By Brian Robinson.
Many people who suffer from general anxiety also develop worries about their health. The tendency for this to emerge is a common characteristic of GAD (General Anxiety Disorder) and panic. When this happens, this could be no more than raised health concerns. Or, it could be that the person has developed a significant health phobia.
As with other phobias, when we become anxious, a system in the brain becomes energised. Because fight or flight is in play, this system assumes something has gone wrong, or that we are in danger in some way. Then, it looks for problems. More often than not, our brain gets the idea that something has gone wrong inside. General anxiety often brings with it a variety of physical symptoms, so it should come as no surprise that the brain jumps to that conclusion. This may mean that thoughts regarding health become a significant feature of our thinking, and indeed, we may feel forced to act on those concerns. However, this would only merit a diagnosis of health anxiety or health phobia if it begins to take over and get in the way of everyday life. Quite often, an increased concern can dissolve away as the general anxiety wanes and tension levels fall.
When someone has health concerns, they may be presenting to their doctor insisting on more and more tests being done; or they may be turning up at accident and emergency on a regular basis. Quite often, the concerns are general and wide-ranging and they are not directed at any specific issue. Worry at this level would naturally impinge on normal life and would therefore merit a diagnosis of health anxiety.
If someone had a more specific health concern, for example, if they only worried about their heart or lungs, then this would probably be referred to as a health phobia. Whenever their heart beats faster, they get a phobic reaction, and this can be quite acute. These specific concerns sometimes defy logic. For example, the person may be suffering from a real illness, yet they do not worry unduly about that. And at the same time, some other trivial symptom may be enough to send them into a tailspin.
Generally speaking, a health phobia is something more complicated than other simple phobias and there are obvious reasons why that’s so. Instinctively, we know we can’t abandon concerns for our health or chose to ignore symptoms. A health phobia therefore, is something we are naturally drawn into. And in that sense, it can sometimes mean we feel in the grip of the phobia with no apparent means of escape. For example, a man with a supermarket phobia can simply avoid supermarkets. However, you can’t walk away from concerns about your health. So we may feel that our only option is repeated visits to the doctor or hospital and the subsequent repeated tests.
All phobias are about avoiding things or not doing something: not going out, not being left alone, not going into tight spaces etc. However, with a health phobia, the opposite seems to be true. The person usually takes positive action by making frequent visits to the doctor, or they may spend hours trawling the internet trying to understand their symptoms. So the question is, what is being avoided here? The answer is they are avoiding risk. By continually checking symptoms; seeking reassurances; presenting to doctors; and getting test after test done, the sufferer believes they are reducing or eliminating the risks of becoming seriously ill.
It is also worth mentioning, that a health phobia can involve more conventional types of avoidance, for example, the sufferer may begin to avoid things that might induce symptoms. This could be things like avoiding physical exercise or avoiding stimulants such as caffeine for example.
So, how do we fix the problem of health anxiety. Well, there is no one answer but there are a number of things we can do. What follows is not an exhaustive list, but it will certainly help get things started.
Firstly, it is important to remember that phobias often develop because of underlying anxiety. They only arise because we are in fight or flight or because we have become stressed. Dealing with that anxiety and relieving stress is the most logical place to start. This means a program of relaxation and dealing with the causes of stress. How to deal with general anxiety is covered extensively elsewhere.
Secondly, we have to understand that there is a very real sense in which our health is in the lap of the gods. We cannot determine what is around the corner. And even when we do become ill, diagnosis and treatment can be a bit of a lottery. Understanding and accepting that we are all at risk to some degree can be a realistic and healthy outlook. However, that does not mean there is nothing we can do to improve matters. It is up to us to push for a proper diagnosis and appropriate treatment.
There is also much we can to to promote good health. We should never ignore symptoms; we can eat healthily; keep active; avoid unhealthy habits like drinking or smoking to excess. When we know we are maintaining a healthy lifestyle this will be psychologically relaxing.
When we experience unsettling symptoms it is helpful to ask relevant questions. Are the symptoms serious? Have they been checked already? Should I leave it and see if they settle? Is it worth getting them checked again, even if only for reassurance? Generally speaking, we would want to draw conclusions from this process of analysis and make decisions based on those conclusions. This again can be relaxing psychologically and will help us pay less attention to our health concerns.
It can sometimes be helpful to look at extremes of behaviour and see how we feel about them. For example, we could ask, how we would feel about finding a significant lump somewhere on our body and doing nothing about it? Would that be a sensible way forward? On the other hand, we could also ask, how would you feel about presenting at accident and emergency several times a week and risk getting banned? It should be fairly obvious that either extreme of behaviour would not be useful strategies for maintaining good health. This reminds us that we have to find a middle way, a balanced response to our health concerns, not ignoring, but not over-focusing either.
We have to try to rediscover what might be a reasonable response to health concerns and there may be other ways to do that. We could ask trusted friends or a family member what they would do if they had our symptoms; if they were in our position. There is also expert advice available on the internet which suggests how we should react to various symptoms. If the symptoms are minor, the advice may be to ignore them. Or we might decide to wait and see if the symptoms persist before acting on them. And if we have already spoken to a doctor and been checked or tested, then we might decide not to re-visit. These responses, which we might describe as normal, will almost certainly leave us feeling anxious and at risk. However, in acting this way we are not taking any real risks with our health. We are only dealing with the exaggerated risks, which in fact are not risks at all. And by doing so, these normal responses will feed into the desensitisation process and have a positive effect on our phobia.
And perhaps most important of all, we have to remember that too much worrying about our health is in itself unhealthy.