Health Anxiety and Generalized Anxiety Disorder

Sad, sick woman laying on the couch talking on the phone
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Health anxiety refers to fear related to developing a dangerous health problem or already having one. In those with generalized anxiety disorder (GAD), this fear can be persistent and hard to let go, even after medical tests show nothing is wrong and the doctor has reassured you that your health is fine.

Health anxiety is also known by other names such as hypochondriasis, somatization disorder, or Illness anxiety disorder. All these illnesses are related in that there is a fear of something being terribly wrong with your body.

Connection to GAD

If you have GAD and worry about your health, you might find yourself up at night, researching on the Internet. You might recognize symptoms that you have and think that you have a terrible disease like cancer or other health issue like heart disease. Things like headaches and other symptoms that can occur due to anxiety might be misinterpreted as something else. You might feel like the doctors are missing something, and so you keep asking for more tests and seeking more reassurance.

Why Health Anxiety Is a Problem

While being on top of your health is important, it's also important to do so in a reasonable manner. Health anxiety crosses that boundary, because no amount of testing, checking, or reassuring will ever make you feel as though things will be okay. In essence, until you actually contract some terrible disease, your mind will never be at rest. That's no way to live.

You might find yourself focused too much on your body such as your rate of breathing or your heartbeat. You might notice changes in your skin and think the worst. Headaches or stomachaches might cause you to seek reassurance that they are not a sign of something lurking. If you hear about a disease on the news, you might worry you will be the next to get it. Symptoms that tend to cause the most fear include changes in vision, heart rate, blood pressure, breathing, and balance.

What Your Doctor Doesn't Know About Health Anxiety

Additionally, if you continue to visit your doctor with no end in sight and your doctor is not knowledgeable about health anxiety, you may never receive the mental health treatment that you need. Well-meaning doctors may do things that actually make your health anxiety worse, such as telling you to stop reading up on side effects or to stay off the internet. They may also agree to do special tests. These actions make your health anxiety worse for two reasons:

  1. When you stop learning about the illnesses that you fear, they grow bigger and more dangerous in your mind. Lack of information can contribute to fear.
  2. When your doctor does test after test to assuage your fears, he only proves to you that there is something wrong that needs continued testing to identify.

In essence, when you have health anxiety, your mind keeps sounding an alarm about your body that you can't seem to turn off. Your doctor needs to be aware of this issue and treat it carefully.

Here are some tips for managing health anxiety with the help of medical professionals:

  1. Rule out physical problems. First, do your best, with the help of your doctor, to rule out physical problems. It might be helpful to gather health information from your relatives as well, so that you can assess your risk of different illnesses. With that information, your doctor will be able to recommend what to watch for and what tests might be appropriate. For example, excessive thirst and changes in vision are signs of diabetes. If you have these symptoms and a family history, it is reasonable to test for this disease.
  2. See a therapist. Once all medical testing is complete, and with a plan for any ongoing check-ups, let it go. Uncertainty is what causes your fear. Be certain that at this moment, it is reasonable to assume that you have no dreaded disease. Now, if your health anxiety persists, ask your doctor about seeing a therapist. While it may be tempting to call your doctor for reassurance each time your anxiety flares, seeing a therapist will have better long-term results.
  3. Receive treatment. Ideally, your therapist will provide treatment such as cognitive-behavioral therapy (CBT). Through this therapy, you will learn how thoughts affect how you feel and behave. You will learn that it is not your physical symptoms, but how you interpret them, that creates your anxiety. And you will learn how to correct those irrational thoughts.

    Research

    In a random telephone survey of 5118 Chinese respondents aged 18 to 64, it was found that people with both GAD and health anxiety tended to be older, less educated, and had lower family income. People with health anxiety were also shown to have more mistrust of doctors. This shows that educating yourself may be important in fighting against health anxiety, but also that lack of trust of doctors may fuel some of your worries.

    Relationship With Your Doctor

    While doctors need to be aware of those with health anxiety, it is also important that your doctor is not dismissive of your concerns. You shouldn't be given labels as a bad patient. As much as it may be frustrating for your doctor to sympathize with your constant worries, a good doctor will be firm but also understanding. A good doctor will also exhibit the following qualities:

    • Encourages you to ask questions and research, but also shares with you when your research is wrong or when your fears are unreasonable
    • Tells you to become familiar with how you react to stress and to learn the symptoms of anxiety so that you can distinguish these from symptoms of physical illness. As there is overlap, they can be hard to tell apart sometimes.
    • Might say to you, "So if you did have [terrible disease], what would that mean?" It's important to talk about your fears and get them out in the open so that they don't grow and fester.
    • Encourages you to stop checking on your health so often and stop seeking reassurance beyond a reasonable point
    • Shares with you the odds of you actually getting various diseases, so you can see that they are very low
    • Encourages you to pursue healthy lifestyle habits such as eating well and exercising
    • Tells you that complete certainty and safety are never guaranteed, but that life must go on

    A Word From Verywell

    Health anxiety overlapping with generalized anxiety disorder can be a source of great distress. Your best options for managing this type of anxiety are to rule of physical concerns in a reasonable way, seek mental health treatment if appropriate, and find a doctor who is sympathetic to your unique set of issues.

    Sources:

    Anxiety and Depression Association of America. Health Anxiety.

    Lee S, Lam IMH, Kwok KPS, Leung CMC. A community-based epidemiological study of health anxiety and generalized anxiety disorder. J Anxiety Disord. 2014;28(2):187-194.

    Starcevic V, Fallon S, Uhlenhuth EH, Pathak D. Generalized anxiety disorder, worries about illness, and hypochondriacal fears and beliefs. Psychother Psychosom. 1994;61(1-2):93-99.