Advertisement

by Ken Goodman, LCSW

As she stares at the ceiling, trying to fall asleep, Dina ruminates on one statement from her doctor, “Brain tumors can grow at any time. Come back in six months if you’re concerned.”   She tosses and turns, “Why did he tell me that? If there was nothing wrong, why would he say come back in six months?”  More questions race through her mind, “Why do I keep getting headaches and dizziness? What if the doctors missed something? Why did he tell me to come back if there was nothing wrong?”  Dina feels so anxious she gets out of bed and searches the web for answers.  As she rereads the same articles about symptoms of brain cancer she begins to feel lightheaded.  “Why do I keep feeling this way? Do I really have brain cancer? Is this really happening?”  

The good news is, Dina does not have brain cancer or a brain tumor.  Dina has a health anxiety.  There are two types of health anxieties: Somatic Symptom Disorder and Illness Anxiety Disorder, formally known as hypochondriasis.  Many people with health anxiety are often unable to function or enjoy life due to their fears and preoccupations.   They obsess over bodily functions (breathing, heartbeat), physical oddities (skin blemishes), and physical discomfort (headaches, stomach aches, lightheadedness). They might worry about a specific organ (brain, heart) or a disease they heard about on the news or at work (MS, diabetes).  They are preoccupied with the belief that they have, or are in danger of contracting, a serious illness. Many will purse doctors and tests repeatedly for reassurance, but are reluctant to seek mental health treatment since they believe their condition is medically based.   

Why does health anxiety persist despite reassurance from doctors?

Although some refuse to be examined by their primary care out of fear of discovering the worst, seeking reassurance from doctors, insisting on repeated medical tests, and visits to the ER and urgent care, are more common in health anxiety. Being reassured by the doctor that there is no serious medical illness brings relief -- temporarily.   The vicious cycle quickly resumes as new thoughts and physical sensation surface, followed by interpretations of danger, anxiety, and more visits to doctors to resolve the uncertainty. Soon the cycle ignites again with the next alarming thought.  

The False Alarm

Car alarms are set off when a criminal breaks in but imagine how problematic it would be if the siren blared each time a pedestrian walked by.  The car alarm would be misinterpreting innocent people as dangerous criminals. 
With health anxiety there is the misinterpretation of discomfort and normal bodily sensations as dangerous. The body is very noisy. Healthy human bodies produce all sorts of physical symptoms that might be uncomfortable, unexpected, and unwanted, but not dangerous. 

Normal sensations in the body that can produce fear and worry include changes in visual acuity, heart rate, blood pressure, saliva levels, depth of breathing, balance, and muscle tone,  just to name a few.  These are normal and harmless bodily changes, but when a person believes they are symptoms of a terrible disease, it causes anxiety.  The sensations are real, but the beliefs are false.

Why do people misinterpret sensations in their body and overestimate danger?  

Sometimes misinterpretation is due to assumptions about an illness. For example, “My cousin died of cancer. It’s only a matter of time until I get it.”  Or, “viruses sped easily. People in Africa are dying of Ebola. It could easily spread to the U.S.” People with health anxiety might hold rigid definitions of good health, perhaps believing that any discomfort whatsoever means bad health. 

Anxiety is a protective mechanism and scanning the body for an illness seems like the right thing to do to protect ourselves. However, when we are preoccupied with something, we tend to notice it.  Last month when I was looking to purchase a new car, I suddenly began to notice every car on the road; the make, model, and the color.  Previously, I didn’t pay attention.  Looking for symptoms makes you notice subtle sensations you might otherwise ignore. When you become preoccupied with bodily sensations, those sensations become amplified and last longer. 

This is when it gets tricky.  

Each scan of the body produces uncertainty and doubt, giving the imagination opportunity to create stories.  As you imagine the worst, your body’s alarm system sounds off in the form of symptoms of anxiety (racing heart, tightness in the chest, difficulty breathing, jitters, tingling, lightheadedness, nausea, stomach discomfort, sweating, headaches, etc.) giving your imagination additional fuel to create great works of fiction.   The symptoms are real. The thoughts are false. 

The Most Effective Treatment is Cognitive-Behavioral Therapy

Since it is possible to suffer with anxiety and a serious medical condition, medical problems must be ruled out with a thorough physical exam. Once this is accomplished, Cognitive Behavioral Therapy (CBT) is the most effective treatment for any form of anxiety including health related anxiety.

CBT is a therapy model that focuses on our cognition, the way we think, and our behaviors, the way we act. The main concept behind CBT is that our thoughts about a situation (the fear of ALS) effect how we feel (afraid and anxious) and how we behave (scanning the body, going to the doctor). We tend to assign meaning to specific situations (tingling means we have MS).  It’s not the actual situation causing our anxiety, but the meaning – accurate or not. And, when you have anxiety, you give your thoughts a lot of meaning, and thus, a lot of power.  

CBT aims to help you overcome fears by correcting irrational thoughts and changing problematic behaviors.  By acquiring a certain mindset, you can learn to approach anxious situations differently and learn to tolerate discomfort and uncertainty. Health anxiety can be overcome with the help of a skilled anxiety specialist and CBT.  You can find a therapist on the ADAA website.  

Also by Ken Goodman:

Additional Resources:
Health Anxiety Is Way More Than Being A Hypochondriac — And It’s Way More Common Than You Think


About the Author

ADAA_Ken-Goodman-websize-1.jpgKen Goodman, LCSW, treats anxiety and OCD in Los Angeles.  He is the author of The Anxiety Solution Series: Your Guide to Overcoming Panic, Worry, Compulsions and Fear, A Step-by-Step Self-help Audio Program., and Break Free from Anxiety, a coloring, self-help book for anxiety sufferers. Ken Goodman is an ADAA board member and Clinical Fellow. Visit his website.

 

3 years ago i fainted 2 times in the span of 20 mins.
Got checked out and found that my heart beats slightly erratic. I’ve got a slow heart beat as well.
Or fast, it’s confusing.
I’ve had test after test reassuring me that I’m ok.
Before I fainted I had slight health anxiety, but ever since I passed out/ fainted all I can do is worry about why this happened and will this happen again.Nobody really knows , can’t get real answers.
Now I’m light headed most the time with a racing heart beat that make me more dizzy with a flushing
Painful feeling that finds it’s way up my throat.
I hate it.
What helps? Keeping busy, doing something I enjoy. When in this state, I forget about my anxiety
and poof no issue.
But it always quickly returns when I’m with me.
A saying I heard the other day.
“Everywhere I go there I am” other then all this I’m normal.
Ps. I’ve got 4 kids as well and my anxiety also spreads with worry about them.
Super frustrating with this condition.

My anxiety started a few years ago. I started having gastro issue to now i have pvc and my heart feels like its skipping beats all the time. I'm constantly worrying something seriously wrong with me and I'm going to die. I cant even take meds for anything because at some point i developed these weird phobias of taking medication. I wish there was a secret fix for this awful condition because it can make you so ill. I really miss my old life and just waking up feeling normal and not whats wrong with me today.

I go to bed and wake up in the morning obsessing over not having a panic attack. Which then causes me to think about it and over analyze everything I’m feeling (muscle tightness, heart beat, light headed ness, random aches in pains) which results in me having a panic attack. My shoulder is in a CONSTANT stage of tightness and discomfort. But I know it’s anxiety. Because as soon as my mind is distracted by something else or actually allows me to stop obsessing over having a panic attack, all the symptoms go away. I’m PRAYING that I can find a better way to control it. But once I have a bad panic attack, I’m back to square one for the next couple of weeks. It’s like my mind links the most random things to panic attacks. I fear that I’m having a heart attack alllllll the time. But again, I remind myself that I felt this the day before and was completely fine. I actually started writing down my symptoms while I’m having an anxiety or panic attack and it gives me ease. I look back at it when I’m having one and connect that I have felt this way before and everything is okay. Good luck to you everyone! You’re not alone!

I have epilepsy and recently about a month ago I found out I also have very low iron (I am taking iron therapy) but I noticed I was getting light headed and confused and also experienced a shoulder twitch while at school it scared me and left me in the nurses office all afternoon. I managed to fall asleep there. But I was told I'd be back to normal in no time Or (2-3 weeks) that has yet to happen. I got a blood test to see if my medication for my seizures was the wrong dose, it was not all my other tests came back negative but I still feel off even more so than before. I had to take a medical leave now I'm just googling any symptom I have and I'm scared I've seen the doctor more times this month alone than I ever have in the whole year. I'm trying to keep my mind occupied but I keep going back to the same thought "what if they missed something" or "what if my medication is messing with me. But I honestly never thought of a mental illness being an issue yes this helps and it's pushing me to go see medical attention. I want my life back. I want to work I want to leave my house. I want to go back to school and be able to drive without that fear of something happening. I keep being told my physical health is fine but I'm still worried and I don't know why. I don't go a day without feeling anxious and when I do the next day is a repeat of being scared and shaky and lightheaded. Hopefully I can get help because my partner says I seem fine and I look better but my head is running in circles making up stupid stories of "what if"

Hospitalized in 2008, 3 days in the cardiac unit, every test known to man, they concluded the elevated heart rate and bp was due to a major panic attack, it came from out of nowhere and ive been scared for my life ever since, they sent me home with no medication - a regular Drs visit showed a slight elevation in bp one day in 2010 (120/86, because I had a horrible job and coworkers were even worse), the Dr gave me bp meds that gave me piercing headaches for 8 years, until a new Dr took me off the meds and my bp has been okay, but I started having pain in my lower back, doctors saying nothing wrong after several tests, then I noticed sudsy deposits in my urine, my doctor said it's nothing, then they call me to say I have kidney stones, then they say I don't have them because nothing shows on the x ray/sonogram/ultrasound tests, the pain is still there, standing and walking hurts so bad, the bp meds I never needed in the first place have apparently affected my kidneys and the doctors I have seen tell me to just drink more water, not helping at all, they say there's no prescription to get rid of kidney stones, I guess they want me to die - my regular Dr gave me low dose anti-anxiety meds because I wasn't sleeping, then took me off after a few months saying they're addictive, so now I'm back to not sleeping, eating too much for comfort, unable to walk off the calories because of the pain in my back, still have the sudsy deposits in my urine with all the water I'm drinking, can't stop smoking because of the anxiety, looking at Google makes everything worse, now I'm afraid of having a heart attack on top of kidney failure, afraid of going to any other Dr or specialist because I know it will be bad news, all this from being misdiagnosed and given harmful drugs for no reason, I think it was done on purpose - I was told the hospitalization in 2008 when they said it was a major panic episode was actually a thyroid storm, they said in 2013 my thyroid was a bit wonky, on the low side, then they said my thyroid tests were all normal, my kidney function is normal, as of a month ago they did all the same tests again and they say everything is normal, then why all the pain in the kidney area and the sudsy deposits in my urine? Why leave me in high anxiety and panic mode and sleepless with no medication? I have read countless articles about doctors misdiagnosing and ignoring symptoms in "certain patients", and i am one of those "certain patients", i conclude they want us all to die, i refuse, I'm scared, but I won't give up trying to restore my health that doctors have ruined, if the pain would go away I could remove the extra pounds, I'm eating better, no restaurant food, no processed food, no carbonated drinks, no caffeine, but the stress and lack of sleep has pushed too much cortisol and expanded my midsection, which puts me at risk for diabetes and heart problems, so now I'm desperate to lose the weight and to quit smoking, I had no health issues at all until that hospitalization in 2008, whether it was a panic attack or a thyroid storm or not, doctors and pharmaceuticals have only made matters worse, before then I enjoyed every single day of my life, since then I am living a never-ending nightmare, I pray to find a naturopath and a nutritionist to restore my health before I die from all this or old age, I have nothing good to say about allopathic medicine, they have ruined my life, I refuse to give up but I can't shake the fear of the next panic attack or something worse, if only I could sleep like I used to, my body would have a chance to heal, I am so scared, I wish someone would help me

I have never felt the need to go to the doctor throughout my entire life and have always been healthy. At most I have only taken a couple if days off from work due to a minor cold. However, recently something scared the living shit out of me to the point that everyday I wake up frustrated and scared of absolutely every disease possible. I have been in and out of the doctor's office no less than two times a week over the last few months and each time I have been cleared of whatever disease I am thinking about in the moment. However, regardless of these clearances I don't seem to be getting any better. In fact, each day brings on newer and shittier challenges. Very frustrated about this recent onset of health anxiety and not really seeing a way out.

Any little thing that happens worries me. My face feel tingly? I think I'm having a stroke. My chest hurts? I feel like I'm having a heart attack. My neck hurts? I feel like my blood is clotting. I can't get over this. I've lost interest in caring for myself. I'm hungry, I'm dehydrated, I'm tired. I don't know what to do.

Hi all. Thank you for sharing it really helps. I started having anxiety issues about my health two months ago. A bad gastritis together with an infection of H Pylori made it worse. Had few panic attacks as well. Feels like I am going to die with a heart attack etc. my energy is totally drained and I can’t seem to be able to bear any sort of stress. A minimal walking is tiring.

So yesterday I went to see a psychiatrist and she diagnosed health anxiety. For all those who feels that a visit to a doctor is reassuring for a bit, I certainly know what you mean. I have cousins and uncles and friends who are doctors yet it’s didn’t work. I shall be trying CBT soon. Hope it helps. Writing that gave me hope and reading through you experience I feel I have a people who could understand me.

We shall overcome

I to suffer with heart anxiety...even though I have been given the all clear from my doctor on numerous visits to him that my heart is ok...why do I keep on worrying I have no symptoms...but then I think what if I did get symptoms...i just want the doctor to stop it from happening to me...I just feel I have no control of my heart and feel it could give out on me anytime...does anybody feel like that???

My wife has severe health anxiety about her heart. Constant fear of dying or something going wrong with her body. She was an ultrasound tech then became too stressed and had to quit. Developed her anxiety during that time. Last fall she was having an intense panic attack and I started having heart symptoms myself, I couldn’t believe it! I think it was due to built up stress. After many tests (CT, heart monitors, etc) the docs finally realized i am a healthy 26 year old and everything was due to stress and anxiety. Took me about 3 months to exercise. I’m on meds and see a therapist often. It has been an exhausting year but I’m starting to feel a little better. Positive attitude, therapy, socializing and meditation/mindfulness have helped. I also found a podcast called the anxiety coaches podcast which has been AMAZING! The host (Gina) is wonderful and has advice for almost every situation. I still deal with anxiety and my wife is currently struggling but I’m not giving up hope! Stay positive everyone because things can and will get better!!!

I have always had a fear of cancer. I also have a hard time dealing with things. About 10 years ago I started drinking. Every evening I would drink about 4 drinks. Started not feeling well in late 2017. Had a cold that I couldn’t shake well into January 2018. Went for checkup and blood work showed body was fighting infection. During this time I noticed some white patches in my throat behind my tonsils. Went to several Drs who said it wasn’t cancer.I was upfront with my alcohol use but that didn’t faze them at all. I pushed and they did biopsies. This is where my distrust comes in. They both sent them to the pathologist as 1 a benign neoplasim and the other was a tonsillectomy and he said it was for tonsil stones after writing in his surgery notes that there was an abnormality. They both came back as chronic irritation or follicular hyperplasia. I’ve tried to put it behind me as of March of this year. However in June I felt a sore spot on my tongue towards the back. I looked and there was a crater like surface lesion. Looked like a canker sore but not painful like they usually are. After two weeks I visited my dentist who thought maybe it was a bad tastebud and lasered it. The sore for the most part is gone but theres still a tenderness that is at the base of my tongue and throat. I am worried that there was something going on from the tonsillectomy that surfaced in the tongue from it’s removal. I don’t know what else to do as there is no visible lesion only persistant tenderness, pain and redness.

The way it currently looks for me- the extreme relentless stressors for years now in my own life plus possibly hormonal changes invariably manifest as various degrees of actual physical ailments.. some have been significant enough to interfere with functioning.. then my mind further manifests the stress as a thought, ‘.. I have discovered this terrible thing.. ‘, and the horror of it in the pit of my stomach which goes with this is just nightmarish.. and I’m convinced I’m dying of whatever it is. But I think it’s just all the stress projected or experienced as illness. The closest I’ve yet achieved to being free from it, is daily measures of anything which calms the nervous system enough and sometimes this involves an hour or two of stuff like breath work yoga and meditation. Still it’s a battle which is exhausting. Ps. I’m a therapist

I’m 24 and feeling extremely anxious about heart failure or having a brain aneurysm. I’ve already had a 300 dollar head CT scan and it checked out fine! Yet every time I get a headache/migraine, my mind goes to the worst. Even right this moment I have a bad headache (probably from stress) and I can’t stop googling or thinking the worst. I’ve also been having chest pains within the last week that also add to my anxiety. They put me on Zoloft and clonzepram for panic attacks but this anxiety feels indefinite. I don’t know what to do. I know my dad is sick of getting phone calls from me @ 3am.

I am glad I am not alone. I recently moved and ever since than my hypochondria has gotten out of control. I am afraid that if I can't start trusting my brain and self, it will end up badly. Everything that is wrong, is cancer. I have convinced myself 100% that this is the case.

Thank u for everyone who commented, reading all this has helped me a lot. I had a major illness as a kid, then unexpected cysts on my ovaries in early 20s, and have watched my father suffer from mental illness all my life..... I am healthiest I’ve ever been, taking better care of myself than ever, look and feel great and nothing comes up at doctors appts but I just feel like I’m going to get sick and die and have all my dreams ripped from me and leave my daughter. It’s horrifically sad and upsetting. When my acupuncturist or doctor dispel one theory of what’s wrong w me, I make up a new one in a diff part of my body, it’s insane and I tell myself it’s insane when I am feeling all this it can’t stop. I am meditating a lot, releasing a lot of fear and visualizing myself healthy and whole, this is helping me a lot. Have done therapy too but meditation works best for me, I am seeing better peace finally. Today was the first time I read about illness Anxiety Disorder and this also helped. We are so programmed by society to believe we are just all gonna get chronic illnesses and die, I mean every other damn commercial is about cancer or some drug, it’s sick! No wonder y’all. Anyway, stay positive out there and I’m sending everyone my love ❤️

I have previously wrote a comment about my health anxiety coming back really bad after having a baby now 8 weeks old I am getting all these new symptoms including etopic a beat chest tightness back pain then today I’m getting a feeling like my throat is numbing and closing in wondering if anyone else has suffered with these symptoms ?

This anxiety issue is terrible, I found relief and calmness by accepting death. I have a new made up sickness nearly every week, most of the time I know I do not have a certain sickness but my brain doubts any thought I have and decides I have it anyway. Sometimes trying to sleep is impossible because I think that relaxing feeling is me dying.

I did have a health scare a couple years ago. Due to that, it has really pinned me down to the point that everything I feel in my body I go right to Dr Google to "in my mind" try to stay proactive. This is proving to be very exhausting and at times I feel almost crippled mentally due to the mental Olympics that I put myself through. I know its not helpful or healthy to try to play Dr., but I struggle with just ignoring things. Currently am seeing a therapist, but still keep going back to those unproductive thoughts. Any other effective suggestions? Thanks for any helpful replies.

I have a very similar issue, and it's great to read Ken's articule, which scenarios are very on pointe. I was diagnosed with an eye infection recently, but the doctor said i will be fine so long as i listen with his instructions with regards to the medicine.

I know that overall, i feel much better, but i have harping thoughts - am i truly recovering or is it the steroids doing the work? what if i the infection comes back once i'm off from the medication. It's making my heart race, im checking my eyesight every few minutes, and panicking to the extent that i am paralysed with fear. I have troubles sleeping at night, and these days, i am required to stay home and just rest. But with every waking moment, i am focusing on my issue, and noticing every little itch on my eyelash, as a sign of the infection returning.

It's really amazing, as i read the comments of others, i find that the fears are unwarranted, and reading mine, i find an uncanny parallel...I hope that all of us are able to snap out of this vicious cycle, and it's actually comforting to know of others encountering the same issues.

Do you have any advice for how to deal with teenage daughter's severe health anxiety? She has just started CBT but is looking for reassurances hourly and it is so distressing for everyone.

I've had an anxiety disorder since early childhood. I'm in my mid fifties now. My entire life has revolved around my anxieties. My health anxieties came later in life after watching both parents die from cancer. I had extreme episodes of fear when ever a test or checkup was due for anyone in my family or myself. I have been working with both a psychiatrist and psychologists for years. It's a slow process, yet it all depends on your determination to "fight back". One of my favorite methods is to challenge my fear to get worse. Yes, GET WORSE!!! Lets face it, we fear our fear. Right? What happens when you challenge your "fear" to get worse? Where can it go? I know up! Maybe a bit, but if you take that leap of faith and truly challenge it to go up, it tends to go down. It feels completely wrong to do this, but it works. When we panic, we tend to "run". Like a dog, it will run after you! Don't run! Dare the anxiety to get worse! It cannot kill you. It never has. Right? Dare it to go out of control, but like the bully when challenged, it is not so tough after all. It is in our minds, but in actual reality it wont get out of control. I have so much I can share on this site with my many, many years of dealing with this. Doing nothing feeds into it. Start challenging your fear. Dare it to rise and rise. It's amazing how this feedback works. When it has no where else to go or to chase, it fades.
What a wonderful community of people here. We all can get through this. We're not alone....