People with health anxiety focus on specific sensations such as feeling dizzy, fatigue, joint pain, digestive problems, a headache or a quick and sudden heartbeat. Such physiological symptoms are typically not harmful if they are short lived and do not re-occur on a repeated basis. The difficulty that people with health anxiety have is that they misattribute these symptoms as indicating there MUST be significant disease lurking.
Like many people, they will make an appointment with their doctor to have these symptoms checked out. Once the doctor has done investigations and checked them over and reassured them that everything is fine, most people will accept this. However the person with health anxiety is not re-assured. They may become convinced that a headache is indicative of a brain tumor. Shaky hands could mean Parkinson’s disease, a racing heart means a heart attack. They rarely attribute their symptoms to the possibility that they perhaps had too much coffee, have been experiencing a great deal of stress, or ate something that didn’t agree with them.
There is nothing wrong with having these sensations checked out. The problem resides when all of the reassurance is ignored and the anxiety continues with a continual stream of catastrophic thinking that everyone is wrong and they are going to die. This can lead to frequent doctor visits, pressing for unnecessary tests or medication, seeking reassurance from loved ones, or spending countless hours on the internet researching their symptoms. It is estimated that the 10-20 percent of the medical budget in the United States is spent on patients with significant health anxiety ($250 billions per year: Barsky, Oravan and Bates, 2006).
Debbie had been nauseous for about 2 months. Her doctor was diligent and checked for pregnancy, ulcers and did all the of the requisite blood work. All of her tests were negative. Debbie continued to seek out 3 more physicians demanding the same tests be repeated and pushing for more and more intrusive testing. All of the results eventually came back to the same conclusion; she was healthy.
Upon visiting her family doctor months later her family physician continued to probe further and was able to determine that she had been experiencing a great deal of stress and sadness and could recognize that she was anxious. Debbie had a warm and good relationship with her doctor and was able to relay the following, that much of her anxiety surrounding her health was based on the emotional response of fear and thoughts such as “What if I have a serious disease, my mom died too young, so that must be the evidence I will too”. “What if this is more serious than anyone realizes and I get sick? I will be a burden on my family. What If my kids don’t have a mother”? From there she would start imagining her death, the funeral, and the grief and loss her children and husband would experience.
Many of us have vivid imaginations and on the odd occasion these thoughts may cross our mind but we realize, it isn’t happening, hasn’t happened and we have received the necessary tests that confirmed we are ok. In Debbie’s case she was never re-assured, despite all the necessary medical tests, until she was able to open up and start expressing her concerns with her doctor.
Debbie’s doctor immediately referred her to a therapist for CBT (Cognitive Behavioral Therapy). CBT involves learning to change the emotions (fear and anxiety), thoughts (what if or catastrophizing) and behaviors (multiple doctor visits, internet surfing, fear of leaving the home, constant reassurance) that contribute to health anxiety. Health anxiety can exist with actual physical illness or in its absence. Either way, CBT is an effective tool to improve the quality of life. For those who are not struggling with an actual illness, CBT is the most researched and effective form of therapy in helping to overcome excessive levels of health anxiety.
While it is fair to say that 1 or 2 out of every 10 people may struggle with health anxiety, it is unfair to say that you have to continue the struggle alone.
Please discuss with your doctor some of the emotions (fear and anxiety) or thoughts (what ifs… and catastrophizing are quite common) that may behind your quest for constant re-assurance. If the medical tests come back negative and your worries continue please seek out a therapist who does CBT.