HEALTH ANXIETY

We all know the importance of staying in good health and the impact that poor health can have on our lives. So, it makes sense to experience worries from time to time about becoming sick. However, when these general concerns shift to more constant, intense worries, that take up a lot of time and interfere with daily life, it may be a sign that you are experiencing health anxiety.

WHAT IS HEALTH ANXIETY?

Health anxiety is quite different from regular concerns about our health that most of us have. When the concerns cause so much distress, when we become preoccupied with these health concerns, and when they start to interfere with daily life, then it’s likely you’re experiencing health anxiety. Incidentally, health anxiety is not a diagnosis in and of itself. Instead it is a common feature of several other disorders including Somatic Symptom Disorder and Illness Anxiety Disorder (DSM-5) [1].

Features of HEALTH ANXIETY (DSM-5) [1]:

• Excessive worry about having a serious illness. This worry is:

  • Out of proportion to the actual likelihood of having a serious medical condition;

  • Persistent, despite reassure from medical practitioners.

• Unhelpful behaviours such as:

  • Frequently checking your body for signs of illness (e.g. lumps or pain), or repeated medical tests and consultations

  • Obsessively looking at health information online or in the media (e.g. Dr Google)

  • Avoiding anything to do with serious illness (e.g. avoiding hospitals)

BUT WHAT IF I’M ACTUALLY UNWELL?

Health anxiety is often triggered from noticing physical sensations or changes in our bodies (e.g. experiencing a headache, and thinking this may be the sign of brain tumour). It can also come from stories we hear about illness in the media, or from our loved ones’ experiences of sickness.

Importantly, health anxiety can be a problem for people who are perfectly healthy, as well as for those who do have diagnosed, medical conditions. The main feature of health anxiety is not so much about your health status, but rather how you respond and manage your symptoms and experience.

HEALTH ANXIETY SYMPTOMS

When looking out for the signs of health anxiety, there are three groups of symptoms to be aware of – cognitive, physical, and behavioural. Here’s what these may look like in health anxiety:

COGNITIVE SYMPTOMS OF HEALTHY ANXIETY

At the core of health anxiety is a fear of becoming seriously ill, accompanied by persistent worries about this. This can lead to the development of several unhelpful thinking patterns including:

• Overestimation of the likelihood of becoming unwell

• Catastrophic interpretations of normal physical sensations (e.g. noticing an increase in heart rate and interpreting that as the sign of a heart attack).

• Black and white thinking, where the person only believes they are healthy if all of their symptoms have entirely gone, otherwise they are seriously unwell.

 For more on catastrophising and black and white thinking styles, check out our blog post on Thinking Styles that Sabotage your Mental Health.

PHYSICAL SYMPTOMS OF HEALTH ANXIETY

The symptoms of anxiety can have very real physical effects, such as increased heart rate, feeling dizzy, or even nausea (You can read more about the physical symptoms of anxiety over at our page on Panic Attacks and Panic Disorder). These are all normal and harmless physical reactions, but in health anxiety they can be misinterpreted as further evidence that there is something seriously wrong. This can create a vicious cycle of anxiety, that can be very difficult to break.

BEHAVIOURAL SYMPTOMS OF HEALTH ANXIETY

It is common for people experiencing health anxiety to spend lots of time checking their bodies for changes or signs and symptoms that might be related to health concerns. While this might seem like an important step in staying well, spending lots of time focusing on physical sensations can make it more likely you will notice subtle changes or sensations that would normally be ignored.

TREATMENT FOR HEALTH ANXIETY

When considering treatment for health anxiety, the following options may be useful:

• MEDICAL REVIEW. Prior to commencement of any treatment it is important to first of all rule out any possible medical problems by having a medical review.

• COGNITIVE BEHAVIOURAL THERAPY (CBT). Cognitive Behaviour Therapy is effective in treating health anxiety [3]. CBT focusses on challenging unhelpful interpretations of bodily sensations, so that these can be viewed in a less anxious manner. CBT also teaches people how to reduce the amount time spent doing problematic behaviours like seeking reassurance and checking symptoms, so that there is more time for the things they enjoy.

• MINDFULNESS-BASED COGNITIVE THERAPY. Like many other ‘new wave’ therapies, Mindfulness-Based Cognitive Therapy draws its foundation from CBT. Unlike CBT, which typically involves directly challenging appraisals and interpretations, Mindfulness-Based Cognitive Therapy teaches the person to change their relationship to their thoughts. This means that distressing thoughts have less power over the person.

• PSYCHOPHARMACOLOGY. At times, health anxiety can seriously interfere with daily life. In these cases, medication can be used to control some of the physical symptoms of anxiety, which can make engaging in ‘talking therapy’ a lot easier to manage. It is always important to talk to your GP about your medication options.

If you think health anxiety may be impacting you, why not Contact Us for a tailored approach?

REFERENCES

[1] American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington: American Psychiatric Publishing.

[2] Furer, P. & Walker, J.R. (2014). Health anxiety and somatization. In A. Carr & M. McNulty (Eds)The Handbook of Adult Clinical Psychology (2nd ed, pp. 607-634). New York: Routledge.

[3] Cooper, K., Gregory, J. D., Walker, I., Lambe, S., & Salkovskis, P. M. (2017). Cognitive behaviour therapy for health anxiety: A systematic review and meta-analysis. Behavioural and cognitive psychotherapy, 45(2), 110-123, doi: 10.1017/s1352465816000527