As the numbers of reported cases of Swine Flu increase, BBC Radio Nottingham broadcasts a balanced view. Nevertheless, some people are experiencing higher levels of anxiety about their health and today I spoke about this on The Morning Show with Frances Finn, and producer Tom Whalley. Tom has become aware that his humorous take on his own preoccupation with his health has become more acute recently, due to the ‘pandemic’ and 5/6 threat scale. 

Health Anxiety is much more common than people generally realise; this is because, often, the individual is embarrassed to admit he/she is worried, when intellectually they acknowledge that their fears are unecessary. Typically, amongst family, friends or work-colleagues, the person might make light of it, even joke…..whilst seeking reassurance that, for example, a particular sensation, skin pigmentation, or other minute change revealed by repeated self-examination, is NORMAL.  The slightest doubt or uncertainty feels intolerable and the person can’t help checking with others, or on the internet, or with the GP etc. People with Health Anxiety tend to screen out information which could allay their fears (eg 5000 people died worldwide with ordinary flu in the same period as 100 of Swine Flu). They may experience panic attacks when they focus on the body sensations naturally produced by being anxious, misinterpret these as a sign of something serious, and as consequent anxiety grows and sensations build, induce a panic attack. 

Thoughts are dominated by ‘What if…?’  and fears of something catastrophic and unbearable happening to self (and/or loved others).

This form of insecurity can arise due to parental modelling; sometimes it develops following a health scare/diagnosis of a condition (eg epilepsy/asthma/diabetes/heart problem); or it may be a focus for other (avoided) feelings which the person would otherwise have to face.  Anxiety is closely associated with anger,  and it may be that the underlying belief is that something important to the person, is, or was, very  unfair/wrong. 

Initially, clients often come to therapy for help with stress or panic attacks, but the news about Swine Flu, provides an opportunity to raise these concerns with the ‘comfort’ of normalisation; ‘after all, everybody’s talking about this, aren’t they? ‘……. 

In fact, anyone who has been feeling depressed, anxious or stressed about difficulties in their life (relationships, work security etc), will have a tendency to feel more so when specific BAD NEWS which could affect them personally, is dominant in the media (eg credit crunch/ Swine Flu). This is because they are already feeling some sense of helplessness, and personal ‘radar’ may be set to ‘search’ for reinforcing information! (Pandemic -which means global epidemic – may be interpreted as ‘universally fatal’)

Treatment for Health Anxiety focuses on the meaning that the person makes of the body sensations, and testing out unhelpful beliefs.  ‘What is the WORST you fear could happen? What would that be like/mean to you?’  It is important to encourage new behaviours and distraction to replace the repeated self-examination and reassurance seeking (which requires co-operation from family/friends etc). Experimenting with inducing structured ‘panic attacks’ in the therapy room can be very effective in illustratingthe meaning of the sensations and how we can correctly interpret them and ‘control’ them. Teaching self-soothing techniques, such as muscle relaxation and regulated slower/deeper breathing is also potentially helpful.

However, whilst some people express their inner fears through Health Anxiety as described above, there are others at the opposite end of the continuum who also have health-related fears; they AVOID any self-examination, regular health check-ups/tests, visits to GP etc.  This, of course, is in its own way, equally unhelpful behaviour.