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Key Points: Driven by worries around COVID-19, many people have been experiencing health anxiety, fixating on the question of whether they may be ill in ways that disrupt their daily lives, including repeated searches of health websites, constant seeking of reassurance, and futile efforts to control the uncontrollable.
COVID-19 has fueled a huge uptick in health anxiety. Given that it is a deadly global pandemic, some of this anxiety is warranted and even a good thing. It propels us to make good decisions, like wearing masks, washing our hands more frequently, and practicing physical distancing.
The difference between normal or mild health anxiety and problematic health anxiety is that the latter is more distressing and likely interferes with your life. It might get in your way of doing your day-to-day activities, like working or trying to find a job. It could cause problems in your relationships or sleep difficulties, or you might drink more alcohol than normal to cope with it. If your health anxiety seems too high, there is good news: Behavior changes can help you start to get a handle on it. Here are four solutions to common health anxiety behaviors:
1. The internet is contraindicated for health anxiety.
Just like it is almost never a good idea to do a deep-dive into your recent ex’s Facebook or Instagram account, a person in the midst of a health anxiety surge should avoid health websites. Using the internet to diagnose yourself can be highly anxiety-producing; it’s so common now that there is a name for it: cyberchondria.
On the internet, any pain or usual symptom can often be found to be an ominous symptom of something serious. While many people have successfully used the internet to accurately self-diagnose, those with high levels of health anxiety should keep their health-related internet searches in check. COVID-19 has presented a unique problem, as we are bombarded constantly with messages about it. However, if you are spending too much time seeking information about it, try to resist and instead find some good distractions, especially if it is feeding into your anxiety.
2. Seeking reassurance can be a trap.
Another problematic behavior associated with health anxiety is excessive reassurance seeking. For example, you might ask a significant other or family member for reassurance about a symptom (e.g., “I just coughed, do you think I have COVID?”). The main problem with this strategy is that the seeker can become overly reliant on reassurance, and they don't learn how to tolerate their anxiety on their own.
Asking for reassurance can be very seductive: it can cause your anxiety to decrease in the moment, which feels good. Unfortunately, it sets you up to ask for more reassurance the next time you feel anxious, and you can get caught in a vicious cycle. Similarly, people can become “frequent fliers” at the doctor’s office as a means of reassurance seeking.
It’s best to tolerate your anxiety without asking for reassurance and to remind yourself that the anxiety will eventually pass on its own. Consider explaining to your well-meaning reassurance-giver(s) why it is counterproductive for anxiety management. Together you can come up with something they can say when you can’t resist asking for reassurance (e.g., “Are you sure you really want me to reassure you right now?”). Doctor’s office regulars should be open with their medical practitioners about their health anxiety and discuss what types of symptoms warrant a visit or call to the office and which ones do not.
3. People looking for symptoms of illness tend to find them.
A common practice of people with health anxiety is to monitor symptoms or frequently check their body (e.g., taking your pulse frequently if you are afraid of a heart attack or seeing how deeply you can breathe if you are afraid of COVID-19).
The problem with this strategy is two-fold. First, by paying attention to the symptoms you are inadvertently reinforcing both the symptoms and the anxiety. It is almost as though you are saying to yourself, I must pay attention to this sensation because something is wrong with me. Second, when you pay attention to sensations you are bound to notice them more. Many people with health anxiety believe that they need to monitor their body, lest they will miss catching something important. However, if you actually have COVID-19 or a heart attack, your body will let you know without you having to closely monitor it. If you notice yourself focusing on body sensations, redirect your attention to something in your external environment (e.g., a picture on the wall, the mess on your desk, a tree, anything will suffice).
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4. Control what you can and accept what you can’t.
Finally, if you are doing any of the behaviors listed above, you are probably trying to get control over the uncontrollable. It is important to work on accepting uncertainty and accepting that there is only so much you can control.
If you are worried about your health, ask yourself if there are any meaningful changes that you can implement, including eating a healthier diet, increasing exercise, consuming less alcohol, and/or practicing good sleep hygiene. Of course, consult with your doctor if needed. If you are feeling lonely or isolated, reach out to old friends, do an on-line class, volunteer, or start a new hobby. Making these types of changes can be empowering and they can help lower your anxiety.
Of course, not all health anxiety is baseless and sometimes you will have an actual illness. However, you can still use these guidelines to manage your anxiety even when you are sick. And when you are healthy, using these principles will help free you from thinking that you are sick.
