder, these worries can become a consuming cycle that affects daily life, relationships, and medical care.
Illness anxiety disorder was once known as hypochondria, a term that carries a stigma that the person’s symptoms are “all in their head.” In reality, illness anxiety disorder at its core is not about the fabrication of symptoms but instead about the excessive focus and time spent ruminating on the fear of getting sick and amplifying potentially minor symptoms into the worst possible scenario.
Illness anxiety disorder intensifies normal sensations; the brain amplifies how those symptoms feel or how threatening they seem. This creates misinterpretations and patterns of reassurance‑seeking that further drive the patient’s anxiety and wear down their peace of mind. Relationships with loved ones can become strained. Trust between patients and clinicians can erode.
Illness anxiety disorder sits at the intersection of physical health and mental health. A vital concept in treating this condition is accepting that multiple things can be true at once:
- A person may have real physical symptoms.
- Anxiety may intensify those symptoms or heighten awareness of them.
- Symptoms can exist but may not signify a more serious concern and may go away on their own with or without medical intervention.
Understanding how illness anxiety disorder starts and how it evolves can help interrupt anxious spirals and open the door to more effective care. With guided therapy and clinical treatment, patients can escape the “reassurance trap” and more confidently manage their health-related anxiety.
A complicated path to care
People with illness anxiety disorder typically seek medical care because something genuinely feels wrong in their body. Their experience of distress is real, even when the medical explanation is uncertain or difficult to identify. How they describe their symptoms is often shaped by prior medical encounters, particularly those that were frightening, confusing, or felt dismissive.
Over time, these experiences can influence which details patients focus on when speaking with clinicians. Emphasizing physical sensations or the most concerning possibilities may reflect an understandable effort to convey the seriousness of their suffering and to ensure they are fully evaluated. This pattern is best understood not as manipulation, but as a response to past experiences and a desire for reassurance, clarity, and safety.
As anxiety grows, a cascade of behaviors can reinforce this anxious cycle:
- Multiple doctor or urgent care visits.
- Switching providers in search of one who will confirm the diagnosis the patient believes they have.
- Skipping medical visits out of fear of what might be found.
- Avoiding social outings or public places out of fear of getting sick.
- Excessive rumination, replaying bodily sensations or trying to reason through worrisome possibilities.
These behaviors provide a short‑term drop in anxiety, but research consistently shows they also reinforce long‑term worry. This creates a powerful reinforcement loop: Reassurance lowers anxiety briefly, which strengthens the brain’s drive to seek reassurance again.
OCD applied to the body
Illness anxiety disorder shares several features with obsessive-compulsive disorder (OCD). At its core is intolerance of uncertainty – the distressing sense that something might be wrong and must be figured out immediately. Bodily sensations become the focus of obsessive attention, while behaviors such as checking, researching, or seeking reassurance function like compulsions. Studies suggest that as many as 60% of people who live with illness anxiety disorder also have another anxiety disorder or depression.
Technology adds fuel to the fire
Today’s technology provides constant feedback. Smart devices can deliver statistics about our heart rate, sleep cycles, and oxygen levels so frequently that normal fluctuations may appear alarming. Each new data point becomes another trigger to analyze and potentially worry about.
Searching symptoms online and self-diagnosing with AI tools can briefly ease anxiety, but the relief is temporary – and the answers can be off base. Chatbots like Gemini or ChatGPT can produce authoritative‑sounding explanations based on incomplete or misinterpreted information. For someone prone to health anxiety, this flood of information can be harmful, particularly when tools are designed to deliver certainty rather than a tolerance for ambiguity. Answers that are optimized to be satisfying are likely to amplify inner fears or biases.
In contrast, human doctors and therapists can identify and integrate what AI cannot: visual cues, tone, environmental context, medical history, and the nuances of how a patient describes their everyday experiences.
How ‘Dr. ChatGPT’ can drive health-related anxiety
A young, active mother notices a small area of facial numbness, followed by episodes of blurry vision and increasing fatigue. Concerned by these unfamiliar symptoms, she consults Google and ChatGPT and becomes worried about multiple sclerosis (MS). As her fear grows, she becomes more attentive to bodily sensations and seeks out symptom checkers and diagnostic tools in an effort to understand what is happening. Over time, her worry escalates to the point that it significantly interferes with her ability to concentrate on daily life.
After evaluation by multiple clinicians, MS is ruled out and she is diagnosed with acute migraine headaches. This outcome is difficult to absorb, particularly as her earlier research seemed to support a more serious neurological explanation. Although she feels relief, she is also distressed by the prolonged period of fear and uncertainty she experienced.
Rather than minimizing this reaction, the provider can validate that her symptoms were real and genuinely alarming. They can explain that migraines can produce neurological symptoms such as numbness and visual changes, and that heightened anxiety can intensify bodily sensations and draw attention to them, making them feel more severe or persistent. Framing the experience this way helps acknowledge her suffering, reduces shame, and supports a clearer understanding of how physical symptoms and anxiety can interact.
Validation without dismissal
In diagnosing illness anxiety disorder, it is essential that the patient feels validated in their emotional and physical experiences. Anxiety can produce real physiological effects, including elevated heart rate, muscle tension, dizziness, and pain. These sensations are not imagined, and they can be genuinely frightening. Patients often arrive at our clinics after seeing a carousel of specialists who may give conflicting information that deepens their frustration.
It is also important to remain attentive to both personal and systemic biases in medical care. Many patients, particularly women and women of color, report repeated experiences of having their physical symptoms minimized, attributed to stress, or not taken seriously. These encounters can leave a lasting impact. When someone has previously been ignored or invalidated, reassurance that “nothing is wrong” may feel unsafe rather than comforting.
In this context, illness anxiety disorder can develop alongside a well-learned vigilance: the belief that symptoms must be emphasized or defended to receive appropriate care. Resistance to a benign medical explanation is often not a rejection of the clinician but a reflection of past medical trauma and a fear of being overlooked again. Recognizing this history helps frame the patient’s response as adaptive within their lived experience and underscores the importance of validation, careful explanation, and collaborative care – especially for patients whose voices have historically been discounted.
Reframing patient-provider discussions
If a physical exam and appropriate testing do not reveal a serious illness, exploring how anxiety may be contributing becomes a next step – not a dismissal. Reframing the conversation helps patients feel heard rather than labeled. The goal is not to replace a physical explanation with a psychological one but to acknowledge that health and mental health are deeply intertwined.
Clear communication among providers, particularly between primary care and mental health clinicians, can reduce confusion and conflicting messages. When everyone is aligned, patients are more likely to feel supported and less likely to continue searching for answers elsewhere.
Evidence-based treatments can break the cycle
Effective treatment blends psychotherapy, behavior change, and, in some cases, medication. We focus on changing the relationship a person has with their symptoms, not eliminating sensations entirely.
Options for treatment
Cognitive behavioral therapy (CBT)
CBT helps patients understand how thoughts, emotions, and behaviors interact, identify unhelpful thinking patterns, and reduce behaviors that keep anxiety going. For illness anxiety disorder, CBT might include:
- Identifying catastrophic thinking patterns
- Challenging cognitive distortions
- Understanding how anxiety creates physical symptoms
- Learning distress‑tolerance skills
- Reducing checking and reassurance‑seeking behaviors
Exposure and response prevention (EXRP / ERP)
ERP or EXRP is a specialized form of CBT. The patient is guided to gradually confront feared sensations or situations, such as noticing a racing heart, without engaging in reassurance-seeking behaviors like checking their heart rate on their smart device. This highly effective approach helps rewire the brain’s threat‑response cycle and reduces hypervigilance to bodily sensations.
Acceptance and commitment therapy (ACT)
ACT adds another layer, teaching patients to tolerate uncomfortable thoughts and physical sensations without trying to eliminate them. Rather than arguing with anxiety, patients learn to acknowledge it and redirect attention toward meaningful activities.
Patients learn how to:
- Allow uncomfortable sensations or thoughts to be present
- Separate themselves from their anxiety (“I am noticing my worry”)
- Make choices based on values instead of fear
- Practice mindfulness and body acceptance
Medication
Medications, most often selective serotonin reuptake inhibitors (SSRIs), can reduce overall anxiety, but treatment may be complicated by heightened sensitivity to bodily sensations or perceived side effects.
Sitting with uncertainty
For individuals who have become overdependent on seeking reassurance or have frequent doctor visits, disengaging from these patterns can be therapeutic. For example:
- Feeling a mild symptom and choosing not to immediately check vitals
- Waiting before sending a MyChart message
- Redirecting attention toward valued activities or family time
Small acts like these help patients build tolerance for uncertainty, which is the core skill needed to disrupt illness anxiety.
How to support a loved one without fueling the cycle
Family and friends often struggle with how to respond. Reassurance may calm a person’s fears briefly, only for them to return stronger than before. Instead, acknowledge the distress rather than automatically offering reassurance or debating their symptoms.
For example, try the "mirror technique.” When your loved one asks for reassurance, respond with a question: "What do you think I am going to say?" This approach shifts focus from the feared illness to the anxiety itself.
Over time, the goal is for the patients to learn to handle uncertainty and soothe themselves with less external validation.
Moving from fear toward clarity
Illness anxiety disorder is not about attention‑seeking or dramatizing symptoms. It’s a complex interaction of real sensations, past experiences, and anxiety‑driven interpretations.
With thoughtful diagnosis, coordinated care, and evidence-based treatment, people can stop the cycle of fear and regain trust with their doctors and themselves. Our role is to help patients understand their bodies more accurately, respond to sensations with less worry, and most importantly, feel heard and not labeled as they work toward long‑term recovery.
To talk with an expert about illness anxiety disorder, make an appointment by calling 214-645-8500 or request an appointment online.
