You notice a headache that’s been there a bit too long, a mole that looks slightly different, a heartbeat that felt off for a second…
And before you’ve even consciously decided to, you’ve typed it into Google.
40 minutes later you have a shortlist of conditions, at least 2 of which are serious, and you feel significantly worse than you did before you started. The reassurance you went looking for is nowhere to be found. Instead there’s a new question, a new symptom to monitor, and a hum of dread that follows you into the rest of your day.
If this is familiar, you’re not being dramatic. What you’re dealing with has a name, a mechanism, and importantly: a way through.
Health anxiety is a pattern of excessive worry about having or developing a serious illness, in the absence of medical evidence to support it, or disproportionate to any evidence that does exist (NICE, 2014).
It exists on a spectrum. At the milder end, it shows up as periodic googling, occasional reassurance-seeking from doctors or loved ones, and a tendency to notice and monitor physical sensations more than most people do. At the more significant end, it can organise entire days with monitoring symptoms, seeking repeated reassurance, avoiding anything that might trigger health-related thoughts, or conversely, compulsively checking the body for signs of illness.
What sits underneath it, in almost every case, is anxiety. The health content is where it’s landed, but the engine running it is the same threat-detection system that drives every other form of anxiety.
This is the part worth understanding properly, because it feels so counterintuitive.
When you’re anxious about a symptom, googling feels like the rational response. You’re seeking information, information should reduce uncertainty, reduced uncertainty should reduce anxiety.
Except that’s not what happens.
Google is not designed to reassure you. Medical information online is comprehensive, which means it includes rare, serious, and frightening possibilities alongside common, benign ones. Your anxious brain, already primed to scan for threat, doesn’t weight these equally. It finds the serious possibility and flags it (Salkovskis & Warwick, 1986).
Then comes the temporary relief: you read something reassuring and the anxiety drops briefly. But that drop is short-lived, because anxiety doesn’t respond to information the way we expect it to. It responds to certainty, and certainty about health is something medicine genuinely cannot always provide. So the relief fades, a new question emerges, and the cycle begins again.
Reassurance-seeking, whether from Google, from doctors, or from people around you, is a compulsion. It provides short-term relief and long-term maintenance of the very anxiety it’s trying to resolve (Salkovskis, 1996).
Anxiety produces physical symptoms: muscle tension, chest tightness, breathlessness, dizziness, nausea, palpitations, fatigue, headaches. All of these are well-documented physical manifestations of an activated nervous system (Barlow, 2002).
For someone with health anxiety, these symptoms become evidence. The chest tightness is monitored, headache is catalogued, fatigue scrutinised… Which creates a feedback loop: anxiety produces a symptom, the symptom feeds the anxiety, the anxiety intensifies the symptom.
This is one of the more cruel aspects of health anxiety. The thing you’re afraid of, something being wrong with your body, is partially being created by the fear itself. The physical sensations are real, they just don’t mean what health anxiety says they mean.
People with health anxiety are often very aware intellectually, that what they’re experiencing is likely anxiety. They’ve been told, they’ve told themselves, they know, on some level, that the googling makes it worse.
And they do it anyway.
This is because health anxiety, like all anxiety-driven patterns, isn’t primarily a thinking problem, but a nervous system problem. Knowing something intellectually doesn’t switch off the threat response. The amygdala doesn’t update its threat assessment because you’ve reasoned with it. It updates through experience, specifically, through repeatedly not getting the reassurance it’s looking for and learning, gradually, that the threat isn’t real (LeDoux, 2000).
This is why information alone -including this post- won’t resolve health anxiety. Understanding it is useful, but the actual shift happens through actually working with the pattern.
The evidence base for health anxiety includes CBT with particular focus on breaking the reassurance cycle, ERP for the compulsive checking and monitoring that maintains it, psychodynamic approaches that explore the deeper relational and historical roots of the need for certainty (NICE, 2014; Foa & Kozak, 1986), Transactional Analysis (TA) which explores relational patterns and ego states underlying the anxiety.
ACT approaches are also well-evidenced, particularly for the monitoring and avoidance patterns, learning to notice physical sensations without immediately attaching threat meaning to them, and to let uncertainty exist without needing to resolve it (Hayes, Strosahl & Wilson, 1999).
Clinical hypnotherapy can be a useful adjunct here, particularly for the hypervigilance to body sensations that keeps the cycle going, helping recalibrate the automatic alarm response that health anxiety depends on (Kirsch, Montgomery & Sapirstein, 1995).
The goal here is to change your relationship with what you notice. There’s a significant difference between being aware of physical sensations and being governed by them.
That shift is possible, it just rarely happens through googling.
If any of this resonates and you’re wondering whether therapy might help, you’re welcome to book a free 15-minute call to explore working together.
Not sure if therapy is right for you yet? Read: How to find the right therapist.
Integrative Therapist (Psychotherapy & Hypnotherapy), working with anxiety, relationships, habits & compulsions, and the not-enough feeling.
A 3-step free guide to understanding and interrupting repetitive patterns in your relationships, behaviour and emotional responses.
