When “What If?” Takes Over: Understanding Health Anxiety and OCD
By: Sarah Herbert, MA, LMHC-A | PILLARS OF WELLNESS
Have you ever had a time where you noticed a new ache, bump, or headache and immediately wondered, “What if something is seriously wrong with me?” For many people, things such as health worries are a normal part of day-to-day life. However, when these fears become persistent, overwhelming, and begin interfering with your daily life, they may point toward either Health Anxiety or Obsessive Compulsive Disorder (OCD).
These two mental health issues look very similar from an outside view. Understanding the differences between the two is important because they can often be confusing to separate. One way to handle both of these different mental health issues is through Acceptance and Commitment Therapy (ACT), where the focus is more on changing our relationship with those thoughts so they have less control over our lives.
Health Anxiety: What does it look like?
Health anxiety involves a persistent fear of having or developing a serious medical condition even if there is no evidence for it. But, what exactly would that look like? The following could be ways that health anxiety can show up for somebody:
- Frequently checking their body for signs of being sick.
- Become highly attuned to normal bodily sensations, interpreting them as dangerous.
- Fixating on the smallest little blemish or spot on their body.
The main concern is the possibility of having an illness. Your mind becomes convinced that having your health be out of your control and uncertain is unacceptable. Usually, once people who have health anxiety receive the ‘all clear’ from a doctor, the anxiety tends to gradually ease.
How does OCD look similar?
OCD can also involve fears about health, especially when it comes to contamination OCD. However, the underlying process is different in people who have been diagnosed with OCD.
In OCD, intrusive thoughts, also known as obsessions, create significant anxiety, and the person performs behaviors or mental rituals, also known as compulsions, to help try to reduce the distress they can be feeling. Someone with health-related/contamination OCD may:
- Constantly monitoring bodily sensations.
- Repeatedly ask others if they think something looks wrong to seek reassurance.
- Googling their symptoms for lengthy periods of time.
- Mentally review every physical sensation from the day.
People with OCD may also experience what can be described as a core fear. A core fear is a deeper fear or concern that sits underneath the obsessive thoughts and compulsions. These fears can vary significantly from person to person and may involve themes such as death, abandonment, uncertainty, or being a “bad” person.
While health anxiety is mostly driven by fear of illness, OCD is driven by the inability to tolerate uncertainty, especially with things outside of our control. The compulsion doesn’t solve the problem, it helps temporarily reduce anxiety, reinforcing that OCD cycle, and leads you back into those feelings of intense anxiety.
How does ACT approach these topics?
ACT doesn’t ask people to convince themselves that nothing is wrong. Instead, it encourages people to notice their anxious thoughts without immediately holding on to that belief.
For example, instead of: “This headache has to mean that I have a brain tumor.”
ACT suggests: “I’m noticing my mind is trying to tell me a really scary story about this headache.”
This helps create some distance away from those thoughts. This helps the thought feel less like a fact. It becomes simply something that your brain is trying to tell you, because our brains love to tell us stories. From there, the goal becomes choosing actions based on our personal values rather than choosing our actions based out of fear and worry.
How do you break free from the cycle?
Whether someone struggles with OCD or Health Anxiety, reassurance often feels helpful, but then the fears creep back up. Especially with OCD, the need to seek reassurance comes back to the forefront and tries to dictate all decisions. ACT helps you learn a different response.
When “What If?” Takes Over: Understanding Health Anxiety and OCD
By: Sarah Herbert, MA, LMHC-A | PILLARS OF WELLNESS
Have you ever had a time where you noticed a new ache, bump, or headache and immediately wondered, “What if something is seriously wrong with me?” For many people, things such as health worries are a normal part of day-to-day life. However, when these fears become persistent, overwhelming, and begin interfering with your daily life, they may point toward either Health Anxiety or Obsessive Compulsive Disorder (OCD).
These two mental health issues look very similar from an outside view. Understanding the differences between the two is important because they can often be confusing to separate. One way to handle both of these different mental health issues is through Acceptance and Commitment Therapy (ACT), where the focus is more on changing our relationship with those thoughts so they have less control over our lives.
Health Anxiety: What does it look like?
Health anxiety involves a persistent fear of having or developing a serious medical condition even if there is no evidence for it. But, what exactly would that look like? The following could be ways that health anxiety can show up for somebody:
- Frequently checking their body for signs of being sick.
- Become highly attuned to normal bodily sensations, interpreting them as dangerous.
- Fixating on the smallest little blemish or spot on their body.
The main concern is the possibility of having an illness. Your mind becomes convinced that having your health be out of your control and uncertain is unacceptable. Usually, once people who have health anxiety receive the ‘all clear’ from a doctor, the anxiety tends to gradually ease.
How does OCD look similar?
OCD can also involve fears about health, especially when it comes to contamination OCD. However, the underlying process is different in people who have been diagnosed with OCD.
In OCD, intrusive thoughts, also known as obsessions, create significant anxiety, and the person performs behaviors or mental rituals, also known as compulsions, to help try to reduce the distress they can be feeling. Someone with health-related/contamination OCD may:
- Constantly monitoring bodily sensations.
- Repeatedly ask others if they think something looks wrong to seek reassurance.
- Googling their symptoms for lengthy periods of time.
- Mentally review every physical sensation from the day.
People with OCD may also experience what can be described as a core fear. A core fear is a deeper fear or concern that sits underneath the obsessive thoughts and compulsions. These fears can vary significantly from person to person and may involve themes such as death, abandonment, uncertainty, or being a “bad” person.
While health anxiety is mostly driven by fear of illness, OCD is driven by the inability to tolerate uncertainty, especially with things outside of our control. The compulsion doesn’t solve the problem, it helps temporarily reduce anxiety, reinforcing that OCD cycle, and leads you back into those feelings of intense anxiety.
How does ACT approach these topics?
ACT doesn’t ask people to convince themselves that nothing is wrong. Instead, it encourages people to notice their anxious thoughts without immediately holding on to that belief.
For example, instead of: “This headache has to mean that I have a brain tumor.”
ACT suggests: “I’m noticing my mind is trying to tell me a really scary story about this headache.”
This helps create some distance away from those thoughts. This helps the thought feel less like a fact. It becomes simply something that your brain is trying to tell you, because our brains love to tell us stories. From there, the goal becomes choosing actions based on our personal values rather than choosing our actions based out of fear and worry.
How do you break free from the cycle?
Whether someone struggles with OCD or Health Anxiety, reassurance often feels helpful, but then the fears creep back up. Especially with OCD, the need to seek reassurance comes back to the forefront and tries to dictate all decisions. ACT helps you learn a different response.
Instead of fighting our thoughts or chasing after certainty, you can practice making space for discomfort while continuing to move toward the life you want to live. Over time, anxiety loses a lot of the hold it has on us. Not because it completely goes away, but because it no longer controls every decision that we want to make.
Related Articles
- Who Really Am I? Identity, Values and Sexuality Explored Through an ACT Lens
- OCD Awareness Week: Understanding, Reframing, and Reclaiming Control
- Your Dermatologist Might Be the First Person to Notice Your OCD
- Therapy Does Not Have to Look Like Two People Staring at Each Other
- Understanding Body-Focused Repetitive Behaviors (BFRBs) in Children
- I’m Successful But Exhausted: Understanding High-Functioning Anxiety in Your Career
- World Panic Day
- Ask a Therapist: Panic Attacks
- Let It Rain: Practicing Acceptance on National Rain Day
If you or someone you know could benefit from support, Pillars of Wellness is here to help. Our OCD & Anxiety Exposure Services team works with people navigating intrusive thoughts, compulsions, and health-related fears. Please visit pillarsinspires.com or call (219) 323-3311 for more information or to schedule an intake. Most insurances are accepted.
Related Articles
- Who Really Am I? Identity, Values and Sexuality Explored Through an ACT Lens
- OCD Awareness Week: Understanding, Reframing, and Reclaiming Control
- Your Dermatologist Might Be the First Person to Notice Your OCD
- Therapy Does Not Have to Look Like Two People Staring at Each Other
- Understanding Body-Focused Repetitive Behaviors (BFRBs) in Children
- I’m Successful But Exhausted: Understanding High-Functioning Anxiety in Your Career
- World Panic Day
- Ask a Therapist: Panic Attacks
- Let It Rain: Practicing Acceptance on National Rain Day
If you or someone you know could benefit from support, Pillars of Wellness is here to help. Our OCD & Anxiety Exposure Services team works with people navigating intrusive thoughts, compulsions, and health-related fears. Please visit pillarsinspires.com or call (219) 323-3311 for more information or to schedule an intake. Most insurances are accepted.