Have you found yourself increasingly fixating on your health in recent months? Or the health of your loved ones? Are you constantly checking for signs or symptoms that you’re unwell? Maybe you’ve even found some; perhaps your heart rate has been irregular recently, you’ve had some dizzy spells, felt nauseous, grown increasingly tired, struggled to catch your breath?
If this sounds like you, you could be experiencing symptoms of health anxiety*.
Given that we are currently almost two years into a global pandemic which has seen a response unlike any in any of our lifetimes – where nationwide lockdowns, mandatory mask-wearing, social distancing measures and mass vaccination rollouts have become the ‘new normal’ – this would not be so surprising.
Many years ago, at the peak of my own health anxiety when I was living in a self-enforced lockdown of my own, these last 18+ months would have seen my worst fear realised, and I know I am not alone in this. I feel I must add here that although there is no doubt that the Covid-19 pandemic has impacted us all in one way or another, for some the direct effects of the virus have been truly devastating, well surpassing these realms of ‘worst fears’. The emphasis of this post, however, is on the indirect implications of the pandemic, which are undoubtedly going to continue to unfold for many years to come, and, for some, this will unfortunately take the shape of health anxiety.
Health Anxiety
Worrying about health has always been part of the normal human experience. Our survival instincts exist to keep us alive, and symptoms of illness are intended to alert us that there is something wrong so that we can seek the appropriate support. Health anxiety is deemed to be a problem when it becomes excessive, when safety-seeking behaviours impact on daily-functioning and stop us from living our lives, despite reassurance from medical professionals and normal test results.
In the midst of a global pandemic, however, it can be difficult to work out where to draw the line between normal, or ‘acceptable’, levels of health anxiety, and those that are disproportionately impacting upon our daily functioning. This is harder still when signs that once would have indicated problematic levels of anxiety – excessive hand-washing, social isolation, avoidance of people or objects for fear of contamination – become the advice of experts. Suddenly those of us with health anxiety, pre-existing or new, find ourselves balancing somewhere between trying to protect ourselves and others from the threat of Covid-19 and attending to our own mental wellbeing.
For some, symptoms of health anxiety may be a completely new experience, arising only since Covid-19 first reared its ugly head in this country in January 2020. For others, who have been struggling with health anxiety since it was more commonly termed ‘hypochondria’, a global pandemic will only mean the exacerbation of symptoms that have been suffered for years, or perhaps a relapse back into a once-defeated pattern of unhelpful or detrimental behaviour. No matter which of these applies to you, the good news is that there are ways to help reduce the symptoms and negative effects of health anxiety.
It begins with understanding a little more about how health anxiety works.
The Vicious Cycle of Anxiety
Health anxiety can be brought on by many different triggers, from bodily symptoms and new health diagnoses to global health scares and many more, but it tends to be maintained in the same way: through unhelpful health-related thinking. This can mean the catastrophic and often misinterpretation of both health-related information and bodily sensations.
What makes health anxiety particularly tricky to manage is that as soon as these catastrophic thoughts begin, our ‘fight or flight’ response is activated to help combat the perceived threat. The fight or flight response is an automatic physiological reaction intended to prime the body to react in the face of a threat. This response sees the activation of the sympathetic nervous system, which is accompanied by a number of physical effects, from raised heart rate to cold and clammy hands to blurred vision, dry mouth, nausea and many more. Though typically harmless, these can be unpleasant sensations for anyone to experience, but for someone with health anxiety they can be truly terrifying, themselves wrongly interpreted as an indication that something is gravely wrong.
Here we have the vicious cycle of health anxiety. A symptom – however minor – triggers a catastrophic thought about the state of one’s health, in turn triggering more unpleasant physical sensations which result in further catastrophic thoughts, and so on.
The Impact of a Global Pandemic
It is not only bodily sensations that can trigger this vicious cycle. Health anxiety can also be brought about by the catastrophic misinterpretation of health-related information. As you have no doubt noticed, over the last 18+ months there has been no scarcity of discussion, speculation and fixation on Covid-19.
We are understandably being encouraged to test and monitor for symptoms in a bid to keep each other safe. But, for someone with health anxiety, what happens when you look inwards and self-monitor? You are all too likely to find something amiss. And if you do, this may well trigger the vicious cycle of anxiety.
Equally, those with pre-existing health anxiety are no doubt well-acquainted with Googling symptoms and fixating on any number of potential threats and diseases. In the current climate however, we no longer need to go out of our way to hear frightening statistics or unnerving anecdotes. Simply not actively seeking this information is no longer enough to filter it out.
Managing Health Anxiety
Finding a way to reduce and drop safety behaviours looks different in the face of a pandemic. Where previous advice would have included ‘stop Googling your symptoms’ and ‘avoid health-related news’ this has been rendered nigh on impossible in the current climate for reasons covered above. Of course, this advice still stands, and if you find yourself feeling overwhelmed do strive to limit your news and current affairs intake, try to avoid seeking out health-related statistics and keep in mind that you can give a gentle nudge to friends and family if you find the content of conversations distressing.
The good news is that there are ways to disrupt the vicious cycle of anxiety and learn to manage health anxiety. I will outline some of these below.
Relaxation techniques. These can include breathing techniques, such as body scans and box breathing [breathe in whilst counting to four slowly, hold for four, slowly exhale through the mouth for four, and repeat until you feel calmer and more centred]. The last two years have been a source of consistent stress and worry for many of us and you might be surprised to find how little time you’ve spent physically relaxing. It is great practice to set aside time each day to attend to this. For more information on relaxation techniques please contact me and I will be happy to talk you through what might work for you.
Keep a thought diary. When we are struggling with anxiety our thoughts can sometimes overwhelm us. Setting aside time to take note of these can help us to untangle the messy knot of thoughts filling our minds and also affords us the opportunity to review and challenge our thoughts. When you have noted down an anxious thought, take a moment to consider a more balanced perspective to counteract the worry. You may find this begins to become second nature over time.
Cognitive Defusion exercises. If your thoughts are becoming too difficult to unpick and are overwhelming you, try a cognitive defusion exercise. These are designed to enable us to put distance between ourselves and our thoughts in order to reduce the power our thoughts have over us. ‘Leaves on a Stream’ is a popular and effective exercise which you can find on the Audio Resources page, but please contact me if you’d like to know more about others.
Return to your routine. This is another technique that has become trickier to follow in the current climate. In theory, keeping busy will distract you from your worries and anxieties, and it is vastly important to your quality of life to be able to continue with activities and hobbies you once enjoyed but that you now feel anxious about. However, there may of course be activities that are no longer possible to continue due to restrictions, or that may have been adjusted due to changing guidelines. The important element here is to loosen the grip health anxiety has over you by not allowing it to continue disrupting your life. This is easier said than done of course, but you will likely find that taking slow and gradual steps to do activities you’ve been avoiding but once enjoyed gives you a renewed sense of power over your anxiety. This is the opposite of a vicious cycle: by challenging your fears and overcoming them you realise which thoughts were unfounded and feel empowered to challenge them further.
Moving Forward
Hopefully you have found something above that assists you in taking the first step to better manage your health anxiety. At the best of times fears about health can be very difficult to cope with, but in the context of a pandemic it may feel impossible. It’s important to acknowledge the extra hurdles we’re currently facing and not to berate yourself for feeling the way you do. The truth is health anxiety can be very tricky to manage, but it can be managed – and that is the most important thing to remember.
To talk through any of these points further, please use the contact form on my website www.laraditzeltherapy.com or book a free telephone consultation with me.
*before self-diagnosing as a result of anything you have read in this post, please do ensure you consult with a medical professional about any new and persistent symptoms that are concerning you.
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