What is health anxiety ?

Pravina is a health 30-year-old mother of two. While at work one day, she suddenly noticed that her heart was beating faster than usual. An automatic thought popped into her, “what if this is a heart attack?”. She started sweating intensely and even developed mild chest pain. She was rushed to the hospital where she was examined and some tests were run. The doctor revealed that she had suffered a panic attack. Pravina, however, was very concerned that she had indeed had a heart attack. She began reading up online about the symptoms of heart disease. She was worried that she was suddenly going to drop dead. She visited several cardiologists, and could even convince one to do invasive investigations. Despite several reassurances and negative tests, she remained preoccupied with her illness. Gradually her ability to indulge on family, work and pleasure was fading.

Pravina was then seen by a mental health provider, health anxiety was diagnosed, medication was prescribed and therapy initiated.

All of us may have fleeting thoughts and worries about health-related issues. Some of the more common health-related fears include having or developing cancer and suffering from a stroke or a heart attack. Health anxiety is an obsessive and irrational worry about having a serious medical condition. These concerns about health can become problematic in the following circumstances.

  • When the concerns are excessive.
  • When fears about illness are out of proportion to the realistic likelihood of having an actual and serious medical problem.
  • When fears about illness are persistent despite negative test results and/or reassurance from a qualified healthcare provider.
  • When worry about illness leads to, unhelpful behaviours such as excessive checking, reassurance seeking (e.g., from doctors, family or friends), or avoidance (e.g., of check-ups, doctors, health-related information).
  • When health-related worries cause you significant distress or impair one’s ability to go about their day-to-day life.

People with health anxiety often indulge in reassurance-seeking behaviour such as visiting several health care providers, taking several tests and investigations and switching health care providers. There is also a subset of people who completely avoid health care providers out of a fear that something dastardly may be diagnosed.


What causes health anxiety?

In addition to a biological and/or environmental predisposition, health anxiety develops due to several psychological factors. There is often a well-defined cycle of events that initiates health anxiety and keeps it going. In a susceptible individual, the initial trigger is either a physical symptom suggestive of a major illness or being in proximity to someone who has developed a major illness. This initial trigger creates anxiety. The physical manifestations of anxiety (e.g tremors, feeling light-headed, dryness of mouth, blurred vision etc.) are perceived as evidence of an underlying illness which triggers further anxiety.

In addition to this dreaded cycle, people with health anxiety also tend to hold a “confirmation bias”, i.e they tend to hold on to information that supports their theories and disregard information that does not. Susceptible biology and averse life situations can lead to the development of health anxiety.


How is health anxiety treated?

A person with health anxiety usually goes through a number of doctors before being referred to a mental health professional. The mental health professional will work toward breaking the above cycle. Medication may be prescribed to treat underlying neurochemical abnormalities. Psychotherapeutic treatments including cognitive behavioural therapy are aimed at identifying and correcting distortions in thinking and behaving. Whether with therapy, medications, or both, the goal of treatment is to reduce distress and improve one’s ability to function optimally.

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If you are concerned about your health or have been experiencing excessive anxiety, please reach out to a qualified mental health professional.