author image Dr. Paul Greene
author image Dr. Paul Greene
Dr. Paul Greene is the founder and director of the Manhattan Center for Cognitive Behavioral Therapy in New York City. With 14 years of dedicated service in private practice, Dr. Greene brings a wealth of experience to his role. His career also includes teaching at the Mount Sinai School of Medicine and conducting research at the Memorial Sloan Kettering Cancer Center.

If you find yourself preoccupied and fearful about having a serious illness, you may suffer from health anxiety. Fortunately, there are concrete steps you can take to (eventually) feel less anxious.

What Is Health Anxiety?

Health anxiety is worry or concern about having a medical condition that is disproportionate to the actual risk. Sometimes health worries are the only topic someone is anxious about. For others, health is just one of several focuses of worry. At its worst, health anxiety can be quite impairing.

If worries about your health don’t stop you from enjoying your life, then it probably doesn’t need to be addressed. However, if you notice some of the following, you might consider addressing the problem:

  • Frequent doctor visits or emails to medical providers
  • Repeatedly checking your body for signs of illness
  • Skipping necessary medical visits due to anxiety
  • Significant time spent researching possible significant health conditions
  • Asking loved ones for reassurance over and over about your health (e.g., “it’s probably nothing, right?”)
  • Frequent checking or awareness of heart rate, blood pressure, etc.
  • Avoiding people with serious illness, due to fear of catching it from them or fear of seeing the illness’ effects
  • Preoccupation with one’s health or frequently discussing one’s health

RELATED: What Is Anxiety?

If health anxiety has gotten out of control for you, consider using any of the following strategies that are commonly used in cognitive-behavioral therapy (CBT) for this problem:

1) Limit Your Checking and Safety Behaviors

If you suffer from health anxiety and you spend time researching health problems online every day, the research may cause more anxiety than it alleviates. Similarly, if you visit your doctor significantly more often than your loved ones (or your doctor) think is necessary, the doctor visits may be a safety behavior.

What are safety behaviors?

A safety behavior is anything we do that serves to make us feel less anxious without significantly reducing the threat. For example, a man who checks that the door is locked five times before leaving home makes himself feel more comfortable without meaningfully reducing the likelihood of a break-in. In contrast, putting out your cigarette before filling up at the gas station does reduce the likelihood of a fire, and so would not be a safety behavior.

For people with health anxiety, getting reassurance from loved ones, from the internet, or even from doctors can become safety behaviors. Take a minute and ask yourself which things you do that help you feel less anxious about your health, but realistically do little to keep you healthy. The more you work to reduce the frequency of these behaviors, the better your health anxiety is likely to get!

2) Assess Threats Correctly

Decades of research on anxiety and how it works show us that threat misappraisal worsens anxiety. Threat misappraisal simply means overestimating how likely it is that something bad will happen. This often happens to people with health anxiety. They may worry significantly about a health problem that is exceedingly unlikely to occur.

For example, someone with health anxiety who is concerned about pancreatic cancer may estimate their chances of getting the disease as 20% or more. However, the actual likelihood of someone in the US being diagnosed with pancreatic cancer in 2021 was approximately 12 out of 100,000, which is 0.012%.

The good news is that if you are consistently able to correct threat misappraisal in your mind, your health anxiety will improve. This doesn’t mean just correcting it once with the hope that “it sticks.” This means that every time you worry about a serious disease, you remind yourself of your actual risk of getting it. This may mean reminding yourself of the facts dozens of times each day, but be willing to try it!

3) Make a Sustained Mental Effort to Tolerate Risk

Sometimes people have anxiety about a health condition that is realistic for them. For example, someone with a family history of a certain cancer may worry excessively about getting that cancer. Similarly, someone with a history of heavy smoking may worry about getting lung disease. So how can you cope with those situations?

Working to tolerate some risk is part of the solution. Health anxiety thrives when we have no tolerance for risk. This means that the more we accept even negative possibilities, the less anxiety we will have. Accepting these risks involves making a conscious effort to give up hope of guaranteed health. None of us are guaranteed good health, so accepting negative possibilities is just accepting reality.

RELATED: Accepting Things As They Are: Why and How to Do It

In CBT therapy, when people with health anxiety are counseled to tolerate some risk of an illness, they often say, “I just want to be sure that I don’t have it.” That’s certainly a reasonable thing to want! They don’t realize that their tolerance for risk on this one concern has fallen to zero. However, these same people are often able to tolerate the possibility that a loved one could get hit by a bus, or that we could die in a nuclear war or environmental disaster, or that their dog will run away. Tolerating the possibility of getting serious illness requires this same type of coping. The secret is to acknowledge how bad the feared illness would be, and to make a mental effort to accept that the risk of contracting it is not zero.

Consider Cognitive-Behavioral Therapy (CBT)

If your own efforts to address health anxiety aren’t as successful as you’d like, consider cognitive-behavioral therapy. It is quite effective against anxiety, and this is true for health anxiety as well. If you’d like to speak to someone about whether CBT is a fit for you, please contact us!

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Dr. Paul Greene Psychologist
Dr. Paul Greene is the founder and director of the Manhattan Center for Cognitive Behavioral Therapy in New York City. With 14 years of dedicated service in private practice, Dr. Greene brings a wealth of experience to his role. His career also includes teaching at the Mount Sinai School of Medicine and conducting research at the Memorial Sloan Kettering Cancer Center.

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