This article was originally published on My Mental Health on 21 July 2020.
What is Health Anxiety?
Health anxiety happens when an individual worries excessively about having a serious medical illness. In the wake of COVID-19, an extensive public health threat, it is common for most of us to be worried about being infected with the coronavirus. Health anxiety becomes a problem when it is persistent, excessive and out of proportion to the likelihood of contracting the illness.
There are two main types of health anxiety-related disorder, Somatic Symptom Disorder (SSD) and Illness Anxiety Disorder (IAD). Those with SSD worry excessively about their physical symptoms, which may or may not be due to any underlying medical conditions. People with IAD may not be experiencing any physical symptoms but they have a general anxiety or fear of contracting an illness
Signs and Symptoms of Health Anxiety
It is important to pay attention to some of our health concerns and safety behaviours. Some signs and symptoms of health anxiety include:
- Preoccupation with or fear of getting a serious illness
- Being easily alarmed about your health status and constantly worrying that minor physical symptoms are signs of a serious illness
- Repeatedly checking for signs of illness, including getting multiple medical consultations to seek reassurance despite a negative diagnosis.
- Constant rumination about your health concerns and incessant searching for related information.
- Marked distress and anxiety that affect your functioning in different aspects of your life and social relationships.
Causes of Health Anxiety during COVID-19
Our environment, our personal response to the pandemic and COVID-19’s threat to our health can all affect our level of health anxiety.
It is undeniable that the coronavirus is highly infectious, which makes good precautionary and infectious control measures essential. The impact of infection can be serious, and death can result from poor healthcare and treatment. The evolving understanding of the virus and lack of a vaccine add to the uncertainty about what can protect us effectively from the virus. The potential threat to health and uncertainty about the virus naturally increase health anxiety in many people.
A key contributor to the spike in health anxiety levels is the huge amount of information on COVID-19 and related concerns that we are inundated with daily over a prolonged period. Even when we are not consuming health-related information, we are constantly reminded of the virus when we put on our masks and when we see everyone on the streets donning one. The constant avalanche of information and reminders overwhelms us cognitively and increases our sense of vulnerability and anxiety.
Our level of health anxiety also depends on our personal traits and responses. People who have gone through some traumatic events or tend towards a worrisome personality are more likely to develop higher levels of health anxiety. We may engage in unhelpful coping behaviours which maintain or exacerbate our level of health anxiety. A lack of accurate understanding of the illness and symptoms may also heighten health anxiety.
Example: Mark had resumed work in the office. He developed an itchy throat after two days. Recalling that an itchy throat is a symptom of COVID-19, Mark felt anxious and worried that he could have contracted COVID-19. He went to the mirror to check if his throat was red. He searched for information on the Internet and repeatedly checked his throat. He was uncertain and got increasingly worried. Mark visited a doctor and was given five days of medical leave. Even though the doctor did not suspect COVID-19, Mark remained worried and saw the five days of medical leave as proof that he was at high risk of being infected. He felt increasingly anxious when his boss asked whom he had been in contact with and told him to monitor his health closely and report his health status twice daily. Mark was worried that he would spread the virus to his family, so he locked himself in the room at home. On the second day, when he did not feel better, he went to consult another doctor. The presence of community transmission, asymptomatic cases, easily available information, his boss’ questioning and Mark’s personal coping behaviours all contributed to his health anxiety.
Long-term Impact of Health Anxiety
Being health conscious and having a heightened level of health anxiety when the situation calls for it can help us to be more vigilant and seek early treatment to maintain good health. However, prolonged or excessive health anxiety can affect our mental health and overall quality of life in the long run. Preoccupation with our fears and excessive health anxiety can hinder our work performance and our relationships with family members and friends. Ineffective coping behaviors can also perpetuate our worries, trapping us in a vicious cycle as anxiety takes over our lives
Managing Health Anxiety
When you find yourself getting anxious, manage your emotions through relaxation techniques such that you maintain control over your anxiety rather than be overwhelmed and controlled by it. Do a few sets of deep breathing or muscle relaxation exercises to regulate your emotions and bodily sensations.
Monitor and limit negative coping behaviours
Note how you cope with your health anxiety and monitor how often you check for physical symptoms, search for related information and seek assurance from others. Set targets to reduce the frequency of such unhelpful behaviours and find new ways of coping.
Catch, check and change your thoughts
Catch any worry about your health and identify the thinking that precedes your anxiety. Check the thoughts on how true they are, how likely your fears will come true and what the consequences are should that happen. Be realistic and refer to facts and evidence. Change your mindset by adopting more positive and helpful ways of thinking.
Seek professional help
If you feel unwell, seek medical consultation to exclude any underlying medical conditions. If there are no diagnosed medical reasons and you remain concerned, consider seeking professional mental health treatment instead. Healthy anxiety is about the anxiety and not the medical condition, so you can be better treated with psychotherapy such as cognitive behaviour therapy. These helplines can offer support:
- Viriya Therapy Centre (Viriya Community Services) – Tel: 6256 1311
- IMH Mental Health Helpline – Tel: 6389 2222
The contributor is a Psychologist at Viriya Community Services.