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Illness Anxiety - "Why am I ALWAYS 'worrying' About My Health?"

How to know you are worrying too much about your health - Illness Anxiety Behaviour | Are You A Hypochondriac - By Dr Sylvia Kama-Kieghe

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Reality of Illness Anxiety Behaviour

As a doctor working in busy health centres, I see people at different stages of illness.

 Of course, being ill usually comes with some amount of worry - common concerns are: what's the cause of this symptom like a lump or dizziness, or how bad is it, could I die.. and so on.

However, there's a point when the anxiety about your health condition can be excessive and have a severe impact on your recovery.

 This post looks at illness anxiety behaviour, which you may also know by the older term Hypochondriasis.

 Anxiety is a huge topic, but here I'm interested in three aspects:

  • How can you tell if you are a hypochondriac?
  • What are the ways it could impact your health or other parts of your life - and very important:
  • If you do have excessive anxiety about your health, how can you get better?

When you have illness anxiety, you are afraid that you have a severe illness. You are - literally - 'always worrying about my health'.

We all have some degree of anxiety when we develop new, unusual and painful symptoms. That is natural.

The problem if you have illness anxiety is that your symptoms do not correlate with your anxiety.

You spend so much time worrying that you are ill or will become sick, thinking over and over about your symptoms - it takes over your life.

Recognition

So for my question one - how can you tell if you are a hypochondriac? 

I've split the answer into two - first, looking at your thoughts and secondly, your actions or behaviour.

Lady with hair tied up in not looking despairingly on computer - worrying about my health

Thoughts

Now thoughts - and these are my terms to describe the mindset or thought process if you have illness anxiety.

  1. Singular Focus. This is when you select just one symptom or event to reach a grand conclusion, disregarding other facts that may refute it. An example is deciding you must have lung cancer a few days after developing a cough with fever. Now, please don't get me wrong - I'm not trying to minimise the significance of any symptom. And don't forget that your personal experience may even bear into the thought process. For example, having a close relative who died of lung cancer. But the point here is that the focus is on the cough only, which could result from other less severe conditions like a chest infection, common cold, etc., and driving ahead to cancer. Another way of looking at this is that you may also over generalise - using only one fact to arrive at general conclusions.
  2. Next is Rushing to Conclusions. This is an interesting one because it means you can make determinations not based on facts. Instead, you make an assumption and come to a decision or mindset from it, regardless of whether or not it is true. As long as it sounds plausible or fits your reasoning, you accept it irrespective of the source. Attitudes like this may be promoted by other people's opinions or what you search for and find on the internet - beware, Dr Google or some viral Tiktok health advice!
  3. Disaster or Catastrophe Seeking. In this case, you will assume the worst-case scenario will be the outcome - particularly before you have had an examination or tests. Here there is no rationalisation or optimism/hope. For example, you may think that if you start feeling dizzy, it means your heart will stop. Now it even goes further. Even after seeing the doctor, you think they didn't take a proper look. Or, listen to you. Or they didn't arrange the appropriate test. You complain of burning chest and internal heat - why didn't they arrange a scan of your chest? This is closely related to another mindset psychologists call Magical Thinking - where you believe that your thoughts or ideas will eventually develop into reality, a severe medical problem.
  4. Subjectiveness. Also known as personalisation, this is when you wrongly attribute or relate bad situations/events to yourself—so using our example of a cough and lung cancer. Even though you are in your 20s or 30s and have never smoked, and your doctor says the chance of lung cancer given a cough of 2 days without other symptoms like coughing up blood or weight loss is very slim, you assume that YOU will be among the tiny percentage that will get lung cancer regardless.
  5. Inflating Danger - Here, you excessively inflate the possibility that something terrible will happen to you, given a symptom that may not necessarily reflect serious illness. For instance, you experienced some palpitations the other day. The blood tests and ECG did not show anything. The doctor was satisfied after your physical examination that things appear normal. There are no other symptoms, and they encourage you to behave normally and come back if there are further problems. But you go home - feeling less than reassured - even though you have had no more symptoms. And while you continue to think about the symptoms, they start to inflate in your mind - next, you fear sleeping alone as you may not wake up. This triggers further anxiety that may create more symptoms utterly unrelated to the palpitations you began with.

Thoughts when you are always worrying...

To summarise this section - if you have these mindsets, here are the thoughts that are likely running through your mind:

  • I must be absolutely sure that this phenomenon is not dangerous.
  • Only someone else can reassure me.
  • If I feel something weird in my body, it is a sign of a serious illness.
  • I am 100% sure what this physical symptom means.
  • When I'm healthy, I shouldn't feel anything unusual in my body.
  • If I'm worried about a serious illness, I will end up getting it.

worrying about my health ? Word breathe pinned on a cork display board.

Actions

Ok, the second part - What about actions or behaviour that indicate excessively 'worrying about my health'?

 If you have illness anxiety, there are some characteristic patterns of behaviour that you may show:

  • You are constantly checking yourself for signs of illness like pain/lumps/ tingling etc.
  • Looking for reassurance from people around you - may include frequent calls and trips to see the doctor. Visiting more than one doctor to get a second, third or fourth opinion and so on.
  • You convince yourself - even after examination or having tests that something has been missed.
  • Search for information or evidence on the internet/ media to prove that what you are thinking is right
  • You behave as if you are seriously ill - avoiding work, socialising or physical activities as a result.

 Honestly, ask - Do you see yourself in any of these?

Recommended Reading

Effects

Now for question number two - how could illness anxiety behaviour affect your ability to receive treatment or recover from genuine sickness?

Or even impact your ordinary life? 

There are many challenges that you could encounter because of illness anxiety behaviour. Some of them are:

  1. The genuine distress can be highly disabling and prevent actual typical day to day activity. Your mind is preoccupied with the symptoms, how they are getting worse, no one believes you, and you will not get better.  
  2. You could develop new symptoms because of anxiety - heart racing, feelings of tension or agitation, headaches and so on. This becomes physically and mentally exhausting. You may lose sleep because you are worried. Sleep deprivation makes you feel more ill, anxious and confused. It's like a vicious cycle begins. 
  3. In the question of treating any actual condition, you may not believe the tests or examinations of your doctors and refuse to use their treatment - worsening any actual illness you may have.
  4. People around you become frustrated as they find it hard to deal with the constant fear and illness association they experience with you. They cannot understand your reasoning and evidence for illness. You also can't enjoy life anymore, making you a pain to be around, damaging your social and personal life.

Pale african lady in blue grey hoodie, head in hands looking down - worrying about my health

Treating Illness Anxiety

 Finally, how can you overcome illness anxiety behaviour?

We have seen it can cause significant problems and nearly paralyse you from proceeding with a healthy life once it takes hold.

But the first solution is recognising the fact you have illness anxiety which many people fail to do. And this is why I've listed the thoughts and actions earlier to help with recognition.

 Next, when you realise and accept that you have this condition, you are on the step to recovery - and treatment is possible.

The primary treatment we use for illness anxiety behaviour is Cognitive Behavioural therapy, and your doctor can refer you to a psychologist or psychiatrist who provides therapy sessions.

 In addition, there may be some medication or natural measures to help you manage anxiety generally - especially if it is so crippling. 

 But there are few things you can do to help yourself overcome the condition.

Self Help To Overcome 'Worrying' About Health

  1. If you have symptoms like a headache or chest pain or lump, get a list of the results of the tests your doctor has done in respect of these symptoms showing your normal findings. This document is helpful for you and those supporting you to refer to when you begin to worry over your symptoms.
  2.  Keep a diary to observe and record your behaviour and thoughts - how often you touch a lump or ring your doctor for help. Then you can start cutting the frequency of these actions down.
  3. Challenge your thoughts. Here's a tip from the NHS website to help:

  • draw a table with two columns
  • write your health worries in the 1st column, then more balanced thoughts in the 2nd
  • for example, in the 1st column, you may write, "I'm worried about these headaches", and in the 2nd, "Headaches can often be a sign of stress."

  1. Employ Distraction intentionally - when you get the urge to check your body - do something else like go out or call a supportive friend. 
  2. Resume normal activities you had started to avoid, like physical activities or socialising - and gradually resume work.
  3. Read self-help guide books for dealing with anxiety.

Do This Next

 I hope this has been useful - I know with the year we've all had from Covid 19, anxiety about ill health has been uppermost in our minds.

 However, always contact your health practitioner with any symptom that concerns you. Hopefully, examining you and running tests will help address the cause and suitable treatment.

Don't forget askawayhealth is here to provide you with factual online health information as a guide - we are better rated than Dr Google for sure!

References

Illness Anxiety Disorder cognitions and behaviour - NiceDay: Online Coaching & Therapy

Health anxiety - NHS. 


Editing by AskAwayHealth Team

Disclaimer

All AskAwayHealth articles are written by practising  Medical Practitioners on a wide range of health care conditions to provide evidence-based guidance and to help promote quality health care. The advice in our material is not meant to replace the management of your specific condition by a qualified health care practitioner.
To discuss your condition, don't hesitate to get in touch with a health practitioner or reach us directly through info@askawayhealth.org

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