What is health anxiety?
Health anxiety is an anxiety disorder that is within the Obsessive Compulsive Disorder (OCD) spectrum of disorders. Those affected by health anxiety have an obsessional preoccupation with the idea or the thought that they are currently (or will be) experiencing a physical illness. The most common health anxieties tend to centre on conditions such as cancer, HIV or AIDs however, the person experiencing health anxiety or illness phobia may fixate on any type of illness. This condition is known as health anxiety, illness phobia/ illness anxiety or hypochondriasis.
Those who are affected by health anxiety are convinced that harmless physical symptoms are indicators of serious disease or severe medical conditions. For example, if a person experiencing health anxiety feels that their chest is getting tight, they may believe that they are having a heart attack. Those with health anxiety frequently misinterpret physical symptoms of anxiety as a sign of an impending physical health problem.
What are the symptoms of health anxiety?
One of the main symptoms of health anxiety is that the individual may scan their body for signs that they are developing a physical illness. For example: a person experiencing health anxiety may interpret their headache as a brain tumour. Some people affected by this disorder may also link non physical problems to having a serious illness. An example of this is may be someone who forgets where they have put their phone or their house keys believing that this means that they have Alzheimer’s disease.
Some individuals who experience this type of anxiety disorder are so convinced that they have a certain physical illness, that all of their focus will be placed on obtaining a diagnosis. They will go to as many doctors as they can and if they do not receive confirmation of a diagnosis, they may continue to seek second, third and fourth opinions from other doctors. In such instances, many different tests (such as MRI, echocardiograms and in some cases even exploratory surgery) are requested by the person experiencing the health anxiety or illness phobia. Unfortunately, these tests are often not enough to convince them that they are not physically ill and can therefore be taken time and time again. Often, a lack of diagnosis is attributed to poor medical care or an under qualified doctor. It is important to remember that repeated visits and consultations with health care professionals are due to the fact the sufferer fully believes that they are experiencing a physical illness, rather than due to attention seeking behaviours. The medical profession often refer to the symptoms experienced by sufferers of health anxiety as ‘medically unexplained symptoms’.
Many people experiencing health anxiety or illness phobia will spend a large amount of their time carrying out excessive checking behaviours where they will look for marks, lumps, sores and rashes on their body which may indicate the onset of a physical illness. These checking behaviours also include asking friends and family members to assist them in checking. The anxiety experienced around the possibility that they may find something to indicate illness or around the idea that they may catch a particular illness can lead to high levels of anxiety. This in turn can increase physical symptoms of anxiety (such as an increased heart rate, chest pain or tightness in the chest, dizziness, blurred vision, confusion, dry mouth or sweating). Upon noticing this increase in physical symptoms, the sufferer’s idea that they are experiencing a physical illness is reinforced.
Media campaigns on specific physical illnesses can also cause problems for people experiencing health and illness anxiety. Often, watching programmes relating to physical illness or reading about specific conditions may lead those affected to feel that they have experienced symptoms of that specific condition.
An individual can exhibit symptoms of health anxiety or illness phobia for long periods of time or may be symptom free for equal amounts of time. Conversely, people affected by health and illness anxiety may refuse to go to the doctor or any other medical practitioners for fear that they will get the worst possible news (i.e. that their suspicion of having a physical medical disorder will be confirmed). Therefore, instead of becoming overly focused on the feared illness, they will avoid any reminders relating to symptoms of the illness and will stay away from people who may be ill. Additionally, they may try to avoid any places where there are likely to be people who are ill (such as hospitals and doctors surgeries). They may fear that any contact with people experiencing physical illness will cause them to catch that illness (regardless of whether or not the illness that they are focusing on is contagious).
Some individuals who are affected by health anxiety may not tell anyone about their fears as they are convinced that they will not be taken seriously.
Health anxiety and illness phobia is found to occur equally in both men and women and can develop at any age.
Although the causes of health and illness anxiety are not always easily identified, there are certain factors which may trigger the disorder:
- Having a serious illness as a child
- Having a close family member or friend with a serious illness
- The death of a close relative/friend
- Being affected by an anxiety disorder
- Having a belief that being ‘healthy’ means that you do not experience any physical symptoms or sensations
- Having close family members who themselves have health anxiety
DIY self diagnosis
If you can answer YES to most of the questions it is likely that you are affected by that condition.
During the past 6 months:
- Have you experienced a preoccupation with having a serious illness due to bodily symptoms that has been ongoing for at least six months?
- Have you felt distressed due to this preoccupation?
- Have you found that this preoccupation impacts negatively on all areas of life including, family life, social life and work?
- Have you felt that you have needed to carry out constant self examination and self diagnosis?
- Have you experienced disbelief over a diagnosis from a doctor or felt that you are unconvinced by your doctor’s reassurances that you are fine?
- Do you constantly need reassurance from doctors, family and friends that you are fine, even if you don’t really believe what you are being told.
Anxiety UK strongly advises that people seek further information and guidance from their GP who will be able to make a formal diagnosis.
The above information is from the Anxiety UK website (Formerly the National Phobic’s Society)
Cognitive Behavioural Therapy (CBT) for health anxiety
During Cognitive behavioural therapy (CBT) the therapist will collaborate with the client to identify and assess all maintaining factors; including thoughts, behaviours, emotions and physical symptoms associated with the problem and develop a working formulation which will be utilised to guide the course of therapy.
A number of techniques will be employed to test predictions and beliefs which may include behavioural strategies such as exposure and cognitive interventions aimed at identifying and challenging unhelpful thoughts and beliefs, possible thinking errors and misinterpretations. These may then be challenged through a combination of Socratic questioning and behavioural experiments.
Counselling and psychotherapy for health anxiety
Counselling and psychotherapy can help you understand what is happening to you and why you feel anxious by recognising and addressing your anxiety triggers. You may also learn techniques to control and manage anxiety symptoms. Understanding where anxiety originated can also help you gain a new perspective.
EMDR for health anxiety
The EMDR approach allows a therapist to act both in the reconstruction of the elements that may have forced the beginning of the typical symptoms of health anxiety and to directly intervene at a neurophysiological level to facilitate the reworking of the elements stored dysfunctional in memory and recurrently expressed as health anxiety.
EMDR processing can be applied to targets such as your first and worst episodes of health anxiety, life events related to health anxiety and anticipated health anxiety attacks. You would also work on current triggers related to health anxiety in the present and prepare for future experiences. Using EMDR we would work towards the elimination of health anxiety and avoidance behaviours, insight about symptoms and return to normal daily functioning.
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