Overcoming the Fear of Illness: Anxiety and Health Concerns

Excessive fear of illness?

Hello, Dr.
Ding.
Yesterday, while walking on the street, I saw something that looked a bit like a sanitary pad with some reddish substance that resembled blood.
I’m not sure if I stepped on it, but I’m very afraid that I might contract HIV, even though I know this is not a transmission route.
Later, I checked inside my shoes and thought I saw some brownish stains that might be blood seeping in.
Rationally, I tell myself that shoes get dirty over time, and the soles didn’t have any red stains.
However, emotionally, I worry that if I walked on it, the blood could have evenly penetrated the shoes, turning into a faint brown color.
I know this thought is irrational.
After an hour or two, I checked my shoes again and even pulled out the insoles, worrying that if I pulled too hard, I might injure my hand and get infected, even though I know that such viruses die quickly outside the body.
I keep going in circles with these thoughts, and even my friends say I have too vivid of an imagination.
I’m very fearful of contracting STDs, thinking that if I do, no one will love me, and I won’t be able to marry or have children (or even die).
I wonder if my low self-esteem and lack of confidence contribute to this.
I also hesitate to have close contact with others for fear of transmission (and I worry about getting STDs from public restrooms), even though I keep telling myself it’s impossible.
I think that whether I get sick is just fate, but it’s always hard to convince myself.
I don’t know what to do.
Could you please give me some advice? Thank you!

Niming, 20~29 year old female. Ask Date: 2015/05/29

Dr. Ding Shuyan reply Psychiatry

Hello, as you mentioned in your inquiry, rational thinking cannot quell obsessive thoughts; the underlying causes are likely deeper issues.
Factors such as physical constitution, personality traits, and life events all play a role.
In facing such situations, if the symptoms are particularly distressing or have begun to affect daily life and work, seeing a doctor and taking medication may be a relatively quick solution.
Psychological therapy, which aims to uncover the more fundamental causes, may be slower but can be more effective in the long run compared to medication.
Cases of depression or obsessive-compulsive disorder often involve these compulsive thoughts or a repetitive cycle of rumination.
Although individuals may recognize that their thoughts are unproductive, they feel uneasy and compelled to think things through, believing that doing so will lead to improvement.
This often results in worsening feelings and a descent into a vicious cycle.

Reflecting on how these cases eventually improved can provide guidance on what we should do now.
In fact, the reason they got better was not because they kept thinking until they reached an epiphany, but rather because they gradually realized that the problems were not as significant as they seemed and did not require constant contemplation.
They actively or passively redirected their attention and time towards daily activities, leaving them with less time to dwell on those issues, thus creating a positive feedback loop and emerging from that quagmire.

A key point in this process is to be aware when you find yourself worrying and your mind is fixated on fears of infection.
Once you notice this, immediately shift your focus to your breathing or observe your surroundings.
Spend a few seconds fully concentrating on the rise and fall of your abdomen while breathing, which can interrupt this stream of thoughts.
When your mind wanders back to those thoughts, gently bring it back to your breath.
It may be challenging at first, but with practice over time, you will notice changes!
Wishing you all the best,
Dr.
Ding Shuo-Yan

Reply Date: 2015/05/29

More Info

It sounds like you're experiencing significant anxiety related to health concerns, particularly fears surrounding illness and potential infections. This type of anxiety can be quite distressing and can interfere with daily life, as you've described. It's important to understand that what you're feeling is not uncommon, and many people experience similar fears, especially in today's world where health information is readily available and often overwhelming.

First, let's break down the situation. You encountered something that triggered a fear response—seeing a substance that you thought might be blood. This led to a cascade of thoughts about potential health risks, which is a common reaction for individuals with health anxiety. The mind tends to latch onto worst-case scenarios, often ignoring rational thoughts that suggest the likelihood of those scenarios occurring is very low.

Your awareness of the irrationality of your fears is a positive sign. It indicates that you have the capacity to recognize when your thoughts may be exaggerated or unfounded. However, the emotional response can still feel very real and overwhelming. This is where cognitive-behavioral strategies can be particularly helpful. Cognitive Behavioral Therapy (CBT) is a well-established approach that helps individuals identify and challenge irrational thoughts, replacing them with more balanced and realistic perspectives.

Here are some strategies you might find useful:
1. Cognitive Restructuring: When you notice anxious thoughts, try to challenge them. Ask yourself questions like, "What evidence do I have that supports this fear?" or "What would I tell a friend who had this fear?" This can help you gain perspective and reduce the intensity of your anxiety.

2. Mindfulness and Grounding Techniques: Practicing mindfulness can help you stay present and reduce anxiety. Techniques such as deep breathing, progressive muscle relaxation, or grounding exercises (focusing on your senses) can help calm your mind when you feel overwhelmed.

3. Limit Information Seeking: It can be tempting to constantly search for information to reassure yourself, but this often leads to more anxiety. Try to set boundaries around how much time you spend researching health concerns or checking your shoes.

4. Seek Professional Help: If your anxiety continues to interfere with your daily life, it may be beneficial to consult a mental health professional. They can provide tailored strategies and support to help you manage your anxiety more effectively.

5. Focus on Self-Care: Engage in activities that promote relaxation and well-being. Regular exercise, a balanced diet, and sufficient sleep can all contribute to better mental health.

6. Build a Support Network: Share your feelings with trusted friends or family members. Sometimes just talking about your fears can help alleviate some of the burden.

7. Gradual Exposure: If certain situations trigger your anxiety (like using public restrooms), consider gradually exposing yourself to these situations in a controlled manner, allowing yourself to build confidence over time.

It's also worth noting that feelings of self-doubt and low self-esteem can exacerbate anxiety. Working on building your self-confidence through positive affirmations, setting small achievable goals, and celebrating your successes can help improve your overall outlook.

In summary, overcoming the fear of illness and health-related anxiety is a process that requires patience and practice. By employing cognitive-behavioral strategies, seeking professional help if needed, and focusing on self-care, you can gradually reduce the impact of these fears on your life. Remember, it's okay to seek help, and you don't have to navigate this journey alone.

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