A Psychological Guide to Coping with Health Anxiety

Recently, an article was penned on the critical topic of safeguarding oneself against skin cancer. Shortly thereafter, a beach getaway unfolded, exposing me to the relentless power of the sun’s UV rays for what felt like an eternity. Although I’ve always been diligent about applying sunscreen—never having suffered a sunburn in my life—this time was different. I found myself in a state of perpetual unease. My mind fixated on the notion that any darkening of my skin or less-than-perfect application of sunscreen might set the stage for future skin cancer.

Anxiety took the reins as I nagged family members to reapply sunscreen, my worries amplifying with every change in their skin tones. I became obsessive, frequently inspecting my arms and chest for any hint of redness or burn. Miraculously, I returned home without so much as a tan line.

For individuals grappling with health anxiety—where otherwise healthy people fret about potential illness despite having no significant symptoms—the overthinking extends far beyond just ruining beach vacations. Estimates suggest that this condition affects roughly 4 to 5 percent of the population, though experts assert that the true figure may be closer to 12 percent or even higher, as noted by Harvard Health. That translates to approximately 80 million people in the United States persistently preoccupied with the fear of being unwell.

Moreover, the prevalence of health anxiety has surged dramatically over the past three decades, particularly among university students, according to a 2020 article in The Journal of Anxiety Disorders. A meta-analysis encompassing 68 studies and over 22,000 participants revealed a troubling rise in the mean score on the Illness Attitudes Scales—a tool used to measure health anxiety—indicating an increase of 4.61 points between 1985 and 2017. The COVID-19 pandemic may have exacerbated this situation, compounded by the overwhelming access to unverified information online.

The phenomenon known as cyberchondria aptly describes how the internet can stoke the flames of health anxiety. It captures those moments when one consults WebMD, leading to a self-diagnosis of dire illness, when all that was needed was an Advil or a restful night’s sleep. Although diving into health research might seem productive, it often does more harm than good. According to Dr. Katia Moritz, a psychologist and chief clinical officer of the Neurobehavioral Institute, health anxiety does not contribute to well-being. Instead, it fosters mental and emotional obstacles, prompting individuals to take extreme measures to avoid perceived triggers and ultimately diminishing their quality of life.

If your reliance on “Dr. Google” is beginning to negatively impact your mental health, therapists provide strategies to effectively navigate health anxiety amid this age of information saturation.

Understanding Health Anxiety: An Overview

Health anxiety, a term encompassing various psychological conditions, can be categorized by professionals as illness anxiety disorder, somatic symptom disorder, or a subtype of obsessive-compulsive disorder (OCD). Illness anxiety disorder manifests as an incessant fear of harboring an undiagnosed illness, regardless of how improbable it may be, and persists even in the face of reassurances from healthcare providers, according to Olivia Verhulst, LMHC, a psychotherapist in New York City with expertise in anxiety.

Somatic symptom disorder shares similarities but is characterized by the presence of physical symptoms that exacerbate the individual’s concerns. OCD, as defined by the American Psychological Association (APA), comprises recurring intrusive thoughts (obsessions) and associated compulsive behaviors. In the context of health anxiety, compulsions may include frequent body checks for symptoms or relentless reassurance-seeking regarding one’s health status, compounded by obsessive worries about potential illnesses.

Individuals afflicted by these conditions may find themselves perpetually anxious about developing specific ailments, dedicating extensive time to researching them, and adhering to stringent behavioral rules designed to evade illness. Several factors may contribute to heightened health anxiety, such as a prior diagnosis, an environment rife with health risks, or a familial history of certain diseases.

While a degree of anxiety can be beneficial—driving one to accomplish necessary tasks or safeguarding against genuinely threatening situations, as noted by Patrick McGrath, PhD, a psychologist and chief clinical officer of NOCD, an online treatment platform for OCD—it can also backfire. As Katia Moritz, a psychologist, points out, diving into articles about health issues can often exacerbate feelings of anxiety. Despite lengthy discussions with friends about symptoms, relief may still feel elusive.

For those grappling with health anxiety, cognitive behavioral therapy (CBT) is a widely endorsed treatment modality. Specifically, exposure response prevention (ERP) serves as the gold standard for addressing OCD, empowering individuals to confront their fixations, tolerate discomfort, and resist compulsive actions. “Cognitive behavioral skills equip you to acknowledge intrusive thoughts without succumbing to them, allowing you to accept the uncertainty of your health,” explains Moritz. This approach cultivates resilience, transforming how one reacts when faced with distressing thoughts.

Consulting a therapist trained in ERP is the most effective way to address health anxiety. However, there are additional strategies to manage the pervasive uncertainty surrounding health concerns, as suggested by McGrath, Moritz, and Verhulst.

Coping Strategies for Health Anxiety

For those who find themselves spending countless hours researching potential health conditions, therapists advocate for establishing boundaries regarding online reassurance-seeking. This chronic engagement with digital platforms can heighten anxiety levels due to phenomena such as negativity bias—the tendency to focus on adverse information more than positive—and confirmation bias, where one interprets new information in a way that supports preexisting fears, explains Verhulst.

“It’s all too easy to let anxiety fill the void left by uncertainty, leading you to fixate on the most catastrophic scenarios,” she warns. To counteract this, it’s advisable to limit the amount of time spent online. While it’s not necessary to completely abstain from searching for information, McGrath suggests setting a clear boundary. Use a timer to regulate your time on platforms like TikTok or health websites, starting with twenty minutes, as recommended by Verhulst.

Consider your anxious thoughts as bullies encroaching on your peace of mind. Just as one would deal with a schoolyard bully by diminishing their power rather than retaliating, the same applies to confronting health anxiety. “If the voice in your head insists you are ill, acknowledge it without argument. Instead, simply respond with ‘So what?’ This disrupts the cycle of spiraling thoughts,” advises Moritz. This technique, referred to as expectation violation, empowers you to defy the anticipatory anxiety that arises, allowing you to reclaim control and resume your daily life.