The rising tide of health anxiety

As a counsellor, I have observed a huge increase in health anxiety among clients since Covid.  

The World Health Organisation's revelation that the global prevalence of anxiety and depression increased by an astonishing 25% since COVID-19, serves as a stark reminder of the crisis we are navigating. This phenomenon raises crucial questions about the nature of health anxiety, its distinction from hypochondria and the various forces fuelling its rise.

Health anxiety vs. hypochondria

Health anxiety and hypochondria are terms that have been used interchangeably in the past, but they are understood differently in contemporary mental health practice. Both involve excessive worry about having or acquiring a serious illness, but there are nuances in their definitions and how they are approached in clinical settings.

Health anxiety

Health anxiety is the more current term used to describe the condition where individuals excessively worry about being sick, to the point where it significantly impacts their daily functioning. This anxiety persists despite medical reassurance and the absence of serious health issues. It's characterised by a preoccupation with the body and bodily functions, vigilant monitoring for signs of illness and a high level of anxiety about health.

Health anxiety can manifest in anyone, regardless of their health status and doesn't necessarily require the belief that one is currently sick — fear of becoming sick in the future is often enough to trigger it.

Hypochondria

Hypochondria, historically used to describe what is now more accurately referred to as health anxiety, was often characterised by an unfounded fear of having a serious medical condition. The term has been perceived as pejorative and less accurate, leading to its replacement in clinical contexts.

In the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition), what might have been called hypochondria is now more likely to be diagnosed as illness anxiety disorder if the criteria are met. This change reflects an effort to focus on the anxiety and worry aspect of the condition rather than imply that concerns are unfounded or merely a product of one's imagination.

The catalysts of health anxiety

Several factors contribute to the rise in health anxiety, transcending the direct impacts of the COVID-19 pandemic. The incessant stream of news, coupled with the ubiquitous nature of social media, has created a constant barrage of information; not all of it accurate or helpful. This overexposure to information, often highlighting the most extreme outcomes, has undoubtedly played a role in heightening fears about health.

Younger generations: A vulnerable demographic

Interestingly, younger populations have reported higher levels of health anxiety. This demographic, having grown up in the digital age, experiences a unique vulnerability to the onslaught of information and the pressures of social media. Moreover, the disruption of their formative years, including significant milestones and social development opportunities by the pandemic has left lasting imprints on their mental health. The WHO's findings corroborate this, highlighting the substantial impact on mental health services and the urgent need for increased support.

Signs and symptoms of health anxiety

Recognising health anxiety in yourself or someone else involves being aware of specific thoughts, behaviours and emotional responses related to health concerns. Health anxiety can manifest in various ways, but some common signs and symptoms can help identify it:

Constant worry about health

Preoccupation with having or acquiring a serious illness, despite having little or no medical evidence to support the presence of an illness. Excessive worry about health that is disproportionate to the actual risk or severity of medical issues.

Checking and seeking reassurance

Frequent checking of the body for signs of illness, such as lumps, rashes or other symptoms.

Repeatedly seeking reassurance from medical professionals, friends or family about health, despite previous reassurances or negative test results.

Regularly researching health information online, which often leads to increased anxiety and worry about potential illnesses.

Avoidance behaviour

Avoiding medical TV shows, articles or discussions about health issues for fear they will trigger anxiety.

Avoiding medical appointments or conversely, frequently visiting doctors to seek reassurance about health.

Physical symptoms of anxiety

Experiencing physical symptoms of anxiety, such as heart palpitations, stomachaches, headaches or dizziness, which may be misinterpreted as signs of a serious illness.

Heightened awareness of bodily sensations, leading to misinterpretation of normal bodily functions as symptoms of serious diseases.

Impact on daily life

Significant distress or impairment in social, occupational or other important areas of functioning due to health-related fears and behaviours.

Emotional distress, including feelings of frustration, helplessness or depression, stemming from the constant worry about health.

Cognitive signs

Catastrophic thinking related to health issues, where minor symptoms are interpreted as signs of serious diseases.

Embracing a new dawn

Dealing with health anxiety is a multifaceted process, requiring both self-care strategies and professional interventions when necessary.

Counselling can be a powerful tool in managing and overcoming health anxiety, offering a structured and supportive environment where individuals can address their fears and develop coping strategies. Here are some ways counselling can help:

Providing a safe space

Counselling offers a non-judgmental space where individuals can express their worries and fears without the risk of dismissal or criticism. This environment fosters openness and trust, allowing for a deep exploration of the anxiety’s roots and triggers.

Identifying and challenging irrational thoughts

A key component of counselling, particularly cognitive-behavioural therapy (CBT), involves identifying irrational or distorted thoughts that fuel health anxiety. Therapists guide clients in challenging these thoughts, replacing them with more balanced and realistic perspectives. 

Teaching coping strategies

Counsellors can equip individuals with effective coping strategies to manage anxiety when it arises. These can include relaxation techniques, mindfulness, stress management skills, and ways to stop the cycle of constant checking or reassurance seeking.

Enhancing understanding of anxiety

Counselling can help demystify the physical and psychological aspects of anxiety, making it less intimidating. Understanding how anxiety works and recognising its common triggers can empower individuals to manage their symptoms more effectively.

Addressing underlying issues

Often, health anxiety is not just about health fears but may be linked to deeper psychological issues such as past traumas, unresolved grief, or low self-esteem. Counselling provides a platform to explore and address these underlying issues, contributing to a holistic approach to healing.

Improving communication skills

Counselling can also help individuals communicate their needs and worries more effectively to their loved ones and healthcare providers. This improved communication can reduce misunderstandings and provide additional support outside the therapeutic setting.

Encouraging behavioural changes

Therapists can encourage and support behavioural changes that contribute to overall well-being, such as adopting a healthier lifestyle, engaging in regular physical activity and practicing self-care. These changes can improve physical health, which, in turn, can reduce health anxiety.

In summary, counselling for health anxiety focuses not just on managing symptoms, but also on understanding and addressing the root causes of anxiety. It empowers individuals with tools and strategies to lead more fulfilling lives, despite the challenges posed by health anxiety. 

If you’re struggling with health anxiety, reaching out to a professional counsellor or therapist could be a significant step towards recovery and well-being.