In response to the Covid 19 pandemic people are naturally becoming afraid of acquiring the viral infection, either in themselves or in people they love.
This fear – also called anxiety – is very uncomfortable and just as the infection itself can be mild, moderate or severe, so too the resulting anxiety can be mild, moderate or severe, sometimes leading to panic. Doctors and scientists know that it is hard to predict who will develop mild or severe symptoms when exposed to the virus. Yet it is well known that elderly people and those with pre-existing chronic medical conditions are more likely to have a more severe illness. Similarly with respect to anxiety, it is hard to predict the potential severity of any one person’s level of fear and worrying, except for people with a pre-existing chronic anxiety disorder. In particular there is a sizable number of people who suffer with health anxiety which is an intense and pervasive worrying and preoccupation with acquiring and suffering with a catastrophic, life threatening disease. It is for this group of people for whom the Covid 19 pandemic is especially frightening. Having worked with these people for many years it is a group that I know well.

People with Health Anxiety (HA) have difficulty thinking rationally about health risks. Intense anxiety disables rational thinking and puts in its place thoughts about potential catastrophic outcomes and “what if” thinking. The rational thinking
process looks at probabilities, whereas HA thinking reflects the belief that if something could happen then it will happen. People with HA need absolute certainty that a disease is not – or will not – be present in order to reduce their anxiety.
They also behave in ways they believe will reduce their anxiety, such as checking
their body for abnormalities, and asking for reassurance from doctors, family members and friends. The problem with these attempts to reduce anxiety is that while they may lower anxiety levels momentarily, the excessive attention to what could happen actually increases anxiety over time, leading to a state of chronic anxiety.

Covid 19 acts as a trigger to bring into awareness the fear that something bad can happen along with recommendations about prevention, i.e. hand washing, social distancing, wearing masks, disinfecting surfaces, etc. People with HA tend to be obsessively fixated on these potential threats and find it difficult to switch back to a more rational perspective. The reminders to be careful are constant, coming from the media and the opinions of experts. So the checking, need for reassurance and overall suffering with anxiety continues within a fearful perspective for people with chronic health anxiety. Without some kind of intervention it is likely that the fear and mental anguish will continue to have increasingly adverse effects on well-being for these individuals.

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