How To Deal With Health Anxiety

Watch first, and then read for more details!

Health Anxiety - The Cycle

Health anxiety can get better without a daily mindfulness practice or anxiety medications. If you want to do those things and they’re helpful for you, then please do them. I often encourage them and sometimes teach mindfulness. But I want to give you some principles that have helped many of my clients break the cycle of worrying about their health—without having to add anything to their lives. Many of them have moved away from spending hours per week (sometimes per day) fretting about their health or the health of someone they care about.

In this case, I’m talking about the person who notices something: a heart flutter, an odd mole, slight dizziness, a rash on their kid’s skin, etc. Then they spiral into a lot of frantic action. This normally looks like Googling, calling people who may or may not even be able to help, and looking up specialists without actually booking an appointment. Maybe it’s just 30 minutes of this, or maybe it’s several days—but either way, they’re anxious for a prolonged period and exhausted afterward. Then they’re more likely to be spiked into intense anxiety again because they’re sensitized and keyed up. It’s a vicious cycle.

Typical advice for how to fix this is something about getting better information or ignoring it: Go get it checked out so you can feel better about it. Just ignore it. Those are both pretty good bits of advice, actually. The problem is in how we apply them. You’ll hear me say something like this again and again: Process is the problem. Content is rarely the problem. Most people know that the heart flutter isn’t a heart attack. Education rarely fixes the issue.

What You Need to Know

This isn’t going to be a comprehensive plan for how to completely fix this problem and the trauma or life experiences that may be fueling it, but I’m going to give you two important principles that you have to understand if you want to put this problem behind you—and keep it there.

First, you’ll hear this from me a lot: You have to understand negative reinforcement. Another term for this is “removal reinforcement.” I get anxious, I work really hard to remove that anxiety by looking for answers and reassurance, and I feel somewhat better. The problem? All of that hard work and frantic energy is going to make that particular anxiety stronger when it comes around the next time.

I often explain it like this: I put broccoli in front of my kid, my kid screams bloody murder, and I take it away. What’s she going to do the next time I put broccoli in front of her? She’s going to scream even louder. Not only that, but her internal sense of distress about not liking broccoli will probably increase as well.

So how do we counteract negative reinforcement? We have to have a plan and a structure that help reduce the intensity and duration of that reinforcement the next time health anxiety inevitably strikes. I’ll explain this process at the end.

In addition to decreasing negative reinforcement of behaviors like Googling or calling a lot of people, we have to do something with our minds.

You know how those annoying non-anxious people say, “Just don’t think about that right now”? Psychologists have always hated that idea—because in many cases, stuffing down a wound or trauma and never thinking about it isn’t wise. The pain ends up coming out sideways when you could just grieve the issue and begin to heal.

BUT, what about these recurrent anxieties—the ones where we’ve thought and thought and thought about the issue, grappled with it, fought with it, imagined every worst-case scenario, and repeated this cycle dozens of times? It might be time to actively ignore that thought on purpose.

I’ll introduce you to how to do that in future posts. But if thought suppression alarms you as a bad idea, here’s some interesting research (reposted by Adam Grant) showing that a few days of thought suppression practice reduced participants’ anxiety and depression at a 3-month follow-up.

How to Apply It

Here’s how I’ve worked with clients to apply this—and it works. They’re able to reduce their health anxiety without doing much more than altering how they handle it.

1. Notice something that sets off the alarm. We can’t control this part of the anxiety—but it gets significantly better over time as a result of the process below.

2. DON’T: Google. Ever. Just don’t. You know it doesn’t help.

3. DO: Talk to only 1 or 2 helpful or informed people about it to figure out how to address it.

4. DO: Work quickly to decide how long you’re willing to tolerate the symptom before addressing it via a visit to a doctor. Put a timeline on it.

• Example: As long as that rash doesn’t spread to X point on my kid’s body, we aren’t going to do anything about it.
  

• Example: If I’m still feeling this pain 4 hours from now, I’ll book an appointment or go to the ER.
  

• Example: If I feel persistent heart flutters again tomorrow, then I’ll book an appointment.
  

• Example: I’ve already seen a cardiologist for this heart flutter, so I’m not going to book another appointment unless this happens for three days in a row.
  

See how this is different from your typical process? What we’re doing is creating a system and reducing the amount (duration) and intensity (frantic energy) of negative reinforcement—that is, the energy you spend trying to make yourself feel better after you get anxious.

Basically, you’re making a decision tree instead of bouncing around. Ambivalence, or oscillating indecision, is like fuel to the anxiety fire. Decisiveness is the water hose that puts it out.

5. Once you’ve made your decision, move on mentally.  You can do this way more than you think at first.

• One helpful statement: “That’s a question that exists. I’ll address it at X point if it’s still there.”
  

• One helpful question: “What would I be thinking about right now if I weren’t anxious?” Then think about and do those things.

Healthy distraction is not a bad thing. What you’ll likely learn by putting this anxiety into a decision tree and moving on is that the symptom fades on its own—without your Googling it or over-monitoring it. This experience, repeated many times, allows you to address the problem wisely without being naive or reckless. But it also reduces the number of logs you throw on the health anxiety fire.

Keep this up, and the fire will burn out. The initial anxiety you feel when you notice another health-related fear will reduce and reduce, and you’ll get your hours back to be present and engaged in things you enjoy.