Identifying and Treating Health Anxiety

What is health anxiety?

Worry about your physical or mental health from time to time is normal. When the worry is really difficult to stop, despite reassurance from your doctor that your tests are normal, you may be dealing with illness anxiety.

Anxiety about health was previously known as hypochondriasis. In the most recent revision of the Diagnostic and Statistical Manual-5, that diagnosis was renamed as Illness Anxiety Disorder. 

Some therapists and researchers consider illness anxiety a form of Obsessive Compulsive Disorder (OCD). Why? Because the pattern of symptoms and the response to them can look a lot like OCD focused on other themes. Being preoccupied with bodily sensations is a lot like the obsessions we see in other forms of OCD, like 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. It’s 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 in fact 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.

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
  • 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 problem with these responses is that the relief from anxiety they provide is temporary. As soon as another worry shows up, the cycle starts all over again: sensation, worry thought, anxiety, response, temporary relief. In the long run, these responses actually trigger more doubt and uncertainty. 

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 health anxiety 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 this 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 free webinar hosted by the Anxiety and Depression Association of America that can get you started. 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 your care coordinator, please call us at 314-462-2965 or click Contact to send us a message.