Do you often find yourself worrying, despite reassurance from doctors, about mysterious tingling, chest pains or some suspicious-looking lump? It could be real, or you may be misinterpreting physical sensations as a sign of an impending health problem: you could be suffering from ‘health anxiety’.
Excessive worrying about your health is surprisingly common, affecting up to 20 per cent of those seen in medical settings. It involves paying undue attention to bodily sensations, risk statistics and medical information that can easily be misinterpreted. This can become an overwhelming and distressing condition that demands reassurance – however, this reassurance can compound the problem; it may offer temporary relief but you can then become dependent on it. Patients often find themselves asking, ‘Yes, but what if..?’
I recently had a flash of insight into what it may be like to worry about the twinges of your body. Although trivial in comparison, I have developed a slight fear of flying. At takeoff, I listen to the sound of the engine powering up, then grip the arms of the chair when it quietens upon levelling out, briefly convinced the engine stalling. As for turbulence – that really gets my heart pounding. I find myself overfocusing, catastrophising and, more often than not, digging my nails into my poor husband’s forearm. So now I sort of get it.
The symptoms of health anxiety can trigger the body’s ‘alarm system’, which causes a racing pulse and hyperventilation, only making matters worse. It can interfere with work, family and social life.
Patients often come to see me with long lists written in capitals, underlined, highlighted and with subheadings, indicating their distressing levels of anxiety. People often ask, ‘How do you know it’s normal for certain?’
For a diagnosis of health anxiety, your worries must be seen to be excessive in relation to the actual risk and impact, and to continue despite reassurance. It may involve disproportionate time spent searching online – described in a recent BMJ article as ‘cyberchondria’, further increasing the risk that ‘normal bodily sensations are interpreted as signs of serious disease’. Of course, medical diagnoses are not clear cut – for many, health anxiety can coexist with a medical diagnosis.
Many people have health concerns but if the following happen often and interfere with your life, you may have health anxiety:
- When reading or hearing about an illness, do you find you get similar symptoms?
- On noticing a bodily sensation, do you find it hard to think of anything else?
- When you feel a sensation in your body, do you worry about it?
Identifying it can be helpful, not only because there is treatment available to reduce symptoms, but it also reduces the need for unnecessary investigations, medications and complications.
Finding ways to tolerate the uncertainty about our unpredictable bodies is usually helpful. Your GP can refer you for cognitive behavioural therapy to make sense of the triggers, identify misinterpretations of normal sensations and find ways to deal with the anxiety, including distraction techniques. Antidepressants are used occasionally, too.
As for flying, my husband now lends me his noise-cancelling headphones – mainly to avoid nail marks in his forearm.
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Keep calm and eat fish
Adding high doses of omega-3 fish oils (up to 2,000mg a day) has been found to reduce symptoms of anxiety among those suffering with mood disorders. This is according to a review of 16 studies which compare the use of fish oils against placebo. In fact, the majority of the population could benefit from increasing their omega-3 intake as well. Increasing these levels can also be done by eating oily fish such as mackerel, salmon or sardines at least twice a week.
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