We’re more than a year into the Covid-19 pandemic, which has altered our health beyond just the virus ― especially our mental health. One byproduct? Constant and excessive stress over our physical well-being, which can morph into health or illness anxiety.
The issue (often called hypochondria) happens when you begin to irrationally or obsessively worry about your health to the point that it’s affecting your daily life. This is something many mental health professionals like Kimberly Presley, clinical director of Taylor Counseling Group in Dallas, have been seeing in their practices during the pandemic.
“It makes sense because, as a culture, we have never spent so much time reading, talking, watching or learning about a specific issue related to our physical health,” she explained.
Anxiety is often sparked by fear, and Covid-19 has implanted real fear in many of us in a number of ways, Presley said ― not to mention we have access to trends, data, graphs and statistics online. The constant influx of information and realisation we have little control over the actions of others in helping to curb the virus has been a lot for people to manage.
“And a feeling of helplessness or lack of control coupled with real fear is a perfect recipe for anxiety,” Presley added.
Vigilance is good when it comes to preventing Covid-19, but there comes a point when you may overcorrect your behaviour or have unhealthy thought patterns. Think you’ve developed health anxiety during the pandemic? Below, experts share some signs you might be struggling and offer some advice on how to address it.
You’re obsessively thinking about the pandemic and having difficulty concentrating throughout the day
“This means that the pandemic is affecting your activities of daily living, making it harder for you to engage in the necessities of life and carrying out your everyday functions,” said Judy Ho, a triple board-certified clinical and forensic neuropsychologist.
If you find yourself constantly ruminating over a fear of contracting Covid-19 or any other health-related train of thought, “turn your mind away from your worry by using cognitive behavioural therapy techniques such as thought-stopping,” Ho said.
Here’s how: Interrupt your thoughts with the word “stop” when you notice your obsessive thinking, and then distract yourself with a pleasant activity or something you enjoy doing. Listen to your favourite song, organise a small part of your home, call a friend, engage in a hobby, or read a chapter from a book.
Stopping worries is all about breaking up your stream of thoughts. Even just a few minutes of interruption can help you disengage from this loop, Ho added.
You talk excessively about your health, or about Covid-19, with others
Of course it’s OK to talk about the pandemic, but if you find that conversation about Covid-19 is crowding out other important topics in your life or other people’s, then it could signify anxiety.
Chloe Greenbaum, a licensed psychologist and adjunct professor at New York University, suggested preemptively starting conversations by saying you’re trying to fixate less on Covid-19 and requesting to steer clear of coronavirus talk.
But what if your mother wants you to assure her that she’s OK after going to the grocery store double-masked and wearing a face shield? “You have to decide what your boundaries are,” Greenbaum said. “If reassuring someone feels OK and doesn’t exacerbate your own anxiety, then that can be your boundary that you can be there and support other people and their concerns but you don’t voice your own.”
But if those comments trigger your own health anxiety, then you need to speak up. Greenbaum said to try: “I’m here for you. But right now I’m really working on reducing my own anxiety about these things. Do you mind if we hold off on talking about Covid for some time?”
You excessively consume news or health information about the coronavirus
Tracking the news is helpful to the extent that it informs you about safety precautions. Beyond that, viewing an endless amount of Covid-19 news might be a cause and effect of health anxiety.
“I recommend regulating the amount and type of news you consume,” Greenbaum said. “Only read the news once or twice per day, rather than having CNN on in the background all day long.”
You’re experiencing sleep disruption or nightmares
It’s normal for people to experience bouts of insomnia or sleeplessness during times of stress. But if you are having more sleepless nights due to worrying over the pandemic ― or having nightmares related Covid-19 ― it could very well be an indication that you have developed significant health anxiety.
“I have definitely noticed an overall increase in pandemic-themed dreams and nightmares with my patients,” said Melissa Giuttari, a licensed clinical mental health counsellor in New York City.
Some dreams, she explained, are laden with overt expressions of fear around one’s safety and health. For example, many people dream about being in a crowd with no mask and feeling vulnerable. Others include more symbolic manifestations of this fear, like contamination-themed dreams.
“Try writing out worries and your pandemic-related dreams, as this helps to externalise them,” Giuttari said. “Assess how likely or realistic each worry is and name them as rational or irrational. Find supportive people or a therapist to talk with to process them.”
You’re avoiding outdoor activities
Are you refraining from approved stress-relieving activities like hiking, cycling or walking where social distance permits? This could be a red flag for anxiety.
“Confinement to your home if you are a healthy person practicing recommended safety measures indicates the kind of excessive catastrophic thinking and behaviour typical of an anxiety disorder,” said Sam Von Reiche, a clinical psychologist and author of “Rethink Your Shrink.”
Avoidance is one of the main reinforcements for anxiety because of the sense of relief it brings. Von Reiche said, “I advise challenging the compulsion to stay sequestered by taking small steps like making sure you go to the mailbox every day, then walk to the end of your block, and so on.”
You’re not reassured by negative test results
Perhaps even when you get negative test results, you don’t feel reassured or you only feel temporarily reassured and it heightens your anxiety. This is common with an anxiety disorder, said Abisola Olulade, a board-certified family medicine physician with Sharp Rees-Stealy Medical Group in San Diego.
“Often even when tests are negative, then patients may still request more and more tests,” she said. “Of course it is important that you don’t feel that your symptoms are being dismissed but if you have had several negative tests and a thorough examination, and you still don’t feel reassured by that, then this may be a sign of an anxiety disorder,” Olulade said, adding that talk therapy can help address these symptoms.
You think every symptom is Covid-related
“With so much talk about Covid surrounding us, it’s easy to see how people can start making connections between something like a stress headache and Covid,” said Jamie Schenk DeWitt, a licensed family therapist based in Los Angeles.
It’s important to remember that many of the symptoms of Covid-19 can also be attributed to other conditions.
“If you are constantly worried about everyday coughs, sneezes, headaches and the occasional aches and pains ― and if you are obsessively taking Covid tests for reassurance ― it is time to control your thoughts and not let them spiral into anxiety,” DeWitt said.
The next time you think a sneeze is Covid-19, DeWitt said, very compassionately stop and redirect your thoughts to positively reinforce all the ways you have been careful and safe.
“Recognise that what is driving these thoughts is a fear of getting sick and losing control,” DeWitt said. “Once you can identify the fear, the better able you are to challenge it with concrete facts.”
You’re afraid that everyone is going to give you Covid-19
Not every interaction with other people is guaranteed to result in the transmission of the coronavirus. And if fear of infection is keeping you from participating in otherwise safe activities ― like being outdoors or potentially even running to the store ― this may also be a sign of health anxiety.
“Remember, your mental health is important too — and being around other people, safely, can be good for your emotional well-being,” DeWitt said. “Social distancing, wearing masks, and visiting outdoors have all been shown to be safe ways of interacting with others during the pandemic.”
DeWitt added that going for a masked walk outside with a loved one is good for the soul; spring break in Florida is the potential super-spreader scenario. This is especially important to remember as more people get vaccinated and reenter daily life.
You’re overusing hand sanitiser and other disinfectants
“There is nothing wrong with taking safety precautions, but when you are constantly dousing yourself and your groceries in disinfectant, it demonstrates you don’t trust the advice from experts and are being overly cautious,” said Dana McNeil, a marriage and family therapist and founder of The Relationship Place in San Diego.
Hygiene is important; hygiene theatre ― especially when it stems from anxiety ― should be addressed. When the urge to be overprotective strikes, McNeil said to remind yourself that you’re taking the proper precautions already. One good-size squirt of hand sanitiser should remove the germs; you don’t need four to five coats to do the trick. If you can’t ignore the overwhelming pull to over-clean, it’s definitely worth chatting with a mental health professional.
You believe everyone you love will die from the virus
Excessive worry over your health often prompts you to jump to the worst-case scenario. “Having a debilitating fear of doing an activity and only being able to envision a catastrophic outcome from performing the activity is a sign that you have heightened anxiety,” McNeil said.
Yes, severe disease and death is an outcome of Covid-19. But there are also other outcomes. Yes, it’s possible you can catch the virus at the store. But there are also preventive measures you can take to ensure you’re safe.
“You don’t need to live in the world, treating yourself as if your worst-case scenario has already happened,” McNeil added. “You are punishing yourself with unnecessary pain now and stripping yourself of the ability to be present in the moment so that you can take necessary precautions or to have your wits around you as you enter a potentially unsafe situation.”
You’re avoiding medical care
“When some people have intense fear of a potential health problem, they may intentionally miss or not schedule appointments, whether it’s a routine checkup or a specific health concern, in fear of being diagnosed with a serious illness,” said David Harari, a psychiatrist and the director of behavioural health at K Health.
He noted that it’s important to keep up with regular visits and to consult with a doctor if you’re having a health issue you’re concerned about. “Ignorance is not bliss when it comes to your health,” he said.
And if any of these warning signs rings a bell, reach out to a mental health professional. It’s possible to navigate the pandemic without exacerbating your anxiety, and a therapist can tailor your coping methods to your specific needs.