Let’s Talk About Health Anxiety

I’ve been getting a lot of calls lately asking if I treat health anxiety (I do!). My colleagues around the country are seeing it, too, and I’m also seeing more symptoms increase in my current clients.

It’s not all that surprising, given we’re living through a pandemic.

As a society, the COVID-19 pandemic has forced us to pay attention to every sneeze, every cough and certainly any temperature over 100. For many of us, this was the first time we’d paid attention to our body so acutely. For those with health anxiety, COVID-19 has probably, as one person put it, taken their worries up a notch.

What is Health Anxiety?

In the most basic sense, health anxiety is just what it sounds like: excessive worry about our health, usually our own, despite not having any symptoms (or experiencing minor ones like a throat tickle). Medically, it goes by numerous different names each with its own traits (e.g., illness anxiety disorder, health anxiety OCD, somatic symptom disorder, hypochondriasis).

Its symptoms are familiar to anyone who deals with uncomfortable anxious thoughts and feelings: lying awake at night worrying about what might happen, dizziness, feelings of being unattached, headaches, nausea, and the like.

While health anxiety gets its name from the content of the worry, from a treatment standpoint, the content doesn’t matter. It’s about how you’re relating to those thoughts, feelings and sensations.

Health Anxiety Treatment

In treating health anxiety, we talk about the same process we do for all anxiety disorders. We work on becoming mindful of our experience: acknowledging how we’re feeling physical and emotionally. Rather than try to get it to go away, we become willing to feel those feelings, sensations and thoughts — this is the hard part — without judgment.

It’s uncomfortable (it sucks sometimes, for sure, especially in the beginning when we’re first learning this new response). But we want to learn how to respond intentionally instead of reacting to our fears. Exposure-based treatment shows you how to let the symptoms be there without engaging in a compulsion, ritual or safety behavior that truly only gives temporary relief. When we engage in these behaviors, we keep the cycle going. Then, every time a thought or fear pops up (which can be often), you’ll have to engage in more and more compulsions to satisfy the ever-expanding fears.

Ultimately, we’re getting better at being uncertain and uncomfortable. This teaches the brain that we can be uncertain and uncomfortable while we live life.

“But does that mean I neglect my symptoms?”

Great question. No, we don’t ignore them. We acknowledge them and right-size our response. In health anxiety, someone’s interpretation of what a symptom must mean isn’t in proportion to the probability of what it might mean.

For example, your brain may tell you that your headache is a sign of brain cancer. Or that cough you just experienced? It’s COVID, and you’re going to die. Rather than search the internet for brain cancer symptoms, we acknowledge that we’re uncomfortable and move on, being “sure enough” that it’s just a headache and not something catastrophic.

How Do I Know If I Have Health Anxiety?

So many people are anxious about their health right now and knowing when it’s excessive can be confusing. To be clear, only a licensed therapist can make a diagnosis. If you think you might, I highly encourage you to seek professional help.

Common Health Anxiety Obsessions

  • What if this is a sign that I’m getting worse?
  • Did I explain everything to the doctor?
  • What if I forgot to tell them something?
  • What if they missed something?
  • What if it’s so rare they can’t help me?
  • What if I give it to someone else?
  • What if I don’t act quickly enough and it spreads?
  • What if I make the wrong decision?
  • How do I know I’m making the right choice?
  • How do I know if this is nothing or something more? I feel worse so it must be.
  • It’s not about me. It’s about keeping other people from getting sick. Seeking reassurance from friends/partners

Common Health Anxiety Compulsions

  • Googling symptoms
  • Excessive visits to the doctor
  • Mentally reviewing events/symptoms to figure out the meaning of symptoms
  • Symptom checking and comparing
  • Hypervigilance to sensations/symptoms
  • Avoiding places/situations where exposure might happen
  • Self-reassurance that you did everything possible
  • Replacing “bad or sick thoughts” with “good or healthy” thoughts

Looking for a therapist? If you live in Ohio, please reach out. If you’re out of state, check out the IOCDF or ADAA websites for providers in your area.