Anxiety Tame Resources

Health Anxiety, a Covid example: Theory A or Theory B?

Photo: Hugo Jehanne @ Unsplash

A state of high alert and chronic reassurance seeking are a couple of the symptoms of health anxiety and also of a realm of other mental health issues. Although asking a physician or friend if there is anything physically wrong with you may provide some instant relief, chances are it won’t stop there and before you know it, the need for reassurance increases and your sense of perspective diminishes. Anxiety and depression can set in. This interferes with you leading a fulfilling and meaningful life.

Take Sarah *. She never really experienced health anxiety before February this year , when she had to cancel a holiday in Spain because of the corona virus outbreak. She was already stressed because of work and very much needed the break.

Sarah couldn’t stop thinking about government advice and Covid news in the media. And then on March 23rd we went into lockdown and things got much worse.

By the time Sarah started therapy 12 weeks later, she had pretty much stopped all of the activities she used to enjoy. She wouldn’t leave her house unless she really had to. Sarah had been monitoring her ‘symptoms’ in a journal and would spend hours every day focusing on changes in her heart rate, breathing, sense of smell and taste. Although she had limited contact with others, she was convinced she could have the virus. Thoughts about dying alone on a covid ward triggered high anxiety and distress. Life really had become quite unfulfilling.

Sarah’s therapist asked her to talk about her symptoms. She had seen a poster about shortness of breath which terrified her. Although she had experience of being out of breath plenty of times in her life: cross country at school, running for a bus, walking up the stairs at home, a new association had formed: shortness of breath = covid.

Sarah had a theory: her body symptoms had changed over the past few months and she probably had undiagnosed covid. She had smoked for a few years at university and was therefore more at risk than others. Spending any time with anyone else, even at a distance, could significantly raise her chances of getting the virus or passing it on to someone else. She wouldn’t be able to live with herself if she passed the virus on. Consequently, Sarah became obsessed with body symptoms and reassurance seeking.

Sarah agreed to try a more open-minded approach and was asked to consider an alternative theory. Theory B if you like. Theory B: I am anxious and worried about picking up Covid 19 or that I might already have it. My anxiety causes many body symptoms like shortness of breath and elevated heart rate. This is a normal and safe fight/flight response. However, it feels pretty horrible!

If Theory B was correct, then Sarah could reduce her body scanning and internet research of symptoms. She could start to focus on more positive and enjoyable activities instead. She was, after all, allowed to feel anxious about Covid and take reasonable and realistic precautions to keep herself and others safe.

Cognitive behavioural therapy is a process and not a quick fix. Sarah chose to take an experimental approach and over the course of treatment, was able to reduce unhelpful behaviours and increase her sense of perspective. Although she was pretty invested in Theory A, she chose to acknowledge there could be at least one alternative.

If you are currently experiencing health anxiety or increased anxiety, cognitive behavioural therapy could help you. A full list of accredited therapists (myself included) is available on the BABCP website.

* Sarah is a purely fictional patient. Due to confidentiality, names and specific details of my own patients are never used in blog posts or resources.