How To Manage Health Anxiety
A chronic illness diagnosis means you are bound to live a life with some symptomolgy. Whether it’s achey bones, migraines, brain fog, or gastro issues….there is always something new to worry about.
Being a patient or caregiver of someone with a chronic illness also requires that you stay on the lookout for new symptoms and report any concerning levels of pain or changes to your medical team. Unfortunately, this vigilance can lead to long nights combing WebMD and a spike in worry.
Chronic illness pairs really well with a side of health anxiety.
Health anxiety is excessive worrying about your health, to the point where it causes great distress and affects your everyday life. People with and without chronic illness can suffer from health anxiety and they usually fall into two categories: avoidant and information seeking. Someone with avoidant health anxiety will skip doctors appointments and anything else that makes the condition worse, while information seekers will constantly research their condition online, make doctors appointments, and have frequent tests that don’t find any problems.
Do I Have Health Anxiety?
During the past six months:
Have you been preoccupied with having a serious illness because of symptoms you have felt or observed on your body?
Have you felt distressed due to preoccupation about these symptoms?
Have you found that this worry is negatively impacting your life, including family life, social life and work?
Do you constantly self-examine and self-diagnosis?
Have you doubted your doctor’s diagnosis or been unconvinced by your doctor’s reassurances that you are fine?
Do you constantly need reassurance from doctors, family and friends that you are fine? Do you believe what you are being told?
If you answered yes to several of these questions, you may have health anxiety.
***Disclaimer***: There is a VERY fine line between vigilance and information seeking health anxiety. You should report new symptoms to your medical team, you should be informed about your illness, and you should fight for answers to your symptoms. There is nothing more frustrating than bringing new symptoms to a health professional and them denying your experience and chalking it up to “just anxiety.” However, this behavior can become obsessive, distressing, and life altering and hyper-focus on symptoms can even make them worse.
Health Anxiety Worsens Symptoms
Individuals who have been exposed to illness become acutely aware of how their bodies function and feel, often more than the regular Joe. This is a safety behavior and coping skill for surviving with chronic illness. When you are triggered by a bodily sensation, your brain goes into overdrive (ok we have a threat, let’s assess). With health anxiety, any bodily sensation is perceived as a threat and can really get out of control.
Let’s break this type of scenario down into a simplified, but possible, situation.
Your stomach starts to hurt a moderate amount (trigger), you perceive this as a new symptom and become fearful (perceived threat). This leads to intense focus on your stomach (increased body focus), possibly some feeling for lumps, and a run through of everything you’ve eaten in the last week (checking). You become physiologically aroused with rapid heart rate, maybe some sweat is forming on your palms, your stomach starts to hurt worse. Cue the worry, racing thoughts, and anxiety. Then maybe you take a journey with your favorite doctor, Dr. Google, and discover all the deadly illnesses that begin with, you guessed it, a stomach ache. This results in a definitive diagnosis that your stomach ache is a new illness and needs immediate medical attention.
Sound familiar?
Focusing your undivided attention on a part of the body can create an awareness of sensation and even leading to feelings of discomfort. Overly watchful behavior can also increase the experience of physical discomfort.
How to Combat Health Anxiety
Focus of Attention: When you are uncomfortable or ill, it becomes very difficult to think about anything else. A simple example: when I am congested I become hyper aware of my nose and head. It hurts, it’s swollen, I can’t breathe. When I can breathe, I am completely unaware of my nose or my breathing. When you are experiencing worry about a symptom attempt to shift your attention to something new. Distract yourself with a demanding or distracting activity or go in public to people watch and observe what is happening around you.
Schedule Your Worry: Did you know your worry doesn’t have to happen right now? Set a time of day where you will attend to your worries. When a worry comes up, write it down and say “I don’t have to worry about this now. I can worry about it later.” When your Worry Time arrives, sit down and address the items you still need to worry about. You may be surprised what can be crossed off the list.
Find Solutions: Worrying will never fix your problem. When you sit down for Worry Time, try to find a solution to address each of your worries. (i.e. I have a stomach ache = I will monitor my diet and document other stomach aches. I will schedule an appointment with my doctor if needed). After I schedule that appointment, I will wait to worry some more!
Reduce Information Seeking: Document how long you spend reading about symptoms and conditions daily. Strive to reduce that number by 30 minutes daily. Information seeking can be helpful when done in moderation. Strive to find information that is helpful for you physically and mentally. Googling your condition should not take precedence over self care, socializing, or spending time with family.
Reduce Checking: Document how often you spend checking your body for new growths, spots, lumps, etc. Each time you do this, you will become fearful of finding something new and adrenaline will spike, leading to more anxiety. Document how often you spend checking your body daily and work on reducing this daily. You will notice you start to worry less.
Seek Credible Reassurance: Before seeking reassurance from people, make sure you consider the source. If you are asking your spouse 30 times a day if you seem tired or if a certain symptom is particularly noticeable, it is not effectively reducing your anxiety. Likely you ask, anxiety is relieved briefly, and then you ask again. This is ineffective and you subconsciously do not trust your spouse to assess your condition. Use your doctor appointments to bring out your Worry List and address it with your medical team. Ask your doctor how often you should be visiting them and what you should do when symptoms arise in-between appointments. Set up a plan that is reasonable and you are both comfortable with.
Wellness: Is there anything you can do that will help you feel healthier? Do it!
New or worsening symptoms can be extremely terrifying when living with chronic illness. Health anxiety can contribute to symptoms feeling worse or recurring. Cognitive Behavioral Therapy can be helpful for individuals with chronic illness and health anxiety.
CBT looks at how to challenge the way you interpret symptoms and will help you to:
learn what seems to make the symptoms worse
develop methods of coping with the symptoms
keep yourself more active, even if you still have symptoms