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Why Health Anxiety is OCD

Why Health Anxiety is OCD


Marcus wanted his life back. His health worries had seemed to take over his life. He went from doctor to doctor trying to feel better, but he couldn't seem to find any answers. Even his family didn't know how to support him. And everything he used to do that gave him joy just stopped. In session when I asked Marcus what health anxiety had taken from him, his eyes began to fill up and a tear came down his face. And he looked up at me and said, "Freedom." Marcus made a decision that day to do what he had to do, to accept and treat his health anxiety and get back to enjoying his life.

This is the first of a three part series on health anxiety. In part one, I will dive into four distinct types of illness worries, so that you can have more insight into what you're experiencing, how to treat it and how to feel better.And in part two, I'll explain how to break the cycle of health anxiety so that you can begin to build your confidence, worry less and feel better. And in part three, I'll discuss relapse prevention and how crucial it is to have the right mindset about health, anxiety, and anxiety in general, to maintain your gains. So if you're wondering or curious if you may have health anxiety, I left you a link in the description below to a free, easy self assessment for health anxiety.


The American Psychiatric Association defines health anxiety as a preoccupation and fear of having a serious life-threatening illness based on misinterpretations of bodily sensations. However, this is a broad definition. Not all anxiety about health and illness is the same.

I've treated people with health anxiety for 20 years, and I see primarily four different types of illness and health themed anxiety in my office. That may sound surprising, but let me explain.So there are people that have what I call undiagnosed panic disorder. This actually happened to me in my twenties. Their symptoms feel intense and can come out of the blue, and they interpret the panic symptoms like heart palpitations and difficulty breathing, as dangerous. And they fear they're having a cardiac event or a heart attack and they typically show up in the ER. They maybe put through huge workup or have loads of tests. And typically are given mixed messages by physicians and often have no definitive diagnosis. Or they're just left uncertain and anxious about their symptoms. Unfortunately, they're often not advised to seek help for panic disorder, which is a very treatable condition. 

Now, the second category of people have an overwhelmingly obsession or urge to keep themselves healthy and/or their loved ones healthy. And there's sometimes called germaphobes. Although this is actually OCD and not a simple phobia. This person tries to avoid all possible contaminants and germs, and people that might be ill. So their main behavior is avoidance. Avoidance of touching things or going places that might contaminate them. But they may also  be cleaners and washers, using lots of disinfection products. They may be very selective about the foods they eat and the preparation of their food. And they're very leery of medications and vaccinations and phobic of medical side effects. They have a difficult time assessing health risks, rationally, and may avoid taking needed medications due to their overwhelming fear of side effects. Their emphasis is about preventing illness and seeking reassurance and certainty in their effort to protect their health.

Now, the next category of people with health anxiety is diagnosed as somatic symptom disorder. They have one or more real physical complaints or symptoms or body sensations, that are distressing or even functionally impairing. But their worries and concerns are actually like very of excessive and disproportionate to their sensation or symptoms. Their worry causes them more suffering than their actual physical complaints. And then finally there is illness anxiety disorder. The main feature here is the worry and preoccupation with the possibility or fear of having a serious illness. So their worries and thoughts and feelings are persistent, even when given reassurance and medical tests are negative. Now, although these four conditions have differences in treatment, they can all behave like OCD in the way that the person responds to their anxiety. Creating a self perpetuating loop, reinforcing and feeding the disorder itself. The last two types I explained, somatic symptom disorder and illness anxiety disorder, are disorders that are considered to be health anxiety. Although all four types have health and illness as themes. And it's also quite common for people to have combinations of different types of health anxiety. And the y can have one or more additional anxiety disorders, OCD or depression, along with health anxiety.

In part two tomorrow, I explain how to break the anxiety cycle. This will give you great insight in how to treat health anxiety, build up your competence again, so you can get back to enjoying your life.

Do you remember Marcus? Marcus sent me a photo that gave me goosebumps, it still gives me goosebumps today. About six months after telling me how health anxiety had taken his freedom, the photo was of Marc us with a huge smile on his face. And the wind was blowing in his hair and he was sitting behind the steering wheel of his boat. You can get your freedom back too. 

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