Facing Fear: How to Cope with Health Anxiety during the COVID-19 Pandemic

By Steph McClean, Psychotherapist

Throughout life, most of us keep an eye on our health and wellbeing. However, there are times when we are more anxious about our health than others. It might be that we need to go back to our GP for a persistent issue, or we need tests or scans to see what is happening.

Now we are in a more extreme situation, with a global pandemic of unprecedented proportions nobody has ever experienced before. The country is in lockdown, and many of us have to shield and isolate for long periods of time in order to keep ourselves safe.

Routine medical procedures and treatments may have been cancelled and some people who are vulnerable might choose not to attend appointments for fear of risking contracting COVID-19. We may know someone who had it, currently has it or perhaps even someone who may have died from it. The news and media are constantly updating us and discussing it.

It seems to be all anybody can talk about.

This can create high levels of anxiety about health and a preoccupation with thinking about the virus and avoiding it at all costs.

Rational Anxiety

It’s important to recognise that anxiety is a perfectly rational response to a crisis situation, particularly if we are in a group who are at risk. It is hardwired into our survival system to want to react and respond when we know there is a threat. Anxiety is an understandable reaction at the moment, and it encourages us to behave in ways that keep us safe in the current circumstances.

For example:

Wanting to isolate or stay at home
Focusing on keeping our environment clean and hygienic
Communicating more with loved ones
Seeking reassurance
Monitoring our sense of wellbeing
Supporting and checking in with vulnerable relatives
Keeping up to date on current advice, guidance and updates from the media
Keeping your distance from others when outside your home

Problematic Anxiety

The difficulty with anxiety is that it can become problematic. Unfortunately the survival system in our bodies is not able to detect between actual danger and a perceived danger. If we get to a stage where our perception of danger is larger than the risk of actual danger, we end up becoming overwhelmed by our anxiety.

This may mean our mental and physical responses become heightened and stay heightened for longer periods of time. When this happens, our anxiety becomes more dominant and in turn we experience an increasing amount of unhelpful behaviours, difficult feelings and physical symptoms.

Signs of problematic anxiety include:

Changes to sleep patterns- you might find it difficult to get to sleep, or wake early in the morning
Mood changes- you may become irritable and bad tempered
Changes to appetite (including nausea, lack of appetite or overeating)
Increased alcohol or smoking
Fatigue
Lack concentration
Body aches and muscle tension
Feeling restless- like you need to constantly keep moving or doing things
Grinding your teeth or experiencing jaw ache and headache
Heart palpitations
Increased rate of breathing
Panic Attacks

Health Anxiety is a specific condition. This is where the above anxiety behaviours can be experienced alongside health-related anxiety behaviours. These tend to centre around fears of being or getting ill that are excessive or create difficulties in everyday life. These behaviours can be obsessive or compulsive, meaning you may feel you have no choice. They can interfere with relationships, work, and other aspects of normal functioning.

Some of these behaviours include:

Refusing to leave the house, even when allowed.
Obsessive checking of media- having the news on all day, constantly checking online, looking up symptoms repeatedly.
Constant body monitoring- taking your temperature excessively or worrying about every little feeling in your body.
Obsessive hygiene behaviours- constant or excessive hand washing or domestic cleaning, particularly of a certain area.
Intrusive or repetitive thoughts about health
Constantly thinking you might die or be dying
Inability to accept reassurance from others, including healthcare professionals
Hypervigilance- closely monitoring those around you for perceived symptoms or signs of illness (coughing is a common one at the moment)
Paranoia- monitoring other people’s behaviour that you believe is a risk to you or others (eg. checking people leaving their house, not observing social distancing or not wearing PPE when in public).

We may briefly experience some of these more problematic aspects of anxiety, particularly health anxiety during the current COVID-19 Pandemic, which is to be expected. These aspects of anxiety will often pass within a few weeks. It is also important to remember that according to WHO: “Illness due to COVID-19 infection is generally mild” and “for most people in most locations the risk of catching COVID-19 is still low” that only 1 in 5 people who do catch it need hospital care.

Anxiety can be managed in the following ways:

Regular sleep pattern
Regular meals
Taking daily exercise, even if it’s a short walk around your garden
Daylight and fresh air- try and keep curtains and a window open
Meditation and mindfulness
Gratitude Journal/ Writing
Yoga and relaxation
Breathing exercises
Regular routine
Talking to others about how you feel
Listening to music
Doing a creative project
Online/Peer support groups

If you are experiencing excessive anxiety that is distressing, lasting longer than a few months or frequent panic attacks, please contact your GP or mental health professional.

Guides to above suggestions:

Meditation/Relaxation Apps: www.calm.com www.headspace.com

NHS Yoga Guide: www.nhs.uk/conditions/nhs-fitness-studio/yoga-with-lj/

Guide to good sleep: https://www.nhs.uk/live-well/sleep-and-tiredness/how-to-get-to-sleep/

Guide to Gratitude Journals: https://positivepsychology.com/gratitude-journal/

Helpful resources for managing anxiety:

www.nhs.uk/oneyou/every-mind-matters/anxiety

www.nhs.uk/conditions/stress-anxiety-depression/ways-relieve-stress/

www.nhs.uk/conditions/stress-anxiety-depression/moodzone-mental-wellbeing-audio-guides/

https://www.mind.org.uk/information-support/types-of-mental-health-problems/anxiety-and-panic-attacks/self-care-for-anxiety/

References: