Excessive worry about having or developing a serious illness, disproportionate to any symptoms or medical findings. Also called illness anxiety disorder. Health anxiety is particularly common following life-threatening events such as [cardiac arrest](/glossary/cardiac-arrest/), and in people living with chronic conditions such as heart disease.
For ICD patients, health anxiety can manifest as excessive monitoring of physical sensations, repeatedly checking the device, fear of every [palpitation](/glossary/palpitations/) or twinge, frequent attendance at A&E, and difficulty trusting that the ICD is functioning correctly. Some degree of heightened body awareness after a cardiac arrest is normal and expected, but when it significantly affects quality of life, causing avoidance, disrupted sleep or inability to return to usual activities, psychological treatment is indicated.
[Cognitive behavioural therapy (CBT)](/glossary/cognitive-behavioural-therapy/) is the most evidence-based treatment for health anxiety and is available through NHS Talking Therapies services. Therapy typically involves understanding the cycle of anxiety and reassurance-seeking, gradually reducing checking behaviours, and building tolerance of uncertainty. [EMDR](/glossary/emdr-eye-movement-desensitisation-and-reprocessing/) may also be appropriate where trauma symptoms overlap with health anxiety.
Health anxiety is different from appropriate vigilance. Cardiac arrest survivors are advised to be aware of warning signs that need medical attention; the goal of treatment is not to eliminate all concern but to restore a proportionate relationship with those concerns. A referral to a [clinical psychologist](/glossary/clinical-psychologist-2/) or specialist cardiac psychology service can be requested via a cardiologist, cardiac nurse, or GP. See also: [PTSD](/glossary/post-traumatic-stress-disorder/), [Psychological Wellbeing Practitioner](/glossary/psychological-wellbeing-practitioner/).
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