The four stages of health anxiety, as illustrated by the coronavirus outbreak
Well, the good news is that neither Terry nor I succumbed to Max’s Hand, Foot & Mouth disease a couple of weeks ago. I did get YET ANOTHER freaking cold (and Terry still has the one he started a few weeks ago…), which allows me to continue my unbroken streak of Being Ill Almost Constantly Since November, but, having seen how rough the HF&M was on poor Max, I think we got off pretty lightly, all things considered.
The bad news, meanwhile, is that it doesn’t really matter, because we’re all going to die from coronavirus now, apparently: or so it would seem from some of the news reports I’ve been reading, anyway.
Now, important disclaimer here: I suffer from health anxiety , and health anxiety has a way of making it completely impossible to rationalise risk, once the anxiety has been triggered. And, wow, has it been triggered.
If you don’t suffer from health anxiety, of course, this post is probably not going to make much sense to you: I just want to put that out there right from the very start, so you don’t waste ten minutes of your life reading something that will just end up annoying you. I mean, if you’ve even made it this far, you’re probably already itching to jump in and tell me that I’m more likely to die in a car crash than by catching coronavirus, or that there’s no point worrying about it, because everything happens for a reason, and worrying won’t help, and so on and so forth.
(If you ARE thinking of saying any of things I will respectfully ask you to read this post first, please and thank you. ) (I’ll also just quickly point out that, like many health anxiety sufferers, I have an answer for EVERYTHING, and you will not like my answers, so … can we just NOT?)
If, on the other hand, you DO suffer from health anxiety – or are prone to ANY kind of anxiety, really – I’m guessing you just might relate to my feelings of terror right now, because, guys? I. AM. TERRIFIED. In fact, I’m beyond terrified. Like, there’s ‘Terrified’, there’s a few thousand miles of road, then there’s me. And I’ve basically reached the stage where my immediate family members don’t want to talk to me about The Terror any more, so I’m going to talk to the internet instead. Please don’t hate me.
the current coronavirus situation – or my reaction to it, rather – is a perfect example of how health anxiety works
As well as writing about this in order to hopefully connect with fellow sufferers who understand what it’s like to live with health anxiety, though, it also occurred to me that the current coronavirus situation – or my reaction to it, rather – is a perfect example of how this kind of anxiety works. For instance, there are several distinct elements of health anxiety which have been coming into play for me lately, and they include things like…
OBSESSIVE / COMPULSIVE BEHAVIOUR
When my health anxiety was first diagnosed, the doctor explained to me that it’s actually classed as a form of OCD (Obsessive Compulsive Disorder). I was a little surprised by that at first, because, like many people, I’d always assumed OCD referred to people who wash their hands constantly, or like to keep their houses super-tidy. (Spoiler alert: NO, IT ISN’T.)
When I really thought about it, though, I realised that it makes perfect sense to classify it like that. In most cases, the OCD element of my health anxiety manifests itself as an obsessive compulsion to check for symptoms: so, if I notice a pain in my leg when I stand in a certain position, for instance, I will repeatedly stand in that position, to see whether or not it’s going to happen again. I’ll basically be doing this in a bid to reassure myself that the pain I felt was just a one-off, and has now disappeared, but, of course, by constantly doing the thing that aggravates it, I will generally just make it worse – which, in turn, makes my anxiety about it worse… and so it goes on.
In the case of the coronavirus outbreak, meanwhile, there are no physical symptoms to check (So far, at least: my current cold started long enough before there were any confirmed cases in the UK for me not to be worried about it, but, obviously any new illnesses that spring up from this point on are going to send my anxiety spiralling…), so the OCD element has manifested itself in obsessive monitoring of the news about the virus, instead.
the OCD element has manifested itself in obsessive monitoring of the news about the virus
Over the last few weeks, I’ve been refreshing news websites constantly: poring over every piece of information I can find, and then looking for more. I’m doing my best to try to stop this, because I know it only makes the anxiety worse – trust me, I KNOW – but there have been times when I’ve been picking up my phone to check the news every ten minutes or so: which is ridiculous, I know, but, again, I’m constantly hoping I’m going to read something that will reassure me… and constantly finding something that only serves to feed the anxiety, itself.
Now, I know perfectly well that I shouldn’t be doing this. The first rule of health anxiety, after all, is don’t talk about health anxiety THOU SHALT NOT GOOGLE… and the second rule of health anxiety is, NO, SERIOUSLY, STEP AWAY FROM DOCTOR GOOGLE, I’M NOT GOING TO TELL YOU AGAIN, WOMAN.
In the case of coronavirus, of course, hitting up Google is a particularly bad idea, because the reporting from some sectors of the media has been irresponsible to say the least. That’s the thing about a compulsion, though: it’s … well, compulsive. So I read the news, and then I refresh it to see if it’s changed, and, when I’ve done refreshing news sites, I move onto forums: because if the World Health Organization can’t reassure me on this one, there’s a good chance Marjorie from Cardiff will be able to do it, on a thread called, ‘Should I bulk-buy face masks, or just kill myself because we’re all going to die anyway?” Amiright?
So: videos of people apparently dropping dead in the street. Rumours of global conspiracies and cover-ups. Scare-mongering “news” reports which you think are going to contain actual information, but which turn out to basically just be about what random people on Twitter have been saying. Forums filled with people who are stockpiling resources and buying up facemasks in preparation for the end of the world. Other forum threads in which people say the facemasks are useless, and, also, will most likely be sent from China, so if you buy one, you’re basically paying to have Amazon deliver your coronavirus. Endless Amazon reviews of facemasks. More videos: this time of doctors and nurses claiming the situation is far, far worse than we’re being told, and that we’re now facing a Walking Dead scenario, only without Daryl and his trusty crossbow to save us.
And so on and so forth.
Honestly, I think all of this would scare someone who ISN’T predisposed to anxiety, if they were exposed to enough of it. As for me, meanwhile, I have exposed myself to a LOT of it. Like, I could probably go on Mastermind with, ‘Unsubstantiated Rumours About Coronavirus’ as my specialist subject at this point. And, once I’ve scared myself witless with all of the forums, and the conspiracy theories, and the tabloids, I move onto Phase 2:
Another big element of health anxiety for me is the Seeking of Reassurance from People Who Aren’t Actually Qualified to Give Reassurance, But Hey, Let’s Ask Them, Anyway! I’ve no idea why I capitalised all of that, but I guess it just seemed important enough for it, so let’s just run with it.
This phase is, of course, merely an extension of the first one, but, instead of looking for “facts” online (I’m putting the word “facts” in inverted commas here, because it’s not often you find the words “facts” and “online” in the same sentence, is it? I mean, I might be terrified, but I’m not insane…), I extend my mission to include Other People, who, sorry if you’re one of them, will now be called upon to reassure me over and over again, until either the scare is over or we all die of old age/coronavirus/whatever comes first.
This phase is particularly annoying for the Other People involved, because I will ask for their reassurance, but – and here’s the kicker – I WILL NOT BELIEVE IT when it’s offered. In fact, I will most likely argue with it, citing all of the “evidence” I’ve gathered in my fact-finding mission above, and also that one video I saw on Twitter that everyone said was most likely fake, but WAS IT REALLY, THOUGH?
“BUT YOU HAVE A MUCH HIGHER CHANCE OF CATCHING REGULAR FLU!”
Yes, and I worry about that too: there is, however, a vaccine for that, and we all get it. No, it doesn’t protect us from ALL strains of flu, but it does give me peace of mind about quite a few of them, and somehow makes me worry less.
“BUT MORE PEOPLE DIE IN CAR ACCIDENTS THAN HAVE DIED FROM CORONAVIRUS!”
Yes, but car accidents aren’t infectious, and viruses are: not really the same thing, are they?
(I should add here that not all health anxiety sufferers seek reassurance exclusively from people who aren’t qualified to give it, obviously: some seek advice from doctors, and other health professionals, but, well, we don’t really believe them either, so the end result is always the same, and Marjorie from Cardiff – or any other random forum poster – is still held to be the Ultimate Authority on all things health-related…)
Why are we more likely to believe the people who confirm our fears than the ones who refuse to? It’s a good question: if you figure it out, please let me know…
The advice I always give to fellow health anxiety sufferers is to try to resist asking for reassurance, because all it does is make people hate you.
The advice I always give to fellow health anxiety sufferers is to try to resist asking for reassurance, because all it does is make people hate you. I obviously don’t feel the need to take my own advice on that, though, so if you happen to have seen me in the past week or so, and I’ve casually tried to bring coronavirus into the conversation, so I can find out if you think we’re all going to die or not, I am so very sorry, seriously.
(DO YOU, THOUGH?)
INTRUSIVE THOUGHTS / CATASTROPHIZING
Of all of the things that suck about health anxiety, I’d say the intrusive thoughts are my least favourite. They kill the joy in everything. So, these days, as I’m playing with my son, or watching TV, say, my mind will be endlessly cycling through all of the possible scenarios in which one or all of us contracts coronavirus and dies. It’s a real buzzkill, to be totally honest.
There are many of these scenarios, each one more terrifying than the last, and while it’s easy enough to be all, “Well, just stop thinking about them, then, dumbass!” it’s unfortunately not QUITE as easy to actually do that.
I have no idea how to stop The Thoughts. Yes, I’ve tried CBT. Didn’t work. And don’t even get me started about yoga , or mindfulness, or whatever it is you’re about to suggest. Trust me, if I knew of a way to stop myself worrying, and catastrophizing, and thinking all the damn time, I would definitely be doing that. It’s not like I’m sitting here thinking, “Well, I could either be totally chill about this, and not give it a second thought, OR I could whip myself into a frenzy in which I will struggle to function because of The Panic. I think I’ll go with The Panic! It’s not like I actually needed to be able to function normally after all, is it?”
(No, worrying doesn’t help, you’re right. We don’t worry because we think it’s going to help, though, do we?)
The big problem here, of course, is that the intrusive thoughts can ALSO get caught up in the OCD cycle, and, when that happens, there’s really only one thing for it:
Panic accompanies every stage of health anxiety, obviously, and it’s THE WORST, really, isn’t it? Once you’re firmly in the grip of a health anxiety attack, though, it’s easy to feel like panic is the only reasonable response: like, I genuinely don’t understand why everyone isn’t panicking right now. How are you all just sitting there reading this stupid blog post when the world is about to end? HOW?
My pet hate here is the sheer number of people who’re just all, “Oh, it’s fine: it’s just the over 65s and people who are immunocompromised who are at risk from it, so I’m not worried!” Which, I mean, cool, I’m glad you’re alright, Jack, but my parents are both over 65, my husband is immunocompromised , and I know no one’s mentioned toddlers specifically, yet, but my child is only 2, and I. Am. Terrified: not because I’m worried that this virus will kill me, but because I’m worried that it will kill all of them, and I’ll be the last woman standing basically.
So, right now, I’m in a state of barely-controlled panic: to the extent that I really wanted to keep Max home from nursery today, and would 100% have done it if Terry hadn’t been there to talk some sense into me. (I did, however, convince him to add some canned goods and paracetamol to the online shop this week. So that’ll help.)
right now, I’m in a state of barely-controlled panic…
I obviously (OBVIOUSLY) understand the importance of hand washing and other good hygiene practices, but, while that might help me, again, it’s not really me I’m worried about: it’s my nursery-attending two-year old, who isn’t old enough to be trusted to use a tissue then dispose of it responsibly, and whose hands are permanently in his mouth. Given that his nursery staff won’t have the time to wash his hands every time he touches something someone might have sneezed on, and also given that our entire family has been ill almost constantly since he started there (Events which I suspect are not unrelated…)… yeah, I’m worried. Er, just in case you hand’t worked that out by now…
There is, of course, a 5th stage of health anxiety, and it’s the one that involves standing down the vigil, and moving on. It’s just… we obviously haven’t reached that stage with this one, yet. So, tell me: are there any other health anxiety sufferers out there? How are you coping?