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Is COVID-19 turning you into a hypochondriac?

Experts weigh in on how you can prevent illness-related anxiety from impacting your mental health.
COVID HYPOCHONDRIAC
During the pandemic, a scratchy throat or sniffle can easily cause us to spiral into anxiety.Jenny Chang-Rodriguez / TODAY illustration / Getty Images

In pre-pandemic times, calling your doctor over a cough and sore throat may have seemed over-the-top. COVID-19 has flipped those norms entirely.

Precautions like masking outside of your home, washing or sanitizing your hands after touching anything, avoiding public spaces and limiting socialization, are appropriate. Taking every single cough and sniffle seriously is responsible.

Given all of these changes in our everyday routines, we might be feeling a little extra anxiety when it comes to taking care of our health and well-being, added Craig Sawchuk, Ph.D., psychologist and co-chair of Mayo Clinic’s Division of Integrated Behavioral Health. “It’s normal not to feel normal right now.”

This makes deciding what constitutes too much worry hard to say right now.

“It’s going to take some settling out in the — hopefully — months to come before we decide nationally and globally, what are the precautions we need or want to take in a post-pandemic future? What will the new norm be?” said Trevor Schraufnagel, Ph.D., a clinical psychologist in private practice and clinical assistant professor and associate director of the Anxiety Disorders Clinic in the psychiatry department at UCLA.

Maybe the handshake will become a relic of the past; masks might not be so ubiquitous, but may be a must for air and train travel.

But it’s important to acknowledge that pre-pandemic, during this health crisis, and after we see it through, no matter what the “norm” is, illness-related anxiety can be a problem in and of itself — and you can get help to cope with it. Here’s what you need to know:

Worries about your health can turn into a problem themselves

In its most recent update to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the American Psychiatric Association (APA) replaced the diagnosis of hypochondriasis (health anxiety) with two separate diagnoses: illness anxiety disorder and somatic symptoms disorder.

Illness anxiety disorder is excessive concern or worry about having or getting a serious condition when symptoms are minimal or absent. Somatic symptom disorder is excessive worry or concern about symptoms that are present. While the physical symptom (like pain or fatigue) is actually present, the individual’s worry or concern over those symptoms is excessive given whatever the individual’s actual diagnosis is for those symptoms.

What the two conditions share is the serious preoccupation with having an illness and being very tuned into health status, Schraufnagel said. “The distinguishing features of these as health disorders is that they’re persistent, highly distressing and impairing.”

It’s normal not to feel normal right now.

Taking extra safety precautions during the pandemic doesn’t mean you have a disorder

Just because you’re washing your hands a lot or sanitizing surfaces in your home more than ever before doesn’t mean you have an anxiety disorder. “Again, it is normal not to feel normal right now,” Sawchuk said.

But there is a point when you can go overboard on safety precautions — even when it comes to COVID-19, he added. “Excessive handwashing or sanitizing to the point of damaging your skin or being so overwhelmed with worry and fear to the point you cannot keep up with day-to-day responsibilities is detrimental to your health.”

Consider whether the precautions you’re taking are affecting your day-to-day functioning, Schraufnagel said. If the measures you’re taking or the distress you’re feeling about COVID-19 risk are interfering with your relationships, sleep, diet or job, you might benefit from talking to your physician or a mental health provider to help manage your anxiety, he said. “There are ways to stay safe from viruses that don’t require a person to experience an anxiety disorder.”

Talking with your primary care provider is a good place to start, Schraufnagel said. Primary care physicians often have some mental health training and can refer you to a specialist if they think you’d benefit from additional expertise. They can also help you understand what health and safety precautions are reasonable and safe to follow.

How to keep anxiety in check, while still protecting your health

It felt somewhat uncomfortable and challenging to ramp up many of the safety precautions we’re taking now, and it’s likely going to feel somewhat uncomfortable easing up on some of them when it becomes appropriate (and recommended by experts) to do so, too, said Schraufnagel.

Here are some tips for not letting the anxiety around it affect your health:

  1. Follow the science. “It’s important that everyone take their lead from public health experts in terms of when it’s safe and encouraged to begin shedding certain habits, like physical distancing or use of masks,” Schraufnagel said.
  2. Take it slow. When the recommendations change, for many people it will be easier to get comfortable with the changes if we make them gradually. We’re not going to go from strict lockdown to crowded concert venues and sports arenas overnight. Similarly, changing personal precautions and decision-making in a measured and gradual manner will likely help prevent unnecessary anxiety and distress, too, Schraufnagel said.
  3. Use people in your life as sounding boards. Talk to your friends and family if you find yourself worrying more about your health more than usual. Is your threshold for being alarmed about your health skewed or is it on par with the general sentiment among your friends and family?
  4. Pay attention to where you’re getting your health information from. Not everything you read online is backed by research. Fruitless online searching of symptoms more often than not backfires on individuals and causes more anxiety about either existent or nonexistent symptoms, Sawchuk added.
  5. Get help if you need it. There are evidence-based treatments that have been shown to be highly effective in managing these conditions and lessening their impact on people’s lives, Sawchuk said. Cognitive behavioral therapy (CBT) — a type of psychotherapy that teaches you skills to manage your anxiety — is a mainstay of treatment for each condition; medications used in tandem with CBT can also help.