For Most people, a recently-appeared skin blemish or a headache is nothing to be alarmed about. But if you suffer from health anxiety, formally known as “hypochondriasis,” symptoms such as these could easily be interpreted as a life-threatening disease. You may visit your doctor excessively, or avoid going to the doctor altogether for fear that you will be diagnosed with something terrible. If you do see your physician, and he or she runs some tests, you are likely to assume the worst — and the waiting period can be agonizing.
Health anxiety can be a central feature of many different diagnoses, including depression, somatoform disorder, adjustment disorder and others. It can also be a central feature of certain anxiety disorders, such as generalized anxiety disorder (GAD), obsessive compulsive disorder (OCD), and panic disorder. Individuals suffering from GAD are most likely fear malignancies, while individuals with OCD most commonly worry about infectious diseases. Panic disorder sufferers often worry that they are going to have a heart attack, and/or fear a catastrophic reaction to a medication resulting in “medication phobia.”
Health anxiety is influenced by a number of other factors as well, such as the media reporting — in an often sensationalized manner — the risk factors for various diseases. In such reportage, the risk factor of “stress” is invariably over-emphasized, which can create an even worse scenario: stressing about the effects of stress on your body! Television dramas such as Grey’s Anatomy or House depict individuals with mysterious (and often fatal) diagnoses. The Internet, of course, is rife with information that is frequently unreliable, and suggestible individuals can spend hours researching just one symptom. These cyberchondriacas are on a desperate search for some reassurance, but more often than not find their anxiety is only exacerbated by the ambiguity of their symptoms.
Two other contributing factors are age and life events. Generally speaking, the older you are, the more vulnerable you feel to developing illness. You may have friends or relatives around your age that have succumbed to a major illness, or died. Health anxiety is, at its very core, a fear of dying. The reality that you cannot control what is imminent forces you to confront your own mortality. And the older you get, the worse your health anxiety will be.
There is effective treatment for health anxiety. However, the treatment of choice for all anxiety involves confronting your fears. Avoiding thinking about it, or trying to stop the thoughts, is not effective. It may help temporarily, but eventually your anxiety will return, because you can’t help but be aware that sickness and death are fundamentally inevitable at some point. In my practice of specializing in anxiety and chronic illness, I have observed that those clients who already have a serious illness usually do not fear falling ill; they’ve already adapted to it and, for the most part, have developed strategies to live within its limitations. Those clients who have had the fortune of being healthy are more likely to fear being diagnosed with a disease. They have not had the opportunity to learn that there are choices and resources available with many illnesses. It is no surprise, then, that the treatment of choice for health anxiety is a combination of cognitive therapy and imaginal exposure therapy. As threatening as these therapies may sound, they are time-limited, and initiate recovery.