Health anxiety

Anxiety is a feeling of worry we get when we think something bad might happen. If we think something bad might happen to our physical, mental or social wellbeing (our hauora or health) it’s normal to worry. 

For example, if you are waiting for a blood test result, or if someone you love has a lump you think might be cancer, then it’s normal to feel health anxiety. 

Health anxiety is not normal when it's: 

• Excessive – you have an extreme level of worry. 
• Out of proportion – the actual risk something is wrong is very low but your level of worry is very high. 
• Persistent – you keep worrying even though your healthcare provider tells you that you're well, or you have tests which come back normal. 
• Leading to unhelpful behaviour – like repeated checking of your body, avoiding check-ups or asking your friends for reassurance many times a day.
• Making you very upset or stopping you doing the things you would normally do. 

If anxiety about your health is doing these things, then you may have a type of anxiety disorder. 

How can it affect me?

Health anxiety can change your daily life for the worse. The constant worry and thinking about your health can lead to increased stress levels, trouble sleeping, and can interfere with your social life and work. It can also strain relationships with friends and whānau. Loved ones may struggle to understand or empathise with your fears. People with health anxiety may push for medical tests to reassure them, which can themselves be risky. 

Health anxiety is real to the person who feels it. It’s not the same as malingering, which is making up symptoms or illnesses on purpose. Health anxiety causes real distress and if it's severe it can make your life narrow and joyless. 

We don’t know exactly what causes some people to have only short-term anxiety, which fits the situation they are in, and some people to have anxiety disorders. We do know anxiety disorders can run in families and can be related to life experience.

People who have health anxiety often report previous negative health experiences. Having a family member experience a serious illness, especially a long illness that gets slowly worse, can make you feel helpless. The death of a family member can make you think about your own death. Having a medical problem yourself can make you more tuned in to your body sensations, and more aware of possible problems.

If somebody in your whānau has health anxiety they may be modelling, or showing you, unhelpful ways of dealing with health worries.

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People with health anxiety can have the same mental and physical symptoms as people with other anxiety disorders. Read more about anxiety symptoms on the anxiety page. 

Health anxiety also includes some or all of the following:

• Compulsive body checking, eg, looking at a mole multiple times a day to see if it's changed.
• Compulsive research, eg, many hours spent on the internet checking the same information over and over again.
• Worrying about normal body sensations, eg, an itch.
• Difficulty concentrating due to intrusive health-related thoughts, eg, not being able to get on with work because of worries that a tingling finger might mean you have multiple sclerosis.
• Worries that move from one diagnosis to another, eg, when you start to feel comfortable that you don't have a rare form of cancer, starting to worry you have a rare brain disease.
• Asking for unnecessary medical tests.
• Avoiding activities or situations because of concern for your health.
• Taking extreme action to avoid illnesses.
• Seeking constant reassurance from friends, whānau or healthcare providers, but feeling unsatisfied with the answers. 

Common worries are having cancer, dementia, heart attacks or mental illness. Health anxiety can also be felt on behalf of others, eg, constantly worrying your child has cancer. 

Health anxiety can happen for people who are completely well, people who have unexplained symptoms and people who have known medical problems. The main problem is not the symptoms, it’s how you respond to symptoms or health problems. 

Health anxiety is a type of anxiety disorder. It’s diagnosed by a healthcare provider.

If you think this sounds like you, you can try this health anxiety questionnaire(external link). If you answer yes to most of the questions, make an appointment to see your GP or nurse practitioner.

Caring for your body and mind is the most important first step. Information on how to do this for all types of anxiety disorders can be found in the self-care section on the anxiety page. 

Here are some useful ideas for managing your health anxiety:

• Have a look at this free CBT based information and self-guided workbook(external link).
• Restrict your internet symptom searching – choose a trusted source of information (eg, Healthify) and chose to search only that site. Set a timer so you don’t spend too long focusing on your concerns. Here's a guideline for how to choose a reliable source of health-related information(external link).
• Distraction – when you catch yourself worrying about your health, change what you’re doing. Change the room you are in. If you can, do an activity that usually holds your attention, eg, listening to music, exercising, drawing or watching a movie.
• Try some relaxation techniques, eg, breathing exercises, meditation or yoga.
• Ask for support from friends and family – not for symptoms you’re worried about, but for the worry itself. It may help to show them this page. 

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A psychologist or counsellor can help with:

• cognitive behavioural therapy (CBT).
• acceptance and commitment therapy (ACT).
• mindfulness-based cognitive therapy and some other types of therapy that can be useful.

Your GP or nurse practitioner can help with:

• Regular planned visits, which work better than urgent visits.
• Carefully checking out your symptoms. They will order tests and referrals to specialists when they are needed, and explain when they're not needed.
• Medicine for anxiety (eg, an SSRI) is sometimes useful if talking therapy hasn’t helped enough.