May 22, 2020

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Guest Author

Health Anxiety Or Illness? How To Tell The Difference

During this time of uncertainty, our health has been placed at the forefront of our minds like no other time before. We have been told to wash our hands almost obsessively, to act as though anything outside could be infected, and to monitor our symptoms closely for signs of COVID-19. If you are feeling health anxiety at this time, you are not alone.

During this time of uncertainty, our health has been placed at the forefront of our minds like no other time before. We have been told to wash our hands almost obsessively, to act as though anything outside could be infected, and to monitor our symptoms closely for signs of COVID-19. If you are feeling health anxiety at this time, you are not alone.

The hypervigilance we need to respond to the coronavirus pandemic can increase health anxiety, particularly if you are prone to it. We are here to help you figure out the differences between health anxiety and illness, and to provide tips on reducing health anxiety.

What is health anxiety?

Health anxiety, also known as illness anxiety disorder or hypochondriasis, is the constant worry that you are seriously ill or will become ill in the future, according to Mayo Clinic. It can occur without the presence of any physical symptoms, or it can be exacerbated by overanalyzing regular, day-to-day bodily sensations. People may deal with this anxiety by continuously checking their symptoms, attempting to avoid symptoms, or excessively making medical appointments to have their symptoms examined, according to the Beck Institute.

“Health anxiety is often a symptom of a wound from your past,...a way for your unconscious mind to tell you, ‘I’m not safe in the world. I feel fragile and vulnerable,’” explains therapist and MyWellbeing community member Michael Shawe.

He says that these feelings may come from long forgotten wounds. While we may not remember what caused them, “the unconscious mind...imprints powerfully and does not forget the feelings of fear, shame, and any sense of being unsafe from childhood,” says Shawe.

Moreover, “clients with health anxiety are downright afraid of what is happening within their own bodies,” says Julia King, a therapist and MyWellbeing community member. She explains that people with illness anxiety scan their bodies for any unusual sensations, scour the internet looking for answers, and look to other people for reassurance.

“But, these behaviors only make their anxiety worse.  The more they try to desperately get rid of the anxiety, the more it grows,” King says.

How do I know if I have health anxiety?

Harvard Medical School describes one telltale sign of health anxiety as assuming you may have a disease that you read about or see in the news. However, since the coronavirus is currently all over the news and at the top of all of our minds, it can be difficult to distinguish whether or not your concerns over it may constitute hypochondria.

Some other characteristic signs of illness anxiety, according to Harvard Medical School, are constantly googling your symptoms, feeling overwhelmingly anxious even if you have no or minimal symptoms, continuing to feel nervous even after being reassured of your health by a doctor, and noticing that your anxiety about your health interferes with your daily activities.

Moreover, if you are dealing with hypochondria, getting negative test results for illnesses you worry about may be unlikely to assuage your fears. In fact, it may even intensify your anxiety.

Can health anxiety cause physical symptoms?

One reason that health anxiety can be so convincing and frightening is that the anxiety itself can actually lead to physical symptoms. These can include dizziness, stomachaches, muscle tension, rapid heartbeat, and more, according to the Anxiety and Depression Association of America. This in turn can further convince you that you are dealing with a much graver health issue.

How can I mitigate health anxiety?

It is helpful to learn a few techniques to discern whether symptoms may be a result of our overactive minds or an indication of a more serious condition. If these techniques are effective at mitigating physical symptoms, there is a chance that what you are feeling may be health anxiety.

Especially in the context of COVID-19, how can we stay aware of potential symptoms without letting our minds spiral? Shawe recommends engaging in a mindfulness practice for ten to fifteen minutes and checking in with yourself afterwards to see if the symptoms are still apparent. If they “...seem to disappear, this might be a good sign that it is more related to your anxiety,” he says.

King also emphasizes the impact that meditation can have on combating illness anxiety. An integrated mind-body approach can both increase our awareness of as well as normalize the sensations in our bodies, she says. Meditation “teaches us how to sit with and manage the emotional discomfort of uncertainty,” while more physical techniques such as yoga can provide additional tools for coping with anxious or depressed moods.

What if someone I know has health anxiety?

Being around someone who has severe health anxiety can be frustrating, but it is best not to tell them that their fears are all in their head. Instead, psychiatrist Timothy Scarella at Harvard Medical School suggests helping them focus on the things they enjoy and how their anxiety may be causing them to miss out on these.

In the context of COVID-19, this may be more difficult, given that many of us may actually be missing out regardless due to the stay-at-home orders. It may instead be helpful to remind loved ones who may be experiencing illness anxiety of activities they enjoy that they can do from home, and to do your best to engage with them in these activities.

Can therapy help with health anxiety?

The short answer: yes!

“There is nothing to be ashamed of if your mental health is not optimum right now,” says Courtney Darsa, a dietitian and member of the MyWellbeing community. “Mental health professionals can be your best resource for helping you work through your day-to-day or even one time challenges.”

Many people with hypochondria may continue to believe that they are sick even if they “intellectually believe the doctor telling them they are not sick,” says King. If this sounds like you, this continuing anxiety may be due to a lack of trust in yourself and your intuition rather than a physical condition. Therapy can be an extremely powerful tool to begin to combat this way of thinking.

In particular, cognitive-behavioral therapy can be helpful for treating hypochondria because of its emphasis on the relationships between our thoughts and our actions. CBT treatment for health anxiety can help you feel less preoccupied and anxious about your physiological symptoms, and can also help you redirect your energy towards activities that you find valuable.

Therapy can be especially helpful if you find that illness anxiety is something that persists in your life, even outside the context of the COVID-19 pandemic. Strengthening our ability to think in ways conducive to a rational evaluation of our symptoms is a skill that will continue to help us long in the future.

In essence, as Shawe explains,  “therapy helps you heal the wound that likely causes your anxiety in the first place.”

“Learning what causes you to feel consistent anxiety and then learning how to soothe that with a good therapist can be life-transforming,” he adds.

During this unprecedented time, health concerns among most people have been at an all time high -- and rightfully so. It is crucial to stay vigilant right now and care for our physical health. However, when we notice that we may be experiencing a level of hypervigilance that causes us incessant anxiety over every bodily sensation, it is important to take a step back and assess the situation.

Meditation and other mindfulness practices can be extremely helpful in allowing our minds to slow down and realistically evaluate whether or not our physical sensations may be caused by a physical illness or by anxiety.

It is important to remember to take things one day at a time and not be too hard on ourselves for feeling “weird” or “different” than normal. This is not a normal time, and it is perfectly okay for that to be reflected in the way we feel.

The overall goal of combating illness anxiety is to get to the root issues -- feelings of fear, insecurity, or mistrust of our intuition -- that may make overcoming these new challenges seem more difficult. If we can equip ourselves with the tools we need in an uncertain time like right now, we will be much better able to approach potential health issues with less anxiety in the future.

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