All kids fake sick… or at least think they’re sick when they’re actually fine. Whether it’s to play hooky from school or because they’re so nervous about an upcoming test they make themselves feel sick (relatable), every parent has had to play the little game in their head of “Is This Legit?” when it comes to a child complaining about a headache or an upset tummy. But you know your kid — and if their complaints start getting more intense or more frequent, you may be worried your kid is a hypochondriac. But how can you tell if your kid has hypochondria? What’s the difference between a child who shares every twinge they feel in their stomach with you and a child who is genuinely a hypochondriac, convinced they’re sick?

Luckily, it’s not too hard to figure out — and therapy will truly help a child suffering from hypochondria, Alex Goodwin, a family therapist and high school guidance counselor, tells Scary Mommy. “Hypochondria can be debilitating, but I also don’t think it’s as prominent as parents believe. Chances are, your child’s suffering more from general anxiety, and their anxiety is often focused on their health rather than a full-blown hypochondria diagnosis.”

What is hypochondria?

Hypochondria is a chronic illness anxiety disorder. People with hypochondria have a persistent fear that they are ill or going to become ill, even if they have zero symptoms. (Having a few symptoms, even something as simple as a sore throat, may have a person experience their hypochondria by convincing themselves they have throat cancer or some other larger illness.)

Everyone is prone to experiencing health anxiety (who among us hasn’t thought “brain tumor” the minute you have a headache?), but hypochondria isn’t just something you can shake off. Those who have this disorder may find it hard to concentrate on literally anything else in their lives because they are so worried about their health. It can affect jobs, relationships, their general day-to-day life — it’s all-consuming.

People with hypochondria might spend all day researching diseases and disorders. They may avoid going somewhere for fear of catching germs, or constantly take their temperature and check their own vital signs to make sure they aren’t sick. It’s incredibly intense.

But the good news is that hypochondria is rare. The Cleveland Clinic reported that about 0.1% of people in the U.S. are affected by this, and it’s a disorder that often comes up in adulthood.

Can kids have hypochondria?

In the way that anything is possible, sure, Goodwin says. But generally, a kid being worried about getting sick isn’t quite on the same level as someone with a hypochondria disorder. When you really think about your kid’s fears — maybe worried about getting a shot at the doctor if they’re sick, or feeling sick over a math test and convincing themselves they have the flu — it can often be attributed to anxiety. “If your child is worried about their headache, but the worry seems to disappear when the headache is gone or after a rest or when they get to stay home from school and relax, that’s not hypochondria,” Goodwin says. Now, if your child refuses to go to school for fear they’ll catch a cold that will turn into pneumonia and then they’ll end up in the hospital? “It might be time for therapy,” he says.

“Hypochondria is a type of anxiety disorder,” Goodwin adds. “But not all people who suffer from hypochondria also have general anxiety, and not all people who experience general anxiety have it present itself as hypochondria.”

In a lot of instances, it’s not that your kid has a full-blown hypochondria disorder; sometimes, it’s that the anxiety they experience makes them feel ill, and this, in turn, can make them worry that they’re actually sick. “Racing heart, pain in the chest, nausea, sleep deprivation — these are all things that can be attributed to anxiety and can then make you feel like something is really wrong,” he says. “Obviously, you should take a kid to the doctor if you think something really is wrong or if it might help reassure them — don’t just dismiss their fears — but therapy can really help for the anxiety.”

My own daughter had an experience like this. She was thoroughly convinced her heart wasn’t beating, and even after having us feel her pulse and time it for her and seeing her pediatrician, who gave her a full exam and checked her heart rate and blood pressure, she was still crying in her bed at night. We reached out to her school counselor, and they were able to give her some coping mechanisms that she still uses two years later.

“Sometimes kids do well with more information,” Goodwin says. “A lot of anxiety presents itself in kids because they just don’t know what’s coming next. So one small thing, like thinking that their heart isn’t beating, allows them to spiral. If you think your kid is suffering from any kind of anxiety, it’s worth reaching out to your pediatrician for a therapist recommendation.”

And, you know, maybe let them stay home from school once in a while. It’s not hypochondria, but a day on the couch with Mom can do wonders for just about anyone’s anxiety.