Have you ever felt “off”, unwell and worried that something might be wrong with your health?
Many of us have had this experience at one time or another. For some, the worry about sickness or poor health is constant - this is known as “health anxiety”. Thoughts and concerns about health can become so persistent that they disrupt an individual’s daily life. For folks with health anxiety, it is extremely challenging to feel reassured that ‘everything is going to be okay’.
Individuals with health anxiety may experience troubling symptoms, including:
Belief or fear that any signs or symptoms they experience might be catastrophic to their health
Hyper-focus on body sensations
Regular checking of one’s body for signs of illness
Excessive anxiety or worry that is out of proportion to the reality of the situation.
Avoiding or seeking medical care – some individuals may avoid medical care due to heightened fear of what may be identified, while others may visit the physician’s office frequently or undergo tests to seek reassurance.
Researchers and mental health professionals are not sure what causes health anxiety. However, there is some evidence that health anxiety may be more common in people with a history of anxiety, distressing personal or family health events, and/or perceptions of susceptibility to illness. No matter the cause, like many mental health challenges, health anxiety can be managed with the right support.
CHALLENGES OF HEALTH ANXIETY
To effectively manage any type of anxiety, a person must develop the right coping skills. Perhaps one of the most challenging aspects of health anxiety is that engaging in “preventative” approaches to illness, or “safety behaviours,” can worsen the health anxiety over time. These behaviours may include:
Being on constant lookout for symptoms: Individuals with health anxiety may attempt to stay on top of their health by assessing for symptoms at all times. Unfortunately, this only builds the anxiety as it prevents the individual from learning how to cope with uncertainty and feel safe in their body.
Avoidance: For individuals with health anxiety, the possibility that they could be harmed or become ill when leaving their “safe places” (like their home) can become overwhelming. This may lead folks to avoid seeing their friends and family, or attending public places, which may harm their relationships and social wellness
Requests for Reassurance: Individuals with health anxiety may ask family, friends, or even medical professionals to reassure them that they are healthy. While this provides a sense of relief for a little while, it does not teach the individual to tolerate uncertainty, so anything that remains an ‘unknown’ feels threatening.
MANAGING HEALTH ANXIETY
Research shows two types of counselling approaches that can be effective in the treatment of health anxiety. Counselling can help individuals that are struggling to learn strategies to manage their health anxiety so that health worries don’t have to consume their lives.
Cognitive Behavioural Therapy (CBT): CBT is one of the best-proven methods to help treat health anxiety. The goal of CBT is to adjust both our thoughts and behaviours to better cope with the anxiety. For example, CBT approaches to health anxiety may focus on helping the individual to:
Understand the cycle that keeps the anxiety active. By helping the individual to understand how their thoughts, emotions, and actions magnify one another, they become better equipped to interrupt the cycle.
Focus on the facts. CBT aims to help people identify what is fact, and what is subjective. Using evidence to determine if the thoughts they are having are based on reality or a result of fear can make these thoughts more manageable.
Face their fears. CBT guides individuals to test their beliefs by thinking through what could happen if they reduced their safety behaviours. This may include working on reducing compulsive checking or working to increase exposure to new places and people.
Acceptance and Commitment Therapy (ACT): ACT is a newer approach to the treatment of health anxiety that has been shown to be effective. While ACT incorporates some aspects of CBT, the goal of the therapy is different. The goal of ACT is to help people better understand themselves and become “psychologically flexible” so that they are better able to act in accordance with their values. Some ACT pillars that may be helpful for health anxiety include:
Awareness. Understanding the function of our thoughts and emotions is an important piece to treating any type of anxiety. We often accept our thoughts as truth. ACT helps folks to better understand their thinking and learn how to notice thought processes as opposed to allowing thoughts to control us.
Values & Action. In ACT, the therapist helps the individual to identify what is most important to them in their life and seek actions – both big and small – that can help them align with their values. Part of this process is also identifying and working through the barriers that stop the individual from acting in line with their values.
The reality is that negative health events are always a possibility - it’s crucial to learn to live with this uncertainty. Unfortunately, this can be extremely challenging for individuals with health anxiety. Nevertheless, with the right support, it is possible to learn how to control the worry, interrupt the cycle of anxiety, and learn how to accept the unknown along with any discomfort that it may bring.