Understanding Health Anxiety

Anxiety comes in many shapes and forms, and surfaces at times when we think something bad is about to happen to us[1]. It is a survival instinct that is invaluable during a real life and death scenario. Our body responds to danger by going through a series of physiological changes known as the “fight or flight” response – which prepares our bodies to fight or run away. However, there are times when there is not a significant threat, but we think we are in danger, and we consequently experience an anxiety response. Have you ever attended an important social gathering and felt your heart rate increase because you were worried that you wouldn’t fit in or others might not find you funny? Or have you ever swum in the ocean and felt tense in the muscles because you feared being attacked by a shark? In both of these scenarios something bad may or may not happen, but what is important is that if we believe something bad will happen that is when we will experience an anxiety response[2]. Many of us therefore experience anxiety in relation to our health, and consequently fear or strongly believe that our health is in danger or that we have a serious physical illness, when we are actually healthy.

What is Health Anxiety?

While it is completely normal to worry about our health and well being to a certain extent, like when waiting for test results to return, concerns about our health can become a problem when they are excessive, cause significant stress and impair our ability to go about day-to-day life[3]. You may visit the doctor and explain that you have or are displaying symptoms of a medical condition, however, the issue with health anxiety is not the condition itself, but rather how you are coping and responding to the condition and or/symptoms[4]. Here are some questions to consider if you believe you are someone who may suffer from health anxiety:

  • Have you experienced a preoccupation about a particular health concern for more than 6 months?[5]
  • Has this preoccupation led to feelings of anxiety or have you felt that it has had a negative impact on your day-to-day life?[6]
  • Have you felt the need to consistently examine your body and self-diagnose symptoms? E.g. looking up images and articles about your medical concern[7]
  • Do you constantly need reassurance from your doctor or friends/family regarding your health concerns?[8]

*It is also important to note that many people who experience health anxiety may display avoidant behaviours, such as not seeing the doctor, for fear of being diagnosed with a condition/terminal illness.

Health Anxiety Symptoms

Health anxiety can impact negatively on us in a number ways. Here are some of the common negative effects health anxiety can have on our body, mind and behaviour:

Physical Symptoms:

  • Fatigue
  • Sweatiness
  • Insomnia
  • Nausea
  • Loss in appetite/weight loss
  • General muscle pain/ physically tense
  • Headache/migraine/chest pain
  • Weakened immune system/ increased susceptibility to colds and flu

Emotional Symptoms:

  • Anxiety
  • Sadness
  • Interpreting physical symptoms of anxiety as a severe illness
  • Feeling unable to relax
  • Depression
  • Lack general enjoyment for life

These physical and emotional symptoms can then influence our behaviours in a negative way:

Behavioral Changes:

  • Trouble concentrating at work/participating in day to day activities
  • Indecision and forgetfulness
  • Withdrawal from friends and activities (friends may join in worrying or even become angry if you continue to worry)
  • Lack of enthusiasm, energy or motivation
  • Restlessness and agitation
  • Changes in eating or sleeping patterns
  • Change in finances due to increased visits to the doctor and paying for many forms of medication/treatments
  • Seeking constant reassurance from the doctor and/or friends and family
  • Increased focus on the body
  • Avoidant behaviors

What Keeps Health Anxiety Going?

Health anxiety can be a vicious cycle[9] – many of the things that people do to cope with health anxiety actually serve to keep the anxiety going. These include:

  • Regular checking behaviours and increasingly focusing on the body – checking for symptoms can feed a vicious cycle
  • Seeking reassurance from doctors, friends and family
  • Excessive research on health concern (internet, books, doctors visits)
  • Avoidant behaviours due to fear of worst case scenarios

Treatment

Health anxiety can be a serious illness and if left untreated, can cause significant stress and impair a person’s ability to go about day-to-day life[10]. If you or someone in your life has experienced health anxiety, it may be necessary to seek professional advice from a therapist. Therapy can help us understand the causes of our anxieties and learn strategies to cope with stressful situations. If our anxieties become debilitating and we are struggling to cope with day-to-day life, the use of anti-anxiety medications may be necessary to reduce the symptoms[11].

Some of the most common and effective ways to combat health related anxiety include:

1) Psychotherapy: provides us with an opportunity to explore events and feelings that are painful or troubling and teaches skills to cope[12]

2) Cognitive-behavioural therapy (CBT): helps us to identify negative patterns of thinking and behaviour and to replace them with more helpful thoughts/behaviours[13]

3) Acceptance and Commitment Therapy (ACT): An increasingly popular mindfulness-based therapy which encourages a person to accept what is out of their control and commit to action that improves/enriches their life[14]

4) Meditation: relieves some symptoms of anxiety by training us to focus our attention away from the thoughts that are bothering us. It is and is often prescribed along with therapy[15]

5) Medication: can be used in combination with the above therapies to help reduce the symptoms of anxiety

If you find health anxiety is really pushing you around, and causing a lot of distress, then see your GP in the first instance. They can talk with you about your concerns, and assist you to find the right approach for you to work through it. Remember too, you are not alone, and there are many useful websites for further information, such as the Centre for Clinical Intervention website (www.cci.health.wa.gov.au).

References:

-“Helping Health Anxiety”. Dr Rebecca Anderson. Centre For Clinical Interventions. Last Modified 2016. http://www.cci.health.wa.gov.au/docs/Health%20Anxiety%20Module%201.pdf.

“Coping With Health Anxiety”. Dr Brendon Hogan. Last Modified 2010. http://www.cpft.nhs.uk/Downloads/DVD-Documents/Leaflets/Coping%20with%20health%20anxiety2%20final.pdf.

-“How to Stop Worrying: Self Help Strategies For Relief From Anxieties, Worries & Fears”. Melinda Smith. Last Modified 2016. http://www.helpguide.org/articles/anxiety/how-to-stop-worrying.htm.

-“Acceptance & Commitment Therapy Training”. Russ Harris. Last Updated 2016. http://www.actmindfully.com.au/acceptance_&_commitment_therapy.

-“Depression in Teens”. Mental Health America. Last Updated March 2016. http://www.mentalhealthamerica.net/conditions/depression-teens.

[1] “Helping Health Anxiety”, Dr Rebecca Anderson, Centre For Clinical Interventions, Last Modified 2016, http://www.cci.health.wa.gov.au/docs/Health%20Anxiety%20Module%201.pdf.

[2] Ibid.

[3] Ibid.

[4] Ibid.

[5] Ibid.

[6] Ibid.

[7] Ibid.

[8] Ibid.

[9] “Coping With Health Anxiety”, Dr Brendon Hogan, Last Modified 2010, http://www.cpft.nhs.uk/Downloads/DVD-Documents/Leaflets/Coping%20with%20health%20anxiety2%20final.pdf.

[10] “Helping Health Anxiety”, Dr Rebecca Anderson, Centre For Clinical Interventions, Last Modified 2016, http://www.cci.health.wa.gov.au/docs/Health%20Anxiety%20Module%201.pdf.

[11] “Depression in Teens”, Mental Health America, Last Updated March 2016, http://www.mentalhealthamerica.net/conditions/depression-teens.

[12] Ibid.

[13] “How to Stop Worrying: Self Help Strategies For Relief From Anxieties, Worries & Fears”. Melinda Smith. Last Modified 2016. http://www.helpguide.org/articles/anxiety/how-to-stop-worrying.htm

[14] “Acceptance & Commitment Therapy Training”, Russ Harris, Last Updated 2016, http://www.actmindfully.com.au/acceptance_&_commitment_therapy.

[15] Ibid.

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