Discourage Their Excessive Worry Checking Research And Reassurance
Illness anxiety causes an inordinate amount of worry and stress, excessive checking and re-checking of what appear as signs or symptoms of an illness as well as compulsive research, and for some, also excessive reassurance-seeking.
When the anxious person has obsessive and negative thoughts, itâs important to empathize about their struggle with anxiety, but try to discourage them from excessive worry, checking, research, and reassurance-seeking. Donât reinforce their obsessions or compulsions by automatically buying in to the health concern, by helping them with excessive research, or by giving reassurance too frequently. Instead, you can help by reminding them of what theyâve learned about illness anxiety, diverting their attention to other issues, or reviewing some coping strategies . Also, remind them that their compulsive behaviors, although intended to ease their anxiety, will actually increase it in the long run.
Match Your Support To Their Preferences And Attachment Style
Its best to ask someone what type of support they prefer rather than guess! However, we know from research that people who have an avoidant attachment style are likely to respond best to strong displays of concrete practical support. That could include helping the anxious person break tasks down into manageable steps, or talking through specific options for how to deal with a difficult situation, like how to respond to an angry email, but still acknowledging their autonomy and independence while doing so.
Other people are more likely to prefer emotional support, especially those who are securely attached, or who have a preoccupied attachment style due to a fear of being abandoned or of their emotions being overwhelming to others. Folks like this respond well to statements emphasizing that theyre part of a tight teamfor example, their supporter saying, This is tough but we love each other and well get through it together.
Avoid Asking Them To Face Their Fears
While its easy to be courageous when youre not scared, full-blown panic can arise from facing your fears before youre ready. If you want to help someone with anxiety, dont suggest facing their fears. If theyre prepared to face their fears, they might ask you to help them themselves. However, it needs to be done on their terms rather than yours.
You might be wondering, how do I help someone with anxiety whos afraid to leave their house? You cant force them out the door especially if theres trauma involved. In their mind, danger awaits them outside that door, so the thought of stepping outside can terrify them. What you can do is offer to join them when they are ready to face their fears. That way, they have a shield protecting them when its time to meet their anxiety.
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What Is Health Anxiety
Symptoms of health anxiety include:
- Preoccupation with having or acquiring a serious illness that persists despite receiving negative results on medical tests and reassurance from professionals.
- Anxiety that is excessive and out of proportion to the actual likelihood of having a serious medical problem.
- Repeatedly checking your body for signs of illness, frequently seeking reassurance about your health from medical professionals.
People who are healthy can develop health anxiety, as can people who have a diagnosed medical condition. To qualify for a diagnosis of health anxiety disorder your symptoms must have persisted for at least six months and must have caused you significant distress, or adversely affected your daily life.
We can separate the effects of health anxiety into thoughts, feelings, and behaviors:
Does Anxiety Disrupt Your Daily Life
No matter how good life is, we all experience a little bit of anxiety now and then. Whether its that upcoming job interview, your wedding day, or even just the first date, feeling anxious or nervous is just part of being human. It is a normal feeling that some may even say makes us feel alive.
However, when your anxiety starts to have an impact on your life and you find yourself worrying more often than usual or the anxiety starts interfering with your day-to-day responsibilities, it might be a sign of a deep-seated anxiety disorder. People who suffer from anxiety disorders tend to live in a state of constant fear and worry.
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The Science Behind The Cycle
Almost every type of anxiety is a vicious cycle. Once it gets its hooks into you, its hard to step out without putting in some serious work.
When my doctor told me about psychosomatic symptoms, I ended up trying to reroute my brain. After blocking Dr. Google from my morning repertoire, I searched for explanations as to how anxiety could result in tangible, physical symptoms.
Turns out, theres a lot of information out there when youre not heading directly to Dr. Google.
Challenge Your Worrying Thoughts
Thoughts are not facts. They are just thoughts and they dont have to be true or based in reality. However, when we ruminate, we begin to believe our thoughts reflect reality. For example, people with health anxiety may often worry about their heart.
They may think their chest or their heartbeat feels off, leading them to think, Theres something wrong with my heart. This can turn into, I have a serious heart condition. Eventually, they may even think, I have a heart condition and Im going to die. The problem here is not that they are seriously ill, the problem is that they think theyre seriously ill.
When we ruminate, our thoughts can represent our perceived reality. In other words, we accept our thoughts as facts. Instead, we need to adopt a practice known as cognitive defusion.
Cognitive defusion teaches us to identify and challenge our negative thoughts. Once a thought like, Theres something wrong with my heart has been identified, you can challenge and reframe it. For example, thinking instead Im only telling myself that there is something wrong with my heart. This process of identifying and challenging takes practice. It helps to work closely with a licensed therapist or psychiatrist to develop coping techniques.
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What Questions Should I Ask My Doctor
You may want to ask your healthcare provider:
- Why do I have illness anxiety disorder?
- What are the best ways to manage illness anxiety disorder?
- Should I look out for signs of complications?
A note from Cleveland Clinic
Everyone worries about their health from time to time. But if health anxiety affects your ability to enjoy life, you should talk honestly with your healthcare provider. Your provider can diagnose and treat illness anxiety disorder. Living with illness anxiety disorder can be challenging, but you can learn coping skills to help you enjoy good health again.
Last reviewed by a Cleveland Clinic medical professional on 02/02/2021.
References
Tips For Managing Health Anxiety
People with health anxiety find themselves worrying a lot about getting ill, or that they might already be ill. In particular, they often have concerns about any physical symptoms they have and what they might mean. Anxiety is a natural response to a threat, or to something we believe is a threat so its no surprise that the coronavirus outbreak has led some peoples health anxiety to get worse. Its also caused others whove never had it before to start experiencing problems.
If you have health anxiety, you could be having a lot of negative or scary thoughts at the moment for example, everyone I care about is going to get ill. You might notice that youre constantly searching online for more information about the illness and the latest statistics. Anxiety can also have physical effects, such as a racing heart or nausea.
Here are five tips put together by Shazna Khanom, CBT therapist and UK Clinical Director with IESO, to help you manage your health anxiety symptoms.
1) Acknowledge how youre feeling. Theres no right or wrong way to feel at the moment. The simple act of naming the emotions and feelings youre experiencing is a really effective first step to reducing their intensity.
3) Stop Googling your symptoms. If you have health anxiety, Google is not your friend! An anxious mind will scan for worst case-scenarios, so youre probably only taking on board all the scary stuff thats out there. This means youre not getting a balanced perspective on things.
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Change Your Focus Of Attention
People with health anxiety will often focus on a particular part or function of their body. The more they focus on a part of their body, the more they notice physical sensations which can then trigger worrying thoughts.
These initial thoughts can trigger anxiety, in turn causing additional physical sensations. At this point, the person may begin to believe their anxiety response is further evidence of physical symptoms. You can see how this creates a cycle of worrying. This cycle is known as rumination.
If you feel yourself becoming too focused on a particular worry, its important to redirect your attention to something else. One of the most straightforward ways of accomplishing this is to turn your focus to an activity, such as:
- Cleaning a room
- Painting or drawing
- Going for a hike
Regardless of the activity, the goal is to pay full attention to what you are doing. For example, if youre gardening, notice the sounds around you. Note how your spade feels as it digs into the soil. Listen to the sloshing sounds of the watering can and feel its weight in your hands. By putting our complete attention into a task, we are able to pull our mind away from our worrisome thoughts.
Sometimes, though, this strategy may be less practical. For example, if youre lying in bed trying to sleep but find yourself becoming stuck on a particular worry. In these situations, we can learn to practice mindfulness exercises that will help us to break out of our ruminations.
Testing Your Beliefs With Behavioral Experiments
The CBT model of health anxiety says that the anxiety can be prolonged by some of the things that you might do to manage. The best way to find out if this is the case is for you is to gather some evidence. Helpful behavioral experiments for health anxiety can include:
- Testing your predictions
- Testing the effects of frequent checking & rubbing does the checking itself produce noticeable effects on your skin
- Testing the effects of researching about a disease that you do not currently fear. Record what happens to your anxiety.
- Test the relationship between frequency of checking and how anxious you feel. E.g. check one day and not the next, then on and off for a week.
- See how many benign explanations you can come up with for a body symptom that worries you.
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Encourage Consulting With A Doctor When It Seems Warranted But Discourage Excessive Trips To See Doctors
Most of us are not qualified to recognize, diagnose, evaluate, or treat medical conditions. So when the anxious person has significant enough symptoms that would cause most people to go to the doctor, then they too should go to the doctor. But it is hard to estimate what most people do. Therefore it may be helpful to have the anxious person call the doctorâs office before making an appointment, to ask whether the nurse or doctor thinks a visit is indicated.
However, if their concern is something familiar, repetitive, and something the doctor already told them not to worry about⦠or if it is something clearly minor and ordinary , then you can discourage them from making a doctorâs appointment. Also, discourage them from seeing multiple doctors, one after another, frequently seeking a third, fourth, or fifth opinion, especially if itâs for the same concern over and over.
If you do not have illness anxiety, and it is clear to you that the anxious person is making way too many visits to see doctors, then it may be helpful for you to give them such feedback, to discourage excessive doctorsâ appointments, and to point out the drawbacks of making too many doctorsâ appointments . If the doctorsâ appointments that they make have an impact on you and your day to day life, then you may also want to set limits on how much you bend over backward to accommodate the logistics of frequent doctorsâ appointments.
If Someone Has A More Serious Anxiety Problem Avoid Stigmatizing Them
What can we do for folks with more serious issues? People experiencing things like panic disorder, depression mixed with anxiety, post-traumatic stress, or obsessional thinking may fear that theyre literally going crazy. Helping them may feel beyond your ability.
You can still be supportive in many ways. When someone is experiencing significant anxiety, its helpful to reassure them that your overall perception of them hasnt changed. Theyre still the same person theyre just suffering a temporary problem situation that has become out of control. Theyre not broken and who they are hasnt changed. To the extent possible, you can help the person stay connected to positive aspects of their identity by participating in or encouraging their interests and hobbies.
Sometimes, individuals who have chronic anxiety problems arent interested in changing. For example, you might be friends with someone who has agoraphobia or an eating disorder, but their condition is long-term and stable. In these cases, you can be accepting of that person so that they dont feel isolated. Being matter-of-fact about their limitations without excessively shaming them or insisting they should pursue becoming normal is often the best strategy.
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How To Help Someone With Anxiety
All of us worry and get scared from time to time. But those with anxiety may feel consumed by fears of things that might seem irrational to others. It can be hard to relate to these concerns, and as a result, many people dont know how to best help someone with anxiety. People are often dismissive of people experiencing anxiety, says Joseph McGuire, Ph.D., a pediatric psychologist with Johns Hopkins Medicine. With other medical illnesses, you may be able to see physical symptoms. But with anxiety, you dont necessarily see what the person is dealing with. So its important to be sensitive to what the person with anxiety is going through, even if it doesnt make sense to you. Its distressing to watch a loved one experience panic attacks and face anxiety every day, but there are things you can do to help. It starts with recognizing the signs of excessive worry and understanding the best ways to support your loved one.
Learn To Recognize The Signs Of Anxiety
Anxiety disorder is the most common mental health condition in the United States, affecting up to 18% of the population. Knowing the signs of anxiety can help you realize when someone you love is having fearful thoughts or feelings. Symptoms vary from person to person but can be broken into three categories:
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Working With Your Thoughts And Images
Thoughts and images are a key part of health anxiety. People with health anxiety often engage in worry & rumination, experience intrusive thoughts and images, and think in other unhelpful ways about their symptoms. People with health anxiety often interpret situations in particularly threatening ways, resulting in strong feelings of anxiety. CBT says that it is not situations that determine how you feel, but the thoughts and interpretations you have about that situation . Some of the unhelpful thinking styles that people with health anxiety have can include:
- Catastrophizing: jumping to the worst possible conclusion, overestimating the probability of something awful happening, underestimating your ability to cope
- Intolerance of uncertainty: not feeling comfortable unless you have a definitive explanation for what you are experiencing
- Selective attention: only paying attention to signs of illness, or ignoring information that does not support your view
- Thought-action fusion: believing that thinking certain things can make them happen
Important steps in CBT treatment for anxiety include learning to recognize and then challenge your negative thinking. Psychology Tools has a number of resources that are helpful for this:
Ways To Deal With Anxiety
Its crucial to recognize that what works for someone elses anxiety may not work for yours. You can start by identifying what triggers your anxiety and what provides relief.
Coping strategies for anxiety include:
- Think about what you can change and confront anxiety head-on so that your feelings of anxiety reduce rather than grow.
- Count to 10 slowly. Repeat and count to 20 if necessary.
- Keep a journal of your moods so you can recognize patterns. You can also write about your thoughts to figure out whats really bothering you.
- Eat balanced, regular meals.
- Exercise three to five times a week for 30 minutes to help relieve your anxiety. This can be biking, dancing, or jogging.
- Avoid drinking too much caffeine such as soft drinks or coffee, which is known to exacerbate anxiety. Chocolate or energy bars may also contain caffeine, so check the ingredient labels before consuming.
- Limit alcohol, which can increase anxiety and panic attacks.
- Reach out to your friends or family who help you cope in a positive way, and consider a timeout from people who trigger your anxiety.
- Breathe with intention to help bring yourself back to the present.
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Stick To Trusted Information Online
It is important only to seek news and information from a reliable trusted source and try to avoid social media which is often not regulated or reliable.
“The internet also holds a vast array of information and tools to self-diagnose an illness or health condition. This could help to explain the rise in health anxiety as people with this condition are able to have access to this information at all times,” says Smithson.
“Also, this information often gives the worst-case scenario for the symptoms provided and therefore reinforces the cycle of health anxiety and increases the physical and psychological symptoms of their anxiety.”
It’s also important to try not to fixate on the media coverage of health topics. If you find yourself getting triggered, take a break from the news and do another activity to distract you.