According to the experts, the COVID-19 pandemic has actually come with a unique set of factors that can certainly fuel health anxiety in people who are already susceptible to it, reports Health.
What is health anxiety?
Health anxiety refers to the preoccupation with having or developing a serious illness—whether that’s COVID-19, cancer, HIV, or something else.
While most people think of health anxiety as “being a hypochondriac,” that diagnosis was actually removed from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) when it was published in 2013, according to the Mayo Clinic.
Instead, health anxiety now typically refers to two distinct mental health conditions: illness anxiety disorder and somatic symptom disorder.
“People who are having real medical and/or physical symptoms and they’re terrified about what they might mean—that’s typically understood as somatic symptom disorder,” Josh Spitalnick, PhD, a licensed psychologist and CEO of Anxiety Specialists of Atlanta, tells Health.
“And then there are people who worry about just getting a disease—getting COVID, getting cancer, having a stroke—where there’s no real physical or medical symptoms.”
Health anxiety can also be a feature of obsessive compulsive disorder (OCD), panic disorder, or other mental health conditions. It can also be something you experience to a lesser extent without quite meeting the criteria for any of these conditions.
It can lead to disturbances in your sleep, mood, or appetite—all of which can also lead to more physical symptoms.
Symptoms
A key characteristic of health anxiety is the presence of rituals or safety behaviors that keep you focused on your worries and actually serve to reinforce your anxiety, explains Dr. Spitalnick.
These rituals could be something you do —like excessively washing hands, taking temperature—or they could be psychological—or they could be psychological—like overanalyzing any physical symptoms and ruminating on all of the “what if” scenarios. Another common safety behavior is reassurance seeking through Googling symptoms or going to the doctor frequently.
Experiencing mounting anxiety about getting sick or dying while home alone, is also another symptom.
What causes health anxiety?
While there’s no specific cause of health anxiety, there are plenty of factors that seem to up a person’s risk.
“One of the most common risk factors for health anxiety is just someone being extra sensitive to or aware of their body,” says Dr. Spitalnick.
This can kick off a horrible cycle where the more we pay attention to these symptoms, the more noticeable they become, and the more anxiety it causes.
“If you tell yourself, ‘I think something is terribly wrong’ and you ruminate over it, the brain can release those anxiety hormones and you will start to feel anxiety-related symptoms like the fight or flight response, which is really uncomfortable”, Merav Gur, PhD, a licensed clinical psychologist in New York City.
Having a family history of health anxiety or a personal history of anxiety can also increase your risk, as can generally being someone who tends to catastrophize and always think of the worst case scenario, says Dr. Spitalnick.
Other risk factors include paying a lot of attention to scary health news and experiencing a traumatic health-related event.
How the pandemic is impacting health anxiety
According to Dr. Gur, the pandemic seems to have exacerbated symptoms, particularly in her patients with health anxiety, OCD, and panic disorder.
“Generally people who have anxiety have an extreme need for control. So living in an ambiguous state—that gray area—feels very uncomfortable,” she says. “When you don’t know what’s going to happen, when it’s hard to predict, the world feels much more dangerous, and that triggers more anxiety symptoms.”
Zeroing in on health anxiety a little more, it seems people are much more aware of—and then worried about—the physical sensations going on in their bodies. “The biggest change I’ve seen from COVID—whether someone has a history of health anxiety or no history—is this trend towards somatic symptom disorder,” says Dr. Spitalnick.
One study published in April 2021 in the International Journal of Cognitive Therapy looked at anxiety in response to past disease outbreaks and compared that to our current reality. The researchers concluded that the COVID-19 pandemic has many unique features that make it especially troubling for people prone to health anxiety.
For starters, there’s the highly transmissible and highly fatal virus. Then there’s the guidance to closely monitor yourself for symptoms, to sanitize our hands and surfaces often, and to make sweeping changes to your daily life to keep you and those around you safe.
“For the last 18 months we’ve been told by the CDC—more so in the beginning—wash your hands, don’t touch doorknobs, don’t shake hands, potentially wear gloves or protective gear,” says Dr. Spitalnick. “We’re now literally being told by the health care professionals to do the things that many of us have encouraged people who battled health anxiety and OCD not to do.”
There’s also the isolation factor. Being as homebound as we have been can strip us of our usual coping strategies and lead to rumination and catastrophic thoughts, says Dr. Gur.
A German study published in the Journal of Anxiety Disorders conducted a survey early on in the pandemic, in mid-March 2020, and found that pandemic anxiety was highest for people who exhibited both health anxiety and excessive Googling of health information. It seemed that seeking out more and more information online was only leading to more distress, which is certainly relatable.
And covering all of this is that dreaded uncertainty, which we know can exacerbate symptoms in people with anxiety.
How to manage your health anxiety
First, if there are some specific symptoms, Dr. Spitalnick suggests seeking medical attention, ideally with a primary care doctor you trust so that you feel more confident with whatever results they give you.
Recommendations from friends and family and reviews on sites like Zocdoc can help. Also, though this may go without saying, the best route for avoiding COVID-19 or at least serious illness caused by the disease is to get vaccinated.
Even after the “all-clear” from a medical professional and still spending a lot of time worrying about physical symptoms—or worrying about your health and safety in the absence of symptoms—then it might be time for mental health support.
Both Dr. Gur and Dr. Spitalnick suggest looking for a therapist who specializes in health anxiety and OCD, ideally with a focus on cognitive behavioral therapy (CBT) or acceptance and commitment therapy (ACT).
Treatment for health anxiety and OCD often includes facing your fears around things like illness or contamination in a safe and controlled setting, but that can be increasingly difficult in a pandemic
Exposure therapy is one aspect of CBT that can be especially helpful for people with health anxiety, says Dr. Spitalnick, which focuses on facing our fears and uncertainties and learning ways to cope that don’t involve those rituals or safety behaviors that we’ve come to rely on.
Other recommendations from the experts include limiting how much pandemic news you’re consuming and finding safe ways to do more of what brings you joy. While it can be tempting to just wait things out and hope that your anxiety subsides as cases subside, it’s worth finding support and coping strategies if you’re struggling now.
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Source: Health
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