Some people are especially attuned to their bodily sensations. When they experience certain symptoms — headache, stomachache, dizziness or any kind of discomfort — they assume the worst. They start worrying that something is very wrong with them.
What if it’s heart disease or cancer? What if it’s a tumor or meningitis? What if it’s an illness I don’t know about or doctors haven’t even discovered?
They may pore over medical websites trying to diagnose their symptoms, trying to figure out if they’re safe or sick. They may become consumed by their worry, ruminating about a specific illness or a range of dangerous or deadly diseases.
As their nervousness intensifies, the physical sensations of anxiety start exacerbating their symptoms. So individuals start feeling worse. Their breath thins, vision blurs, heart races, chest pounds, stomach twists, and they become more and more convinced they’ve contracted something terrible.
Experiencing such symptoms is scary, so, instead of realizing that anxiety may be the culprit, their mind misinterprets these sensations and presumes they’re in trouble.
Of course, some level of worry about one’s health is helpful. It keeps us alive.
Without it, as authors Katherine Owens, Ph.D, and Martin Antony, Ph.D, write in Overcoming Health Anxiety: Letting Go of Your Fear of Illness, we might never go for a checkup, get a cavity filled or take a vacation. “Not all health anxiety is unrealistic or exaggerated,” they write.
When you notice a new or unusual symptom or several bothersome symptoms that persist, it makes sense to consult a doctor, said Irena Milosevic, Ph.D, C.Psych., a psychologist at the Anxiety Treatment & Research Clinic at St. Joseph’s Healthcare Hamilton in Ontario.
However, if you’re still worried after you’ve received negative results and sound medical feedback that your symptoms are harmless, your anxiety is likely excessive, she said.
It’s also excessive when your worry is time-consuming, distressing and disruptive to your daily routine, or when it’s “out of proportion to the realistic probability of having a particular medical diagnosis,” Milosevic said.
This might mean you’re struggling with health anxiety. About 3 to 10 percent of the population struggles with significant health anxiety, she said. “[M]any more people report experiencing occasional or more mild anxiety about their health.”
In addition to negatively interpreting physical sensations and symptoms, people with health anxiety may regularly seek reassurance from loved ones and professionals that they aren’t sick, she said.
Other individuals practice avoidance. They “try to avoid triggers of their health-related worry, such as medical settings, articles or news stories about illness, or even talking about illness.”
She noted that in CBT, people learn “how to identify and change their unhelpful beliefs about health and illness and their interpretations of physical symptoms, and how to decrease the behaviors that fuel anxiety. They are taught to gradually expose themselves to feared situations and bodily sensations until these experiences become less anxiety-provoking.”
Working with a therapist can be tremendously helpful. Depending on the severity of your health anxiety, trying strategies on your own also can help. Below, Milosevic shared three strategies.
1. Reduce your checking behavior.
Checking your symptoms, reading about them online and asking others for reassurance may reduce anxiety temporarily, Milosevic said. However, over time, these behaviors maintain your anxiety, she said.
Instead, it’s important to let anxiety run its course, without engaging in these checking or reassurance-seeking behaviors, she said. Doing so helps anxiety dissipate in the long run.
Naturally, stopping these behaviors can be tough. They’ve become habits, after all — habits that soothe your worry (again, albeit in the short term).
This is why it helps to start gradually, Milosevic said. She shared this example: Let’s say you spend about 60 minutes a day on the computer reading about your symptoms. Start by reducing this time to 30 minutes a day. Then reduce your time to 15 minutes a day, and “then to every other day, until you can reduce the time to zero.”
2. Revise your thinking.
People with health anxiety — and all kinds of anxiety — tend to overestimate the chances of something bad happening, Milosevic said. They also assume that if a negative outcome does occur, it’ll be “utterly devastating or unmanageable.”
However, these expectations and assumptions aren’t facts. They’re distortions, which only spike your anxiety.
The key is to reconsider these thoughts and adopt a more realistic perspective. Milosevic suggested readers ask themselves these questions about their thoughts:
- Is this a fact or an assumption?
- Am I jumping to conclusions?
- Am I catastrophizing (expecting the worst possible scenario)?
- What evidence do I have to support my prediction? What evidence do I have that does not support my prediction?
- Am I underestimating my ability to cope? Are there other times in my life when I have coped effectively with health problems or other challenges?
3. Reduce avoidance.
If your health anxiety manifests in avoidance — you avoid reminders of illness or death — it’s important to reduce this avoidance. (It, too, only feeds your anxiety.)
According to Milosevic, these are examples of avoidance-reducing behaviors you could try: “reading or talking about a feared illness, reading obituaries, spending time in a hospital (even just the lobby or waiting area), scheduling avoided medical follow-ups, or inducing avoided physical sensations (e.g., running up the stairs to increase heart palpitations).”
Practice avoidance-reducing behaviors on a regular basis, such as three to four times a week, she said. This “ensure[s] that the avoided situations eventually become less scary.”
Worrying about your health is adaptive. However, when that worry becomes persistent and excessive, it starts hurting your health. Practicing the above strategies and seeking professional counseling provides you with genuine relief.
In addition to Owens and Antony’s book Overcoming Health Anxiety, Milosevic also recommended It’s Not All in Your Head: How Worrying about Your Health Could Be Making You Sick — and What You Can Do About It by Gordon J G. Asmundson, Ph.D, and Steven Taylor, Ph.D. Both books are based on cognitive-behavioral therapy.