In the midst of a global health crisis, many individuals might be experiencing increased health anxiety. Health anxiety is a condition in which a person may excessively worry about contracting a disease – even if they do not have any symptoms or are experiencing minor symptoms like an itchy throat. People who deal with diagnosed health anxiety conditions – such as Somatic Symptom Disorder or Illness Anxiety Disorder – face many challenges in their everyday life due to their health-related fears and preoccupations.
A person with healthy anxiety may worry about their bodily functions, any physical changes they notice and even the slightest physical discomfort. They may keep thinking that they have contracted a new illness – based on something they have heard or read in the news. The idea that they have a severe or chronic illness occupies most of their time and energy, and, in extreme cases, one may find it difficult to go about their everyday life with such thoughts.
When a person spends all the time ruminating over their illness, and are constantly in the fight-or-flight mode, they experience fatigue and exhaustion. Without having mental peace, the body becomes tired quickly. This can also cause a strain on the muscles and the release of cortisol (the stress hormone), which can then lead to a number of health problems. People with health anxiety may also have difficulty sleeping and may experience a change in their appetite. All of these physiological changes can impact immunity and make the person with health anxiety more susceptible to falling ill. This can confirm their fears and worsen their health anxiety.
Factors contributing to health anxiety
A number of factors maintain or even worsen the symptoms of health anxiety. Let’s take a look at some of these below.
Thinking of the worst case scenario
People who have health anxiety tend to think of the worst possible outcome in any given situation, and end up considering this worst possibility as reality. For most people, having a clean bill of health would elicit relief. However, people who deal with health anxiety often have unhelpful thoughts and assumptions which hold them back. They may believe that even a small discomfort is indicative of a major illness. For example, they may consider a pimple as a probable sign of skin cancer, a small cough as a sign of the novel virus or a headache as a sign of a tumour.
They will also assume that the health concern they suffer from may have long-term effects on their life. Such thoughts can cause significant distress to the person.
Misinterpreting illness-related information
A person dealing with health anxiety would try to seek out as much information as they can about an illness and may often end up misinterpreting what they read or find. They may believe that they are at higher risk to develop an illness. For example, if they read that cases of dengue increase during monsoon, they may be convinced that they have (or will have) dengue throughout the monsoon period.
They may also do this with information they get from doctors or during health check-ups and medical examinations. For example, if a doctor says that the person’s sugar levels can be lowered, the person with health anxiety may conclude that this means they have diabetes. On the other hand, they may also undermine others’ opinions and may dismiss expert advice. They may not believe their nurse or doctor and may look for multiple opinions and run different tests.
Misinterpreting minor body sensations
When you think about your health, you may experience slight stress about any recent ailments you have experienced as well as relief that you are in good health at the moment. However, for a person with health anxiety, the very thought of their health can trigger an anxiety response. Every minor bodily sensation can lead to a fight-or-flight response. This is characterised by muscle tension, exhaustion, increased heart rate, breathlessness, light-headedness, blurred vision, and confusion.
If they experience minor illnesses or even symptoms of an illness, they may immediately have catastrophic thoughts about the severity of the illness. These thoughts can lead to feelings of anxiety which make them more likely to believe that something is physically wrong with them.
Seeking reassurance from others
People who experience health anxiety tend to constantly worry about their health and end up feeling anxious. This may cause them to constantly seek reassurance in different ways.
They may check in the mirror for signs of asymmetry, areas of discolouration, or new moles or lumps. They might constantly examine their bodily waste like sweat, urine or feces for signs of blood or infection, and may even measure parts of their body. This could involve checking their weight, taking their pulse, checking blood pressure, monitoring sleep patterns, and more.
They may also ask trusted family members, friends, and healthcare providers to ensure that they do not have any signs of illness or that their perceived symptoms are treated soon. However, they may not be satisfied easily and may request medical tests or evaluations as well as second or third opinions. They may also look up their symptoms on the internet, in medical texts, on forums on internet sites and may obtain opinions from unknown people having similar symptoms.
Avoiding situations or people
In order to feel better about their health status, they may avoid any situation that they believe can worsen their health. People with health anxiety may also avoid situations and activities that could expose them to harm or infection – such as crowded areas, public restrooms, public transportation, hiking, participating in adventure sports, drinking or anything else they deem dangerous. They may also refuse to attend funerals, not watch medical dramas, be picky about the food they eat, try not to think of death, postpone making a will and be overly concerned with hygiene and health. This can significantly hamper the quality of their life, and can make those with healthy anxiety feel unhappier than others.
Engaging in safety behaviours
Safety behaviours are elaborate rituals or behaviours that a person may complete before, during or after they enter a situation they were otherwise avoiding. A person with health anxiety might only approach a feared place, person or activity if back-up plans exist. These safety behaviours serve to reduce the distress a person is experiencing. For example, a person worried about falling sick might always carry sanitiser with them and use it each time they come in contact with another person or a foreign surface.
While engaging in safety behaviours temporarily reduces their health worries and concerns, in the long run, the anxiety they experience may increase. In fact, safety behaviours create an unhealthy dependence – the person may find it difficult to manage without these behaviours.
When does concern about one’s health turn to health anxiety?
Considering the current global health crisis, everyone may be concerned about protecting their health. However, there is a difference between being concerned about one’s well-being (and taking proactive measures to ensure safety) and having excessive anxiety which hampers everyday life. Health concerns become problematic when:
• The person is constantly having thoughts about health and sickness and is unable to focus on anything else
• The fear experienced is out of proportion to the realistic likelihood of having an actual medical problem
• They are adamant that they have an illness despite negative test results
• They deal with significant distress, which impairs their ability to go about day-to-day life
• They develop unhelpful behaviours such as excessive checking, reassurance seeking or avoidance
While medical professionals, researchers, governments and communities come together to try to deal with the current health crisis, it is important for all of us to not give in to unhelpful thoughts regarding health anxiety and to stay well-informed, calm and rational.
If you think that you are unable to manage your anxiety and that it is stopping you from getting through your day, don’t hesitate to reach out for support. A qualified professional can help you work through your fears and get through each day with a sense of calm, peace and hope.
References:
CCI(n.d.). Retrieved April 2020, from www.cci.health.wa.gov.au website: https://www.cci.health.wa.gov.au/~/media/CCI/Consumer%20Modules/Helping%20Health%20Anxiety/Helping%20Health%20Anxiety%20-%2001%20-%20Understanding%20Health%20Anxiety.pdf
Every Mind Matters | One You. (n.d.). Retrieved from www.nhs.uk website: https://www.nhs.uk/oneyou/every-mind-matters/coronavirus-covid-19-anxiety-tips/
Harvard Health Publishing. (2018, September). Always worried about your health? You may be dealing with a health anxiety disorder – Harvard Health. Retrieved from Harvard Health website: https://www.health.harvard.edu/mind-and-mood/always-worried-about-your-health-you-may-be-dealing-with-health-anxiety-disorder
Health Anxiety. (n.d.). Retrieved April 2020, from Anxiety Canada website: https://www.anxietycanada.com/disorders/health-anxiety/
Health Anxiety: What It is and How to Beat It. (2019). Retrieved May 23, 2019, from Adaa.org website: https://adaa.org/learn-from-us/from-the-experts/blog-posts/consumer/health-anxiety-what-it-and-how-beat-it