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Health Anxiety: A Common Treatable Problem

Adapted from: Treating Health Anxiety by Steven Taylor and Gordon J.G. Asmundson, Guildford Press, 2004

What is heath anxiety?

Health anxiety is characterized by excessive worry or fear about disease, despite the fact that you have had medical tests and checkups that have ruled out physical disease. Some health-anxious people are mainly worried about having a dreaded disease such as cancer while other health-anxious people are primarily worried that they could catch a serious disease by coming into contact with sick people, hospitals or other sources of germs.

Where do my symptoms come from?

People with health anxiety experience a lot of physical symptoms. The symptoms are real but harmless. They are caused by many different things. You and your therapist can work together to help understand why you experience unwanted bodily changes or sensations. In some cases the sensations are part of the body’s anxiety response. Anxiety is associated with many harmless bodily changes or sensation, including stomach upset (e.g. nausea, bloating), fatigue, flushing and hot flashes, shortness of breath, chest tightness, racing or pounding heart, dizziness, and diarrhea. If you notice these changes or sensations and start to worry about them, then you will become more anxious and these bodily reactions will persist. These reactions may be inconvenient but are completely harmless.

Do healthy people experience physical symptoms?

People who are perfectly healthy experience many bodily changes and sensations. Most people don’t notice them because hey don’t pay much attention to their bodies. People with health anxiety tend to be preoccupied with their bodies. They focus a lot of their attention on their bodies and so hey are more likely to notice and worry about harmless bodily sensations. This can happen because some people have particularly “noisy” bodies, in the same way that a rattling car can be mechanically fine.

Should I seek reassurance or discuss my symptoms with other people (aside from my therapist)?

No. Once your doctor has ruled out physical disease, then there is no need to seek further reassurance. In fact, seeking reassurance and discussing symptoms can make your health anxiety worse. Reassurance seeking has the following effects:

It puts you in a passive, dependent role, which prevents you from proving to yourself that the bodily changes or sensations are harmless. It encourage you to become preoccupied with your body, which means that you will continue to notice harmless changes or sensations and become alarmed by them It encourages the incorrect belief that you are physically sick.

Once your doctor has ruled out a harmful physical disease, then we strongly recommend that you try to stop seeking reassurance, and stop discussing your health with friends, family members, and others. We also strongly recommend that you do not check up on symptoms by reading medical article or textbooks or by searching for medical information on the Internet. These activities will make your health anxiety worse.

How do I know my symptoms are caused by something harmless, like anxiety?

By collecting evidence. No doubt you have been to your doctor to look for evidence of a physical disease, but have you looked for evidence that your bodily concerns are due to something harmless, like anxiety? Most people with health anxiety fail to do this. If your bodily concerns are due to anxiety, then it would be important to prove to yourself that this is the case.

How would someone overcome a fear of getting sick?

This is called disease phobia. It can be treated in the same way that other fears are treated, by gradually and systematically confronting the thing that you fear. You and your therapist can discuss ways that this can be done, in a way that is not too difficult for you.

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