People with health anxiety use a variety of different mechanisms to cope –which usually make the situation worse in the long term.
When the fear is high, you may either try to avoid, distract yourself from your thoughts and feelings or to escape from or avoid situations that remind you of illness or death. Here health anxiety becomes like an illness phobia. Thus you might avoid going to the doctor because you are convinced you will be given bad news. You might be avoiding people who are ill, hospitals, doctor’s surgeries, funerals, cemeteries, or reading anything about illness in the media. Here you may have magical thinking that believes that thinking about bad events could make them happen.
When your doubts are high, you may be excessively checking in the form of self-examination. Examples include checking whether:
- you have a lump
- your heart rate is too fast or blood pressure is too high
- you are losing excessive weight
- your nervous system is still normal
- you can still swallow
You might also be checking for information on the internet or in books and in the media. Checking is an example of a “safety seeking behaviour” in which aims to prevent harm and reduce anxiety. People with health anxiety try to adopt ways to improve the way they feel but unfortunately the solutions usually leave them feeling worse and prevent them from testing out their fears. Safety seeking behaviours are a way of “trying too hard” to prevent bad consequences but then the solutions become the problem. We shall look at this more in Chapter x when we look at a psychological understanding of health anxiety. Needless to say, you have to stop all your safety seeking behaviours if you are to overcome your health anxiety successfully.
You may be seeking repeated reassurance from friends or your doctor to find out the cause of your symptoms. When you are dissatisfied by one doctor, you may seek a second and third opinion and so on. Each doctor may order a new set of tests. Some of these tests may have ambiguous findings leading to further tests. You in turn may become very dismissive or dissatisfied with your doctors. Interestingly doctors also become very frustrated with people with health anxiety and may prefer to refer you on to another doctor (rather than a mental health professional). Health anxiety has an effect on your friends and family as when you are preoccupied with your health, you may appear uninterested and distant. This in turn leads people to be frustrated and fed up with you.
The content of worries, safety behaviours and avoidance behaviour are closely related. When the person has to enter a situation that she normally avoids, then the safety behaviours starts to reduce the potential for harm and discomfort. You may then try to avoid thinking about it by distracting yourself or suppressing the thought.