Health Anxiety Treatment in Ireland | My Therapist

What causes Health Anxiety?

Vulnerability factors

When trying to understand how your health anxiety started, an excellent place to start is looking at underlying factors that might have made you more vulnerable to developing health anxiety.

• Did you have an illness as a child that might have made you more alert to symptoms in your body?
• The way you react to physical symptoms may make you more prone to developing health anxiety regarding how you think about the ailment. For example, can you brush it off, or do you go to the worst possible scenario? These are known as cognitive factors, which are treated effectively with CBT, and include Catastrophic Thinking where you interpret benign sensations or events as much worse than they are. For example, a slight cough might be seen as a sign of lung cancer.
• Did you grow up with an overly anxious parent who was excessively concerned about health?
• Did you grow up with a parent or close relative who had severe health conditions?

I think I have a good example that can show what I mean by vulnerability factors. I was diagnosed with chronic fatigue syndrome many years ago, which is still a bit of an anomaly, but seems to occur after an illness; it can post viral. In the early days of Covid- 19 when some people where not recovering as a new term came into our day to day language – long covid, I was terrified as I was aware I contracted something over 20 years ago that could still make me sick and didn’t not want to add another post viral condition. Perhaps because I am a psychologist I saw my own behaviour changing, my own underlying vulnerability factors of pre exiting health condition could have led me to developing health anxiety, if I did not see it coming.

While the exact cause of health anxiety is unknown, it is believed to result from a complex interplay of biological, psychological, cognitive, and environmental factors.

Environmental Factors

1. Exposure to Extensive Health-Related Media Coverage: Frequent exposure to news about diseases can heighten your health anxiety. Sensationalised media reports about health crises or outbreaks can amplify fears about personal health.
2. Traumatic Health-Related Events: Witnessing or experiencing a traumatic health event can trigger health anxiety. For instance, surviving a severe illness or accident can lead to ongoing fears about health and safety.
3. Social Media and Online Health Information Seeking: Constant exposure to health information and the habit of searching for symptoms online can worsen health anxiety. “Dr. Google” often provides alarming and inaccurate information, leading to increased worry.

Brain Functioning

I want to talk about new and merging research that can inform what we currently know about health anxiety, it sheds a different light on possible causes which hopefully give rise to new targeting treatments. In recent years, our understanding of health anxiety—or illness anxiety disorder as it is called now—has evolved to reflect a more nuanced picture of how the brain’s threat detection and worry circuits become dysregulated, as well as how innovative therapies are emerging to address these imbalances.

Brain Functioning and Overactivation in Fear and Worry Circuits
As I stated at the beginning of this article, Health anxiety often involves persistent fear and worry about having or acquiring serious illnesses. Neuroscientific studies suggest that this excessive concern involves hyperactivity within the brain’s threat circuitry, particularly in regions such as the amygdala, anterior cingulate cortex (ACC), and parts of the prefrontal cortex (PFC). If you haven’t already done so, watch my video at the top of the page as I discuss some pathways involved in health anxiety.

The amygdala and this overestimation of threat can be calmed down using different types of talking therapy, specifically CBT, particularly the behavioural part of CBT where you are teaching your brain over and over again until it habituates, that this is not a threat.

• Amygdala: The amygdala is crucial for processing fear-related cues. In individuals with high anxiety, this region can be hypersensitive, signaling alarm too frequently or too intensely. Learn more about the amygdala.
• Anterior Cingulate Cortex (ACC): The ACC is involved in error detection, conflict monitoring, and integrating emotional responses. Overactivation here may contribute to constant rumination over health worries.
• Prefrontal Cortex (PFC): The PFC normally exerts top-down control over emotional responses, helping dampen anxiety. In people with health anxiety, this regulatory capacity may be compromised, leading to intrusive worry and difficulty in rationally evaluating health concerns.

Specific Brain Mechanisms and the TrkC-PTP Protein Complex

This is a very interesting field of development, as we are living in an era of targeted therapy. I myself have been using what is termed, targeted nutrition, food that specifically helps my body and I am more than excited about targeted treatment for health anxiety, or any disorder for that matter.
On a molecular level, scientists² have increasingly focused on receptor-protein interactions and their roles in anxiety disorders. One notable recent discovery involves the TrkC-PTP complex:

• TrkC Receptor: A neurotrophin receptor involved in the development and function of the nervous system.
• PTP (Protein Tyrosine Phosphatase): Enzymes that remove phosphate groups from proteins, influencing how neurons signal and adapt.
  Studies suggest that abnormalities in TrkC-PTP signaling pathways could alter synaptic plasticity and stress responses, thereby impacting anxiety symptomatology. By better understanding how TrkC-PTP dysfunction contributes to anxiety, researchers hope to design more precisely targeted pharmacological interventions—medications that can modulate these specific molecular interactions and restore balance in neural circuits linked to worry and fear.

Why doesn’t it go away? 

Health anxiety will not go away on its’ own if you are unintentionally helping to maintain it.

At the start of this article, I stated that health anxiety shares characteristics of OCD in terms of obsessions and compulsions. The compulsions help in the short term but eventually keep you stuck with concerns about your health.

For example, if you have a headache and your mind jumps to the conclusion that it might be a brain tumour, it is understandable if you Google brain tumour symptoms.

This googling or seeking reassurance is a compulsion in that you feel compelled to do something to ease the fear that you might have a brain tumour. Compulsions like this only make you more anxious and further down a rabbit hole. Just like OCD, you need to learn to stop any compulsive behaviours to stop the cycle.

In addition, the more you worry about having an illness, the more likely you are to have similar thoughts in the future, as you are unknowingly ‘teaching’ your brain to do this. You are forming pathways in your brain, which I shall explain in the following video.