What is health anxiety?
Although it’s normal to worry from time to time, when worry about your health is difficult to stop, despite reassurance from your doctor that your tests are normal, you may be dealing with health anxiety.
In this post I’ll explain what health anxiety is, what causes it and keeps it going, and some coping strategies for dealing with it more effectively.
Health anxiety, formerly known as hypochondriasis, is a condition in which a person becomes excessively worried or preoccupied with the idea that they are seriously ill, despite having no or only mild symptoms. This condition can be extremely distressing and can significantly affect a person’s quality of life.
In the most recent revision of the Diagnostic and Statistical Manual-5, the diagnosis of hypochondriasis was changed to Illness Anxiety Disorder, reflecting a growing understanding of the condition and its impact on individuals.
What’s the difference between health anxiety and OCD?
Some therapists and researchers consider health anxiety a form of Obsessive Compulsive Disorder (OCD). This is because the pattern of symptoms and the response to them can resemble OCD focused on other themes. Being preoccupied with bodily sensations is similar to the obsessions we see in other forms of OCD, such as contamination or taboo thoughts or superstitions.
Illness anxiety is also similar to OCD in that it is driven by uncertainty and doubt. Bodies are noisy, and it is normal to have occasional unexplained sensations of pain, pressure, or tension. Headaches, dizziness, numbness, or urgency to urinate are also normal experiences that come and go.
When we try to get explanations for fluctuations in how our bodies feel, we introduce doubt. Why did my heart feel like that? How can I know for sure that this isn’t a medical emergency? What if this is something serious and I’m ignoring it? Should I call my doctor?
Trying to answer these questions and spending time looking for answers only leads to more questions and more uncertainty.
Over time, normal sensations begin to trigger an internal alarm system that something is really wrong. Some people naturally have more sensitive alarm systems, but we can also inadvertently exacerbate this process by the way we deal with bodily sensations.
By responding to these symptoms as though they are signs of real danger, we reinforce the idea that they are dangerous. We begin to treat each change in how our body feels as very important and potentially meaningful, spending a lot of time analyzing them. This may cause us to notice even more sensations, leading to more alarms and more anxiety.
Doubt in health anxiety is very similar to doubt in OCD.
Is it normal to google my symptoms?
It makes sense that we turn to the internet to get information about things that scare us. Knowing the cause of symptoms and what we might do to relieve them can be helpful. The problem with this approach, though, is that it can become a go-to strategy to get rid of uncomfortable feelings.
As anyone who has ever searched the internet for health related information knows, though, this approach will quickly cause even more anxiety as we read more about the worst case scenarios. So we keep searching, looking for information that will calm us.
Other behaviors we often see related to health anxiety include:
- Seeking reassurance from other people, asking if they have ever had the symptoms and if they think the symptoms are serious
- Trying to figure out what the symptoms mean, comparing them to past symptoms or using logic to get certainty that they are not significant
- Body checking, scanning your body for symptoms or changes that might indicate something is wrong
- Avoiding activities that might cause unwanted symptoms or where it might be difficult to get medical help (for example, hiking or being in an unfamiliar place)
- Seeking medical tests, evaluations, scans or frequent appointments with medical providers
The issue with these responses is that while they may provide temporary relief from anxiety, they do not address the underlying cause of the worry. In fact, as soon as another concern arises, the same cycle of sensation, worry thought, anxiety, and response is initiated all over again. This repetitive pattern can lead to more doubt and uncertainty in the long run.
Is there treatment?
Becoming so focused on your body, its reactions, and what those reactions might mean can make you miserable. You may feel like you can’t focus on anything else because of your constant fear that something is wrong. It may be hard to focus on the present moment, and you may have trouble enjoying things in your life because you’re preoccupied with your symptoms. But there is hope! Cognitive Behavioral Therapy (CBT) and Exposure and Response Prevention (ERP) can free you from the cycle of anxiety and distress.
What does treatment involve?
Most people have had their unexplained symptoms checked out by a doctor before they begin therapy. They may have seen specialists or had multiple tests done, all with normal results. If you haven’t seen a doctor lately, it may make sense as a first step to get a physical exam and have some blood work done. If your doctor indicates that everything looks okay physically, it may be time to try a different approach.
Getting unstuck from health anxiety means learning a different response to anxiety. Instead of trying to make the anxiety go away by researching or checking or seeking reassurance, try doing nothing instead.
When the rush of anxiety shows up, first practice taking a deep breath. Then notice what’s happening. Identify the thoughts that are going through your mind and the effect those thoughts have on your body. Do you notice a rapid heart rate? Do you feel tension in your chest or butterflies in your stomach?
Try treating health anxiety as a false alarm. When your smoke detector goes off because you’ve just used the toaster, you don’t react with panic. You treat it as a false alarm, right? Remind yourself that this is an unhelpful cycle and that the first step is to practice allowing these thoughts and feelings to be with you.
If you’d like to learn more, Ken Goodman, LCSW, has a great interview video here where he describes more about strategies you can try. You can also learn more about Exposure and Response Prevention Therapy here.
If you have questions about this or would like to talk more with our intake coordinator, please call us at 314-462-2965 or click Contact to send us a message.