Two Tips for Health Anxiety



The clinical term for health anxiety used to be hypochondriasis, but now it’s been split into two disorders, somatic symptom disorder and illness anxiety disorder.

With health anxiety you are oversensitive to body sensations and fear you have a serious illness. The fear of having that illness overwhelms you and leads to you engaging in behaviors that keep the anxiety going. Many people realize their fears are irrational to some degree, but it’s like you can’t break out of the cycle of fear about it.

The key to getting past the health anxiety is being able to focus on the problems as being anxiety out of control rather than on getting proof or reassurance that you don’t have an illness. That reassurance is always short-lived. It’s like taking short cuts to avoid work. You may feel better in the short-term when you hear you don’t have the illness, but your distress eventually comes back because the real problem is your anxiety, not whether or not you have an illness.

Some researchers out of Sweden did a clinical trial testing CBT delivered by the internet. The results were that the internet therapy was equally effective as therapy delivered by face to face with a therapist. With the internet therapy, the participants worked with a therapist through brief email communications. But the bulk of the work was done by doing exercises.

Two strategies that are included in the CBT program are

1. Practice mindfulness for 10 minutes a day.
2. Practice response prevention
Two sources of mindfulness meditations are the UCLA Mindfulness podcast and my website were you can download a Body Scan meditation here

With response prevention, you want to restrict how much you engage in the behavior that reinforce your anxiety. So an example may be that you will only check your pulse three times a day instead of the usual 20. Or you when you start to feel worried, you will wait at least 1 hour before you talk to your partner about your concerns. By waiting, you may find that you don’t have as strong of a need to talk to them.

Practice this each day. You can set aside a certain time of day to review your list of behaviors and track your progress. If you’ve spent the day holding back on your behaviors, you may be tense. And this may be when you do a mindfulness exercise.

Other parts of the therapy involved gradually exposing yourself to anxiety provoking situations while you resist engaging in your usual behaviors. This is really where you make the progress in reducing your anxiety and breaking the connection between physical sensations and anxiety. The exercises expose you to actual situations as well as imagined situations to purposely trigger your anxiety while you suppress your response.

Through these gradual exposure’s you become desensitized to the trigger. We call it habituation. The exposure exercises are best done under the supervision of the therapist but even with this Internet model the therapist intervention is minimal compared to what would be required if you were seeing a therapist in person for a full psychotherapy session. So it’s good to know that the cognitive behavior therapy can be modified to be a hybrid of self-help with some therapist intervention.

Reference
Axelsson E, Andersson E, Ljótsson B, Björkander D, Hedman-Lagerlöf M, Hedman-Lagerlöf E. Effect of Internet vs Face-to-Face Cognitive Behavior Therapy for Health Anxiety: A Randomized Noninferiority Clinical Trial. JAMA Psychiatry. Published online May 13, 2020.

Want to know more about mental health and self-improvement? On this channel I discuss topics such as bipolar disorder, major depression, anxiety disorders, attention deficit disorder (ADHD), relationships and personal development/self-improvement. I upload weekly. If you don’t want to miss a video, click here to subscribe.

Disclaimer: All of the information on this channel is for educational purposes and not intended to be specific/personal medical advice from me to you. Watching the videos or getting answers to comments/question, does not establish a doctor-patient relationship. If you have your own doctor, perhaps these videos can help prepare you for your discussion with your doctor.

45 comments

  1. I been suffering anxiety as I was a teen! Now I’m 30 I’m still suffering health anxiety is so worse that I end up going to the ER 1 million time going to so many doctors and was doing so many test I even got mri cat scan and even so many things for my heart! I would think that I have a heart attack or a stroke then I end up thinking that I have MS it ALS and then I will think that I have cancer or so many diseases in my body I no longer can’t live my life with this anymore! Everytime I watch your video I cry.

  2. Oh boy!!! This video revealed so much truth about my day. I check my pulse, blood oxygen, heart rate, & blood pressure at least 15 times a day. I have so many weird symptoms and they all make it seems like I have heart issues or stomach cancer. I’m 53 and I can’t see living another 20 years or so like this. This all started in 2015 when I almost passed out the day after Christmas. I have not had a speck of relief since. Over 2015, 16 & 17 I spent a very large sum of money getting tested for everything that my doctor could think of. Not one positive test. The only thing I accomplished with that was I was put on high blood pressure medication. My step sisters are experiencing the same health issues and they are over 9 years younger than me. They have each been to their doctors and nothing can be found. I am a Christian so I pray about it a lot.

  3. I'm writing my physical symptoms so you can comment down your symptoms too!
    1. Heart racing
    2. Feeling heart beat in stomach and fingers
    3. Headaches of different types
    4. Tingling of foot and palms
    5. Dizziness & Lightheadedness throughout the day
    6. Having tight stomach muscles
    7. Peeing a lot
    8. Uneasiness in stomach
    9. Fatigue throughout the day like having a low BP
    10. Muscles ache pain in different areas of skin
    11. Googling everyday symptoms ;(
    12. Loss of appetite ( not will to eat)

    These are my everyday symptoms hope it helps you !

  4. I have really bad health anxiety.I have not had a good day for the last month, everyday I feel like I will get a heart attack…. pain in my chest, hands and stomach….sweating. I am trying not to go to the doctor but I will have no choice… it’s so terrible.

  5. Anyone else get anxiety chest discomfort for days?? Literally went to the hospital 3 days ago and was like I think It’s my asthma or something & they we’re like, you’re fine. Still getting it but I know it’s just anxiety now and distracting myself

  6. I have had health anxiety since my early 20s… now Im 36, everytime I feel my hand tremble, I feel like it will blow up to a seizure and I will be down on the floor shaking, getting no oxygen and stuff… I am taking SSRI now and will do CBT to help

  7. I never comment on YouTube post but these comments are very inspiring and helpful.

    I’m suffering with thinking I am having a heart attack. My left arm and fingers keep tingling I got it diagnosed to be a pinched nerve in my elbow. In my mind I am still thinking it’s a heart attack. My mind will play tricks on me and think the numbness is going to my leg which it is not because I’ll smack the shit out of it to make sure it’s not asleep. Also I am waking up in the middle of the night because my arm and my hand are asleep. I will spring out of bed as if someone threw cold water on me (scares the shit out of my wife and dog). Iv never heard of health anxiety until coming across this video and I am convinced. I have honestly already got some relief from the video it’s self and the comments. So I figured I would put my two cents in I hope this helps anyone else out there.

  8. Thank you for this video. It helped my husband understand what I’m going through. Absolutely horrible. Do you have any idea when this CBT program will be available online?

  9. IV got my heart checked last week and this week because i was getting severe palpitations that take my breath away and my doctor said its normal nothing wrong with my heart still getting the palpitations so convinced he missed something and I'm going to die im constantly checking my pulse my whole body is twitching so now im convinced I'm going to have a seizure it's a never ending cycle and im exhausted

  10. It feeld as though the only way to end health anxiety is by getting over it,but how?????? Like god damnit man leave me alone,i just wanna live life, today i managed to completly forget about my brain tumor health anxiety problem,until of course i reach home,instant head aches,ice pick headaches and over all ass. Health anxeity has been a thing for me since i was 7,i remember hearing about some one choking and dying and for 2 f@cking years of my life i had felt this lump in my throat until my body just said "no" and forgot,then around 12 yrs old i heard about apendictis,instant simptoms in the end no result,now itd brain tumor which has been on for 2 weeks now,only simptoms are slight speech problems,forgeting,headaches,random blurred vision,hearing and thats it. Hope i don't give anyone my problem by telling you guys the symtoms. F@ck health anxiety.

    Good day

  11. I started having health anxiety a month ago when i woke up struggling to breathe, i went to the hospital they did a radiography of my thorax and a blood test everything was normal. then a week later i swallowed a big pill, thought it got stuck and had a feeling of lump in my throat for days so i went to the hospital and everything was ok, then i started getting headaches and numbness on one side of my body, went to the hospital, got a blood test, a scan of my brain and an ultrasound of my neck, still nothing! i've been feeling sick this entire month and i convinced myself i had a brain tumor or something really bad but apparently i don't. every doctor told me it was probably due to stress and anxiety so i'm hopping all these symptoms will go away so i can live normally again without feeling pain and stress all the time.. if anyone is experiencing something similar you are not alone!

  12. Reading all of your comments has calmed me down, I was losing my breath. But I’m okay now. You all are so amazing. I’m so glad I’m not the only one, but at the same time my heart goes out to you all. Not many people around you IRL understand your struggle and that can be the worst part for some. I love you all ❤️

  13. I think it's a common assumption that those of us with health anxiety rush to the doctor for reassurance, but we rarely hear about those with health anxiety who avoid going to the doc, even though we know how important it is.

  14. I'm 23 turning 24 and eversince my health anxiety began I've never been the same. Self diagnosing and google triggered my anxiety because of an elevated blood pressure now I'm having issues with my gastro, my heart and just recently my head. I've been sleepless at times because of this and it just worsens what i feel. I feel like I have cancer everywhere and I'm dying everyday. I just want to become the normal me again before any of these things happen. Now it's affecting my social life and my everyday routine. I hate this, this is the worst thing that happened to me

  15. Youtube and the comment section helped me so many times with my anxiety..I cant imagine dealing with this without yall..Love you guys😘Stay strong

  16. oh my musculoskeletal chest pain that’s presumably from stress? oh that’s a heart attack actually!! the normal EKG i got two weeks ago? yeah it was lying to me. what do you mean do i have the medical credentials to diagnose myself with things?

  17. Thank you Doctor! You are wonderful! Is it me. And you all can tell me. I had Covid pneumonia and was terrified but I was like …. Okay I’m gonna beat it. I took my pulse ox ( sometimes I couldn’t look at the oxygen number so my husband would read it) did breathing exercises, drove myself! To the hospital! Like a superwoman!
    But…when I have nothing….a gnawing pain in my head I automatically think it a blood clot I’m going to die I’m going to have a stroke and head into a panic attack. So why can I handle when I’m really sick….and can’t handle when I’m not.

  18. I heard ringing in my ears and believed I had hearing loss and tinnitus and when I began getting calmer I realized the ringing went away

  19. I always feel like something is stuck in my stomach while eating. Well I am being diagnosed with internal hemorrhoids but doctor says it not that much big deal. But I always assume something more is happening in my body and I can't fully concentrate on my workouts.

  20. I just found out through a blood test that my B12 is SUPER high. Like super high, but the scales are all different as to what’s high. So my mind automatically went to liver/kidney failure or leukemia. When it could just be that I’m actually really deficient and somehow it shows up high (don’t know how it works) and now I have to wait until Tuesday to talk to my doctor (it’s Friday🙃). I’m 19 by the way. There’s such a good chance I’m fine, but my health anxiety says CANCER

  21. It's been 2 and a half years Since I am dealing with it 🙂I am awake And not able to sleep because I think My brain Has Some disease because I have been keeping my phone Beside me during sleeping Even through it's always in Airplane mode but still I am scared 🙂and I had A panic attack too recently 🙂

  22. Hi Dr Tracey, thank you for addressing and explaining so many upsetting issues in a way that's educational and informative. Sadly the pandemic has heightened the already thousands of folk suffering from numerous forms of anxiety, depression and disorders, myself and children included. So many doctors, psychiatrists, psychologists and mental health trained specialists are still so unaware of how to deal with the individuals core issues, for example, triggers, past experiences and spending time listening to how it all began. They are all too quick to suggest antidepressants and send them home to further deal with possible side effects or multiple side effects as well as dealing with, family, friends, work and so on, thus adding to the already delicate, frightening place they find themselves in. Every single human being will experience mental health issues at some form of level in their lifetime sadly as such is life, however, learning to listen to the individual and help address these issues in a safe and trusting environment before they escalate, I believe would help many deal with life and issues in a more productive way.
    I am autistic, I have fibromyalgia, I have allergic reaction to foods, most conventional medicines and I have been physically mentally and sexually abused from the age of six. I have been terribly bullied all my life and yet I have and am successful in achieving goals daily, but I have done so by understanding that I have to overcome fears daily. I have learned that those who have studied all about these issues are learning from those who have suffered, unless they draw from their own issues/struggles. My heart goes out to all those struggling. You are all far much stronger that you believe….It's in you to make it happen☺🌼

  23. because of this, i couldn't function well. i already went to multiple doctors, and my family is already tired of all of my complains.

  24. I have this so bad that on my phone I have letters to my love ones for (Just in case). I also have a 6 year old which makes it feel even worse to think she will grow up without her daddy. This mental disability sucks! Hard to stay asleep. wake up middle of the night just over thinking. Sometimes cant help but to turn to the phone and check google for some reassurance but just makes it worst. STAY AWAY FROM GOOGLE!!. Just know you are not alone with this illness. Stay strong. And seek professional help for your mental state. Only way to get out of this is to treat the main source.

  25. Now I don't want to complain but I'll give you a short description of my symptoms as they are a bit different. I constantly overthink things some times it gets out of control and if I am tired or if I haven't eaten properly my body goes into a collapse which means I lose my body energy reserve in a matter of minutes and my whole body goes numb even muscles on my face start to move involuntary, and I feel massive chest pressure twice I ended up in the hospital, obviously, all the chest scan and blood were perfect(to improve this condition I have to eat something, but you can imagine taking food in those moments is a nightmare as I'm almost vomiting it back) This feel like my body is not accepting food or drink and I have to go to the toilet every 15 min) Last night I didn't go to sleep in time(usually I go around 12 so around 3 pm I tried to go to sleep and here where the nightmare started some incredible chest pulsion, chest crave. I see how other people work 24 hours shifts and if I compare it to myself it feels like I am disabled not being able to stay awake in normal operating conditions longer than 12 hours/ I am so angry, this kills me. I've been having this for 4 years now. Please any help!?

  26. Man I hate health anxiety! Literally runs my life. On top of that I have a phobia of doctors also. So I'm just drowning in this prison of a head! Sad that some ppl have to live this way while others get an awesome quality of life😣

  27. My problem about health anxiety is that you cant differentiate anxiety/panic attack between Heart attack or stroke. It's crazy. I cant control overthinking about WHAT IF my symotons are actually serious than just anxiety. I got xray and ecg 2 months ago yet i still think i have heart diseqse even my tests are normal. I cant help it. 😢

  28. thnku for your views my whole family have a anxiety problem. we tried a lot of treatments but didn't get results
    but after getting treatment from planet ayurveda now we are fine.

  29. My health anxiety is at an all time high since I was diagnosed with a hiatal hernia, causing me palpitations. I’ve seen two cardiologist telling me not to worry but it’s debilitating. My trigger is eating, my palpitations get worse while eating

  30. Just wanted to say yo anyway reading this your not alone been to the er 7 times in two weeks health anxiety is no joke take it day by day Jesus in the only healer we need

  31. Hi Dr. Can you get health anxiety for mentall illnesses, like fear of being bipolar or fall into severe depression that make you question your sanity? Thanks for your videos

  32. Can you have anxiety disorder and have normal levels of cortisol via saliva tests. I only mildly get palpations occasionaly, have trouble sleeping though everynight. Basically im aware of my breathing all day everyday but im not hyperventilating

  33. I just want to thank you so much sister for these videos! My the most high continue to bless you and keep you.

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