Anxiety Files

Simple and powerful techniques for coping with anxiety and worry.

Are You a Hypochondriac?

Ways to handle your health anxiety.

Millions of people live in constant dread that they either have or will get a terrible disease. They focus on their "symptoms", which often are simple small differences from the norm. A headache is interpreted as a brain tumor, indigestion is a sign that you are having a heart attack, fatigue becomes a sure sign of cancer. People with hypochondriasis over-use doctors, google diseases, search WebMD for articles about their "diseases", check their skin under magnifying lenses, ask for reassurance, pray for help from God that they won't die, and live in constant worry about something they really don't have. These people are often known by medical professionals as "doctor-shoppers", going from one doctor to another. When the first doctor says, "I can't find anything wrong with you", they seek out second and third opinions. Nothing will satisfy them.

Estimates of the prevalence of health anxiety range widely---from less than 1 % to over 7 %, but medical professionals find their practice often burdened with these complaints and concerns. They may call the doctor repeatedly, often complaining about any discomfort that they may have.

I view these as health anxiety-or health worries. In my book, The Worry Cure, I discuss a number of ways to handle your anxiety, including health anxiety. Let's take a quick look here at what leads you to have health anxiety and then what you can do to change it.

What drives this kind of worry?

You believe that your worries about your health protect you

Obviously there is some truth in this. If you don't have regular checkups you may miss someone. People with health anxiety think that their constant checking and reassurance seeking keeps them on guard-they will catch the illness before it gets too late. The question, of course, is one of balance. What is prudent? What is obsessive? If you have a long history of false predictions, doctor shopping, reassurance-seeking, and miserable worry, then you are not protecting yourself---you are harming yourself.

You have perfectionistic ideas about health and body functions
Rather than viewing your body functions as variable and involving occasional discomfort (aches, pains, headaches, nausea, dizziness), you believe that anything less than perfect functioning or feeling is a sign that you have a serious illness. But bodies and functions are not perfect. A headache is likely to be a sign of nothing special. But you may jump to conclusions because your default is death.

You equate uncertainty with a catastrophe about ready to happen
You may think that if there is any possible doubt then it means that you have a responsibility and a necessity to keep seeking more examinations. But uncertainty is neutral. Just because you don't know does not mean it is a bad outcome.

You avoid people, places and things that remind you of illness
Some people with health anxiety use avoidance to cope. They may avoid people who are sick ("I don't want to catch what he has" or "It reminds me of sickness"), places (hospitals), or things (television or movies that remind you of sickness). Some people with health anxiety actually avoid going to a doctor because they don't want to find out about anything bad.

You search for information about disease
You may have fallen in love with google because you are continually googling symptoms and diseases. When was the last time you looked up a symptom or a disease with the idea that you would find yourself described in an article? Of course, if you search for "cancer" you will find millions of articles with thousands of "signs" of cancer. But you are biased and unbalanced in your search. This only adds to your anxiety.

Changing Your Health Anxiety

1. What are the costs to you of your health anxiety?
Think about how your worries about health are affecting your life? You are spending an inordinate amount of time worrying and ruminating. You can't enjoy your present life. You are driving other people crazy with your complaints and reassurance seeking. You are probably getting depressed because you are living in a world of threat and pessimism. And you are spending time and money on useless visits to doctors.

2. Be prudent
Before you start considering changing your health anxiety, think about being prudent without being obsessive. Don't give up your doctors or medication. You cannot replace appropriate and prudent medical attention with "positive thinking". See your doctors for regular checkups, take medication that is prescribed. If you have dramatic and difficult conditions, seek out medical care. But think about whether your worry, reassurance seeking, second-guessing, checking and avoidance are ruining your life. If they are, then your health anxiety is not prudent thinking-it's obsessive thinking and behaving.

3. Eliminate safety behaviors
There are a lot of superstitious things that you do that you believe keep you safe. You may be checking your skin, feeling or rubbing or pinching parts of your body, seeking reassurance, restricting what you eat or what you do---all to make yourself feel safer. Consider whether these are simply part of your superstitious set of behaviors and, if so, begin to eliminate them. As long as you hold onto these behaviors you will maintain your health anxiety.

4. Refrain from "searching for information"
Think about all the hours you waste making yourself feel more anxious by searching for clues and evidence of your dreaded disease. Consider giving up this endless "confirmation bias" by refraining from internet searches.

5. Accept uncertainty
Like all worries you think that worrying and ruminating will eliminate your uncertainty. But there is no certainty in this uncertain world. Consider accepting uncertainty as part of living in real life. Giving up on certainty is the most important step in getting your life back.

6. Set aside worry time
I've discussed this before in previous blogs (Make an Appointment with Your Worries), but it is a useful technique. Set aside your health worries until a specific time of the day (say, 4:30 PM) and then delay these worries until that time. You will find that by 4:30 most of these worries make no sense.

7. Bore yourself
There's nothing like a little boredom to get rid of anxiety. Take your feared thought, "I might have cancer", and repeat it slowly for twenty minutes. Very slowly. You will find you will get bored and the next time you think this thought you will recall how boring it is.

8. Accept death to live your life
No one gets out alive. Trying to eliminate death means you won't live your life. Simply realize that you need to accept that dying is part of living and that you can't eliminate this inevitability. Maybe it's sad, but it's the way to get on with life.

Worrying about health may be part of the human condition. And, it's important to have regular checkups and to see your doctor for real problems. But continual worry about your health robs you of living your life completely. Consider putting things in perspective by using some techniques that can help you get control of your worries so that they don't control your life.

 

 

Robert L. Leahy, Ph.D., is the author of Anxiety Free,The Worry Cure and Beat the Blues. He is Clinical Professor of Psychology at Weill-Cornell Medical School. more...

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