Health Anxiety

How occupational therapists can support people living with health anxiety

The last two years have been a rollercoaster of emotions for everyone. The pandemic has undoubtedly put our health at the forefront of our minds, each day posing a worry when leaving the house. Our daily routines and regular activities were halted, and socialising was banned for fear of transmitting this invisible disease. Hand-washing songs were introduced, hand-sanitising was constant, cleaning surfaces became like a ritual and face masks became second nature. COVID-19 was not the only thing that was spreading over the last two years, fear was also spreading throughout the population. Fear of catching COVID-19, fear of passing it on to loved ones, fear of unknowingly spreading this virus to people with underlying health conditions. A justified fear that helped keep us safe during a time of grave uncertainty, but that for many has had a more lasting effect. As restrictions are seemingly coming to an end and the world is opening back up, despite the virus still being prevalent, many people are still feeling understandably worried and cautious about re-entering the world as we once knew it. A healthy amount of caution and worry over our health is only natural considering the pandemic, but there can be a point where too much concern over our health can start affecting our lives negatively. Health anxiety, commonly known as hypochondria, has been a very real consequence of the pandemic, affecting more people’s lives than ever. If left unchecked, health anxiety can have a serious impact on the way people lead their lives, and occupational therapists are well-placed to both recognise the signs of health anxiety and to help people manage it.

If left unchecked, health anxiety can have a serious impact on the way people lead their lives RECOGNISING SIGNS OF HEALTH ANXIETY

Health anxiety can manifest itself without the person even being aware of it. As an OT, the ability to recognise the signs of health anxiety in a patient can go a long way to helping that person understand their anxiety and help to support them to manage their condition. The NHS website lists the signs of health anxiety as follows: 1 constantly worry about your health 2 frequently check your body for signs of illness, such as lumps, tingling or pain 3 are always asking people for reassurance that you’re not ill 4 worry that a doctor or medical tests may have missed something 5 obsessively look at health information on the internet or in the media 6 avoid anything to do with serious illness, such as medical TV programmes 7 act as if you were ill (for example, avoiding physical activities) Worrying about our health has become routine throughout the pandemic, making it difficult to recognise obvious signs of a more serious anxiety. The above list can act as a base from which to decipher if health anxiety is affecting a person’s life. Being sensitive to people’s health concerns is of vital importance, and understanding that there are many disabled or chronically ill people who live with genuine health concerns on a day-to-day basis and do not need their precautions undermined. For many disabled people, leaving the house, travelling on public transport, engaging in social activities or simply going to work, have always posed a risk to their health in some way and they have found a way to manage this before the pandemic was even in existence. It is therefore only natural that their anxiety will be heightened in these circumstances that we now live in. Many people likening the symptoms of the most recent strain of coronavirus to “a bad cold” does not provide relief to those living with respiratory conditions or chronic illnesses. 36-year-old blogger Gemma, who lives with spinal muscular atrophy recently shared

her experience of shielding in an article for disability lifestyle magazine PosAbility. Gemma, who had been hospitalised for influenza two months prior to COVID-19 taking hold of the world, stated that she took little reassurance from the disease being referred to as “just like the flu”, explaining that her experience of shielding had been a difficult time. “Let’s face it, being told in written text that you’re at a high chance of dying were you to catch a highly infectious virus that is currently spreading across the world is scary stuff. It’s nothing we’ve ever had to face before.” Gemma’s sentiments ring true for many disabled people who have been shielding for the last two years, and this is something that must be taken into consideration when working with anyone who is experiencing anxiety about their health. Circumstances play a major role in a person’s concerns about their health, especially for those living with a disability, impairment, chronic illness or other health condition. They must attribute their own risk assessment to their own set of circumstances, and this should not be misconstrued as health anxiety.

MANAGING HEALTH ANXIETY

If you do recognise the signs that health anxiety is affecting someone’s life adversely, it is important to help support the person to come to terms with recognising this. Recognition is the first step to helping a person manage their anxiety. There are a variety of activities that people can practice to help alleviate their anxiety about their health, and as an occupational therapist you can help guide them to implementing changes or activities that will be most effective for the individual. These activities may include keeping a record or diary of the occasions they seek reassurance on their health, allowing them to see on paper how many times this occurs, and this can then be something they work on reducing. Other techniques can involve using distractions through activities or writing down concerns and then rationalising them out loud. Breathing and relaxation exercises can also be an effective tool when managing anxiety and you can find many apps nowadays to assist with this. Talking therapies or cognitive behavioural therapy (CBT) could also provide an avenue of support to live with health anxiety. As OTs you know the importance of providing personcentred care, and in these circumstances individuals will respond to different avenues of support, the important thing is that you are there to support them to manage their anxiety to allow them to live their lives to the fullest as independently as possible.

Recognition is the first step to helping a person manage their anxiety