Most people are happy if their medical test results come back negative – but for at least 5% of us such news brings no relief. If you have health anxiety, there is no test on earth to reassure you. You may pore over the internet picking the most serious diagnosis for your symptoms. And last week brought evidence that health anxiety can make you physically ill. A study of more than 7,000 Norwegians found that people with such anxiety had a 73% greater chance of developing heart disease over 10 years, compared with those who weren’t anxious.
The solution
Health anxiety is the persistent preoccupation with having a serious illness. It involves monitoring your body closely, misinterpreting symptoms and often seeking medical advice. Prof Peter Tyrer, professor of community psychiatry and an expert on health anxiety, says it is the level of anxiety that sets it apart from hypochondriasis. If you have health anxiety, you want to stop worrying about being ill rather than have your physical symptoms relieved. However, this latest study will ramp up any existing anxiety by linking it to heart disease. Anxiety is already associated with increased thickness in artery walls and activation of hormone systems involved in stress – both increasing the risk of heart disease. This new study took into account lifestyle factors that promote heart disease, but it was impossible to exclude actual illness being the cause of some of the health anxiety.
Tyrer asks people with symptoms and suspected health anxiety three questions: have you been worrying a lot about this (problem)? Do you tend to worry about your health in general? And have you ever felt that the problem is more serious than the doctors have found? If there’s a yes to any of them, he gently suggests help. Simple reassurance is useless – Tyrer’s research shows cognitive behavioural therapy is needed to reinterpret their obsessive thoughts about their health. It helps to keep a diary to link symptoms with daily activities.
“The symptoms themselves are often due to anxiety, such as chest pain,” says Tyrer. “We get people to make the connection themselves. For example, if they get chest pain at work but not when digging the garden then it’s unlikely to be physical, cardiac pain.” Tyrer says that health anxiety usually starts young: the death of a grandparent can be a trigger. About five to 10 therapy sessions seems to work – as does mindfulness – and the benefits seem long-lasting. So, if you overmonitor your health and can’t be reassured enough (by tests if needed), suspect that your real condition is health anxiety and ask your GP for help.
