All The Anxieties

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Definition of Health Anxiety

Health Anxiety is actually known by several different names. The oldest name is Hypochrondriasis, which isn’t a recognized diagnosis any more. Some people refer to it as Medical Anxiety Disorder. The more common name used today by medical professionals is Illness Anxiety Disorder. This renaming is a result of splitting the old diagnosis of Hypochrondiasis into two categories: Illness Anxiety Disorder and Somatic Symptom Disorder.

Illness Anxiety Disorder

Illness Anxiety Disorder, or Health Anxiety, is a long-term disorder that fluctuates in severity, but in general leaves a person worrying excessively that they may become seriously ill despite a lack of symptoms, or that their minor symptoms could be a sign of a much greater illness.

The level of worrying and stress over health problems becomes so overwhelming that the worry over your health can disrupt your life or relationships and impede your ability to function normally.

Somatic Symptom Disorder

The term “soma” is Greek and it means body. With this disorder, what happens is you present with physical symptoms that suggest a physical disorder, but there aren’t any medical findings to support a diagnosis, and there is no clear psychological connection for the symptoms.

Somatoform Disorder, as a diagnosis, was used to explain something that during Freud’s era was referred to ‘hysteria’. He explained it as being a “conversion of emotional distress into physical symptoms”.

Wilhelm Stekel renamed the diagnosis ‘hysteria’ in 1924 to Somatization and the Diagnostic Manual and Statistics for Mental Disorders characterize Somatoform Disorder (from DSM IV) as the “presence of physical symptoms which suggest a general medical condition and are not fully explained by general medical condition, substance use or another mental disorder”.

However, some clinical use of these diagnoses has not shown significant results to justify splitting Hypochondriasis into two different diagnoses.

Translation: The mental health community is still deciding which diagnosis is most appropriate for the symptoms and the clinical treatment of each disorder.

Perception

While some people might be tempted to view someone with Health Anxiety, Illness Anxiety Disorder or Somatoform Disorder as someone who is lazy or is faking their symptoms, this diagnosis makes it clear that the symptoms are not intentional and that they cause significant distress and impairment socially, occupationally and in other major areas of functionality.

Statistics

Unfortunately, with an estimated 0.3% to 8.5% range of people suffering from this disorder, and with changing diagnostics, Illness Anxiety Disorder and Somatization or Somatic Symptom Disorder are considered a bit of a ‘blind spot’ in the Medical Community.

Treatment

Because medical professionals are still learning how to diagnose Hypochondriasis, Health Anxiety, Medical Anxiety, Illness Anxiety, or Somatic Symptom Disorder, the most often recommended form of treatment is Cognitive Behavioral Therapy with little other recommendations.

Signs of Health Anxiety

While Anxiety is capable of causing severe physical health issues, and there are physical health issues that are commonly associated with Anxiety, not all symptoms are indicative of a greater, more serious health issue. If you are battling Health Anxiety, something like a minor health quirk (small upset stomach) could feel indicative of a greater problem.

Here are some scenarios that you might be familiar with if you, or someone you know, is dealing with Health Anxiety.

• Constant worry over minor symptoms or body sensations
• Excessive worry about a family medical condition that you may/may not develop
• Constant fear of having or developing a serious health condition
• Overreacting to minor health changes
• Feeling so distressed over your health that you can’t function
• Constantly checking for symptoms of illness or disease
• Frequent internet searches to see if your symptoms match an illness
• Making frequent trips to the doctor for reassurance
• Avoiding Medical care for fear of a serious diagnosis
• Feeling unheard, ridiculed or unreassured by doctor at visits
• Avoiding people, places or regular activities for fear of impact on your health
• You constantly talk about your health or potential illness

Cause of Health Anxiety

Past experiences with health, either with how illness was treated in your family, or your own past with battling a serious illness (especially a childhood illness) can be the root cause of your Health Anxiety.

Health Anxiety is thought to be most prevalent in middle age and potentially increasing as you age.

Dealing with Health Anxiety

Seek Medical Help

Because you never know if symptoms you’re experiencing are real or not, the first step for anyone with a physical health concern is to see a doctor. If you go through all the normal steps and nothing materializes in your results that leads to a diagnosis or treatment plan, then move onto step two.

Seek Psychiatric Help

The underlying causes for Health Anxiety involve Anxiety and past experiences. If seeking professional help is still possible for you, try meeting with a psychiatrist who can help you understand where the cause of your anxiety is from, and what you may need to do to cope with your disorder.

If Psychiatric Help isn’t possible …

Make a list

Make a list of the childhood/adolescent illnesses you went through. Describe their symptoms, how long you had them, how they affected you physically, socially, academically, with your family, your ability to travel …. you name it. Everything.

Consider the emotional side

Then describe how your illness affected you emotionally. Long-term or severe illnesses or embarrassing incidents linked to an illness are bound to leave an impression on anyone. What was yours?

Repeat the process

Go through this same process if you have/had a loved one go through a major illness while you were growing up.

Consider how this has impacted you

Describe to yourself how this perception of health and illness has impacted you.

• Has it made you sad?
• Angry?
• Fearful?
• Hypervigilant?

Consider your preferences or limits

Also, be honest with yourself and how well you deal with physical discomfort, and why that may be the case. Sometimes people have high pain thresholds, but they don’t like dealing with stomach noises/issues. Whatever your feelings on discomfort, try to assess where you are on a scale from one to ten, with one being you can’t take any form of discomfort, to ten, you have an extremely high pain threshold to the point of almost full dissociation with pain.

Discuss your findings

Reach out to a loved one and discuss your findings. Maybe they will be able to add to your list or help you clarify something, especially if they’re a family member who witnessed your physical illness. They might have some insight for you to better understand how to move forward.

Dealing with Health Anxiety

I’ve dealt with a lot of physical health issues and mental health issues. Put these together and from time to time I also struggle with Health Anxiety. I find myself googling my symptoms (something doctors will tell you not to do if you struggle with Illness Anxiety Disorder) and then I catastrophize what could happen next. Every struggle and eventuality plays out in my head while I sit and do nothing. I’ve had days and nights where I’ve spent hours wondering how I’d handle my next struggle.

Which is why I made a Health Flowchart.

Health Flowchart for Overcoming Health Anxiety

This flow chart isn’t meant to be exhaustive but an example and starting point for anyone who needs help exploring the reasons why they may feel different sensations or physical discomforts and how to begin to deal with those directly.

List symptoms- major and minor

First, make a list of the symptoms you tend to experience.

• Are they minor? (Objectively speaking.) Minor rashes, loud stomach noises, etc.
• Are they major? Persistent or substantial pain. (If so, you may not have Health Anxiety, you may be closer to Somatoform Disorder, but check with a doctor before you leap to that as your official diagnosis.)

Create strategies for tackling each symptom

If what you’re experiencing is minor, or if there is no major medical advice given to you, find ways to deal with each individual symptom.

• Hand pain? Stretch your fingers and try and gauge how much physical exertion is too much for you.
• Gurgling Stomach? Recheck your diet. You may need a probiotic or to cut certain foods or drinks out. (Caffeine, alcohol and smoking are generally not recommended for people with Anxiety.)
• Odd Skin Issues? Hydrate and Moisturize. If things continue see a dermatologist and let them prescribe the correct products for you.
• Acute or General Pain? You may need to stretch, use a hot pack, go for a light walk, or see a Chiropractor. Pain pills are easy to get onto, but Acetaminophen has a lot of negative effects on your intestines and gut flora. Anything you can do to avoid taking meds to deal with your pain is a win, even if it doesn’t always feel like it.

I realize this list isn’t exhaustive, but I hope that it will get you thinking strategically about how to tackle each of your symptoms.

Whatever you are facing, create a physical flow chart with options for dealing with each individual pain and what you tried that’s helped you out. Whenever you start to notice something that concerns you, refer back to your chart.

Keep a Health Journal

With experience we learn what works and what doesn’t. You may thrive with a Health Flowchart, or you may need a loved one to reassure you when you’re struggling. Perhaps therapy is the key for you, or maybe reminders placed around your home or on your phone are necessary to help you approach your issues with Health Anxiety with as clear a mind as you can.

Journaling will help you remember the things that worked, and keep you honest with yourself about how you’re doing. Since Health Anxiety can fluctuate throughout your life, it is possible that over time, you will be able to identify what causes the onset of your more severe symptoms of Health Anxiety so that you can proactively treat yourself in the way that works best for you.

Conclusion

Due to the severe impact Health Anxiety has on many people’s psychological well-being as well as their social isolation, sometimes people might not misunderstand why you feel sick all the time, or why you’re afraid you’ll get sick, or why you have symptoms no one can explain.

Health Anxiety is one of the most draining types of Anxiety Disorders.

It affects you financially with doctor’s visits. Loss of income from not working, and the symptoms and fears people experience isolate them from their normal support systems.

If you struggle with Health Anxiety seek medical and psychological help first. If affording treatment is a problem, try and understand where your perceptions of Health and Illness come from, how illness was treated in your family, and how well you deal with discomfort. Then isolate your symptoms and take back your power by dealing with them one by one. Use of a Health Flowchart and Journaling about the outcomes of your strategies will help you to face future issues with Health Anxiety.

May God Bless and Keep You.

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