Overcoming Health Anxiety: Strategies for a Peaceful Mind - Psychiatry

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The suffering of illness anxiety?


Hello, Doctor.
Since a family member fell ill years ago, I have become a hypochondriac and often feel overly anxious.
I constantly overthink and pay excessive attention to my body.
I have been in counseling for two years and have improved significantly, but I still experience some of these issues.
For example, I used to have a habit of poking my nose with tissue, and one time I noticed blood on the tissue, which made me very anxious.
I went to see an ENT specialist, who performed a nasopharyngoscopy and reassured me that it was just a minor abrasion and there was nothing abnormal inside.
The doctor advised me not to poke my nose with tissue, as it could increase friction and worsen the situation.
However, I worry about how to check if the abrasion has healed without poking my nose.
The doctor mentioned that it would heal on its own in a week or two and that I shouldn't worry about it.
Still, I can't help but think, what if it doesn't heal? Yesterday, I checked my medical history on the health insurance app and saw that the doctor had diagnosed me with nasal polyps after the nasopharyngoscopy, which confused me because the doctor said there was nothing abnormal.
Upon reviewing my history more closely, I found that a long time ago, I had also been diagnosed with vocal cord polyps and laryngeal polyps (after a laryngoscopy), along with some serious-sounding diagnoses from other clinics that I had never heard from a doctor, which triggered my anxiety again.

What should I do about this tendency for catastrophic thinking? My counselor once told me that mindfulness could be helpful.
During counseling, I did practice mindfulness and felt much better, but it seems like I've only improved to a certain extent.
For instance, in the past, I would continue to poke my nose with tissue to check for blood, and even if there was no blood, I would still poke several times a day and repeatedly return to the doctor for checks.
After counseling and practicing mindfulness, I have managed to stop the habit of poking my nose and have not returned to the doctor, but the anxious thoughts still make me wonder if I will always be an overly worried person.
My husband advises me to think normally, for example, if he has a little nosebleed, he wouldn't see a doctor unless it happened frequently, and if he did see a doctor who said everything was fine, he would just forget about it.
He doesn't immediately think of the worst-case scenario for any bodily symptoms.

Besides the examples mentioned, I have many other instances of overthinking, such as worrying about swollen lymph nodes and constantly feeling my neck.
Doctor, what can I do to help myself? When I find myself worrying again, should I try to distract myself or practice mindfulness? Is there still room for improvement? Thank you.

Simin, 30~39 year old female. Ask Date: 2020/11/16

Dr. Lin Mianzhang reply Psychiatry


Hello, Simin: Thank you for your hard work.
It seems that this anxiety about your health is quite troubling for you.
You mentioned several important points.
First, your health anxiety symptoms appeared after a family member fell ill.
May I ask who that family member is? What is your relationship with them? How is their current health condition? How has your relationship changed since they became ill? These are all important aspects to reflect on.
Health anxiety may likely be a way for you to redirect your deep-seated anxieties, and it is essential to explore what those underlying anxieties are.
Second, you have undergone two years of counseling and have seen significant improvement in your symptoms.
What do you think contributed to this improvement? Did you gain any motivation during the counseling process that helped you? Understanding this could be very beneficial in improving your current situation.
Excessive and repetitive thinking is indeed harder to overcome than repetitive actions.
Mindfulness can be helpful, and redirecting your attention is also a method; it depends on what you find most effective for yourself.
If you truly feel that it is difficult to manage on your own, I still recommend seeking professional help from a psychiatrist.
Whether through psychological counseling or medication, discussing your options with a doctor can help you further improve your situation.
Wishing you a speedy recovery!

Reply Date: 2020/11/16

More Info


Overcoming health anxiety can be a challenging journey, especially when it has been a long-standing issue. Your experiences reflect a common struggle faced by many individuals who have been affected by the illness of a loved one or have had their own health scares. It's important to recognize that health anxiety, also known as illness anxiety disorder, can lead to a cycle of worry and compulsive behaviors that can be difficult to break. However, there are effective strategies you can employ to help manage your anxiety and cultivate a more peaceful mind.

Firstly, it's commendable that you've already made significant progress through counseling and mindfulness practices. These tools are essential in managing anxiety. Mindfulness, in particular, can help you stay grounded in the present moment and reduce the tendency to catastrophize. When you find yourself spiraling into negative thoughts about your health, try to focus on your breath. Take a few deep breaths, inhaling through your nose and exhaling through your mouth. This simple act can help calm your nervous system and bring your attention back to the present.

In addition to mindfulness, cognitive-behavioral therapy (CBT) techniques can be particularly beneficial for health anxiety. CBT focuses on identifying and challenging negative thought patterns. For instance, when you notice yourself thinking, "What if I have something serious?" try to counter that thought with evidence. Ask yourself, "What do I know to be true? Have I seen a doctor who has reassured me?" This practice can help you develop a more balanced perspective and reduce the intensity of your fears.

Another effective strategy is to limit your exposure to health-related information, especially online. The internet can be a breeding ground for misinformation and can exacerbate anxiety. Consider setting boundaries around how much time you spend researching health issues or reading about symptoms. Instead, focus on activities that bring you joy and fulfillment, such as hobbies, exercise, or spending time with loved ones. Engaging in these activities can serve as a positive distraction and help shift your focus away from anxious thoughts.

It's also important to establish a routine that includes regular physical activity. Exercise has been shown to reduce anxiety and improve mood by releasing endorphins, which are natural mood lifters. Whether it's going for a walk, practicing yoga, or participating in a sport, find an activity that you enjoy and make it a regular part of your life.

When you feel the urge to check for symptoms or engage in compulsive behaviors, try to implement a delay tactic. For example, tell yourself that you will wait for a certain period (e.g., 30 minutes) before checking your body or looking up symptoms. Often, the urge will pass, and you may find that you can resist the impulse altogether.

Lastly, consider continuing your work with a therapist or counselor who specializes in anxiety disorders. They can provide you with tailored strategies and support as you navigate your feelings. If you feel comfortable, you might also explore support groups where you can connect with others who share similar experiences. Sharing your thoughts and feelings in a safe environment can be incredibly validating and helpful.

In conclusion, while it may feel daunting, there is hope for improvement. By incorporating mindfulness, cognitive-behavioral techniques, limiting exposure to health information, engaging in physical activity, and seeking professional support, you can take significant steps toward managing your health anxiety. Remember, progress takes time, and it's okay to have setbacks along the way. Be gentle with yourself as you navigate this journey, and celebrate the small victories you achieve along the way.

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