Health Anxiety

Jane Leu Rekas January 07, 2024

Health Anxiety

What do we know about health anxiety?


Health Anxiety is one of many manifestations of anxiety which causes increased focus on physical sensations and symptoms, and leads to fears of possible serious illness or disease.

Health Anxiety can occur with or without a pre-existing illness or condition, but causes increasing distress in and of itself.

Health Anxiety can also be triggered by other mood conditions, including childhood separation anxiety, social anxiety, generalized anxiety, OCD, Panic Disorder, or trauma resulting in PTSD, and forms of depression as well.

Some personality types may be more prone to anxiety about their health, if they tend towards worrying in general.  Other times a tolerable baseline amount of worry can be increased by life stressors, whether health related or not.

Health Anxiety can result in over focus on health, seeking diagnoses and treatment, by researching online or making multiple medical appointments.  Or the reverse can happen, resulting in medical avoidance.

What are the treatments for Health Anxiety?

Cognitive Behavioral Therapy (CBT)


"CBT looks at how to challenge the way you interpret symptoms, to encourage a more balanced and realistic view. It should help you to:
  • learn what seems to make the symptoms worse
  • develop methods of coping with the symptoms
  • keep yourself more active, even if you still have symptoms"
"Cognitive behavioural treatment involves: 

  •  Self monitoring 
  • Identifying and challenging negative thoughts 
  • Modifying abnormal illness related behaviours. e.g. checking, reassurance seeking 
  • Identifying and correcting core beliefs using disputation and behavioural experiments 
  •  Attention training and worry postponement may also be part of treatment for health anxiety."
  • http://www.anxietyaustralia.com.au/anxiety-help/health-anxiety/

Hypnosis for Health Anxiety

Hypnosis can be used for all types of anxiety, including Health Anxiety, as well as stress reduction for all types of healing.  Hypnosis can also be paired with CBT for a very effective treatment.

Read about Anxiety and Hypnosis at Web MD:
http://www.webmd.com/anxiety-panic/guide/does-hypnotherapy-work#1

see also: https://www.resolvedhypnotherapy.co.uk/health-anxiety-it-can-be-cured-hypnotherapy-could-help-you/


Exposure Therapy

According to Dr. Abramowitz:
“In my mind, hypochondriasis is a form of OCD.  In fact, as I describe below, I tend to use the same treatment techniques as I would use to help someone with OCD.”
"Dr. Abramowitz goes on to discuss in detail the treatment for hypochondriasis, and you guessed it, it involves exposure and response prevention (ERP) therapy. This front-line treatment for OCD also helps those with health anxiety."
https://ocdtalk.wordpress.com/2015/05/17/ocd-and-health-anxiety/

"Illness phobias could be placed nearer to the Obsessive/Compulsive category of anxiety disorders than most other phobias as the accompanying rituals of checking and reassurance can be troublesome. The ruminations about a particular illness or disease are like an obsession in many ways. Very often this phobia is found in people suffering from depression and may well fluctuate according to the level of depression experienced. This phobia tends to be quite short-lived often, less than a year. However, there is no reliable data on the length of illness phobias when there is no depressive element present."
https://www.nopanic.org.uk/health-anxiety-sidebarlink/

Health Anxiety/Hypochondriasis - Houston OCD Program


PTSD Treatment (if Comorbid)


"If you have PTSD, it might feel like you’ll never get your life back. But treatment is available -- certain kinds of psychotherapy and medications can work very well. PTSD therapy has three main goals: to improve your symptoms, teach you coping skills, and bring back your self-esteem.

Most PTSD therapies fall under the umbrella of cognitive behavioral therapy. That involves trying to change the thought patterns that are disturbing your life. This might happen through talking about your trauma or concentrating on where your fears come from."

http://www.webmd.com/mental-health/what-are-treatments-for-posttraumatic-stress-disorder#1

Trauma 101
Recommended Treatment Modalities
https://trauma101.com/?pID=26




Anti-depressant Medication


"Antidepressants may be helpful if you have a mental health condition such as depression. For some people, these may work better than CBT. Your GP can directly prescribe antidepressants or refer you to a mental health specialist for treatment."


Worried Sick?

excerpt from Psychology Today

"The therapy program for health anxiety instituted at the White Plains Anxiety and Phobia Center revolves about six principles. The patients are instructed:

 1. A. Learn the truth about yourself—the particular physical symptoms you characteristically develop, over and over again, in the face of stress. For example, fatigue, back pain, panic attacks, palpitations, etc. These accustomed complaints are not likely to reflect some new physical disorder.

 B. You need to learn about the illnesses you fear. Knowing a little is scary. Knowing a lot is reassuring.

 2. Confront your fears. Thinking the unthinkable diminishes fear. (This is an allusion to the “Nightmare Fantasy” in which patients are asked to imagine, in detail, the worst case scenario of their fears. It is possible to desensitize to a fear of illness and death by fantasizing.)

 3. Avoid checking and the search for empty reassurance. (Patients are not allowed to ask the same question twice.)

 4. Think of the odds against being desperately ill rather than the stakes. (“Wouldn’t it be awful if I died suddenly from a ruptured aneurysm?” “Yes, but what are the chances of that happening?”)

 5. Do not seek absolute certainty or safety.

 6. Live in a healthy way. (Including principles of eating properly and exercising.) These summarize to certain “dos” and “don’ts”

Things to do

  •  Research diseases. 
  • Construct and dwell on the Nightmare (at the prescribed time) 
  •  Exercise. 
Things to avoid doing

  •  Do not examine yourself. 
  • Do not ask M.D. s for reassurance 
  •  Do not ask your doctor to do tests or prescribe drugs he does not think to do on his own initiative."

Cognitive Distortions Characteristic of Patients with Excessive Worry

Intolerance for uncertainty:
“If I think about this enough, I should feel a sense of certainty.”
Intolerance for discomfort:
“If I can just think this through, I won’t have to feel this way.”
Inflated sense of culpability:
“If bad things happen, it is my fault.”
Distorted risk assessments/emotional reasoning:
“If it feels likely, it is likely. If it feels dangerous, it is dangerous.”
Perfectionism about mistakes:
“Mistakes mean I screwed up because I was not in control.”
Pessimism/presumed incapability:
“Bad things will happen to me and I will not be able to deal with it.”
Misconstrued virtue:
“Worry shows how deeply I care about my children.”
Overvaluation of the thought process:
“Because I have a thought, it is important and I must give it my full attention.”
Implicit magical beliefs about worry:
“Worry prevents bad things from happening. It keeps me from being blindsided. It keeps loved ones safer.”
Worry about worrying too much:
“I am out of control. I am making myself sick. I have got to stop worrying.”
http://www.aafp.org/afp/2006/0315/p1049.html
 

Illness Anxiety Disorder DSM-5 300.7 (F45.21) care seeking type, vs care avoidant type


"Illness Anxiety Disorder (formerly called Hypochondriasis). People with this type are preoccupied with a concern they have or may acquire a serious disease. They may believe that minor complaints are signs of very serious medical problems. For example, they may believe that a common headache is a sign of a brain tumor.

Conversion disorder (also called Functional Neurological Symptom Disorder). This condition is diagnosed when people have neurological symptoms that can't be traced back to a medical cause. For example, patients may have symptoms such as:
  • Weakness or paralysis
  • Abnormal movements (such as tremor, unsteady gait, or seizures)
  • Blindness
  • Hearing loss
  • Loss of sensation or numbness
  • Seizures (called nonepileptic seizures and pseudoseizures) 

Stress usually makes symptoms of conversion disorder worse.

Other Specific Somatic Symptom and Related Disorders. This category describes situations in which somatic symptoms occur for less than six months or may involve a specific condition called pseudocyesis, which is a false belief women have that they are pregnant along with other outward signs of pregnancy, including an expanding abdomen; feeling labor pains, nausea, fetal movement; breast changes; and cessation of the menstrual period.
 
Treatment of Somatic Symptom Disorders
Patients who experience SSD may cling to the belief that their symptoms have an underlying physical cause despite a lack of evidence for a physical explanation. Or if there is a medical condition causing their symptoms, they may not recognize that the amount of distress they are experiencing or displaying is excessive. Patients may also dismiss any suggestion that psychiatric factors are playing a role in their symptoms.

A strong doctor-patient relationship is key to getting help with SSD. Seeing a single health care provider with experience managing SSD can help cut down on unnecessary tests and treatments.

The focus of treatment is on improving daily functioning, not on managing symptoms. Stress reduction is often an important part of getting better. Counseling for family and friends may also be useful.

Cognitive behavioral therapy may help relieve symptoms associated with SSD. The therapy focuses on correcting:
  • Distorted thoughts
  • Unrealistic beliefs
  • Behaviors that feed the anxiety"


 
Jane Leu Rekas

Posted by Jane Leu Rekas

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