Maybe it starts with a headache that feels slightly different than your usual headaches.
Or you notice your heart beating strangely for a second. You feel dizzy when you stand up or some fatigue. There’s a pain in your side you don’t remember having yesterday. You find a lump, notice a twitch, or suddenly become aware of a sensation that you can’t seem to stop noticing.
And then comes the thought:
What if something is actually wrong?
You try to move on, but your attention keeps returning to it. You check the area again. You Google the symptom. You read a few reassuring explanations but inevitably find a frightening one too.
Now you’re paying even closer attention to your body.
Maybe you ask your partner, “Does this seem normal to you?” You make a doctor’s appointment. Your doctor isn’t concerned, and for a little while you feel better.
Until you notice something else. And you think about the person you heard of who was written off by Doctor’s only to find out she had stage 4 cancer the whole time.
Another thought appears:
What if they missed something?
If this sounds familiar, you might be experiencing health anxiety.
And I understand how convincing health anxiety can feel not only because I specialize in treating anxiety disorders, but because I have experienced health anxiety myself.
There was a time in my own life when health-related fears took up far more mental space than they do today. Going through therapy and learning how to respond differently to those fears changed that significantly for me. Looking back, one of the biggest differences isn’t simply that I worry less. It’s how much more room I have in my life when I’m not constantly trying to make absolutely sure that I’m okay (or that my kids are okay).
That experience has influenced the way I understand and treat health anxiety today.
Health Anxiety Isn’t “Imagining” Symptoms
One of the most frustrating things someone with health anxiety can hear is some version of:
“It’s just anxiety.”
Because you really did feel the heart palpitation.
Your headache really does hurt.
The dizziness happened and the sensation of vertigo.
Your stomach really does feel strange.
Health anxiety does not mean that every physical sensation you experience is imaginary or caused by anxiety. Human bodies produce an enormous number of sensations every day, and sometimes we experience legitimate symptoms that deserve medical attention.
The difficulty with health anxiety is often what happens after we notice the sensation.
Consider two people who experience the same brief heart flutter.
One thinks:
That was weird.
And continues making dinner.
The other thinks:
Why did my heart just do that?
Then:
Could that be an arrhythmia?
Then:
What if something is wrong with my heart? Maybe that is why I have been feeling so tired lately.
Now her attention is focused inward. She notices her heartbeat more. Anxiety activates her nervous system, which may cause her heart to beat faster or harder.
The new sensations feel like additional evidence of impending major medical diagnosis or death.
The cycle often starts and is reinforced in this way.
The Meaning We Give a Sensation Can Change What Happens Next
This is one of the concepts I find most important in working with health anxiety. We often assume the physical sensation causes the anxiety. Sometimes it does.
But very often, our interpretation of the sensation is what keeps the cycle moving. A sensation occurs. Your brain interprets it as potentially dangerous. You become anxious. Anxiety creates additional physical sensations. You monitor those sensations more closely. As therapists we call this “overly internally focused”. You find more things to notice. Your brain interprets those sensations as further evidence that something could be wrong.
Before long, a sensation that lasted three seconds has consumed 45 minutes of your day. And because anxiety is uncomfortable, your brain naturally looks for a way to make the uncertainty disappear.
That’s where checking and reassurance come in.
“I Just Want to Make Sure”
Health anxiety can be surprisingly good at disguising itself as responsible behavior.
I’ll just Google it once.
I’ll check the lump one more time.
I’ll ask my husband what he thinks.
I’ll send my doctor a message just to be safe.
I’ll check my heart rate again.
I’ll make one more appointment, and then I’ll let it go.
Sometimes checking is completely appropriate. We should pay attention to our health.
But with health anxiety, the goal of checking often changes. You’re no longer gathering information so you can make a reasonable decision. You’re trying to make the anxiety disappear.
And it usually works… for a little while.
Your partner tells you they’ve experienced the same thing. Your doctor says they’re not concerned and maybe tell you to drink more water and add some electrolytes. Your Google search turns up a benign explanation (sometimes).
You feel the tension leave your body. That relief is powerful. And it also teaches your brain something you probably didn’t intend to teach it:
When I feel uncertain about my health, I need to check in order to feel safe. The next time uncertainty appears, your brain asks you to check again. This is how reassurance can become part of the problem even though it feels like the solution.
Health Anxiety Can Quietly Make Your Life Smaller
When people think about health anxiety, they often picture someone Googling symptoms. But that’s only one part of it. What concerns me clinically is how much life can begin organizing itself around the possibility that something might be wrong.
You might stop exercising because you’re afraid of your heart rate increasing. You may avoid travel because you worry about being far from your doctors. You might struggle to be fully present with your children because part of your attention is constantly monitoring your body.
A news story about cancer can affect the rest of your day. Someone else’s diagnosis can suddenly feel like evidence about your own health. You might avoid scheduling a doctor’s appointment because you’re terrified of what they’ll find, while simultaneously thinking about your health throughout the day.
You can be sitting at dinner with people you love while mentally reviewing symptoms. That’s the part of health anxiety I wish we talked about more. It’s not only about fear.
It’s about how much attention, time and freedom the fear takes from you.
That’s also why recovery can be so meaningful. Getting my own health anxiety under control didn’t mean I became someone who never worries about my health. I still have a human brain, and human brains worry.
The difference is that those thoughts don’t have the same authority they once did. I don’t have to answer every question anxiety asks me. And that has had a real impact on my quality of life.
Why Health Anxiety May Show Up Differently for Women
Health anxiety can affect anyone. But in my work with women, I also think it’s important to consider the context in which these fears develop.
Women’s bodies go through significant changes across the lifespan. Menstrual cycles, pregnancy, postpartum changes, fertility experiences, perimenopause and menopause can all introduce new or changing physical sensations.
Many women are also carrying responsibility for other people’s health. Once you become a mother, for example, health anxiety may no longer be limited to your own body.
What if something happens to my child?
What if I miss a symptom?
What if the pediatrician is wrong?
For other women, the anxiety makes complete sense in the context of what they’ve lived through. Maybe someone you loved became seriously ill. Maybe a diagnosis was initially missed. Maybe you’ve experienced a medical emergency or witnessed this occur to a loved one. Maybe you watched a parent die from an illness and now find yourself scanning your own body for signs of the same thing.
Or perhaps you have had the experience of raising a medical concern and feeling dismissed.
Your brain learns from experience.
If life has taught your nervous system that terrible medical events can happen unexpectedly, hypervigilance (that is being overly on-guard) may start to feel like protection.
There is compassion in understanding that. We don’t need to shame the anxious part of your brain for trying to protect you. In fact, I constantly tell clients “these parts are brilliant! They are trying so hard to protect you. Let’s be curious with them, let’s learn to connect with them in a new way.” Because while all parts are welcome, we also don’t have to let them run your life by accident.
You Might Now Like This: But The Goal Isn’t to Convince You That You’re Healthy
This is an important distinction in how I approach health anxiety treatment.
My job as a therapist isn’t to convince you that you’re healthy. In fact, repeatedly reassuring someone that nothing is wrong can accidentally recreate the same reassurance cycle we’re trying to change.
The harder truth is also the more freeing one: None of us can achieve absolute certainty about our health. None of us. And sometimes our Doctors might miss things in bad ways. But do we want to live our life in fear and suffering while we are alive?
We can take reasonable care of ourselves. We can attend medical appointments. We can follow recommendations from qualified healthcare professionals. We can seek evaluation when something reasonably warrants evaluation.
And after we’ve done those things, there will still be some uncertainty.
Health anxiety says:
Keep checking until you’re certain.
Treatment teaches:
I can make reasonable decisions about my health without requiring complete certainty.
That is a very different goal.
How CBT and ERP Help Break the Cycle
At North Shore Professional Therapy, we specialize in the treatment of anxiety and trauma, and have advanced training in evidence-based approaches such as Cognitive Behavioral Therapy (CBT) and Exposure and Response Prevention (ERP).
With CBT, we become curious about what happens between the sensation and the fear.
What did you notice?
What meaning did your brain immediately assign to it?
What are you predicting?
What happens next?
We aren’t trying to force positive thoughts such as “I’m definitely fine.”
That can become another form of reassurance.
Instead, we work toward more flexible thinking and a greater ability to recognize anxious interpretations without automatically treating them as facts.
ERP helps us work directly with the behaviors maintaining the anxiety.
If your brain has learned:
uncertainty → check → relief
we gradually practice a new pattern:
uncertainty → resist the checking behavior → allow discomfort → continue living
That may involve reducing Googling, delaying reassurance seeking, decreasing body checking, allowing certain physical sensations to be present without analyzing them, or returning to activities you’ve avoided.
This isn’t done recklessly, and it isn’t about ignoring legitimate medical advice. It’s structured therapeutic work designed around your individual fears and behaviors. Over time, your brain can learn something incredibly important:
I can feel uncertain and still be okay and move on with my day.
Not because you’ve proven that the feared outcome could never happen, but because you’ve discovered that you don’t have to organize your life around preventing every possible threat.
“But How Will I Know When I Actually Need a Doctor?”
Almost every person with significant health anxiety eventually asks some version of this question. It deserves a thoughtful answer.
Treating health anxiety should never mean ignoring legitimate health concerns. We want you to have appropriate medical care. We want you to attend recommended screenings. We want you to follow the advice of your healthcare providers and seek medical attention when reasonably indicated.
The work is learning to recognize the point where appropriate healthcare ends and anxiety’s search for certainty begins. Sometimes the question isn’t:
“Should I ever get this checked?”
It’s:
“I’ve already gotten appropriate medical guidance. Why does my brain still need one more answer?”
That’s where therapy can be particularly helpful.
Recovery Doesn’t Mean Never Feeling Health Anxiety Again
I think this is worth saying because it’s something I understand personally. Success doesn’t require becoming a person who never has an anxious thought about her health again.
A strange sensation may still get your attention. A medical test may still make you nervous.Someone else’s illness may still bring up uncomfortable thoughts.
The change is in what happens next. You can notice the thought without automatically Googling.You can feel a sensation without spending the next hour monitoring it. You can receive reasonable medical reassurance without asking anxiety whether it would like a second, third and fourth opinion.
You can feel uncertainty and continue with your day.
For me, that has been one of the most meaningful parts of getting health anxiety under control. The biggest gain wasn’t simply fewer anxious thoughts.
It was getting more of my life back.
More attention for my kids. More ability to enjoy something without mentally checking my body. More freedom to let a strange sensation be strange without immediately needing to solve it. That’s what I want people struggling with health anxiety to know is possible.
Therapy for Health Anxiety in Massachusetts
At North Shore Professional Therapy, we work with women and teen girls experiencing anxiety, trauma and related concerns, including health anxiety.
We understand that health anxiety isn’t solved by someone telling you to “stop worrying.” If that worked, you probably would have done it already.
Instead, we help you understand the cycle your brain has learned, identify the behaviors that are unintentionally reinforcing it, and begin practicing new ways of responding using evidence-based anxiety treatment approaches. You are not in this alone.
When trauma, frightening medical experiences, loss, or other lived experiences are contributing to the anxiety, we make room for those too.
Our work will be tailored to your nervous system, your lived experiences, and the kind of change you want to create.
North Shore Professional Therapy offers in-person anxiety therapy in Topsfield, Massachusetts, and virtual therapy throughout Massachusetts.
You don’t have to become completely certain about your health in order to start feeling safe enough to live your life again.