Hypochondriasis and obsessive-compulsive disorder (OCD) have many similarities, with underlying anxiety being at the root of both conditions. In response, many types of “safety behaviors” may be shared by both disorders. In contrast, there are important differences as well. Let’s begin by noting the ways in which they differ, as distinguishing these conditions is important in finding the best treatment.
How Hypochondriasis and OCD Differ
There are several differences between obsessive-compulsive disorder (OCD) and hypochondriasis. Some of the more common differences include are listed here.
Focus on Obsessions vs Specific Concerns
The biggest difference between OCD and hypochondriasis is the focus of the person’s worry and anxiety. People with OCD have obsessions that relate to a variety of themes, such as contamination, sexuality, religion, personal harm, or morals. In contrast, people with hypochondriasis have obsession-like concerns primarily related to their health. These concerns often have to do with developing a serious medical condition, such as cancer. (Nosophobia, or “cyberchondria,” is the fear of having a specific disease.)
Preoccupation With Physical Sensations
People with hypochondriasis are often preoccupied or even consumed with bodily symptoms that can be quite vague, like “my heart is tired," or very specific, such as “my throat is always sore." People with OCD are generally less preoccupied with physical sensations.
Type of Help Sought: Medical vs. Psychological
People with hypochondriasis often have difficulty accepting that their problems are anything but physical, and as such, seek medical rather than psychiatric or psychological help. On the other hand, people with OCD are much more likely to seek psychiatric or psychological help for the intense anxiety or distress caused by their symptoms.
Awareness and Insight
In general, people with hypochondriasis have less awareness or insight as to the irrationality of their fears than people with OCD. A person with OCD will often seek psychological treatment after recognizing the symptoms. A person with hypochondriasis, in contrast, will often have a medical professional recommend psychological treatment.
How Hypochondriasis and OCD Are Similar
Though the differences between OCD and hypochondriasis exceed the similarities, there are some characteristics that remain similar between the two. Important similarities are listed below.
Ways of Reducing Anxiety
Just as people with OCD often use compulsions or rituals, such as counting, checking, ordering or washing, to reduce anxiety related to obsessions, people with hypochondriasis will often try to reduce anxiety about their health by taking their pulse or checking their blood pressure. People with hypochondriasis may also frequently seek reassurance from doctors, family or friends to reduce anxiety about their health.
Impact on Life, Relationships, and Work
For both those who are living with OCD and those with hypochondriasis, the distress and worry are often so intense that there is a severe impact on interpersonal relationships and/or performance at school or work.
Safety Behaviors
Whether a person has OCD or hypochondriasis, safety behaviors, such as checking or seeking reassurance, are used to prevent a feared outcome, or to reduce distress and anxiety. The safety behaviors feel good and are therefore used again and again. Safety behaviors actually maintain the fear and anxiety they are supposed to prevent because they keep the person from having new experiences that could help disprove their worries. For example, constantly running to the doctor for reassurance at the first sign of a stomachache does not allow a person with hypochondriasis to learn that dangerous symptoms often go away on their own. For someone with OCD, constantly ordering shirts in the closet to prevent the death of a loved one will never allow them to learn that their loved one will be OK despite having not performed the ritual. For this reason, psychological therapies for both OCD and hypochondriasis specifically target these kinds of rituals and compulsions.
A Word From Verywell
Only a qualified mental health professional should diagnose a complex illness, such as OCD or hypochondriasis. Extensive assessment is often required to arrive at the correct diagnosis. The treatment you receive is very much tied to your diagnosis, so it is essential that you are diagnosed correctly.
