Trigger warning: Though I’ve steered clear of discussing COVID or other illnesses in detail, there are some mentions of death and illness. The last three paragraphs deal with advice without discussing illness.
Before 2020 I’d never worried that much about my health. I’d suffered from anxiety since I was a child, but until then it had been a far less specific animal, manifesting as a vague sense of worry and unease about the unknown future and persistent feeling of shame and discomfort.
It was annoying, sure, a second shadow trailing around behind me while I ran through DBT exercises in my head and tried to practice mindful breathing, but it was something I could mostly manage.
About six months after the first COVID-19 lockdown I was in a bad way, immobilised by fears of disease and dying. I zeroed in on my breathing, sometimes hyperventilating because I was trying so hard to focus on it. Was I getting less air than usual? Was there a tightness? Did it hurt to take a deep breath? How did it feel to take lots of shallower, quicker breaths? I had several anxiety attacks like that, and I’d come of them the other side feeling drained and more convinced than ever that I had some new and undetectable strain of COVID that would either kill me or wreak terrible damage on my body. I stayed up late looking up my symptoms, learning about obscure diseases and putting together a horrifying picture of my health.
The current health headlines are not helping.
I know I’m not alone in this. When I tweeted to ask if anyone else had experienced health anxiety I received a flurry of replies. Yes - me - I have - ever since - I’ve always— dozens and dozens of messages of lived experience and recognition. Health anxiety is an irrational and distressing fear of having a serious illness or condition, described on the NHS website as ‘when you spend so much time worrying you're ill, or about getting ill, that it starts to take over your life.’ It can look like hyper-awareness around possible symptoms and obsessive tracking and scanning for new or changing bodily sensations mean that sufferers can often mistake the physical symptoms of anxiety or stress such as heart palpitations, shortness of breath, light-headedness, GI issues, skin flushes, headaches, for hard evidence that something else really is the matter.
For a lot of us the pandemic was a perfect pressure cooker for anxiety triggers and existing fears. I spoke to Marta, 30, who has lived with health anxiety for as long as she can remember. ‘The start of COVID was a really, really hard time. I was so used to being reassured by my therapist and doctor and told not to Google symptoms and so suddenly having the advice change to tell us all to remain vigilant to them was really tough.’ She credits remote therapy and the support of her partner for getting her through those months and helping her manage through the still ongoing pandemic.
Sarah, 41, lost her husband to cancer in 2018 and has since struggled with health anxiety and an acute fear of hospitals and all medical procedures. ‘Since it happened it just represents death and terror to me. Even having to turn around in the carpark of a clinic would make me feel lightheaded… it’s not rational but I believe if I go in I will either never come out or will be told I’m dying.’ She tells me that different things can trigger it. ‘It could be a minor pain that wasn’t there the day before… any kind of swelling or really my body feeling or looking “different” or someone mentioning an illness in conversation. If I’m already in poor mental health it’s more likely to take hold and become a spiral.’ She takes antidepressants and occasionally anti-anxiety medication.
But the app being blamed for the uptick in ADHD diagnoses is not only incorrect, but also hugely reductive.
Many parents also got in touch to say that their health anxiety has expanded to include obsessive fears and concerns around their children’s health. One such message I received- ’I see other parents who have a son or daughter off school sick and they’re calm about it and are confident enough to say it’s just a bug or a cold. My mind always goes to the very worst and darkest scenario.’
I spoke to Mike, a GP based in the UK who manages patients with health anxiety on a regular basis. He tells me that while some patients will come in with an existing awareness of what’s happening, in other cases it’s something he may only suspect based on a patient’s behaviour- the frequency of appointments perhaps, or the persistence of certain fears despite investigation and reassurance. ‘In this case I try and raise it sensitively … and make it clear that we’re not dismissing physical concerns or any health anxiety itself.’ Helping a patient manage health anxiety may look like a mental health referral or scheduling fixed appointments with him that can be gradually phased out as things improve.
Managing anxiety on your own is often a case of trial and error, and it’s worth remembering that it’s not you failing if certain approaches aren’t quite working or offering immediate relief. Awareness around your own triggers can be key, and can also allow you to let the people close to you know what is likely to cause overwhelm, panic or rumination. Distractions can help, playing a video game or taking a walk in the fresh air to try and lessen the temptation to go searching the internet or a medical book for answers. Exercise can have a very therapeutic effect for some people, though it can also be a trigger in other cases. Personally I try and engage with the anxiety logic in as detached way as possible, treating it with curiosity and reminding myself that thoughts and feelings are not facts and that they always pass. If possible I might try and ask myself what a person without this anxiety might think about the pain or sensation I’m hyper focused on, and then do my best to mimic that response.
In the case of a loved one suffering from health anxiety it can be tempting to try and snap them out of it or force their thoughts into more rational territory, but this is unlikely to help and may discourage them from being open in future. Be calm and try simply to listen and ask what, if anything, they need from you. If you want to vent or express your difficulty grasping what they’re going through, do so elsewhere. In the worst moments of my own health anxiety it felt overwhelmingly isolating and humiliating, and discussing it even with my most trusted loved ones felt near impossible. Being met with judgement or frustration would have only sent me further into shame, even though I know now there’s nothing shameful about this. It’s not a choice nor a manifestation of something wrong or broken in a person and whatever the root or the trigger, each of us deserve compassion and support in navigating it.
For more information about health anxiety and where to start if you’d like support in addressing it you can visit the NHS website Health anxiety
