Dr. Tracey Marks
Two Tips for Health Anxiety
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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 http://markspsychiatry.com/two-tips-for-health-anxiety
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.
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.
Hi, I'm Dr. Tracey Marks a Psychiatrist, and I make mental health education videos. Today, I'm talking about some
solutions for health anxiety. I've previously talked about
health anxiety in this video. If you didn't see it,
watch it after this one. The clinical term for it
used to be hypochondriasis, but it's now been split
into two disorders, somatic symptom disorder,
and illness anxiety disorder. I am still going to
call it health anxiety, because I think it's a
more descriptive term. With health anxiety, you're over sensitive to
body sensations and fear that you have a serious illness. The fear of having that
illness overwhelms you and leads you to engaging in behaviors that keep the anxiety going. Many people realize that
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 to be able to focus on
the problem as being anxiety out of control, rather than getting proof or reassurance that you don't have an illness. That reassurance is always short-lived. It's like taking shortcuts to avoid work. You may feel better in the short-term when you hear that 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. Now, to be clear, you shouldn't always
ignore physical symptoms. Sometimes physical symptoms
need to be evaluated to make sure that you don't have something other than anxiety. But with health anxiety, you've been tested several
times for certain illnesses, and you've been told
that you don't have it, but as soon as you
experience a physical symptom that you think is the illness, you doubt what you've been told and continue to worry
that you have the disease. So the road to helping you
focus more on your anxiety is cognitive behavior therapy. Now here's some good news. Some researchers out of Sweden did a clinical trial testing, CBT delivered by the Internet. And the results were
that the Internet therapy was equally as effective as
therapy delivered 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. This Internet-based program
isn't available yet, but this is promising because
this could make the therapy much more accessible to people. So I wanna share with you
some of the techniques that they use to help, and some of these may be helpful now as a self-help approach. One thing that they did was to practice mindfulness
for 10 minutes a day. Mindfulness meditation helps
you experience the sensations in your body and sit with the emotions, without trying to suppress
them or escape them. The more you get comfortable
with your emotions and accept them without judgment, the less power they have over you. The University of California, Los Angeles, has a mindfulness podcast that has six years of meditations
that you can listen to. I have a body scan meditation that you can download on my website. So you have plenty of
resources to get you started on guided meditations. A second strategy was to
practice response prevention. This means you resist doing the things that reinforce your anxiety. These generally fall
under four categories: Seeking information
like searching the web, avoiding things that you believe
will trigger your anxiety, getting reassurance from others like family members or doctors, and scanning your body for symptoms. Those are the broad categories. You wanna write down your behaviors that fit into these four categories. And also take note of how
often you do these things. Next, you wanna restrict how much you engage in these behaviors. So an example may be that you
will only check your pulse three times a day instead of the usual 20, or when you start to feel worried, you'll wait at least an 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 the day to review your list of behaviors
and track your progress. If you spent the day holding
back on your behaviors, you may be tense, and this may be a good time to
do your mindfulness exercise. Other parts of the therapy involved gradually exposing yourself to
anxiety provoking situations while you resist engaging
in your usual behaviors. And 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 exposures, you become desensitized to the trigger. We call it habituation. The exposure exercises are best done under the supervision of a 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. I don't know when the program
will become available, but just seeing that
it's just as effective as traditional therapy, is the first step toward
gaining acceptance in clinical practice. In the meantime, try using daily mindfulness and changing how you
respond to your triggers. That's a very good first step. I hope this was helpful for you. See you next time.
#Tips #Health #Anxiety
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The worst kind of health anxiety is the one where you think every new freckle, mole, or skin blemish is the C word (I don't even want to say or type it), and you want to go to the doctor/dermatologist for reassurance that it's not, but you also don't want to to go the doctor because you're terrified they'll say that it is. What do I do to calm myself down?
I no used to be Cronic and haven’t had it for 5 years. It’s been triggered off and I can’t get back to the way I was. What can I do
Your brilliant. God bless you ❤
Everything we practice mentally gets stronger. When we worry and don't interrupt that, it grows stronger. We become what we judge.
I’m telling you the gym is the key. Being active and busy will help you out so much more.
I’m telling you the gym is the key. Being active and busy will help you out so much more.
but what if i actually have it?
my health anxiety lead to my panic attack
Im just about to stop caring. If I die so be it. Worrying about it and stressing alone is literally killing me 😔
I'm sick of having it like I'm bad with thinking I'm going to have a heart attack my belly hurts bad. Plus I have bad muscle tension in my neck my shoulders and into my legs I also have a bad stomach cramps are bad diarrhea bloating and gas are bad. I have been checked over and over in good well it's been 2 years since I had blood work and EKGs and they found nothing. I just feel super sick all the time. Mine is all physical issues. I am now have this itching on my face and on top of my head
wow finally got a comment section with most relate able comments.
I am petrified of catching pneumonia after I had it before..any time I even have a cold I worry and have to seek reassurance..I try to tell myself I should be ok, but the worry won’t go away..
I’ve had anxiety all of my 78 years. I was in a serious space in my early 30’s. Panic attacks all day for months. I found a specialist who told me to immediately raise my bp by vigorous exercise. Basically ringing my body to a place where I should be having rapid heartbeat, then when I stopped my heart rate would come down same as when you stop exercising. I shut down the next two attacks with this method. It is very hard to do fast deep knee bends, when you think you are having a heart attack but I did it. I e never had another attack. Now it’s something different, an uneasiness. Weird feeling. At my age I have had cancer, mild stroke, mild heart attack. So these feelings could actually be serious. But, I can’t spend the rest of my life monitoring my heart. I find something on YouTube or listen to a book to get my mind off my physical symptoms, it always works. Also, I still do deep knee bends.
My heart goes out to all of you who deal with this, it’s frightening. During my life at stressful times I’ve taken Wellbutrin which also helped, and is the only anxiety med that you lose weight instead of gain weight.
I’m conclusion, I redirect my attention as soon as I notice the feeling coming on, clearly I’m having one now. I’ve found these YouTube pieces helpful, along with knowing there are so many other healthy people anxious about weird feelings they have.
I am checking often and drawn to youtube videos on cancer testimonials.
My health anxiety started at age 61 after broken ribs and complications thereafter. Now back pain is kidney disease and my bra wire irritation is cancerous lymph nodes. Its so terrifying
I have made a rule that for every anxiety based internet search I require myself to watch one video on health anxiety. Its really helping a lot to calm me down so I dont drone on with my family.
I have health anxiety because I think I had 2 concussions in the span of a week, I got a concussion because I got hit in the side of the head with a soccer ball, the next week I was on my way out of the school and some kid slammed the door on my face, I hit my head and I felt dizzy again, this was months ago by the way, I’m worried if I have SIS, I feel normal now, but I am worried if I have potential brain damage
Is the internet program now available?
I have since I am six an anxiety disorder… now 12 years later I still right with it and with many more Problems, including Health anxiety… I am 24/7 in fear and even my therapy Sessions dient help, or just for some time. I Never fehlt Understood! Usually my Family just tells me that I am okay-I AM NOT!
Scrolling through These comments is so refreshing and I love you guys for commenting, even if it’s from 5 years ago, haha
Hi stranger. I hope you listen my story 😢.
I've been feeling really anxious while eating-like I get scared I might vomit and people will notice. Even though nothing happens, my mind keeps panicking. I think it might be health anxiety.
Because of this, I've not been able to enjoy myself properly or talk freely like I used to. I feel like I'm becoming more introverted and lonely, even though I don't want to be. I just miss feeling like myself.
this is an older video now, but i've had health anxiety on and off for about two years now, and major depression for ~5 years. a couple years ago my father died suddenly of liver failure and i initially was not manifesting any symptoms, then about a year after i started having headaches when i was straining myself, and then i imagined i was losing feeling in my right leg and it was going numb, which to me felt as real as breathing, but in reality there was nothing wrong, i was taken to a hospital with an ambulance, i was hysterical and thinking i was going to die in that ambulance, i called my mom and said goodbye before they scanned my brain which of course showed nothing and i was completely fine, the headaches went away after i got a new chair and changed my working posture. Since then i've had liver related anxiety for months, brain related stuff, and now most recently heart related fears, which so far have been the most tolling but maybe not as bad as the brain ones. I think of myself as a tough man, i was in the finnish military as a military police, ive worked a triple shift job at an assembly line, ive gone to university when i got fed up with that and gotten myself a degree and a job in software, i am someone who never got anything from anyone except my mother (God bless her) and i like to think i am a quite resilient person, but this illness has me on my knees and crying like a little boy and i am so tired, so done with it, ive even considered doing something to myself so i could concentrate on that instead of these made up symptoms by my brain. i guess i felt the need to share this somewhere, thanks to whoever read this far. to make matters worse, one of my fears over a year ago was appendicitis, and i ended up having a real appendicitis few months ago, a thing i was paranoid about became true and it was the worst. but at least i didn't worry about anything other than the appendicities when i had it.
Mines from psin and burning in mouth. I had teeth pulled and can't mentally handle the pain!
watching this instead of focusing on my leg pain so I don't start googling pulminary embolism again
My health anxiety is disgusting I hate myself for it and am causing myself to be ill as I am convinced constantly I am dying ! I dont know how to shake it off and what to do . I never ever go to a GP
Too many health commercials on television. Too many drug commercials
It’s been to long. I’m tired.
My mom died when I was 13. Gave me health anxiety
I’m 35 and never in my life ever worried about my health. Brown belt in jiu jitsu, workout since I was 15. I got the flu in December and got more sick than I can remember, one of the worst things was shortness of breath. That scared the hell out of me. It lasted a few months after the flu. This lead to what I didn’t know but apparently is considered health anxiety. I get dizzy when I stand up sometimes. Any little thing I feel I worry now. Been to doctor twice and had bloodwork and I’m very healthy. Now it’s learning to get my head right. I didn’t know what I was feeling was actually a thing. I thought I was just going crazy. It is exhausting living like this.
I hate health anxiery it has ruined my entire life now i dont know how to deal with this crap ive had it now for over twelve hours now i dont know what to do no more.
When i start to get a bout of anxiety/depression which lasts for around 4/6 months i get health anxiety from stomach cancer to a nervous breakdown. Then also intrusive thought which are really alarming had this on and off for more than 20 years.
Hi have illness and that's why I have anxiety
I developed health anxiety after scare with covid. I haven't been the same since. Im still struggling with long covid symptoms which keeps me in a fight or flight mode
Dr. Marks thank you for understanding us and helping us understand ourselves.
Try having stroke symptoms and crying wolf…Story of my life.
I am a hypochondriac.
People know it, my doctor knows it. But having stroke symptoms and cardiac arrest pains…is out of this world. If I could go donate myself to science I would. I don’t want anybody to experience this
Some one please help me I want just normal life I,m fed up from health anxiety
My health anxiety gets worse every winter. I know its irrational fear. But im terrified of dying. Ive been dealing with it for about 9 years on and off, but mostly on. Ive been completely sober for almost 2 years now. No drugs, alcohol, nicotine and even caffeine. Its helped me tremendously, although i still suffer almost daily but just fight through it. Physical symptoms are insanely real and scary. I miss the spring and summer.
Thank you so much! I atleast feel heard thanks to this video
Mine got worse in perimenopause.
Finally, i am starting to relax after 3 years of Health Anxiety 😃
I had to laugh when you mentioned the checking your pulse 20 times a day. I thought it was just me LOL period in heaven to tell someone immediately that your nerves or anxiety is bothering you
This was so helpful❤
I sometimes use ChatGPT as a therapist. It's like a chat and unlike the internet it won't sell my information.
What happens with rubes like me who are scared to death of doctors and examinations? Tell me that! My life is hell. I am 81 now and still terrified of illness.
I can get over the health anxiety, the problem is overcompensating to a point where you tell yourself “it’s probably just anxiety” when instead it’s something you should get checked
My symptoms is always my air hunger. The feeling of being suffocated that can only be better with a deep sigh. Tried breathing technique, try to ignore, exercise and everything but it's still here lingering for about 2 years now.
I am scared of death
My Dad has health anxiety and he gave it to me. So im always suffering but dont want to talk to anybody about my concerns because I think im crazy. Luckily my partner forces me to go to the doctor. Im always getting sick for real but im terrified to go to the doctor and confirm my catastrophic fears. For example, I thought I had cancer and it was just plantar faciitis, but I suffered for months thinking that i was dying.
Can this be also associated with mental health anxiety?