You Can't Escape Health Anxiety. But You Can Learn To Live With It, Experts Say
Recently, I wrote an article about protecting yourself from skin cancer. The next week, I went on a beach vacation, where I was subject to the sun’s powerful UV rays for hours on end. I’ve always worn sunscreen and have never gotten a sunburn in my life (brag), but this time, I couldn’t relax. All I could think about was how if my skin got any darker, or if I didn’t apply sunscreen perfectly, it might lead to skin cancer in the future. I pestered my family members to reapply and worried on their behalf when I saw their changing hues. I checked my arms and chest constantly for signs of redness or burns—but I went home without so much as a tanline.
For people who experience health anxiety, a condition where generally healthy people worry that they’re sick despite having no or innocuous symptoms, overthinking can ruin a lot more than beach vacations. Health anxiety is estimated to affect 4 to 5 percent of the population, though experts believe it’s underreported and could be closer to 12 percent or double that, according to Harvard Health. That’s potentially 80 million people in the United States constantly worried that they’re sick.
It’s also on the rise, having grown exponentially over the past 30 years—particularly for university students, per a 2020 article in The Journal of Anxiety Disorders. (In the meta-analysis and systematic review of 68 studies and over 22,000 participants, the mean score on the Illness Attitudes Scales, a tool used to measure health anxiety, had increased by 4.61 points between 1985 and 2017).
COVID may have contributed to this, and access to unlimited (and unvetted) information online hasn’t helped. There’s even a name for how the internet can fuel health anxiety’s flames: cyberchondria, otherwise known as all those times you take to WebMD to diagnose your symptoms and decide that you have a horrible illness when really you needed to take an Advil or get a good night’s sleep.
Meet the experts: E. Katia Moritz, PhD, is a psychologist, chief clinical officer and founder of the Neurobehavioral Institute, and a member of the Scientific & Clinical Advisory Board and the Diversity Council of the International Obsessive-Compulsive Disorder Foundation. Patrick McGrath, PhD, is lead psychologist at Ascension Illinois Alexian Brothers Behavioral Health Hospital and chief clinical officer at NOCD, an online treatment option for people with OCD. Olivia Verhulst, LMHC, is a licensed psychotherapist specializing in anxiety in New York City.
Spending time researching illnesses on your own might feel productive, but it can cause more harm than good. In fact, health anxiety doesn’t actually help you stay well, says Katia Moritz, PhD, a psychologist and chief clinical officer of the Neurobehavioral Institute. Instead, it can create mental and emotional challenges, cause you to go to extreme lengths to avoid certain triggers, and decrease your quality of life. If your relationship with Dr. Google is affecting your mental health, therapists explain how to navigate health anxiety during a time of information overload.
What is health anxiety?
The term “health anxiety” can be classified by psychologists as one of a few things: illness anxiety disorder, somatic symptom disorder, or a form of obsessive compulsive disorder.
Illness anxiety disorder is when you're constantly worrying about having an undiagnosed condition, no matter how unlikely it is and despite reassurance from others—even doctors—that you're fine, says Olivia Verhulst, LMHC, a New York City-based psychotherapist specializing in anxiety. Somatic symptom disorder is similar, but the person is also experiencing physical symptoms that are driving their concerns.
OCD involves a combination of recurrent intrusive thoughts (obsessions) and rituals (compulsions) per the American Psychological Association (APA). With health anxiety, you might have compulsions—like checking your body frequently for certain symptoms or seeking reassurance about your health status—on top of your obsessive concerns about health. Someone suffering from any one of these conditions might constantly be worried about developing a specific illness, spend a lot of time researching it, and follow rigid rules or behaviors to avoid getting sick.
There are plenty of reasons you might have anxiety about your health, like a diagnosis, a day-to-day environment that poses risks to your well-being, or a family history of an illness.
Some level of anxiety is normal, and even good, Patrick McGrath, PhD, a psychologist and chief clinical officer of NOCD, an online treatment option for people with OCD says, since it might push you to accomplish something you need to get done or protect you from things that are genuinely anxiety-inducing. But on the other hand, you could find yourself reading articles about a condition only to realize that you feel more anxious, says Moritz. And no matter how much you describe your symptoms to your friends, you still don’t feel any better.
Whether you've been diagnosed with a formal disorder or not, one of the most common treatment methods psychologists use is a type of cognitive behavioral therapy known as exposure response prevention (ERP), the gold-standard treatment for OCD that helps people learn to confront their fixations, sit with discomfort, and not act on their compulsions.
“Cognitive behavioral skills teach you how to have the [intrusive] thought, not engage in any action, and accept that you don't know if you are sick or not,” says Moritz. “You're going to build this strength, this muscle, that when the thought gets thrown at you, it's not going to hurt you anymore.”
The best way to get treatment for health anxiety is to consult a therapist trained in ERP. But in the meantime, here are a few other ways to start managing uncertainty around your health, per McGrath, Moritz, and Verhulst.
How To Cope With Health Anxiety
Limit worry time, especially on the internet.
If you spend hours on end researching potential conditions, therapists recommend setting boundaries around reassurance-seeking online, especially since your worries can be insatiable.
Being chronically online can make you more anxious because of negativity bias, the tendency to overemphasize bad things compared to good ones, and confirmation bias, the tendency to interpret information to fit the conclusion you’ve already jumped to in your head, says Verhulst.
“It's easy to find yourself in a situation where anxiety is filling in the gaps because you don't like uncertainty—and anxiety latches on to the most catastrophic things you can find,” she says.
To that end, it can help to set boundaries around how much time you’re on Google. “I would never tell anyone not to look something up, but I would also say there has to be a limit,” says McGrath. Set a timer for how long you’re going to spend scrolling on niche corners of TikTok or checking WebMD, and hold yourself to it. Twenty minutes is a good place to start, says Verhulst.
Think of anxious thoughts as bullies—and take away their power.
Just like a playground bully intrudes on your well-being (say, with unwanted comments and attention), your anxiety does, too. The best way to respond to a bully isn’t necessarily to fight back, it’s to show them you don’t care, says Moritz—and you can do the same in approaching health anxiety.
For example, if the bully in your head is convincing you that you have an illness, and you know it’s unfounded, you don’t have to try and argue against it or prove it wrong. Instead, try saying, “So what?” as a way of interrupting the potential thought spiral, says Moritz. While the pros call this expectation violation—because your brain is expecting you to freak out, and you’re attempting to do the opposite—you can think of it as taking the power away from the bully in your head, and hopefully, making it easier to move on with your day.
Recognize that anxious thoughts about your health aren't productive.
One question to ask yourself is if your health anxiety is doing anything useful. Constant worrying doesn’t actually have an impact on whether or not you get sick.
“Anxiety doesn't make you healthier or take better care of yourself,” says Dr. Moritz. “If you had zero health anxiety right now, [your health] would be the same.”
Learn to identify and manage your triggers.
Triggers for a health anxiety freakout are a part of life, says Dr. Moritz. Whether you just read a news story about a condition, sat next to someone with a terrible cough on public transportation, or woke up with a sore throat, you might be concerned. The more you get to know what your triggers are—and how you typically react to them—the better you can interrupt a spiral. If you can identify a trigger and decide to react differently than what your anxiety wants you to do, you can diminish its power.
“You don't have to go down the path that your thoughts, images, and urges take you,” says McGrath. “You can acknowledge them and you can move on.”
This isn’t to say you should avoid your triggers altogether, since this can actually reinforce anxiety. Instead, the best way to get over any fear is to face it head on, says McGrath. While this doesn’t mean you should go out and get the sickness you’re afraid of, it means dealing with the discomfort that you can’t have 100 percent certainty about your health.
Consider cognitive behavioral therapy.
If health anxiety is having a major impact on your life (like interfering with work or relationships or it taking up a significant amount of your time), it’s a good idea to talk to a therapist about it.
Rather than going to a traditional talk therapist who might try and reassure you about your health, going to someone trained in cognitive behavioral therapy and ERP can help you recognize what triggers you and acknowledge your thoughts—without falling into an anxiety spiral.
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