Illness Related Anxiety
Illness-related anxiety attack is a form of anxiety that occurs after a person has experienced or been diagnosed with a serious illness, such as; any type of cancer, brain tumour, multiple sclerosis, HIV, Autoimmune Disorders, Motor Neuron Disease (or anything that has ongoing and lasting effects). This type of anxiety related illness can often be mislabeled or misplaced within the category of Health Anxiety or Hypochondriasis; however, one main difference between these forms of anxiety is that illness-related anxiety occurs as a result of a real life-threat (where as hypochondriasis is fear of having an illness that is not real, and therefore the threat is not real either).
With illness related-anxiety the initial fear perceived is realistic because the threat is real; therefore, the anxiety stems from a rational place and from then on the anxiety system will be hypersensitive to symptoms that may suggest the illness is escalating or has returned. This type of anxiety may cause a person to feel like they cannot switch off the worrying thoughts because the anxiety system will keep picking up on very minor symptoms as problematic. It is at this point that the anxiety system may be perceiving “threat” that is not real. People with illness-related anxiety often say things like: “my mind is constantly considering every possible negative outcome of having this illness for the future”; “I just keep thinking ‘what if’ this new symptom means there’s something seriously wrong again?”; “There’s every chance that the illness has become worse so I feel like I need to be aware of every symptom.”
People with illness related anxiety usually experience a consistent feeling of threat, racing thoughts, fear of future consequences, restlessness, irritability, sleep issues, and symptoms similar to panic, which include; heart palpitations, dry mouth, sweating or hot flashes, trembling or tense muscles, and upset stomach (or butterflies in the stomach). These symptoms are usually brought on by thoughts about any illness related symptoms the person believes they are experiencing and worrying about what it means.
The person may feel like they are walking around with a brain that is always switched “ON” to analysing any physical sensation occurring, worrying about any potential new symptom (that may actually have been experienced before but not noticed), and thinking about every negative future consequence of the illness for the future. One of the issues with illness-related anxiety is that the future consequences the person may be constantly be worrying about may be likely to occur, and therefore, once again, the thoughts might be rational and realistic. This makes it difficult for the person to try to fight the thoughts with logic or evidence because the evidence may suggest that it is not a good outcome. This is also what separates it from Health Anxiety or Hypochondriasis.
Anxiety in general is an important and natural part of being a human; everyone has an anxiety response that helps to alert us to threat. So when a person has faced a life-threatening or seriously dangerous illness, the anxiety system becomes alerted. When a person continues to feel threatened by symptoms that may be a sign of the illness, the anxiety system becomes alerted often and therefore becomes hypersensitive. As a result, more things appear threatening to the anxiety system causing it be alerted even more often; and so the cycle continues. Some people are also more prone to experiencing sensitivity to anxiety; this may depend on a combination of factors such as genetic, behavioural, and developmental factors. However, there is much research to be done in this area
Psychological intervention can be very useful in helping people manage their anxiety and learn to move forward with life despite their illness. An assessment will be conducted initially where your psychologist works with you to understand the problems you are facing. This information will then be used to choose the most suitable evidence-based intervention for your specific needs.
Acceptance and Commitment Therapy (ACT) is a useful treatment intervention for illness-related anxiety; it is a mindfulness-based behaviour therapy, which focuses on managing worrying thoughts by changing the relationship a person has to their thoughts and how much importance they place on them. Specifically, ACT and mindfulness provide a person with the skills to separate and distance themselves from their thoughts, and accept that thoughts can be present without having a negative impact on their life. ACT aims to help a person create a meaningful and enjoyable life despite the physical and emotional pain that comes with having a serious or terminal illness. Another very useful intervention for Anxiety is Cognitive-Behaviour Therapy (CBT). The cognitive part involves dealing with unhelpful thinking patterns and the behavioural part aims to deal with a person’s reactions to anxiety-provoking situations or other triggers. The aim is to decreases the sensitivity of the anxiety system so that it is activated less frequently.
There are additional areas of a person’s life that may also be impacted by illness and may be helpful to address as part of therapy. This includes helping the person to understand and manage the effect of the illness (such as fatigue, pain, cognitive changes, behavioural changes) and the effects of treatment (such as dealing with fatigue and concentration issues from chemotherapy or certain medications). Other aspects include existential issues regarding the diagnosis, uncertain prognosis, and end of life issues. Your psychologist will work with you to prioritise and address your goals.