Formerly a bodybuilder and personal trainer, Legna Martin never thought of herself as anxious—more like faith-fueled and optimistic. Being overcome with fear of disease completely changed her nature and her life.
Paranoia bloomed when she developed cold urticaria, a rare skin reaction to the cold that causes hives and swelling. Before long, she had more unusual symptoms such as dizziness, followed by severe anxiety. After many emergency room visits and specialist appointments, she no longer left home. Martin no longer recognized herself.
Then she was diagnosed with breast cancer—in part because she was so hyperfocused on her body and noticed the unusual pain. That only intensified her anxiety into something concrete and necessary.
“The hard part even now for me is every soreness, every ache, everything that might feel a little different today compared to yesterday; my mind instantly wants to go to, ‘You’re gonna die,’” Martin told The Epoch Times.
Martin’s experience isn’t singular. There’s even a name for it—illness anxiety disorder. It can range from catastrophizing after a diagnosis to fear over physical symptoms that can make someone freeze and avoid doctors and treatments that could help.
Has Your Fear Gone Too Far?
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Transient health concerns and the distress that comes along with them are a normal part of life. So is using technology to check symptoms.
“All of us, if we got a scary diagnosis, would start to become anxious about it, understandably. For the most part, we try to move through it, and it doesn’t preoccupy all of our time or affect our lives,” Michael Stier, a licensed professional counselor, told The Epoch Times. “With health anxiety, it just starts to slowly take over the person’s life with more and more anxiety.”
For some, especially those with a history of anxiety, the brain seeks something to latch onto, even in the absence of a diagnosis, said Stier, who’s co-author of “The Complete Guide to Overcoming Health Anxiety.”
Illness anxiety disorder, the new term for hypochondriasis, is an intense fear of getting a serious disease accompanied by intrusive thoughts. There are two subtypes: care-seeking and care-avoidant, with some evidence showing that most people with the disorder fluctuate between types. They’re also often on constant lookout for reassurance, whether from body cues, medical tests, or online health searches.
It’s not unlike the vigilance encouraged during the COVID-19 pandemic: monitor, assess, report. While online searches help patients advocate for and monitor their health, information overload also makes it easier to be triggered, Stier said.
“With health anxiety, it’s not really about information; it’s about feeling better. It becomes a slippery slope whenever we’re using it for reducing anxiety,” he said.
If reassurance doesn’t satisfy, it can lead to more searching, appointments, and tests. Even then, they may doubt the test wasn’t run correctly or that the doctor was wrong. “Then they’re right back into the cycle,” Stier said.
When Fear Inhibits Healing
Fear of illness can affect healing by keeping you stuck in hypervigilance, changing how you experience symptoms, affecting how well treatment works, and causing avoidance of treatment. The common thread is cognitive inflexibility; in other words, what you think can influence your outcome.
The scientific word for the phenomenon is nocebo. Patients feel actual pain because they expect it due to anxiety, conditioning, or warnings from healthcare providers or media. Increased fears can trigger cholecystokinin, a neurotransmitter that sends pain signals. Fear can also stop your brain from releasing endogenous opioids, or natural painkillers.
“If they’re having a harder time getting unstuck from unhelpful things that they do, it’s going to be harder to make progress,” Stier said. It’s why someone might avoid exercise. Feeling the heart rate rise and breathing intensify can feel like a heart attack or panic, and someone with illness anxiety disorder is seeking safety above everything else.
Cancer patients struggle with fear of disease progression and recurrence, dying, and becoming a burden to family—but so do people with diseases such as multiple sclerosis and Type 2 diabetes.
When to Lean Into Fear
Fear is rarely a character flaw. Rather, it’s a signal from your body that you need to take action.
It might mean it’s time for a new doctor or test because there is something besides anxiety at the root of your symptoms, as was the case for Martin when she was experiencing breast pain and a test in between appointments confirmed her suspicion. “There’s a lot of research out there that shows that people, even women, are treated differently in the medical system,” Stein added. “We want to make sure that we have a trusting relationship with our provider.”
Being sent away because your symptoms are “in your head” is unhelpful. Whether symptoms indicate disease or anxiety, they are physiological and treatable, Stein said. However, the goal is to ensure neither the chase for answers nor the answers themselves create a mental spiral.
How to Face Your Fears
Cognitive behavioral therapy—talk therapy that helps you connect thoughts, feelings, and action—can be helpful. In particular, acceptance and commitment therapy (ACT) and exposure and response prevention (ERP) help patients face their fears.
ERP is a type of obsessive-compulsive therapy in which patients deliberately face anxieties in order to practice not performing their usual behavior. ACT teaches patients to accept difficult thoughts and feelings and take actions that align with their values, rather than their emotions.
One element of health anxiety that patients often fail to recognize is that their biggest fears—losing family, finances, hobbies, or joy—have already come true, because of their anxiety and not their diagnosis.
“They start to lose things. They start to not exercise. They start to not go to work. They start to not hang out with family, and that’s where life with all the avoidances gets really small,” Stier said. “The more that we can help people lean into things that are scary, it not only helps just with anxiety, but it makes their life bigger.”
Martin has learned to interrupt her fears with an internal dialogue. On one occasion, she reminded herself that she’d done squats the day before, when her legs hurt and her mind initially gravitated to worst-case scenarios. She also listens to music to counter triggers for dizzy spells.
Rediscovering things she used to enjoy is helping Martin get back to the life she remembers before she got sick. She’s leading fitness classes and starting personal training—sharing optimism not only in her self-talk but also with clients watching her in real time as she gets unstuck.
“My goal is obviously to keep getting better,” she said. “There are days that I have low energy, but I still have to do something. I’m moving forward.”
