Health anxiety

Recent data from 2012 suggest that health anxiety (also called illness phobia or hy-pochondriasis) may affect up to 5% of a population across the lifespan. Health anxiety is associated with significant distress, impairment, disability and health service-utilization.

In health anxiety it seems that people suffer from a restrictive concept of good health and that they misinterpret ambiguous bodily symptoms as a sign of illness. Swellings, pain, loss of energy, dizzy spells, skin-spots etc. provoke ‘catastrophic’ thinking about cancer like brain tumors, skincancer or gastro-intestinal cancers and a general, and intense, fear of dying. Where panic symptoms cause dizziness and stomach problems, the fears might be both a brain tumor and stomach cancer. Headache can provoke doubt about whether a brain tumor may be the cause.

Symptoms of health anxiety include ruminating endlessly about the disease (or death); avoiding anything in the way of radio, TV, newspaper, or magazine coverage on the subject. Often it is a problem that one is repeating bodily examinations – personally and through the medical practitioner and a constant need of reassurance that the disease is not present, from family, friends and doctors.

When something makes us anxious we will usually try to avoid it. Avoiding gives an instant relief of tension. However, in health anxiety people cannot avoid the anxiety provoking stimulation because most of it – in the form of thoughts and bodily pains – is inside themselves. The anxiety does not reduce even though the person cannot escape it – so it does not respond well to traditional cognitive behavioral ‘desensiti-zation’ treatment. It is likely to be more permanent and so more of a problem.

Cognitive behavioral therapy with psycho-education about the body and its func-tions together with training in realistic thinking is often helpful combined with psychiatric counseling.

Relaxation techniques and mindfulness therapy can be added as a next step in the treatment. The anti-panic and relaxation methods shown in PanicRelief might be of help in this second phase of the treatment.