Health anxiety

Last updated September 2023 | Next review due March 2025

Health anxiety is a form of anxiety where someone is constantly worrying about their own or someone else’s health. The fear that they're either unwell or will become unwell starts to take over their life. Here we explore how health anxiety can affect you and how hypnotherapy can help.

What is health anxiety?  

In 1952, the American Psychiatric Association published the first edition of the DSM - Diagnostic and Statistical Manual of Mental Disorders - listing descriptions and symptoms of mental health disorders for clinicians in the US. While the most recent version (DSM-5 published in 2013) faced criticism and controversy, I keep it on hand as a basic guide. 

The DSM has a chapter titled 'Somatic Symptom and Related Disorders', where you find the diagnostic criteria and explanations for two listed disorders which cover what we colloquially describe as health anxiety: illness anxiety disorder and somatic symptom disorder. 

In this video, hypnotherapist Alexandra Vessey explains how health anxiety can impact us and how hypnotherapy can help.

Illness anxiety disorder

The diagnostic criteria for illness anxiety disorder are:

  • Preoccupation with having or getting a serious illness. 
  • Physical symptoms are not present, or mild. If you have another medical condition or there is a high risk of you developing a medical condition, your preoccupation is excessive or disproportionate.
  • You have a high level of anxiety about your health and feel easily alarmed about your personal health status.
  • You perform excessive health-related behaviours, for example, repeatedly checking your body for signs of illness. Or inappropriately avoid doctors' appointments and/or hospitals. 
  • Your preoccupation with illness has lasted for at least six months, even though the specifics might have changed. 
  • The preoccupation with illness is not better characterised by another mental disorder.  

Within the diagnosis, there are two types of illness anxiety, those who seek care and frequently visit the doctor or request tests, and those who avoid medical care. 

The book specifies that most people in the US receive a diagnosis of somatic symptom disorder rather than illness anxiety disorder. 

Somatic symptom disorder

The diagnostic criteria for somatic symptom disorder are:

  • At least one somatic (physical) symptom that is distressing or disrupts your daily life.
  • Excessive thoughts, feelings or behaviours that relate to the somatic symptoms or associated health concerns that specifically meet one of the following:

    • Out of proportion and persistent thoughts about the seriousness of the symptoms.
    • Persistently high levels of anxiety about symptoms or health.
    • Spending excessive amounts of time and energy focusing on the symptoms or health concerns.
  • Your symptomatic state (though symptoms might change) is consistent.

In this case, the diagnosis varies from mild, moderate or severe, depending on how many of the symptoms in criteria B are present. 

The NHS description of health anxiety is a less formal combination of the above criteria:

  • Constantly worrying about your health.
  • Regularly checking your body for signs of illness.
  • Regularly seeking reassurance that you are not ill. 
  • Worrying that the doctor or medical tests missed something.
  • Obsessively researching health information.
  • Avoiding anything to do with serious illness.
  • Behaving as if you are ill.

What is cyberchondria? 

Cyberchondria is a term that we’re seeing on the rise as information becomes more easily accessible online. It’s the term used to describe people that excessively research symptoms on the internet and go on to self-diagnose medical concerns. This can lead to the person becoming stuck in a cycle of anxiety. They typically believe that they have a medical problem which exacerbates anxiety, rather than seeking further advice from a GP.

It’s important to note that this is not an official diagnosis, but it stems from ‘hypochondria’. This is the negative connotation that someone is ‘overreacting’ about their health, rather than recognising that health anxiety is a debilitating illness for those living with it. 

If you’re constantly checking parts of your body that worry you throughout the day, this can be extremely draining. Your fear is so severe that you can’t overcome the compulsion to act upon it. This is why health anxiety is often compared to OCD.

- explains writer Kat in Hypnotherapy for health anxiety.

My experience of health anxiety

Years ago a friend and I sat in a new restaurant. We ate delicious Thai food as my friend casually and blithely told me how she’d recently had a patch of skin removed from her face due to cancerous cells. I heard her words, but in a fuzz, and her easygoing attitude completely contradicted mine as it occurred to me that I was rubbing a lump on my neck, a tiny lump. Maybe the size of a small pea. Despite touching it, I had no awareness of this habit I’d started until that conversation. Of course, the combination of hearing the word ‘cancer’ and feeling the lump triggered my consciousness. I instantly recognised that I regularly sat and rubbed it when working and concentrating. Panic set in and I felt convinced there must be something sinister about the tiny lump. 

For a long time, I felt terrified, too scared to even speak with anyone about it for fear of what it might be. Eventually, I found my rational mind, acknowledged my health anxiety and took a small step - which for me was going to see an osteopath. Someone I work alongside and trust. When she ran her hands along my neck, feeling for what I described to her, she assured me that in her professional opinion, it was nothing to worry about. I felt myself take a sigh of relief.

Yet it did not fully leave my mind, so I took another brave step and booked a doctor's appointment. When the doctor felt my neck, she was unable to feel what I described to her. She booked me a blood test to ease my anxiety and sent me on my way. When the results of the blood test showed all was well within my body, I made a conscious decision to stop touching my neck. It did not take long to change the habit, and interestingly, the lump disappeared. 

Although I do not know what the lump was or is, I suspect I was irritating my body which caused it to swell slightly. Either that or I just got to know that particular part of me really well, including all normal lumps and bumps. While I know the importance of getting anything checked that does not seem right, I feel strongly that I experienced a form of health anxiety during this period of my life. My proactive decision to stop was the key to its ending. 

What support is available for health anxiety?

One of the most challenging aspects of health anxiety is that anxiety itself causes physical symptoms. When the anxiety you feel about your health causes you to develop physical symptoms, such as a pounding heart or a headache, you believe the symptoms to be a part of your perceived illness. This exasperates the feeling of fear and the cycle continues. 

The NHS recommends self-help unless the feelings you experience interfere with your daily life, in which case the recommendation is to see your GP who can refer you to a cognitive behavioural therapist. Sometimes your GP will refer you to a counsellor or other talking therapist, support group or for guided self-help. 

It might be the case that there is a long waiting list or the support is restricted and you need further help. If this is the case you will need to seek out your own support. There are many charities in the UK that offer help, such as the Samaritans, MIND, Calm, Young Minds and AnxietyUK, although frustratingly, it does take a bit of research and reaching out. 

If this is something you find difficult, asking a friend for help can make it easier. If you struggle to find someone you trust, your GP surgery should point you in the right direction, or you can find a list of crisis lines on Hypnotherapy Directory.

If you have the resources to see someone privately and research your therapist, you will receive personalised service from someone with experience. 

Hypnotherapists working with health anxiety

Hypnotherapy for health anxiety

Hypnotherapy is a form of therapy that combines hypnosis with therapy to help you overcome challenges, and change negative behaviour and mindset. Hypnosis is the same state of mind as that achieved through meditation. Hypnosis helps the user to focus and take control of their thoughts and actions. Most hypnotherapists have a thorough understanding of the neuroscience of the autonomic nervous system and can help you with generalised or specific anxiety. 

Your hypnotherapist will use therapeutic techniques to help you redirect your mind and feel in control of your thinking so that it stops running away from you. Many people fear letting go of their health anxiety because of the fear that something is wrong. They worry that when they remove the focus on health, the illness will take hold and their worst nightmare will come true. Therefore, your hypnotherapist will spend time helping you to feel safe living a life with a fair and rational focus on health. 

For example, most people with breasts know the importance of checking for breast cancer. As do most people with testicles for testicular cancer. However, the recommendation is to check once a month, not once (or more) a day. Your hypnotherapist will help you feel safe with the recommendations and confident in your body’s ability to remain healthy. 

Mindfulness techniques can bring your attention back to the present moment... When you remind yourself that you are in control of your own destructive thoughts it is easier to stop them and create a happier life for yourself.

How to deal with health anxiety

What clients can expect from working with a hypnotherapist

Expect your hypnotherapist to conduct a thorough consultation so they get a good idea of your life, past and present. Your hypnotherapist might ask you questions that have more depth than you expected. Hypnotherapists do not do something to you, rather they help you to find your own power to make the desired changes. 

Hypnosis is generally a relaxing experience, enjoyable to most. Sometimes you will find that your hypnotherapy session disturbed some emotion, but your hypnotherapist has the experience to help you navigate this. You will spend some of your session talking - sometimes all of it - and part of it in hypnosis. 

Your hypnotherapist will guide you into hypnosis, just like a guided meditation (similar to savasana and yoga nidra at the end of a yoga practice) and will either continue to speak to you about something relevant to your situation or ask you questions. 

Your hypnotherapist will also teach you various techniques to use at home. The techniques might include tools to help you when you feel anxious and ideas to stop the habits which increase your health anxiety, such as going for a walk instead of scouring the internet for more health-related information. 

Taking the first step sometimes feels huge, but remember that it's OK to take a tiny step and see how that feels. When it is comfortable, take another tiny step. Eventually, you’ll find yourself in a place with the support you need to get through it. 

This page was written in January 2022 by hypnotherapist Juliet Hollingsworth MSc, Dhp.

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