What to Know About Health Anxiety

YouIs it a sign that you have seasonal allergies? It’s a question you’ve likely asked yourself at least once—and perhaps lots of times—over the last few years.

Especially during a pandemic, it’s normal to analyze your health. For some, these thoughts may become more serious. At least 4% of the U.S. population lives with what’s known as health anxiety, or an excessive preoccupation with health and illness—and symptoms of the condition may have emerged or worsened for certain people during these virus-dominated recent years, experts say.

“Health anxiety, to a certain extent, is normal during the pandemic,” says Michelle Patriquin, director of research at the Menninger Clinic, a mental health treatment center in Texas.

In 2013, the Diagnostic and Statistical Manual of Mental Disorders retired the term “hypochondriasis,” which many people found belittling and inadequate. Since then, health anxiety has been formally known as “illness anxiety disorder” and is characterized by excessive worry about having or developing a serious disease, often even if tests don’t show anything wrong. People with this condition frequently become fixated on mild or routine physical sensations—fearing that a headache could be an early sign of a brain tumor, for example.

Paul Salkovskis is a British clinical psychologist who studies health anxiety over many decades. OCD and health anxiety can lead to OCD-like behaviors such as frequent hand washing or temperature taking. Health anxiety, which can be similar to panic attacks and manifest as symptoms such as shortness of breath or dizziness. Health anxiety sufferers often mistake these symptoms for a sign of something more serious, both in the near future and in the present. People with anxiety may mistakenly believe that a racing heart is an indication of cardiovascular disease.

All people worry about their own health occasionally. But when that worry interferes with daily life or spirals into behaviors like obsessively researching symptoms online (what some researchers call “cyberchondria”), it could be health anxiety.

Patriquin said that the pandemic added to the problem. Due to valid fears of catching and spreading COVID-19, isolation, political unrest, and upticks in substance use, it’s no surprise that many people have experienced psychological distress over the past few years, she says. Since the outbreak of the pandemic, anxiety and depression rates have increased around the world. Research by Menninger Clinic has shown that many individuals with mental disorders such as schizophrenia and bipolar disorder are experiencing worsening symptoms.

According to the 2021 study, some people may feel that the COVID-19 epidemic has exacerbated or caused symptoms of anxiety. This is due to their legitimate concerns about illness, 24/7 coverage of disease and other factors. International Journal of Cognitive Therapy Anxiety can be fueled by the fact that even people with no symptoms are susceptible to the virus.

Another team of researchers used Reddit to learn more about anxiety among the general public. In January 2020, even before many countries began responding to the threat of COVID-19, they saw that activity in Reddit’s health anxiety forum began to spike—and as time went on, the language used in other mental health-related forums began to mirror that used in the health anxiety thread, with many posts using words like “virus,” “respirator,” and “vaccine,” they found.

Salkovskis did however notice something very interesting about his practice. Some people suffering from contamination fear saw some improvement in their symptoms during the pandemic. It was because so many people had taken disease precautions. “However, that’s kind of a holiday rather than a cure,” he says.

Indeed, by the spring of 2021, rates of psychological distress—including health anxiety—were elevated in high-income countries including the U.S., U.K., and Italy, according to research that has not yet been published in a peer-reviewed journal and was led by Marcantonio Spada, a professor of addictive behaviors and mental health at London South Bank University. Spada says that countries that had adopted aggressive strategies like locking downs as part of their pandemic-management strategy were more likely to experience anxiety than those that followed more relaxed methods.

“You ask people to avoid situations, to mask, to monitor a threat,” Spada says. “Then you’re left with a collection of thinking patterns and behaviors that make you vulnerable next time there’s uncertainty.” Spada’s research also suggests that people who score highly on measures of neuroticism have been more likely to develop health anxiety during the pandemic, which is in turn correlated with the development of generalized anxiety and depression.

Salkovskis states three years worth of worry and wondering about COVID-19 have led to generalized anxiety and obsessive behaviours, such as wiping down the grocery list. He says not all who experience these symptoms meet the criteria to be diagnosed with illness anxiety disorder. According to him, people suffering from health anxiety may believe that they are sick and will hold this belief for a prolonged period. Someone could think for years that they’re in the early stages of developing cancer or heart disease, and it’s hard to definitively prove them wrong. Salkovskis states that COVID-19 is easily diagnosed.

It can be difficult to tell if your health concerns are normal in the COVID-19 era, when it’s natural to be on high alert about disease. In the last few years, behaviors that might otherwise be a sign of health anxiety like mask-wearing and frequent hand-washing have been accepted as normal. Patriquin said there are some signs that you need to be aware of. If you feel compelled to take virus precautions in very low-risk situations—such as wearing a mask when you’re at home, around only those you live with—or if your relationships and work are suffering as a result of your routine, speaking to a mental-health professional may be worthwhile.

Salkovskis claims that CBT (cognitive behavioral therapy) is the best and most effective treatment for health anxiety. CBT, according to the Mayo Clinic can assist people suffering from anxiety with their fear of illness or physical sensations. According to research published in 2019, two-thirds of those suffering from anxiety experienced a decrease in their symptoms. About half were able to go into total remission.

Patriquin suggests that lifestyle changes can be helpful in the management of anxiety disorders. She says that getting enough sleep and seeking support from others can help make a big difference. Even socializing online can help buffer the negative consequences of health anxiety, one study published in 2021 found—so if you’re struggling with this condition, reaching out to both a mental-health professional and your loved ones is a good place to start.

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