4 Steps to Managing Health Anxiety During the COVID-19 Pandemic

As someone in the mental health field, there are few topics so prevalent in my work or study as anxiety. As a person with many chronic diseases, there is no anxiety more prevalent to me than health anxiety. Our time of shared experience during the coronavirus (COVID-19) pandemic — the new-to humans virus that causes respiratory infection and can lead to serious or fatal health complications — has led to a shared experience of health anxiety, some for the first time and others in addition to regular anxiety. Whether health anxiety is a new perspective for you or a familiar one, I wanted to share a few perspectives I find helpful in my own experience. This is from my own experience, and should not be substituted for professional advice.

Step 1: Acknowledging the anxiety.

I would consider health anxiety to be any preoccupations, worries, fears or other maladaptive ways of coping that relate to our health, mortality or purpose in life. Those are some heavy things! I imagine that everyone experiences health anxiety at some point, even if fleeting. Unlike the other types of fears and phobias, health anxiety is about your own body and the many unpredictable parts of it. If you are afraid of heights, you can avoid tall buildings or places — you can’t detach from your body in the same way.

If your health anxiety is new, it may be helpful to acknowledge that it is overwhelming because it is new and you haven’t adjusted or learned coping methods yet. It can help to know you don’t have to jump to the point of adjustment if you aren’t ready.

After addressing the anxiety, it can help to understand what lingers behind the fear. If you remember much about geometry, you might remember the phrase “vectors have direction and magnitude,” meaning you need to find the direction as well as the size.

How big are your fears? What is behind them, and where are they going? Can you find the source?

I’ve often found that most of my health anxiety comes from a fear of the timing in my life. Identifying what I feel I would be missing can be important. It’s also helpful to know whether I am afraid of loss and what that loss looks like.

Your “fear vector” is a crucial step in order to address and feel capable of coping with health anxiety.

Step 2: Identifying your needs.

If you are able to complete the first step and have a sense of where your fear is going, and where it came from, you now have a greater ability to intervene and redirect the path. This intervention happens by understanding what you need to adequately address your health-related fear.

You might ask yourself the question: “What could happen to stop this fear? “If you can identify the specific thing or event, it can help you understand the motivation for your identified need.

What does your need to accomplish? Is there a different way to accomplish that need, and how?

I’ll stop asking questions and give an example. Let’s say I experience health anxiety over fear of catching an illness, developing complications and having to be hospitalized and complete expensive medical treatment. By asking the previous questions, I can determine that my fear is not getting sick, or the complications. My fear is the expense, which may translate to a perceived burden on others. So now, I have found my need: not to feel like a burden. An alternate route for this fear of being a burden might be to remove some of my own sense of responsibility. It might also be important to remove expenses from any implication of meaning “burden.”

Sometimes the quickest and easiest intervention is to address the problem directly. In my example, I could have a direct conversation in which I challenge my own thought process. It’s important to note that challenging my thoughts should come after validating my thoughts and feelings in step one.

Step 3: Pragmatism.

The third step is the most practical and concrete. I now know how I feel, what I think and what I need. Now, I can determine what I can do. This step is about action and combines all of the previous steps to come up with a solution.

As in my previous example, this step may prompt me to have a direct discussion with myself or others. It may also prompt change in the thought patterns I experience about thinking I am a burden. The following are four different strategies for changing thought patterns. They can be used together or individually.

Replacing: Whenever I make a judgment about my own value, I can replace that statement with a feeling statement. Instead of “I am a burden,” I instead say: “I feel like a burden.”
Reframing: Reframing acknowledges my own feelings but also finds an alternative. I know I feel like a burden, but how might I also feel like a benefit or a gift?
Rehearsing: I may need to go so far as to practice and set reminders on a regular basis to change my thoughts. I can feel uncomfortable to think in the opposite way, and takes practice.
Distress tolerance: This applies to a situation I cannot avoid. If I know I am going to have medical costs I can’t avoid, how can I make the situation ideal? Is there anything I can do to make it more tolerable and reduce distressing thoughts and feelings?

Step 4: There is no final step.

Due to the fluid nature of our lives and health, the final step may vary and need to be completed when new experiences arise. The final step consists of knowing how to process and address fear and apply this approach to similar situations. The more exposure and experience, the easier it gets.

With practice, I find myself having smaller scale anxiety before I implement what helps. These steps are not likely to eliminate all fear and anxiety, but rather break it down to be more manageable.

There are times I have to fully acknowledge both the good and bad of a situation and determine what I can do with both options. I am less a “Pollyanna type” as I am focused on what is most productive and helpful to my life. The dual nature of uncertainty is that the worst could happen, but so could the best. Even if the worst happens, it may not develop in the way we anticipate. I try to challenge the instinct to assume the worst from a distant perspective. We all can decide on the meaning of events in our lives.

Struggling with anxiety due to COVID-19? Check out the following articles from our community:

Coronavirus Disease 2019 (COVID-19)

4 Steps to Managing Health Anxiety During the COVID-19 Pandemic

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