What Health Anxiety Is: Why the More We Check, the More We Worry, and How to Care for It

Fresh out of the shower, drying her hair, Bo happened to feel a small lump on her neck. Her stomach dropped.

She felt for it again and again, then picked up her phone and searched the symptom. The more she read, the more frightening the diseases became. She barely slept that night. The next morning she went straight to a doctor. The examination found the lymph node entirely normal, nothing to be concerned about. Bo’s relief lasted a day or two, before a small voice began working its way back in: “what if the doctor missed it? Maybe I should get checked somewhere else.” And the old loop began again. This time, beyond the lump on her neck, she developed a headache she was certain must be a tumor. Bo’s life began revolving around monitoring her own body constantly, until neither body nor mind got any rest at all.

What health anxiety is, and how it differs from ordinary care for your health

Caring about your health, noticing changes in your body, and getting checked when symptoms appear are good things and should be done. Worry at a proportionate level helps us look after ourselves and see a doctor in time. That is reasonable self-care.

Health anxiety differs in the persistence of the symptoms and in the impact they have. The fear of having, or being about to have, a serious illness is severe and long-lasting. It usually arises from interpreting a sensation or a slightly unusual signal in the body — a fast heartbeat, an ache, a lump somewhere that is in fact nothing out of the ordinary — as evidence of serious disease. And these fears usually do not go anywhere even after a doctor has examined the person and said all is well, until the worry begins consuming time and emotional energy and interfering with life, work, or relationships. In some cases medicine calls this condition illness anxiety disorder.

That said, having worried heavily about health during some period — particularly after finding that someone close has fallen ill — does not always mean you have this condition. And importantly, health anxiety and genuine illness can occur at the same time. Having this condition therefore does not mean that every symptom you feel is not real, and it is not a reason for a doctor to overlook a new symptom or to stop assessing physical conditions that may genuinely be present. Diagnosis, and the assessment of physical symptoms, require a doctor and other professionals.

Why the more we check, the more we worry

The principal factor keeping health anxiety running without pause is the loop of reassurance-seeking.

It usually begins with finding some signal in the body, which the brain then interprets in the worst possible way. Once the fear arrives, we want to do something to make it stop: feel the same spot again, check the body repeatedly, search symptoms online, or see a doctor to be reassured. These actions can certainly deliver relief — but only temporary relief, because before long the doubt and the worry work their way back: “are you sure? Was that really a thorough check?” — until we go back to check again, and the loop turns and turns. Worse still, the more we check, the more intense it becomes, because each time checking brings relief, the brain learns that checking is the way out of fear, leaving us wanting to check more often.

Searching symptoms online is also a very common accelerant now that everything can be searched in seconds, sometimes called cyberchondria, because information online almost always includes severe possibilities mixed in — and it is ordinary for someone already worried to be caught by the worst of them. So the more we read, the more frightened we become. All of this happens because our mind finds it extremely hard, or impossible, to accept not knowing with a hundred percent certainty that we are safe, and so has to chase perfect certainty. In matters of health that is almost never conclusively available, and so the chase can never end.

Health anxiety is like drinking salt water for thirst

Think of drinking salt water to quench thirst. The first mouthfuls feel as though the water is helping. Before long the thirst returns heavier than before, because salt water cannot quench thirst at all — the more you drink, the thirstier you become. Seeking reassurance repeatedly, by checking the body or searching for what might be wrong, works much the same way. It gives relief for a moment, and then the fear returns and demands more checking still.

But seeing a doctor when you have a symptom that should be examined is not salt water. It is the fresh water the body genuinely needs, and it is the right thing to do — something that can actually help. The salt water is checking the body over and over, long after a clear medical answer has been given. The goal is therefore not to stop drinking altogether until you are dehydrated. It is to learn to tell the fresh water your body needs from the salt water that torments you the more you drink it — and that is best done with a doctor you trust assessing symptoms on an ongoing basis.

When to see a doctor, and when health anxiety needs serious care

This part matters a great deal and is worth reading in full. To say it again: physical symptoms that are new, persistent, changed from before, worsening, or worrying to you should always be assessed by a doctor. Having health anxiety does not mean the body is a hundred percent healthy and free of illness, so caring for this condition does not mean stopping going to the doctor.

What signals that health anxiety itself needs serious care is when the fear of illness stays severe and continues to consume your life even after examination and a clear medical explanation; when checking the body, searching symptoms, or seeking reassurance begins to take up a great deal of your time and emotional energy; or when the fear leaves you distressed enough to affect sleep, work, and relationships. At that point, care for the mind — alongside a regular doctor you trust looking after the body — will help you gradually leave the loop, without having to fear that you are missing something genuinely physical. And if at any point the distress becomes more than you can carry, Thailand’s mental health hotline, 1323, is staffed by people who will listen, twenty-four hours a day.

What part hypnotherapy plays with health anxiety

At NBRH we use hypnotherapy as our principal approach with the people we work with, working alongside medical care and not in place of examination or treatment for physical illness. From experience in practice, work with health anxiety in the therapy room tends to focus on helping a person gradually adjust their relationship with bodily signals, from interpreting every sensation as a sign of serious disease toward being able to notice it without immediate alarm; on gradually easing the loop of checking and reassurance that increases worry the more it is done; and on adjusting the relationship with uncertainty about health, from needing a hundred percent certainty of safety in order to be calm, toward being more able to live with the uncertainty natural to life. These are things we encounter often in real work, and they align with the goals of care that a number of studies describe.

At NBRH we work on the principle of Neuro-Behavioral Repatterning & Hypnotherapy: adjusting the nervous system’s patterns of response, and behavior, systematically. Because lasting care for health anxiety does not come from finding evidence that you are a hundred percent safe, which is never conclusively available. It comes from gradually changing the pattern of response to bodily signals and to uncertainty, so that the system does not have to jump into fear and checking every time — until worry about health no longer sets the rhythm of your life.

If the symptom worrying you is palpitations or breathlessness arriving in sudden waves, “What a Panic Attack Is” may be worth reading. And if your worry is not confined to health but floats across many things in your life, “Generalized Anxiety Disorder” connects that part of the picture.