Healthy human bodies produce all sorts of physical symptoms that might be uncomfortable, unexpected, and unwanted.
With health anxiety there is a misinterpretation of discomfort and normal bodily sensations as dangerous. This typically leads to excessive checking behaviors that are uncontrollable, physically draining, and significantly impacts our quality of life.
Normal sensations in the body that can produce fear and worry include changes in visual acuity, heart rate, blood pressure, saliva levels, depth of breathing, balance, and muscle tone, just to name a few. These are typically harmless bodily changes, but when a person believes they are symptoms of a terrible disease, it causes anxiety.
Anxiety is a protective mechanism and scanning the body for an illness seems like the right thing to do to keep ourselves safe. However, when we are preoccupied with something, we tend to notice it. Looking for symptoms makes us notice subtle sensations we might otherwise ignore and when we become preoccupied with bodily sensations, those sensations become amplified and last longer.
For those with health anxiety, a scan of the body can produce uncertainty and doubt, giving the imagination opportunity to create stories. As we imagine the worst, our body’s alarm system sounds off in the form of anxiety (racing heart, tightness in the chest, difficulty breathing, jitters, tingling, lightheadedness, nausea, stomach discomfort, sweating, headaches, etc.) giving our imagination additional fuel to create great works of fiction. The symptoms are real, but conclusions we jump to are inaccurate.
Thoughts are not facts, they are just associations and ideas, but we don’t have to believe everything we think! The problem is not that we are in danger, the problem is that we THINK we are at risk of some threat occurring. That’s a big difference!
So let’s say, we are not seriously ill, but just think we are. It stands to reason that constantly worrying and thinking about our health isn’t going to be helpful, but it can still have an adverse affect on us. Thinking we’re ill when we’re not is stressful, which can lower our immune system and make us more likely to get ill.
What can we do to manage health anxiety?
It helps to challenge our pessimistic, anxiety provoking thoughts:
Do we know for certain that we have this serious illness?
Do we want to spend the rest of our life worrying about illness, or do we want to get the most out of life as it is?
We can look for facts that tell us we are not seriously ill, so that when the thoughts about being ill come back, we can be better prepared and challenge them. The more we challenge them, the weaker and less powerful the thoughts become.
We might repeatedly ask our family and friends, or visit our doctor often, in order to hear the words “everything is ok – there’s nothing wrong”. This seems helpful….for a short while…until the worrying thoughts come back again, then we start all over again. So the reassurance seeking helps to keep the anxiety going, in the long term.
We can aim to reduce visiting the doctor or asking others for reassurance. If we usually ask our partner 30 times a day, then aim to reduce over the period of a few days, as much as we can. We might write down the number of times we ask, because writing it down helps us notice, and also helps us think twice about doing it! We can also notice our success at reducing the reassurance over time.
We can use the same reducing approach to looking up information (internet, books etc) about the health problem. In seeking more information, we will worry more and feel more anxious, so we need to reduce it in the same way as we reduce the checking behavior.
Use STOPP skill to incorporate all these strategies
Stop and just pause for a moment
Take a few slow deep breaths
Observe that the health worry is there again. Our minds are reacting to a body sensation and we feel anxious.
Pull back and let’s not believe everything we think! Let’s stick with the facts – these thoughts are just opinions. We don’t have to react right now. There’s another explanation for this…(normal body sensation etc). We are ok right now.
Practice / Proceed – What can we do right now? We don’t need to check or seek reassurance. What will make us happy?
While our doctor can do tests and tell us that we don’t have a particular illness, we have to accept that, we can never be certain that we will never have a serious illness. The odds are more likely that we are giving urgency and excessive significance to things that are ordinary, normal and natural.