It seems like absolutely ages since I last wrote a blog post, and SO much has happened in that time frame! I think we can all relate to life feeling like a bit of a whirlwind at the moment.
This week I wanted to talk a little bit about health anxiety. I don’t think in society there is a lot of awareness or understanding of health anxiety. I know personally, a lot of people tend to laugh off my health anxiety as something very trivial, almost like a little quirk in my personality – you know, like “hahahaa you’re such a hypochondriac!”
And yes, I often use humour myself to cope with it, but in reality, health anxiety and the feeling of being terrified of your own body is not something I would wish upon my worst enemy. In fact, rewinding to way back when I first sought help for my mental health, it was a bout of health anxiety that finally pushed me into thinking “I actually can’t deal with this on my own”.
I wanted to write this post because I know the whole Covid-19 situation will be bringing up some uncomfortable feelings for many health anxiety sufferers, and also a lot of people who have never experienced it before. I will briefly go over what health anxiety is and what it often involves, what it looks like from a personal perspective and, most importantly, a few useful strategies to help ease health anxiety, if it is something you’re dealing with at the moment (and trust me, if you are, you’re not alone in that!)
So what is healthy anxiety?
Well according to the NHS: “Health anxiety (sometimes called hypochondria) is when you spend so much time worrying you’re ill, or about getting ill, that it starts to take over your life.”
It often involves (I found this info in an leaflet I got from therapy a few years ago):
- Physical symptoms such as chest pain, general aches and pains, headaches numbness or tingling. This may also take the form of a noticed bodily change like a lump.
- These physical sensations are interpreted as indicating a severe illness, for example a heart attack or cancer.
- Physiological arousal caused by anxiety. This can lead to symptoms like trembling or increased heart rate. Unfortunately, these symptoms can fuel further health anxiety (e.g. my heart is racing, there must be something seriously wrong with my heart), which then fuels the symptoms more, forming a vicious cycle.
- Checking behaviours such as checking over the body excessively for changes.
- Reassurance-seeking. This can be from medical professionals or from family and friends.
Personally, I can relate to every one of these. My first ever experience of health anxiety (and probably the most severe) was a preoccupation that I had cancer, fuelled by the feeling of a lump in my throat. Unfortunately, a lump in the throat is a common symptom of anxiety, so I ended up in a very vicious cycle as you can probably imagine. I convinced myself that if I laid down I would choke, and eating and swallowing gave me terrible anxiety; it reminded me of what I thought was wrong and seemed to ‘solidify’ my opinion that something awful was going on in my body.
This anxiety then led to a fixation on cancer more generally, which is where more checking behaviours came in. I went through phases of checking my body for changes excessively, in order to facilitate a feeling of reassurance when I found nothing ‘wrong’ (however this never lasted very long before I had to repeat the whole procedure again). Conversely, I went through phases where I avoided doing this so avidly that I would not even touch or look at certain areas of my body for fear of finding something terrifying.
This period of my life was also plagued by intrusive thoughts relating to myself having a serious illness, dying or having died of said illness. At times, I also engaged in various random rituals that I realistically knew would not stop me from getting a serious illness, but somehow gave me brief periods of reassurance anyway. This generally involved touching certain objects or repeating phrases in my head (the latter is something I’ve actually never managed to get out of the habit of doing before I go to sleep at night). Similarly to the bodily checking, these behaviours only provided relief for very short periods, so I ended up doing them hundreds of times every day, which took a huge amount of mental energy.
Since then, I’ve had various periods of health anxiety related to different things, but the first was definitely the most notable of them all. After this episode, I managed to figure out some strategies which enabled me to cope better with those feelings when they did arise, which is what I wanted to share today. In the midst of a global pandemic, health anxiety will be something many people are struggling with, even people who may never have experienced it before. I know it is definitely affecting me, although I think I’m coping pretty ok. Regardless, I have found myself thinking back to the strategies I learnt and trying to utilise them, just to keep my emotions in check and stay as rational as possible during a scary time! So now I just want to go over a few of my favourite coping strategies in the hope that they might be helpful to a few others:
- Limit internet/media consumption. This is a huge one, and for me probably the most important of them all. During the pandemic so far, we have been exposed to a lot of huge and scary information – not all of which is accurate. The media capitalises on shock factor, and exposing yourself constantly to shocking and terrifying news articles is for obvious reasons, not helpful for health anxiety. I’m not suggesting to cut off from the news completely (although, if that’s what you need to do to cope, do it), but DO limit your exposure. Limit the sources you read from – a healthy way to go would perhaps be to keep tabs on official government guidelines, but restrict yourself from reading tabloid articles. Because when have tabloids ever been helpful?
- Rationalise thoughts. Catastrophising is a huge element of health anxiety, and a good way of dealing with this is to consciously cut into those thoughts with rationalisations before they run away with you (even if you don’t quite believe what you’re saying)! For example, maybe you have a bit of a sore throat, and start thinking you have Covid-19. Instead of letting your thoughts spiral from there, try to rationalise the situation with counter-arguments. For example, you might say “there are many reasons behind having a sore throat which are much more common than Covid-19” or “I don’t have any of the other common symptoms”. Or if you do have more of the symptoms, remind yourself that for the majority of people, it is a mild illness, think about how many people have made a full recovery and remind yourself that the media only reports the most tragic or shocking cases. The main thing is to try to actively change those thought processes.
- Keep tabs on checking behaviours. A common one here is checking for lumps, but with the current situation you might find yourself carrying out other checking behaviours (I’m not going to give examples because I don’t want to trigger anyone – I know that viewing examples would definitely make me tempted to start doing them). It can be really hard to get out of the habit of seeking reassurance via checking yourself over, which is why it’s important to have some positive distractions on hand for when you get those urges. Remember that repeated checking only leads to temporary reassurance (if any), and really can become a vicious cycle. Maybe you have a hobby you can do from home, pets to play with or a list of films to watch. It doesn’t really matter what it is, it’s finding that distraction from obsessing over your body that’s important.
- End the cycle of reassurance. Essentially the same applies here as is mentioned above. Getting into a cycle of seeking reassurance through friends, family or Doctors will only lead to further needs for that reassurance in the long-run. Practice recognising these cycles in yourself. It can help to keep a diary to work on figuring out when you really need to see a Doctor, for example. I know first hand that when health anxiety is in full swing, it can be extremely difficult to recognise what symptoms are real and which you have manifested through anxiety and fixation.
Above all else, remember to take care of yourself in these difficult times. There’s a lot of pressure out there (I’m looking at YOU, Instagram!) to “use this time to better yourself” and “pick up a new skill” and whilst all that is great if that’s what you want to do, don’t feel pressured to “become your best self” during this lockdown. This is a scary time. Many of us are in a high-risk group or know someone who is. Many of us are struggling with health, financial or general anxiety about the situation. It’s ok to just focus on getting through the day-to-day and looking after yourself.
Take care, stay at home and stay safe x