What Is Health Anxiety?
In a time where health is at the forefront of people’s minds and anxiety is on the rise, many people are wondering if they have “health anxiety.” Health anxiety, called illness anxiety disorder in the DSM-5, involves preoccupation with either having or acquiring a serious illness. Due to COVID-19, more people than ever are experiencing anxiety that affects their day-to-day life. Many are specifically worried that they or someone they love will catch COVID-19. Suddenly a cough is a worrisome symptom, whereas this time last summer it might have quickly been written off as allergies or a summer cold. But is worrying that a cough portends a COVID-19 infection the same thing as having health anxiety? Not necessarily! If you’re wondering if you may be experiencing health anxiety, read on to learn more about this disorder.
Signs and Symptoms
Although illness anxiety disorder is classified under “Somatic Symptom Disorders” in the DSM-5, individuals with health anxiety may experience symptoms similar to other anxiety disorders. However, there are a few signs and symptoms that differentiate health anxiety. They include:
Persistent, enduring worry about your health
Performing excessive health-related behaviors such as checking your body for signs of illness
Excessive worry that a minor symptom (such as a headache) is actually a symptom of a much more serious condition (such as brain cancer)
Repeatedly seeking reassurance from others regarding your health, but finding that reassurance does not ease your worry
Frequently making medical appointments but not feeling reassured by your doctor and/or tests that indicate you are healthy
Avoiding any medical appointment out of fear you will be told you have an illness
Spending a lot of time researching symptoms or sensations on the internet to try to determine if you have an illness
Diagnosis
It is very common to have some anxiety around your health. Particularly in the time of COVID-19, a degree of worry about your health is an appropriate response. It is also very normal to feel anxious when you first realize you may be experiencing a health challenge, such as discovering a lump in your breast tissue during a self-exam.
But there are important distinctions to make between normal worry about a health issue and health anxiety. In the example of a person discovering a lump in their breast, a person who is experiencing typical worry about their health may do/think the following: Schedule a doctor’s appointment, and then attend the appointment and follow the doctor’s recommendations. If the doctor evaluates them and determines it’s a cyst, the person follows the doctor’s advice regarding how to handle it and their worry is relieved. If additional testing is needed, they attend those appointments. Test results that suggest they’re healthy are accepted, and the worry diminishes and disappears.
In contrast, a person with health anxiety will act and think differently. In response to finding a lump in their breast, a person with health anxiety may entirely avoid seeking medical care. Or they may schedule an appointment, but if the doctor determines the lump is a cyst, they will not believe the doctor. They may insist on more testing and seek out second, third, or fourth opinions. Their concern over the possibility that they have breast cancer will not be alleviated by a doctor’s findings, and will impact their day-to-day life.
While the difference between normal worry, health anxiety, and another anxiety disorder may appear obvious, there are subtle differences. Getting an accurate diagnosis, (or non-diagnosis!), impacts treatment, so it is important to see a mental health professional for evaluation.
Treatment
Health anxiety responds well to psychotherapy, particularly CBT and ACT. Psychotherapy treatment for health anxiety focuses on identifying thoughts that are not in line with reality or helpful to you in living a meaningful life. A therapist will help you to challenge those thoughts, ultimately decreasing the power they have over you. Other therapy approaches that may be integrated into treatment include person-centered therapy, IFS, and mindfulness practices.
Some clients also respond well to medications. For individuals with health anxiety the most commonly prescribed medications are SSRIs. As with many medications, one of the issues with opting for a medication only treatment plan is that once you stop the medication, all of your previous symptoms will return as they were before.
Therapy is typically the first treatment choice, with medication added in later if it’s needed. The primary benefit to a therapy-forward treatment plan is that the underlying issues can be addressed. Clients who undergo therapy for health anxiety often maintain their progress well beyond their last session.
There are also self-help books, worksheets, and exercises that you can use at home or in conjunction with therapy. If you’re interested, check out this workbook for “Helping Health Anxiety” by the Centre for Clinical Interventions.
Health Anxiety vs Anxious About Health
Like with any other disorder, there is a wide range from wellness to illness. While few people have a diagnosis of illness anxiety disorder, many people do still experience anxiety around their health. Even if you do not have a diagnosis of illness anxiety disorder, if you find that you are preoccupied with anxiety about your health, therapy can help.
Anxiety, particularly around health concerns, is affecting record numbers of people. If you are suffering from anxiety or think you may have health anxiety, reach out to a mental health professional. They can help determine whether or not a diagnosis is appropriate, and offer you treatment options that can improve your functioning and sense of well-being.
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If you are experiencing anxiety around your health or health anxiety, please reach out to learn how I can help you.
