Overcoming Health Anxiety: Strategies to Break the Cycle of Worry

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Hello, Doctor: I have been struggling with obsessive thoughts about illness for a long time, which leads me to self-examine, such as constantly feeling my neck for lumps, and I always end up thinking there’s something there; or I keep looking at my throat and the more I look, the more I feel that the sides are asymmetrical and wonder if there’s a problem inside.
I shine a light in my eyes to check the patterns and always feel that something is off.
This self-examination only increases my anxiety and doubts, making my life a constant state of worry.
I have actually consulted doctors about the illnesses I worry about, and they have told me there’s nothing wrong, but instead of feeling reassured, I start to doubt whether the doctor really examined me thoroughly.
I still end up touching and self-checking.
I previously saw a psychologist who advised me not to seek random treatments (I took an antidepressant for a while, but I felt a tingling sensation on my scalp, and since I later wanted to prepare for pregnancy, I stopped taking it.
Honestly, during the medication period, I didn’t feel particularly relaxed).
In the past, I worried so much that I consulted five or six doctors for validation, but I still felt anxious.
Now, I can manage to resist seeing multiple doctors after one consultation, but I still worry and self-check.
Living in this cycle of self-examination is exhausting, but on the bright side, I have learned to distract myself and keep busy, which often helps me temporarily forget my worries for a few days.
I have been long-term worried about several conditions (A, B, C, D), and even after seeing a doctor, I still feel uneasy.
However, time can indirectly show whether there’s a real issue with my body, and I think I’ll just leave it at that (since I still doubt and worry after seeing a doctor).
The problem with self-examination troubles me; for example, if I’m worried about condition A, I will keep checking in the mirror, wasting a lot of time, and the more I look, the more I feel there’s a problem, which increases my anxiety.
But if I clear my mind and step away from the mirror, carrying my anxiety into activities, I can forget about it after a few days, and I might even think I’m overreacting about condition A.
Then I might start worrying about condition B.
When I focus on one condition, I tend not to worry about another, but these worries often cycle back, making it hard to breathe.
Recently, I started looking in the mirror less and found that I hadn’t worried about conditions A, B, C, or D for a while.
This period of relief has been truly relaxing! However, after about a month, I might have stared in the mirror for a few extra seconds one day and started worrying again.
Doctor, when I distract myself and live without looking in the mirror, I do feel a sense of relief for a while, but how can I extend this period? Can it be prolonged with each distraction? For instance, one month this time, two months next time, or will it never get better, and I can only enjoy a month of lightness before returning to a hell of anxiety? Will this personality trait follow me for life? Thank you.

PP, 30~39 year old female. Ask Date: 2017/03/03

Dr. Ding Shuyan reply Psychiatry

Hello, obsessive thoughts inherently possess a strong allure, making us feel they are important and cannot be ignored; we must drop everything and address them immediately.
However, this is a trick of such thoughts, as the reality is quite different.
Have you ever experienced days where you didn't check the mirror and ended up feeling happier and more at ease? That serves as the best example.

Rationally speaking, this is correct; when the thought of checking for illness arises, it can be a method to counteract and remind oneself.
However, the best strategy is still to divert attention and avoid confronting the thought directly.
Once you engage in a tug-of-war with obsessive thoughts, it will inevitably end in failure.
This is not a matter of weak willpower; it is an inherent characteristic of human psychology.
Everyone has worries; most people might think about them briefly and then move on to other tasks.

Diverting attention helps prevent us from continuously feeding energy into these obsessive thoughts, stopping them from growing stronger, like an uncontrollable monster.
Those with obsessive-compulsive disorder or depression do not experience this in the same way; they tend to cling to these thoughts, resulting in a sense of entrapment.
Therefore, when you notice yourself focusing on bodily symptoms, be immediately aware that this is yet another trick of obsessive thinking, and gently redirect your attention to other matters.

If that is inconvenient, you can focus on the rise and fall of your abdomen with each breath to interrupt these obsessive thoughts.
Indeed, if obsessive thoughts arise a hundred times in a day, you should practice redirecting your attention a hundred times.
It’s like when you visit a night market and want to eat steak but have no interest in ice cream; you walk past the ice cream stand without pausing for even a second, not contemplating whether to have ice cream at all.

Facing obsessive thoughts should be approached in the same manner.
Neither welcoming nor rejecting them, simply do what you want or need to do, and redirect your attention.
Wishing you all the best.

Sincerely,
Dr.
Ding Shuo-Yan

Reply Date: 2017/03/03

More Info

Overcoming health anxiety can be a challenging journey, especially when it manifests as compulsive self-checking and persistent worry about various illnesses. Your experience reflects a common pattern seen in individuals with health anxiety, where the fear of having a serious medical condition leads to excessive self-examination and a cycle of worry that can be exhausting and debilitating.

Firstly, it's important to acknowledge that health anxiety often stems from a combination of psychological and physiological factors. The brain's natural tendency to focus on potential threats can be amplified by stress, past experiences, or even societal influences regarding health. This can lead to a heightened state of vigilance regarding bodily sensations and changes, resulting in a cycle of worry and compulsive checking behaviors.

One effective strategy for managing health anxiety is cognitive-behavioral therapy (CBT). CBT helps individuals identify and challenge irrational thoughts and beliefs that contribute to anxiety. For instance, when you find yourself obsessively checking for lumps or asymmetries, CBT can guide you to recognize these thoughts as irrational and help you develop healthier coping mechanisms. Engaging in therapy with a trained professional can provide you with tools to break the cycle of worry and reduce the compulsion to self-check.

Another approach is mindfulness and acceptance-based strategies. Mindfulness encourages you to observe your thoughts and feelings without judgment, allowing you to create space between your anxious thoughts and your reactions to them. This can be particularly helpful when you feel the urge to check your body. Instead of immediately responding to the anxiety by looking in the mirror or touching your neck, you can practice acknowledging the thought and then redirecting your focus to another activity. Over time, this can help reduce the power that these anxious thoughts hold over you.

It's also beneficial to establish a routine that includes activities that promote relaxation and distraction. Engaging in hobbies, exercise, or social activities can help shift your focus away from health concerns. As you mentioned, staying busy can temporarily alleviate anxiety, and the goal is to extend these periods of distraction. Gradually increasing the time spent on enjoyable activities can help you build resilience against intrusive thoughts.

Setting boundaries around health-related internet searches is another crucial step. The internet can be a double-edged sword; while it provides information, it can also exacerbate anxiety. Limiting your online research about health conditions can help reduce the cycle of worry. Instead, consider scheduling specific times to check in with your health concerns, allowing you to maintain a sense of control without becoming overwhelmed.

In terms of your question about whether this pattern of anxiety will persist, it's essential to understand that while health anxiety can be a long-term challenge, it is manageable. Many individuals find that with consistent effort, therapy, and self-care strategies, they can significantly reduce their anxiety levels and improve their quality of life. The key is to remain patient and compassionate with yourself throughout this process.

Lastly, if you find that your anxiety continues to interfere with your daily life, seeking professional help from a mental health provider who specializes in anxiety disorders can be incredibly beneficial. They can offer personalized strategies and support tailored to your specific needs.

In summary, overcoming health anxiety involves a combination of cognitive restructuring, mindfulness practices, lifestyle changes, and possibly professional support. By implementing these strategies, you can gradually extend the periods of relief from anxiety and develop a healthier relationship with your thoughts and body. Remember, progress may take time, but with persistence and the right tools, it is entirely achievable.

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