by Joel Schmidt, MA, Licensed Mental Health Counselor, in Tampa, FL
Overcoming Health Anxiety: Things You Should Stop Doing (and Some You Should Start)
Are you constantly worried about your health? Does even the slightest new and unusual bodily sensation or symptom have you running to the doctor, sure that it must be something serious? Are you often worried that, even though you’re being told by medical professionals that everything is okay, something undetected and undiagnosed is growing inside of you and slowly killing you? Do you find yourself checking stuff a lot — such as your heart rate or different parts of your body — looking for reassurance that nothing is wrong? Are you spending a good deal of time googling symptoms and researching medical conditions that you may or may not have? If so, you’re probably dealing with disordered health anxiety: a health-focused anxiety that can cause a good deal of distress and an endless cycle of worry.
Although it’s never a bad idea to check in with the doctor every so often (get that annual physical!) or to do health screenings as recommended, excessive checking and reassurance-seeking may be making your anxiety worse instead of providing the much-desired comfort you’re hoping to gain from some of your behaviors.
What to Stop Doing
Here are four things you should stop doing (or at least do less of) if you have health anxiety, followed by some healthier ways of coping.
1. Stop googling symptoms.
We google symptoms to seek reassurance, not realizing that this kind of reassurance-seeking is actually increasing and reinforcing our anxiety.
2. Stop obsessing over your fitness watch.
If you have a Fitbit, Apple watch, or any other health tracking wrist device, ditch it if you find yourself constantly checking different measures such as your heart rate, heart rate variability, or ECG results. Like googling symptoms, this sort of behavior keeps us too internally focused and increases the anxiety surrounding health — and only provides very short-term comfort and reassurance.
3. Pay attention to your other checking and reassurance-seeking behaviors and limit them also.
Common checking behaviors include checking the mirror for discoloration of the skin or eyes, looking for new moles or bumps, weighing in or measuring different parts of the body, monitoring your pulse or blood pressure, asking family members or health professionals about your symptoms, and posting questions online for opinions about the health issues you have or suspect you have. Being aware of your body and checking for anything out of the ordinary can be smart and healthy when done as the medical community recommends, but the kind of checking that often comes along with health anxiety is generally excessive and unnecessary.
4. Stop interpreting every new and unusual bodily symptom as a sign of danger.
Our bodies do weird things. Everyone experiences odd pains and sensations every once in a while. It’s normal, and they usually come and go. The average person experiences these things as well but isn’t as internally focused and doesn’t pay the same level of attention to them.
It’s not easy to stop doing these things. It will be uncomfortable, especially at first. What you’ll likely find over time, though, is that stopping these things will liberate you from the prison that health anxiety can create that prevents you from living your life fully.
What to Start Doing
It’s best to replace old habits with new ones. Here are some things you should do instead of the four behaviors above.
1. Check in with your doctor every once in a while.
Get to the doctor to rule out any true medical concerns if you’ve been avoiding this, get your annual physical, do the recommended screenings, and follow through on your doctor’s recommendations. The key here, though, is to follow what your doctor recommends and not what your anxiety dictates. Certainly seek medical help if you suspect something serious, but try to recognize when what you’re doing is just looking for short-term relief and reassurance. The comfort is fleeting and soon enough you’ll be on to the next thing.
2. Talk to a therapist.
Find a therapist that specializes in anxiety disorders – specifically one with experience working with health anxiety. A therapist can help you better understand your health anxiety and teach you some healthier coping mechanisms for dealing with it. They’ll also help you gain insight about how you got here and help you better recognize the thoughts and behaviors that are contributing to your anxiety. Overcoming health anxiety takes work, but a therapist can help you make strides.
3. Recognize that some health anxiety is normal.
As humans, we all have some worry and concern surrounding our health and well-being. When we are struggling with health anxiety, though, our threat detection system is just a little more heightened than it needs to be. This can lead to nonstop false alarms.
4. Be open to the idea of tolerating and accepting a certain amount of uncertainty.
The only thing that would likely bring your health anxiety to zero would be knowing that your risk of experiencing future health-related issues is zero — and that’s just not going to happen. As you start to accept and tolerate some risk above zero, you’ll find that you also start to shift out of anxious thinking and into the kind of life you really want to live.
5. Remember how many times you’ve been wrong about your anxious thoughts.
“What ifs†are at the core of health anxiety — or any other anxiety for that matter. “What if this headache is a tumor growing in my brain?†“What if this stomachache is a sign of something really serious?†“What if this pain in my leg is a deadly blood clot?†How many times have you found yourself having these anxious thoughts and questions? And how many times have you been wrong about those worst-case assumptions? Since you’re reading this, you’ve probably been wrong about most, if not all of them. Let that fact sink in.
6. Shift your focus outward.
One of the hallmarks of health anxiety is an overly strong internal focus. When you notice yourself scanning your body or engaging with and entertaining anxious thoughts, try to shift from an internal to a more outward focus. Find something to do. Call a friend, go for a walk, read a book, and get engaged with the world.
Overcoming Health Anxiety
Living with health anxiety can feel like a rollercoaster. Following this advice will help you get off that ride and free you up to enjoy and make the most of your life. Connect with a therapist who understands what you’re dealing with and start making progress.
Dear GoodTherapy.org,
I’m a 27-year-old dental student with no serious medical issues other than sports injuries. Over the past few years, I have developed these thoughts about getting/being sick. I am constantly paying attention to my body. Any little thing I notice, I freak out. I am frequently going to the doctor for one thing after another and can’t seem to control my brain immediately thinking the worst. And every time I go, I am perfectly healthy.
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I also think that because I am believing in these fake ailments, it’s causing my brain to create symptoms! It’s frustrating because I don’t know how to stop feeling like this even though I know it’s mostly in my head. At this point, my girlfriend and family are getting sick of me asking things like “This isn’t cancer, right?” or “I’m going to be okay, right? It’s not going to kill me or anything?”
My main question is why am I always thinking of the worst-case scenario with my health? Why can’t I just have a sore throat and think “I must have a cold” instead of “I must have a rare infection that’s going to eventually kill me”? Any help would be awesome because as of now I feel myself worrying about being sick more than actually enjoying my life. Thank you. —Worried Sick
Submit Your Own Question to a Therapist
Dear Worried Sick,
You’ve asked a great question, and you are not alone in asking it: Why do you seem to always think of the worst-case scenario when it comes to your health, and what can you do differently so you are not immediately thinking the worst? The answer to this question is very much tied to understanding what may be behind this in the first place.
How you describe your concerns is consistent with what is conceptualized in the DSM-5 (the most recent version of the Diagnostic and Statistical Manual) as illness anxiety, as well as what prior to this would have been considered hypochondriasis (debilitating worry about having a serious illness). Regardless, please know there are things you can do to keep the worry from getting the better of you.
It’s worth stating this about anxiety more generally: some people are more prone to either anxiety or hypervigilance (heightened awareness about small sensations or possible threats, in this case health-related symptoms) than others. This can happen for any number of reasons, and it’s okay if you tend to be that way. What you are doing, essentially, is making sense of your experiences and protecting yourself from perceived threats of danger. While this can be adaptive—as doing so can tune you in to something that is wrong—it may become a problem when your interpretations are in overdrive. Furthermore, when you worry excessively, there is a negative filter operating on your thoughts which further intensifies and reinforces the worry.
You can learn how to modify your thoughts through psychotherapy. By seeking help for this, you can learn and practice skills to help you reduce hypervigilance and significantly reduce the tendency to immediately think the worst.
The bottom line is thoughts are powerful. When we experience a symptom such as pain, fatigue, or bloating, many people try to better understand and make sense of the experience, and depending on our thoughts, this may work for us or it may signal our thoughts are in overdrive. Additionally, constantly paying attention to bodily symptoms—and perhaps even creating symptoms, as you indicated—is a pattern worth changing. When we think the worst, this sends us down a dark path leading to debilitating anxiety. Furthermore, the way we think significantly affects the way we feel. So it makes sense that if we are thinking the worst about our health, we will feel bad. We are focusing on even the slightest discomfort or sensation and then feeling distressed over the worry around what it could mean. Clearly, you have realized that health-related anxiety or worry can become extremely uncomfortable.
By modifying the thoughts you have around bodily sensations, you can change your level of comfort. You will, in fact, be able to do just as you want—to be able to enjoy your life. Imagine how powerful a small shift in a thought can be. Instead of “This means I have a rare infection that will kill me,†try something else. Perhaps, “It is possible this is something that warrants medical attention, but it is also possible this will go away on its own.†You can learn how to modify your thoughts through psychotherapy. By seeking help for this, you can learn and practice skills to help you reduce hypervigilance and significantly reduce the tendency to immediately think the worst.
Here are some other tips that are important to consider:
- Beware of conducting your own health-related research. Many individuals who experience illness anxiety find they spend a lot of time online researching suspected conditions or symptoms. I suspect you know this already, being a dental student, but sometimes reading about things that “could†happen serves as an unnecessary trigger for anxiety. Be mindful of the amount of time you spend conducting such research, as well as how you feel while reading information (especially compared to times when you are not reading about symptoms). I suspect such information may spike anxiety in you. If so, consider whether this is useful for you to do.
- Consider new ways of coping and reframing. You mentioned you gather that the people close to you are already getting annoyed by you regularly seeking reassurance. This is one mechanism you have developed as a pattern to manage anxiety. Another is to frequently make medical appointments for these symptoms, which is essentially doing the same thing. You want reassurance that everything is okay. Because neither of these practices is sustainable in the long run, you’ll have to learn additional coping and reframing skills so you can adequately assess when it may be appropriate to seek reassurance.
- Implement relaxation as a regular practice. What usually helps you reduce anxiety? Finding a healthy outlet for stress and anxiety can be a useful tool to have at your disposal, regardless of the stressors you face.
Glad you’ve reached out!
Best wishes,