Worried About Your Health? Understanding Health Anxiety

Have you ever found yourself feeling anxious whilst waiting for your latest blood test results, or worrying about the size of a new lump you’ve noticed on your body?

Nearly every person experiences a level of worry about their physical health at some point in their lives. To some extent, a mild level of temporary anxiety about our health is actually very helpful. For example, if you notice a new symptom such as a sore throat and are worried about it, this increases the likelihood that you will visit your GP for a check up, and perhaps find out that you need to start a course of antibiotics to prevent it from worsening. So, in these circumstances, being worried about our health actually helps us to protect ourselves.

However, for some people, worries about one’s health can be distressing, ongoing and pervasive. If that’s the case for you, you may be struggling with a psychological condition called health anxiety.

What is Health Anxiety?

Health anxiety is characterized by a preoccupation about your or your loved ones’ health, or anxiety about developing a medical illness or a worsening condition. Individuals with health anxiety often find it hard to ‘switch off’ worries about their or others’ health, making it difficult to focus on their day-to-day life at home, school or work. Health anxiety also involves a range of behaviours such as:

• Excessively checking for bodily changes or new symptoms
• Monitoring of bodily processes (e.g. frequently checking your pulse or blood pressure)
• Frequent visits to your GP or specialists for more tests or second opinions
• Googling and researching symptoms or diagnoses
• Seeking reassurance from family or friends about symptoms
• Avoiding medical check-ups or talking about health-related information

It is important to understand that health anxiety can occur regardless of whether you are physically healthy, you are experiencing ongoing but unexplained medical issues, or you have a diagnosed medical condition. So, whether or not you have ‘real’ health issues is not the problem with health anxiety – instead, the majority of the distress often comes from how you are responding to and coping with your health concerns.

The Vicious Cycle of Health Anxiety

At the core of health anxiety lies a range of unhelpful beliefs or assumptions about one’s health. Some of these beliefs may include “if I don’t keep having more tests, I might miss something important” or  “if I’m not checking, my symptoms could be getting worse”. Some individuals may also hold more concrete rules or criteria such as “I need to have every symptom explained by my doctor” or “I can’t rest until I get a diagnosis”. Whilst you might be aware of these beliefs, the often automatic and deeply ingrained nature of these thoughts can make it difficult to notice when they pop up. These health beliefs then drive us to engage in some of the health behaviors such as checking or reassurance seeking because they provide us with a sense of temporary relief from our worries and the uncomfortable feelings of anxiety.

However in the long run, these behaviors actually serve to increase the likelihood of you experiencing further anxiety. For example, being reassured by your GP may make you feel better for a while, however in the long run, constantly seeking reassurance about every new symptom will make it difficult to tolerate any level of uncertainty about your health – as well as being time consuming and potentially expensive. Similarly, whilst monitoring your body for new symptoms seems like the best thing to do if you’re worried, this can actually increase your anxiety as you become even more focused on your body. For example, have you ever thought about buying a new car, and then suddenly started noticing all the cars around you – the brand, color and even small details like the shape of the indicator lights? In a similar way, focussing your attention on your symptoms may increase our awareness—and thus anxiety about—many of the subtle and normal changes that occur in our body, which we would usually otherwise ignore.

Additionally, when we start to worry about our bodily sensations, our brain perceives these worries as a threat, which triggers off our body’s natural inbuilt anxiety mechanism – the ‘flight or fight’ response. This automatic physiological response causes our body to release stress hormones including adrenaline and cortisol, which results in a set of bodily reactions such as nausea, heart palpitations, shortness of breath, chest pain or tightness, sweating, light-headedness, and tingling sensations. These symptoms can amplify the intensity of your existing physical sensations, and even make them last longer. Plus, given you are already worrying about your health, experiencing these new symptoms gives you even more sensations to think about.​ Ultimately, these unhelpful beliefs and behaviors lock us in a vicious cycle where our anxiety becomes intensified and maintained in the long-term.

Seeking Support for Health Anxiety

If you feel you may be struggling with health anxiety, it may be helpful to raise your concerns with a trusted healthcare professional such as your GP. Evidence-based psychological treatments such as Cognitive Behavioural Therapy (CBT) have been demonstrated to be effective in reducing the distress associated with health anxiety, and helping individuals learn to cope in more adaptive ways. Talking to a psychologist can help you to better understand your particular triggers, thought patterns and behaviors which may be keeping you stuck in the cycle of health anxiety.

References

Arnáez, S., García-Soriano, G., López-Santiago, J., & Belloch, A. (2020). Dysfunctional beliefs as mediators between illness-related intrusive thoughts and health anxiety symptoms. Behavioural and Cognitive Psychotherapy, 48(3), 315-326.

Olatunji, B., Kauffman, B., Meltzer, S., Davis, M., Smits, J., & Powers, M. (2014). Cognitive-behavioral therapy for hypochondriasis/health anxiety: a meta-analysis of treatment outcome and moderators. Behaviour Research and Therapy, 58, 65-74.