Health Anxiety: When being health conscious becomes a problem

It is good to be conscious of your health and wellbeing. If you are, it is almost impossible not to be aware of messages about growing public health concerns everywhere in the media. And this is a positive thing: a little bit of worry might encourage you to visit the doctor to get checked out. General concern for your health might also be the impetus for other healthy life choices, such as wearing sunscreen, eating well, and exercising.

With all this increased awareness about what can go wrong, it’s natural to feel nervous about your health from time to time. You might notice a change in the way your body looks or feels, and become worried that this is a sign of an illness. You might have also turned to ‘Dr Google’ for some answers, only to find that the sheer volume of information made you even more anxious than before! Usually, this worry is short-term, and it goes away after a reassuring visit to the doctor, or once the symptoms have cleared up.

However, some people find that they worry a lot about their health, to the point that it becomes overwhelming and disruptive to their lives. This is sometimes referred to as health anxiety, or illness anxiety disorder.

What is health anxiety?

Health anxiety can be very scary, and it is exhausting to feel so worried all the time. Health anxiety is characterised by excessive worry about illness. People with health anxiety are hyperaware of any changes in their body, and often interpret any change as a symptom of a serious disease. This might be fear of having cancer, STIs, neurological issues, heart problems, or viruses like HIV/AIDS. This worry is usually persistent and distressing, and can be associated with the following behaviour:

•       Repeatedly checking your body for symptoms.

•       Continually seeking reassurance from family and friends or medical professionals. This might provide a temporary sense of reprieve from the constant worry.

•       Avoiding the doctor completely out of fear that a serious illness will be diagnosed.

•       Feeling so preoccupied with worry that it is difficult to concentrate on work and other everyday activities.

•       Persistent worry even after a visit to the GP.

•       Obsessively using resources such as the Internet to research symptoms.

•       The worry itself can also trigger physical symptoms of anxiety, such as a racing heart and perspiration, which can in turn be interpreted as further evidence of an underlying illness.

People with health anxiety often really do have an unexplained physical change or symptom. In other words, the source of their fear isn't necessarily "all in the head". However, an unhelpful process occurs in health anxiety, where even though the symptom might be real, it is often interpreted as more dangerous and threatening than it really is.

Frequently, people experiencing health anxiety require certainty, and find it very difficult to be able to sit with an unexplained symptom, even if they have been assured that it is not dangerous.

People may also experience health anxiety in the absence of any physiological symptoms. This might manifest in a continual feeling of dread, and the inability to stop thinking about sickness.

How do I know if the way I worry about my health is a problem?

·       It is long-lasting and reoccurring.

·       Your anxiety is out of proportion to the threat posed by the symptom.

·       It is causing you distress.

·       It is impacting your life and taking up your time. For example, constant reassurance-seeking is affecting your relationships, your school or work performance is declining, you are absent from work or social engagements due to medical appointments, or, you are seeking second, third, fourth and fifth opinions for the same issue. 

Health anxiety is often caused and maintained by certain patterns of thought. This includes thoughts about what "health" should look and feel like, and overestimation of the likelihood of contracting a serious illness.

People with health anxiety also find it hard to believe information that would ordinarily be reassuring or contrary to their worry. For example, they might get a test result which discounts a specific illness. While this should be a comforting outcome, a person with health anxiety might doubt the accuracy of the test, or worry that the doctor has missed something.

How can I manage health anxiety?

·       Try to postpone your worry. Say to yourself I will check back in on this in one week, and will worry about it then. Set a reminder in your phone, and remind yourself that you aren’t going to worry until it’s time. When your “worry time” arrives, assess how necessary it is to still be worried, and decide if you would then like to visit your doctor.

·       Similarly, you can reduce your checking by postponing according to medical advice. Ask your doctor for guidelines on how often you should get a health examination, how often you should check parts of your body (e.g. moles and breasts), and how long they advise you wait to get a new symptom checked out.

·       Practice focusing your attention. It can take time to get better at this. Start with everyday jobs around the house, like cleaning the dishes or folding clothes, and practice keep your mind focused on the task at hand. This will help you to redirect your mind from worrying about health issues when these come up for you.

·       Rethink your beliefs about health. Often people with health anxiety have fixed views about health and illness, for example, I must be completely free of symptoms or I am not healthy, or, my doctor must be absolutely certain that I am not sick. It can be helpful to review these thinking patterns, and adopt a more flexible way of understanding health, for example, I know my doctor can’t always be 100% sure, but I will trust their knowledge and experience.

Where can I get help?

Firstly, it is a good idea to check in with your GP, and talk about the concerns you are having. A supportive GP can talk you through your symptoms, and will be able to advise if further investigation is needed.

A psychologist can also help you to work through unhelpful ways of thinking that lead to anxiety and worry. Cognitive Behavioural Therapy (CBT) is a therapeutic approach that can help you to learn strategies for coping with worry and behaviours like checking and reassurance-seeking. Another approach, Acceptance and Commitment Therapy (ACT), helps people to sit with the uncertainty of health anxiety. Many psychologists use elements of both these therapies in combination.

Resources

•       http://www.cci.health.wa.gov.au/resources/infopax.cfm?Info_ID=53

The Centre for Clinical Interventions has an evidence-based workbook for managing Health Anxiety. You may find some helpful strategies here for managing some of your symptoms. However, it is important to also seek professional support alongside any self-help module to help with applying the concepts to your unique situation.