So what is Health Anxiety?

Most people have felt anxious about their health or the health of a loved one at some point in their lives.  When faced with a health situation it is normal to feel some anxiety, such as when you are waiting for the results of a biopsy or your friend may have just been diagnosed with a serious illness.  It is natural to feel anxious and upset in these situations.

Health anxiety involves fears of having or getting a serious disease such as cancer, heart disease, or multiple sclerosis.  Health anxiety is often associated with high levels of worry, substantial focus on bodily symptoms, repeated checking for signs and symptoms related to health concerns, focus on death and dying, and frequent efforts to obtain reassurance from family members, friends, or health care professionals.

Some people with health anxiety avoid going to doctors because of fears of being diagnosed with a serious disease or because of dissatisfaction with previous health care experiences.

Worries about health may be triggered by experiences such as everyday symptoms (a skipped heartbeat, a headache), a frightening experience such as finding a breast lump, or coping with illness or death of a loved one.  Anxiety may also be triggered by stories about health issues in the community or media.  Worries may be mild and transient or they may have a more severe and chronic course, waxing and waning over time.   Some individuals may worry about a specific illness or body symptom, while others worry about many.  Health anxiety can occur on its own or it may be part of other problems such as panic disorder, obsessive-compulsive disorder and depression.

People who have diagnosed medical conditions may also experience high levels of anxiety as a reaction to their health problems.  In some circumstances, the level of health anxiety may be excessive and may interfere with normal functioning and enjoyment of life.

How prevalent is health anxiety?

Estimates suggest that 3-10% of the general population suffer from significant health anxiety.  Up to 30% of the population experience intermittent or milder fears about their health.  This is a relatively common problem and one that can cause significant interference.  It can also be costly when it results in frequent visits to the doctor’s office.

What are the main causes of health anxiety?

There are a variety of factors that may contribute to the development and onset of problems with health anxiety.  These include:

Genetics:  Some people are born with a temperament that leads them to be more prone to experiencing anxiety than most people.  In addition, most forms of anxiety run in families to some degree.

Family backgrounds and childhood experiences:  Individuals who experience a stressful family life during their childhood (such as family conflict, high family stress, or abuse) are more likely to develop problems with anxiety and depression.  People who have problems with anxiety in general may be more likely to also have worries and fears about health and illness.

Social Learning:  We can learn many things from our parents, siblings, or other significant people in our lives.  Sometimes these lessons can be positive, but at times, we can pick up negative things from those around us.  Children often model what their parents or siblings do.  For example, if an anxious parent avoids a range of situations, children watching this are likely to behave in similar ways (i.e., engaging in avoidance).

Parents or other important people can also pass on fears through verbal communication.  For instance, fearful or anxious people may be overly concerned about potential dangers and often communicate these fears to their children by saying certain things, such as:  “If you have a stomach ache you had better stay home and be in bed until you feel better” or “Did you hear about Hayden – he was fine one day then he was diagnosed with brain cancer, and now he’s dead”.

In this case, viewing health as fragile and illness as painful and deadly may lead a child to become focused on health concerns, avoid certain situations, or worry excessively about illness and death.

Illness and death experience:  Health anxiety may be related to stressful experiences with illness and death in childhood or during the adult years.

What treatments are used to cope with health anxiety?

The primary treatment that has been shown to be most effective with this problem is Cognitive Behavioral Therapy (CBT).  This treatment involves:  Understanding anxiety and how problems with anxiety can develop; decreasing specific behaviors such as checking one’s body for symptoms and asking for reassurance about one’s health; learning how to counter the excessive worries about health and illness; overcoming avoidance of situations related to illness and death; learning to face worries about illness realistically and directly which can reduce the fear associated with these thoughts; coping with fear of death by emphasizing the importance of accepting the reality of death and enjoying life to the fullest; and general anxiety management strategies such as relaxation techniques and increasing exercise.

How effective is Cognitive Behavioral Therapy in treating health anxiety?

Research demonstrates that CBT is helpful in reducing fears about having or getting a serious illness.  Studies show that individuals receiving from 6 to 20 CBT treatment sessions with a Licensed Clinical Psychologist generally report decreased illness fear and a reduction in accompanying depression.  Both individual and group treatments are effective.

Breakthrough Case Study

One CBT technique used with a Breakthrough client involved encouraging a client who believed her headaches were a sign that she had a brain tumor to identify the other causes for headaches.  The client was encouraged to create a pie chart representing all the people who woke up that day with a headache, and dividing the pie into the causes for the headache according to probability: dehydration, a cold, migraine, tiredness, too much caffeine, etc. Utilizing this exercise, the client was able to develop a new way of thinking that not every symptom means the worst diagnosis. It was a great benefit to be able to assign this exercise while working via video and to see her get the same great results that I get with my face-to-face clients.

Books on the Health Anxiety:

  •  It’s Not All in Your Head:  How Worrying About Your Health Could be Making You Sick – and What You Can Do About it.  G.J.G. Asmundson &  S. Taylor (2004).  New York: Guilford Press.
  • Ten Simple Solutions to Worry.  Kevin Gyoerkoe & Pamela Wiegartz (2006).  Oakland, CA  New Harbinger.
  • Women Who Worry Too Much.  Holly Hazlett-Stevens (2005).  Oakland, CA Harbinger.

 

Wikler_profile_picDr. Bonnie Wagner is a California licensed Psychologist.  Her education includes intensive study of the biological, emotional, cognitive, and behavioral aspects of human functioning. In addition to understanding how these forces interact to influence what we think, feel, and do, specializing in CBT, she uses various forms of therapy techniques, psychological assessments, and evaluations, to provide diagnosis.

Dr. Wagner places a high priority on professional development. She regularly engages in continuing education courses and keeps up with current research findings. She is a member of the National Academy of Neuropsychology; International OCD Foundation; California Psychological Association; and American Psychological Association.

Because of her in-depth training as a Licensed Clinical Psychologist, she provides effective treatments for a wide range of difficulties. She has a special interest in and dedication to a full array of stress-related, anxiety, and emotional issues.  She also specializes in the treatment of gambling and addiction problems.

 Schedule a video session with Dr. Wagner today!

 

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