As I started to open up about my health anxiety, I was amazed at how many people I knew had the same difficulties controlling their health worries. I was astonished! I would never have guessed that these friends, who seemed so calm, cool and collected were quietly suffering. Likewise, they were surprised to find out I completely understood what they were going through. But it made me wonder. Why us? Why do we have health anxiety?
Why do we ‘worry’?
Anxiety is normal and can be helpful. Our feelings of anxiety are what tell us that something might be dangerous. When faced with a threat, it’s our ‘warning system’ that spurs us into action – to stay and confront that bear on the trail or run away! (the “fight-or-flight” response)
Our attention immediately focuses on what could hurt us and our brain gives a message to our nervous system which releases a rush of adrenaline. We can thank adrenaline for making us stronger and more alert, getting us ready to protect ourselves by either ‘attacking’ or ‘fleeing’ to safety! It can also leave us with sweaty palms, tightness in our chest, a headache, hot flashes, shaking, unable to catch our breath, and feeling nauseous (among other things). Sound familiar?
Fight-or-Flight and Perceived Threats
Thankfully, most of us don’t run into bears everyday. But we are still wired for this “fight-or-flight” response and it can be set off by “perceived threats” we encounter at work, in our relationships, to our money, or in our case here – to our health.
I believe that a new sensation in my body could be a serious illness (the threat); I’m consumed by worry (focused attention); my heart starts to race and throat feels tight (those not so desirable physical effects); and then I start repeatedly checking my symptoms to make sure I’m not getting sick (protective action).
We all experience some anxiety at one time or another, but these symptoms don’t usually happen often and are short lived. The problem is when we get ‘stuck’ in this heightened state of anxiety and it starts to take over our lives.
Why do I have Health Anxiety?
No one knows for sure why some of us are more prone to health anxiety than others. According to Willson and Veale, studies suggest anxiety disorders may be partly genetic and inherited from our family. Researchers are looking into how our brain activity, hormones (like the balance between serotonin and cortisol levels), and temperament can make us more predisposed.
But that’s only one piece of the picture. As the authors explain, our experiences play an important role in our development – shaping how we respond to and understand the world. They note, “It’s likely that some of your experiences from a young age until now have helped train your brain in an unhelpful way, making you more vulnerable to developing health anxiety.” (p35)
The Centre for Clinical Interventions’ workbook, Helping Health Anxiety, suggests that most people who suffer from health anxiety have had some sort of negative health experience: ( p 2-3)
1. Seeing someone in our family struggle with health anxiety
I’m always amazed at how much my children pay attention to everything I do. Even when I think they are engrossed in the latest episode of Teen Titan, a moment later I’ll hear them repeating something I just said to their dad. Our kids learn how to relate to the world by observing our own attitudes and beliefs. If we grow up listening to a family member worry about their health or see them constantly checking for signs that they might be sick, we might approach our own health concerns in the same way.
2. Hearing tragic health stories on the news or online
The news tends to focus on those stories that will ‘grab our attention’ and raise their viewing profile. This usually means they feature reports about rare and frightening diseases and doctors making mistakes. Today’s social media networks bring these stories about health concerns closer to us than ever before. Support forums are full of testimonies from people who had their diagnosis missed or delayed. This might lead us to think these situations are common and sometimes causes us to mistrust our medical systems.
3. Having been sick with a serious illness in the past
Going through a period of illness may understandably make us feel very insecure about our health. We might pay more attention to how our body feels and any changes we notice – afraid that it could be a sign of recurrence or another disabling medical condition.
4. Seeing someone we love fall ill or pass away
It’s heart breaking when someone you love gets sick and suffers from a serious disease. We can feel helpless and it might make us uncertain about the state of our own health. This is especially true if their illness is hereditary.
If that person tragically passes, we might start to believe that treatments can’t work and getting sick inevitably means dying. Trying to protect ourselves, we may become extra vigilant looking for any signs that we might be ill. If someone dies suddenly, especially if we thought that person was ‘healthy’, we might be even more unsure. Some studies suggest that watching someone we love die, whether it was unexpected or after a chronic illness, can even cause some of us to develop PTSD (Post Traumatic Stress Disorder).
How does Health Anxiety Develop?
It’s only natural that these kinds of past negative experiences can shape the way we approach our health problems. According to Willson and Veale, this can influence:
our beliefs and attitudes about health, illness and death (e.g. how much we can cope with uncertainty, whether we are scared of dying)
how much attention we should pay to any signs of sickness in our body
how “robust or fragile” we think our body is
how we should respond to health concerns (e.g. when to see a doctor or ask for tests)
The Helping Health Anxiety workbook I mentioned earlier includes a model that I found very helpful for understanding where my anxiety stems from and how it influences what I do and think:
Our past negative health experiences can make us feel vulnerable about our health.
That fight-or-flight response focuses our attention on the perceived threat and finding ways to protect it.
This leads us to
develop new ways of thinking (rules and assumptions ) that we follow to make sure we stay healthy and
go on ‘high alert‘ paying more attention to sensations in our body or health changes that others would just ignore.
All this together can make us
more susceptible to developing health anxiety.
Understanding my own Health Anxiety
Most of my anxiety has been triggered by knowing someone who has suffered from a terminal cancer diagnosis. It began when my colleague passed unexpectedly from oral cancer at only 25 years old. I wrote a little about this in my story here. What impacted me the most happened closer to home.
Several years ago my father-in-law was diagnosed with melanoma. There was a lot of confusion at first as we tried to figure out what treatments the doctors were recommending and his prognosis. Everyone was optimistic – isn’t skin cancer just something you can remove and then all would be good? But as the test results came back we found out how far it had spread. He developed a brain tumor that slowly took away his ability to think, speak, and recognize his family. He passed away a year later.
Going on ‘High Alert’
Watching my father-in-law and family go through this experience changed me. I felt so powerless and it made me start questioning everything I believed about my own health. His diagnosis had caught everyone off guard. He was strong and healthy. He had just started building his dream retirement house.
I went on ‘high alert’, as the model describes, and it transformed all of my beliefs and the assumptions I held. I began scrutinizing any new spot I found on my body. If it could happen to him, it could happen to me – and I would do anything to try and spare my own children from that experience. (I shared one of my episodes of anxiety over ‘My Red Spot’ in my first post here).
I no longer felt safe. I now believed that any change I noticed or new ache/pain I felt might be a secret sign of an underlying serious illness. I wasn’t able to let go of my worries until I received a definitive diagnosis. This usually meant a trip to the specialist or a series of tests. I worried that if I didn’t pay enough attention, if I didn’t constantly check for any possible symptoms, I might not catch “it” in time – and a stage 1 cancer would become stage 4. I couldn’t get rid of the feeling that I might be missing something, and that I too, could pass away within a year.
When I examined my past experiences, I was able to see the profound affect they have on the way I view my health and the actions I take to protect it. I can’t change the past but I can work to change the strategies I use in the future and show my children a ‘new way of being’.
I’m not an expert. If you have any concerns about your health, you should always consult your doctor or other qualified health-care provider and don’t disregard or delay seeking professional medical or mental health advice, diagnosis or treatment because of anything you read on this site. Wishing you well.
Anderson, R., Saulsman, L., & Nathan, P. (2011). Helping Health Anxiety. Perth, Western Australia: Centre for Clinical Interventions.
Rector, N., Bourdeau, D., Kitchen, K., & Joseph-Massiah, L. (2005) Anxiety disorders: An Information Guide. Canada: Centre for Addiction and Mental Health.
Willson, R & Veale, D. (2009) Overcoming Health Anxiety: A self-help guide using cognitive behavioural techniques. London, Robinson.
Zisook, S., Chentsova-Dutton, Y., & Shuchter, S. (1998). PTSD Following Bereavement. Annals of Clinical Psychiatry, 10(4), 157-163.