Health anxiety can interfere with your life, but it's highly treatable.
Image: © XiXinXing/Getty Images
You spend hours on the Internet researching health information. When you get a scratchy throat you automatically think cancer — not a cold. And even when medical tests come back showing that you're healthy, it doesn't make you feel better. In the back of your mind you still feel like something is wrong.
If this sounds like you or a loved one, it may be health anxiety.
Health anxiety is a condition that causes healthy people to worry that they are sick — even when they have no symptoms, or minor symptoms like a scratchy throat.
"People with health anxiety for the most part tend to fear severe illness, such as HIV, cancer, or dementia. They worry far less about strep throat, twisting their ankle, or getting a cold," says Dr. Timothy Scarella, instructor in psychiatry at Harvard Medical School. This fear that they have a serious illness can interfere with their daily life. It might lead them to seek out unnecessary testing, to waste hours in the doctor's office, and to spend days consumed by worry. But it's not only their own health that people with health anxiety may focus on. "Some people also worry excessively about their children's health," he says.
Health anxiety is a relatively common condition, known to affect some 4% to 5% of people. But experts believe it may be underreported and that the percentage could be closer to 12% — or even twice that, says Dr. Scarella. Unlike other anxiety disorders that are more prevalent in women, health anxiety appears to affect men and women equally.
Not all health worries indicate health anxiety
Being concerned about your health is not the same as health anxiety. It's normal to be worried about your health from time to time. You may wonder if your stomachache is a sign of a more serious condition. If you have had a severe illness in the past, you may be anxious about an upcoming imaging scan.
"There is a difference — at least medically speaking — between a person who has no symptoms or minimal symptoms and is frequently worried and anxious about being or getting sick and a person who is worried about concerning symptoms," says Dr. Scarella. However, he notes that anxiety about real health conditions can also become problematic.
People with health anxiety often misinterpret normal or benign physical symptoms and attribute them to something more serious. For example, if they were to compress an arm while asleep, instead of rolling over and shaking off the numb feeling, they might worry they were having a stroke. Symptoms produced by anxiety — which can include muscle pain, chest pain, heart rate changes, headaches, and dizziness, among others — can heighten existing anxiety about one's health.
Is it health anxiety?
So how do you know if you are sick, or if you're just anxious about being sick? Here are some telltale signs of health anxiety:
- You have no symptoms, but still fear that you are sick.
- When a doctor reassures you that you don't have an illness or a test shows you're healthy, it doesn't relieve your nervousness.
- You find yourself constantly seeking health information online.
- If you read a news story about a disease, you start worrying that you have it.
- Your worries about your health are interfering with your life, family, work, or hobbies and activities.
Most often, people with health anxiety have a pattern of this behavior that a primary care physician may begin to notice over time. "I talk to people who call their doctor five, six, or seven times a week," says Dr. Scarella. "Every three or four months they may go to their doctor looking for an HIV test despite the fact that they haven't had any new sexual partners or any experiences that would elevate their risk."
Does testing ease the nerves?
While testing may seem like a quick, easy way to alleviate health-related worries, for people in whom health anxiety has become uncontrollable, testing rarely provides lasting relief. "Repeated testing is unable to reassure people with health anxiety; people don't feel calmed when they get new information that disproves their fear," says Dr. Scarella. Doctors often fall into this trap, thinking "What's the harm in doing a test to reassure this person?" It seems like a reasonable approach. But, ultimately, no amount of testing ends the worry, Dr. Scarella says, and in fact, it may only serve to reinforce the anxiety.
While some people constantly consult their doctor and request testing, in other cases health anxiety causes people to avoid the doctor entirely, which can lead to treatable conditions going undiagnosed. "There are real risks in not going to the doctor — for example, not getting appropriate cancer screenings," says Dr. Scarella. This avoidance can become very dangerous when someone has a real condition but is afraid to get checked out for fear of bad news—such as a person who has appendicitis but puts off going to the doctor.
Treating health anxiety
"The most important thing to know about health anxiety is that it's a treatable problem," says Dr. Scarella. Statistics show that anxiety disorders, in general, are vastly undertreated. Only 37% of people with anxiety disorders receive treatment, according to the Anxiety and Depression Association of America.
This may reflect the stigma related to these conditions, and in the case of health anxiety, people may not actually attribute their symptoms to anxiety, but truly believe they are sick. And they may not know that help is available.
For people who are suffering from health anxiety, it's not helpful to tell them that their symptoms are fake or it's all in their head, says Dr. Scarella. "It's often more constructive to encourage them to look at what the worry is doing to their life," he says. "How is it interfering with the things they enjoy?"
If you suspect you might have health anxiety, focus on what you're losing. Would you rather spend several hours in the emergency room waiting for a test result — when you already had the same test two weeks ago — or do something you love?
Then seek an evaluation from a mental health professional. Your primary care doctor can provide a referral.
It's common for people with health anxiety to have other mental health conditions as well, such as depression, an anxiety disorder, or post-traumatic stress disorder, says Dr. Scarella. Because of this, treatment may need to address multiple issues. Treatment options include medications and psychotherapy, often in the form of talk therapy, which can help you manage and move past your worries.
But ultimately, those who seek help are often able to overcome the constant anxiety. "This can get better," says Dr. Scarella.