Understanding health anxiety

Many of us find ourselves occasionally grappling with concerns about our health. Yet, for a subset of people, this unease goes beyond sporadic worry; it transforms into a constant, exaggerated fear centred on health.


Someone with generalized anxiety disorder (GAD) – in layman's terms, a chronic worrier – may worry about their health, but their concerns will also encompass other everyday matters like finances, family, and work. In contrast, someone with health anxiety, or hypochondria, hones in relentlessly on health-related matters.


Health anxiety is characterised by catastrophised thinking. Common physiological sensations like dizziness, tiredness, and minor aches and pains may be misinterpreted as evidence of something sinister. The mind becomes ensnared in a loop of unsettling "what if?" thoughts. Seeking solace, you frequently turn to medical professionals for reassurance, yet even negative test results and comforting words from doctors fail to pacify your distress for long. Did the doctor perhaps overlook something? Could the tests have been inaccurate? Is a second opinion warranted? How can I know for sure?


Health anxiety affects perfectly healthy people as well as people with diagnosed medical conditions. The focal point isn't whether your symptoms are genuine; it's about how you react to them, constructively or otherwise.


Health anxiety is very similar to obsessive-compulsive disorder (OCD). In fact, some experts view health anxiety as a variant of OCD, wherein individuals become trapped in a cycle of health-related obsessions and compulsions. Health-related worries or obsessions often lead to compulsions - repetitive self-checks for possible signs of illness, frequent doctor visits, soliciting reassurance from friends and family, avoiding places that might expose you to potential contagions, scouring the internet for symptoms of diseases, or shunning media that might discuss medical topics for fear you will hear something that results in you becoming gripped by worry.


Health anxiety can sometimes be trickier than OCD when it comes to treatment. With OCD, people often seek out help because they know their obsessions are excessive and unwarranted, and want advice on how to manage their compulsive behaviour. While this can also be the case with people with health anxiety, some sufferers may lack awareness and attribute their distress to a physical ailment rather than a psychological issue. This misperception steers them toward seeking medical intervention rather than psychological assistance; thus, the terrible cycle of worrying and checking continues.



While diagnostic mental health guidelines regard health anxiety and OCD as distinct concerns, the treatment strategies largely overlap. Psycho-education, cultivating tolerance for uncertainty, abstaining from unhelpful safety behaviors and compulsions, gradually confronting dreaded situations, enhancing your ability to endure discomfort, resisting the urge to ruminate – these are all crucial facets of managing both health anxiety and OCD.


If health anxiety plagues you, chances are you hold positive beliefs about worry, thinking it safeguards your well-being. However, the reality is quite the opposite – it leaves you ensnared in misery.


It's crucial to recognise that absolute certainty is unattainable. For example, if you asked me if I have an untreatable disease, I would instinctively answer no. But let's say you then ask: how do you know? How can you be certain? I would have to accept that no, I can't be certain. Maybe I do have an undetected and untreatable disease. If I tried to get certainty on this, I would drive myself up the wall with worry, because no amount of proof will be enough; there will always be another "Yes, but what if?" scenario.


The point is, certainty is a feeling, not a fact. Just as you accept uncertainty in other areas of your life, you must be willing to accept uncertainty when it comes to your health.


While your attention may be fixated on the perils of illness, it's imperative to recognize the perils of health anxiety itself – sleepless nights, strained relationships with frustrated partners, missed opportunities, the sheer hellishness of obsessive anxiety.


Health anxiety is treatable. The first step on the road to recovery is recognising the things you do to ease your anxiety – the rumination, the checking, the reassurance-seeking – are the very things keeping you stuck.


To use a line often quoted in therapeutic circles, if you always do what you've always done, you'll always get what you've always got.

(First published in Southern Star on 21/09/2023).