‘Is My Fear Irrational?’ Managing Illness Anxiety in COVID Times
When the looming threat of the illness is so real, how can you tell if your fear is irrational?
Do I have a fever? I’m sure I have a fever.
Am I getting a sore throat? Was that one of the symptoms?
Did someone just cough? I’d better stay home.
I should wash my hands. And my clothes. What about the groceries?
These were some of the thoughts I was having back in December 2019. Yes, before the first case of COVID infection was even confirmed in India in January 2020.
Needless to say, things have only gotten worse since, for the world, and also my old buddy, illness anxiety, who’s been visiting me a lot more frequently.
Anxiety and stress are very much appropriate responses to a pandemic that is constantly threatening our safety and wellbeing and that of our loved ones.
“Anxiety and stress have both escalated in people during this time,” says Dr Kamna Chhibber, Head, Mental Health and Behavioral Sciences at Fortis Healthcare.
Naturally, the uncertainties of the time, the lack of enough reliable information, sometimes too much information, and not knowing how the future will look, have taken a toll on all our mental health.
But, says Dr Kamna Chhibber, “This becomes a problem when it starts hampering your functionality.”
But before we get into it, let's look at what it is.
What Is Illness Anxiety?
Illness anxiety or hypochondriasis’ is a persistent preoccupation with the possibility of having one or more serious, progressive, or life-threatening diseases.
According to Mayo Clinic, some signs of illness anxiety include getting easily alarmed about the status of your health, and repeatedly checking your body for signs of illness or disease.
Someone with illness anxiety is hypersensitive to the changes in their body, perceiving even the most benign sensations as a symptom. This is followed by one frantic google search after another, or frequent appointments made with doctors.
Having a bout of illness anxiety doesn’t mean you’re not sensible, rational or logical. It doesn’t mean you’re overreacting either. Because when your mind is convinced you’re going to die, there isn’t much reasoning you can do.
Now Throw a Global Pandemic Into the Mix
Earlier on—I’ll call it pre-COVID times— I could still manage to walk back from the feeling when the familiar intense fear caught hold of me.
It was hard, but I could reason with myself that the threat was only an imagined one. ‘No, I’m not having a heart attack’, ‘no, that is not a tumour’, and ‘no my appendix is not about to burst’.
But as hard as it was before, now when the threat of the illness looming over our heads is so very real, it’s almost impossible to do so.
To paint you a picture of what happens when you put someone with illness anxiety in the global pandemic scenario, I spent the better part of the first few weeks of the lockdown channeling lady Macbeth, incessantly washing my hands, and cleaning every surface. The rest of the time was spent tending to the reddened blotches of rashes on my hands from over scrubbing them.
A few months in, I was still scrolling through my phone at night, ceaselessly skipping from article to article, looking at numbers and graphs and curves that were only getting steeper and steeper.
Now with the threat of a second wave looming on the horizon, new variants being discovered, not knowing when I might get the vaccine, and flu season bringing in all these ‘COVID-like’ symptoms, things have taken another nosedive.
Getting Caught in a Vicious Circle
It sounds like something that should be obvious, but the pandemic has forced us to confront just how interconnected our mental and physical selves are, and how profoundly the wellbeing of one affects the other.
In people with illness anxiety, this connection becomes all the more apparent.
A random pain opens up a flood gate of anxious thoughts which further perpetuates the pain, making you sicker.
And no, it’s not always just ‘in your head’.
Dr Ritika Aggarwal, Consultant Psychologist, Jaslok Hospital & Research Centre, Mumbai, talks about the havoc that stress can wreak on your immunity.
She talks about the influx of cases she’s had of people coming into the hospital, convinced they have COVID or are so afraid of catching it that they actually ‘worry themselves sick.’
“I had someone come in with a fever who was convinced she had COVID even though her tests came back negative,” says Dr Aggarwal. She goes on to talk about how she worked with her patient, having her do certain mindfulness exercises over multiple sessions before she was able to make a breakthrough.
She also talks about another instance of a woman who kept falling sick and kept getting tested for COVID, until they figured out that her symptoms were stemming from her constant fear of falling sick itself.
…And Finding Way to Break Out of It
Dr Aggrawal and Dr Chhibber tell us how to cope with illness anxiety during a pandemic, and how to keep the intrusive thoughts from taking over.
Watch what you watch
The first thing Dr Aggrawal talks about is keeping a check on the content you you’re consuming.
“We figured out that one of her (patient A’s) biggest triggers was TV, and especially news. So the first thing we did was limit her TV timings and ensured she was being more mindful of what she was watching.”Dr Ritika Aggrawal, Consultant Psychologist, Jaslok Hospital & Research Centre, Mumbai
She recommends setting a fixed ‘TV time’ schedule.
Technology allows us to get direct access to the latest stats, updates, and developments, and while this is very helpful in keeping up with the situation, the barrage of information can be very overwhelming, says Dr Kamna Chhibber.
People with illness anxiety will have the tendency to seek more and more of it, which can lead them further down a rabbit hole of worry and stress.
For this reason, “it is also important to know when to stop and restrict information,” she adds.
Give Dr Google a break
It’s especially important to be mindful of the time you spend on the internet, and to stop and fight the urge to continue, whenever you catch yourself going down the rabbit hole of googling your symptoms and self-diagnosing.
Keep note of your reactions
According to Dr Chhibber, something else that can help is acknowledging that you have a tendency to have a heightened reaction to possible symptoms.
“Take a step back, and remind yourself of all the previous times you have felt this way, and it was a false alarm.”Dr Kamna Chhibber, Head, Mental Health and Behavioral Sciences at Fortis Healthcare
Dr Aggrawal goes on to suggest keeping a diary and noting down how often you are having these bouts of anxiety and what ‘symptoms’ are causing it, along with your reaction to them. Going back to this list, can be helpful the next time you feel overwhelmed with worry.
Trust your doctor
Dr Aggrawal suggests keeping a track of the symptoms and your level of risk. “If you think you’re at high risk, get yourself tested. But make sure you first consult with a doctor.”
But don’t rely on reassurance
Dr Chhibber talks about how seeking reassurance from the people around you can be counterproductive.
Constantly looking for reassurance can create a dependency, “making you feel like only reassurance can help ease your mind. this can actually perpetuate the problem,” she says.
Focus on what you can control
“Feeling a sense of control is very important,” says Dr Aggrawal. “People with anxiety usually tend to spiral when they start thinking about things that are beyond their control.” Like, perhaps the spread of an infections virus?
“Refocus your thoughts, make schedules and occupy yourself with things that are in your control. When you keep yourself busy, you’re less likely to dwell on symptoms.”Dr Ritika Aggrawal, Consultant Psychologist, Jaslok Hospital & Research Centre, Mumbai
This also included taking walks and spending at least some time in the day exercising.
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