What is Health Anxiety?
As humans, we all experience changes in our health as we grow. Symptoms can be uncomfortable in the moment, but we know that they will pass. For some people, new symptoms, even mild ones, can signal something serious. They may constantly scan their body for signs of something wrong or search for answers on the internet. A high heart rate feels like a heart attack, and headaches could mean brain cancer. The idea of being faced with anything medical is overwhelming. If this sounds familiar, you may be experiencing health anxiety.
Defining Health Anxiety
Health anxiety is a common experience that shows up in many forms. When having anxiety about health, someone may have mild symptoms but feel like something is serious. Someone may have no symptoms but worry that something will happen in the future. Someone else may have severe health challenges as well as anxiety about them. The tough part is that symptoms of anxiety can mimic or intensify current concerns. A higher heart rate, stomach upset, or dizziness can feel like something else is going on. As you have fearful thoughts about your health, it can trigger anxiety and its symptoms, making the cycle worse.
There are different diagnoses, such as Illness Anxiety Disorder, Somatic Symptom Disorder, and Obsessive Compulsive Disorder. It may also be possible that you have challenging health issues and anxiety about them. Let’s explore the differences between these experiences:
Illness Anxiety Disorder
Illness Anxiety Disorder involves anxiety around developing a serious illness. The distress is intense, often leading to checking behaviors or avoidance of anything medical. Some things you might experience are:
A strong feeling that something is wrong with your health
Worrying about having a serious illness in the future
Little to no actual medical symptoms
Paying attention to your body for signs of illness
Going to the doctor to check
Avoidance of doctors or medical settings
If you struggle with symptoms like these, it can feel like your whole world revolves around the fear of illness. You may isolate from others or find other parts of your life slipping away. It can be hard to find trust in your own body or in the medical field. You might seek medical testing to get answers, but still feel unsettled. Without many symptoms, you may feel invalidated by others, even though your feelings are strong. Most often, when struggling with what we refer to as health anxiety, it is what we diagnose as illness anxiety disorder.
Somatic Symptom Disorder
In Somatic Symptom Disorder, someone’s physical symptoms cause great distress. They may fixate on them, feeling them as more severe than if the emotional distress wasn’t present. Here are some things to look out for:
At least one somatic symptom
Strong emotions or anxiety about symptoms
Fixating on bodily sensations and how serious they might be
Consistent thought patterns or behaviors related to symptoms
Difficulty focusing on things other than health
Unlike Illness Anxiety Disorder, those with Somatic Symptom Disorder have current symptoms. This might be an illness, chronic pain, or a persistent sensation. These symptoms might be mild, but the intense focus on them makes them feel more severe.
Health Anxiety OCD
Those with Health OCD can experience intrusive thoughts about their health, leading to anxiety and compulsive behaviors. The health concerns are often highly specific, along with the behaviors used to avoid them. The following are things you might experience:
Intrusive thoughts or images about developing a serious medical condition
Perceiving normal sensations as something severe
Fixations on health concerns like cancer, sexually transmitted diseases, or rare conditions
Going to the doctor for reassurance
Avoiding people or places that could make developing the condition more likely
With health OCD, it might feel like your entire life is consumed by preventing health issues. You may seek more advice from your doctor than you do anyone else. A simple google search can turn into hours of research. You may take many steps to avoid a health condition, even if they don’t make sense. Your fears can feel daunting, causing you to do anything you can to relieve anxiety. What makes OCD different is that there are typically other presentations of OCD outside of health as well. Meaning there could be contamination OCD there could be just right forms of OCD other types of OCD are present with health anxiety OCD.
Anxiety about health
Aside from the diagnoses above, many people have health conditions along with anxiety about them. They may have challenging symptoms to manage that create distress. Chronic illnesses, pain, or cancer are hard enough to push through, especially with anxiety. They may dread doctors appointments or worry about the unpredictability of their illness. New symptoms can create anxiety about what the future holds. These experiences are valid as well.
Who does health anxiety impact?
Health anxiety is more common than you might think. It impacts around 5% of people, but may be higher because so many are undiagnosed (UCLA health). Even though there are multiple forms of health anxiety, many studies focus on hypochondriasis, an older name for Illness Anxiety Disorder. This leaves out those who deal with Somatic Symptom Disorder, Health OCD, or anxiety alongside a health concern. Health anxiety impacts people of any age, but usually begins in adulthood.
Why do people develop anxiety about their health?
There are many factors that contribute to health anxiety. Genetics can be involved; if you have a parent with anxiety or OCD, you may be more likely to develop these conditions. People with other anxiety disorders may develop health anxiety. You might be used to being in a high state of fear or worry about other things. When a health concern pops up, you respond to it in a similar way. Learning from our environment or our families can make an impact. If you grew up in a home where someone was anxious about their health, you may see it as the normal way to respond. If you or a family member had a challenging medical experience, it may have created fear about how future health concerns will go. Seeing news headlines and information online about serious conditions can create anxious spirals. Trauma or difficult medical experiences can lead to anxiety and avoidance as well.
Core beliefs that maintain health anxiety
Oftentimes, people with health anxiety hold beliefs about who they are or who they may become. These beliefs are strong and feel difficult to shake. However, they are unhelpful and drive engagement in disordered thought patterns and behaviors. Here are common beliefs you may experience:
“I must focus on my symptoms, or else I might miss something.”
“If I know my diagnosis, I know I will feel relief.”
“I need 100% certainty of what’s going on with my health.”
“If I get sick or get someone else sick, it will be all my fault.”
“I need to prevent health issues at all costs.”
Holding beliefs like these can feel very heavy. They might feel like the truth, but are actually built on cognitive distortions. The reality is, our bodies are complex and don’t feel the same every day. It’s normal to feel some aches, pains, or discomfort; our bodies usually tell us when something is wrong. If we scan and pay attention all day, we will misinterpret regular sensations as major issues. It’s also true that none of us can be certain about our current or future health. We can try our best to make good choices, but we can’t prevent everything. Knowing a diagnosis may provide temporary relief, but your brain will likely create more questions. That’s why learning to sit with uncertainty is important, whether that’s about a diagnosis, symptom, or treatment. Blaming yourself for illness or health issues doesn’t have to be your default response. Some things are out of your control and are not your fault.
Why is seeking help for health anxiety important?
Living with health anxiety creates many challenges. Without proper therapy, you may be doing too little or too much to care for your health. If you avoid doctor’s visits out of fear, you will likely miss important tests or screenings. This can lead to being faced with a bigger issue, later on. In an opposite case, you may be seeking out too much testing. Going to different specialists and getting unnecessary tests can be costly. You might feel relief, but it’s only temporary. Health anxiety will always come up with something new to worry about.
One of the hardest parts is knowing when you have a real health concern versus one that is based on fear. The lines are probably blurry, making you feel confused. Building a sense of trust and knowledge of your body is an important skill. In therapy, you will work on identifying what feels serious and what feels like anxiety. Sometimes there really is a reason to go to the doctor. Other times, anxiety is in the drivers-seat. Often, it can feel like a mix of both. Talking with a trusted therapist can help you figure out what path to take, depending on the situation. Developing self-awareness can help you make the best decisions for your physical and mental health.
Another important piece is that you might have lost touch with your goals or values. When health fears are at the forefront, it can be hard to engage in things you enjoy. You might find that you can’t focus as well at school or work. You may be isolating yourself from others. By slowly adding in activities or responsibilities that mean something to you, you’ll realize there is more to life than your fears.
What does treatment for health anxiety look like?
Although health anxiety is overwhelming, there are effective treatments that can help. You are not alone. Seeking out support is the first step in building a life with more flexibility and freedom. The most effective therapy for health anxiety includes a mix of Cognitive Behavioral Therapy (CBT) and Exposure and Response Prevention (ERP). Working with a therapist trained in these treatments will help you manage discomfort and face what you have been avoiding. You may untangle beliefs about yourself or your health. Starting slowly, you will work together to figure out what ways health anxiety impacts you. There are differences based on the diagnosis or presence of symptoms. Identifying triggers or which feelings you get stuck on can help you figure out what to work on first.
You might perceive normal bodily functions as something serious. This might be a brief stomach cramp or your heart rate. In therapy, you will learn how to respond differently. As your brain jumps to conclusions, you might sit with uncertainty or label it objectively. Instead of “This must mean I have cancer”, saying “I’m experiencing a cramp right now. It may or may not be serious”. This can also work for those with present symptoms. Learning to resist compulsions, like checking, over-thinking, or researching is also a part of treatment. You and your therapist may make a list of things that feel easier and harder to face. You might begin to imagine yourself in a feared situation, go to an appointment you’ve been avoiding, or delay researching your symptoms. Relaxation techniques are also helpful. Learning to breathe through anxiety and calm yourself down can reduce your stress response.
Since health anxiety looks so different for everyone, working with a therapist who understands this is important. Someone who has no symptoms but ruminates on feared scenarios would have a different treatment plan than someone who has health conditions along with anxiety. Someone with Somatic Symptom Disorder may need distress tolerance techniques while someone with Health OCD may do more exposures. In any case, learning to sit with uncertainty is a core part of treatment. You may gain more awareness of when something is serious and when it is not. You will also learn that sometimes you can’t figure out that answer right away. Being able to trust yourself, not what anxiety is telling you, is an important skill to build in therapy.
Health Anxiety ERP therapy in San Diego, CA
At Resilience Counseling, our team of Health Anxiety therapists understands the challenges health anxiety presents. Whether this is a new struggle or something you have experienced for years, our goal is to help you find relief. We specialize in the treatment of anxiety disorders and OCD. Using evidence-based therapies like Cognitive Behavioral Therapy (CBT) and Exposure and Response Prevention (ERP), we help you create lasting change. Starting small, we will guide you through challenging beliefs, reducing avoidance, and facing situations that create anxiety. Over time, your brain and body will respond in a different way. You may have a more objective sense about your health or push through challenges with flexibility. Helping you revisit parts of your life you may have neglected because of health anxiety is also important to us. Adding in moments of joy, peace, and connection can increase your motivation to face hard things.
Our compassionate Health Anxiety & OCD therapists have worked with countless kids, teens, and adults. We help people understand their triggers and have confidence in their ability to face them. We meet you where you are at, going at a pace that makes sense to you. The anxiety or OCD cycle, especially when it is about health, can be overwhelming. We see how it can completely take over clients’ lives. Slowly, pulling back on compulsive behaviors and managing uncomfortable feelings can help you regain control. You may find it easier to accept the things that are out of your control. Gaining tools to use between sessions can create structure, even when things feel uncertain.
You don’t have to figure this out on your own. If you’re ready to take the first step, reach out to us. We can work together to figure out the best treatment approach. With the right support, you can create a life that is flexible and calm, not ruled by health anxiety. Contact us today!
Katherine Pica OCD Therapist - San Diego, CA
Katherine Pica, LCSW, is the Founder and Clinical Director of Resilience Counseling and has been practicing since 2007. With more than 19 years of clinical experience, she provides supervision and training to the practice’s OCD therapists with a focus on Exposure and Response Prevention (ERP) and EMDR for trauma. Katherine brings extensive experience treating OCD to both her clients and the clinicians she mentors.
Katherine also serves as the Training Director and board member for OCD SoCal, where she is actively involved in increasing OCD awareness, education, and community support throughout San Diego, CA and Southern California.
Health Anxiety & OCD therapy in the
San Diego, CA based office
The information shared on this website is intended for general educational purposes and does not replace professional medical or mental health advice, diagnosis, or treatment. Always seek guidance from a qualified healthcare provider regarding any medical or mental health concerns. Do not postpone or avoid professional care based on information found here. If you believe you are experiencing a medical emergency, contact your doctor, call 911, or reach out to your local emergency number immediately.
