Overthinking Health Anxiety: How to Write Your Way Out of the Loop

Your chest feels a little heavy. There was a tingling in your fingertips. A small sensation that caught your attention, once it snags in your head, won't let go. "Could this be—" you type the symptom into the search box, and your heart jumps at the serious-sounding diagnosis that comes up. From there you search more, and before you know it you're reading nothing but worst-case possibilities into the small hours. Have you ever been through that?

What makes health anxiety so tricky is that its subject — bodily sensation — is hard to verify. The more you think, the more the imagining grows into something that feels like certainty. This article is for anyone who overthinks health anxiety: it walks you through writing it down, splitting fact from imagination, and stopping the loop. It cannot diagnose the symptom itself, but it offers a way of writing to settle the feeling, and touches on when it's worth seeing someone.

How health anxiety grows into overthinking

Health anxiety grows, in most cases, because the mind takes the uncertain information of a bodily sensation and slaps the worst possibility onto it. A sensation that might just be "you're tired" gets tied straight to a serious diagnosis, and you become trapped in that single reading.

On top of that, repeating the worry over and over — rumination — and the behavior of not being able to stop searching both intensify the anxiety. What searching turns up isn't necessarily information that applies to you. Yet the more anxious you are, the more the alarming material catches your eye, and the imagining swells. Attending to your body is itself a natural function that tries to protect you — it isn't that you're at fault for being a worrier. But when that function spins its wheels, you fall into the loop of overthinking.

Write it down and split "fact" from "imagination"

Health anxiety is hard because the actual bodily sensation and the imagining in your head have fused into one. This is where writing to separate them helps.

Paper or a phone note is fine. First, write out only the facts of what you feel now. "Since evening my chest has felt a bit heavy" — as far as you can observe is fact. Next, write the imagining that rose in response on a separate line. "It might be a serious illness." "What if it's beyond fixing." Laid out this way, you'll see the facts are tiny and most of the rest was imagining you can't verify.

You were being swept around by an unestablished imagining as if it carried the same weight as fact. Just noticing that settles you a little. Then, crucially, don't try to decide the things that need judgment by circling them in your head. Set down one line — "if it keeps nagging, I'll discuss it with a medical provider another day" — and entrust the rest to a professional. No amount of searching produces a diagnosis inside your head.

Instead of searching, write and close

When health anxiety is strong, many people reach for search. But search, though you're after reassurance, not rarely carries in fresh material for worry instead. Confirm one thing, and another worry rises, and you fall into an endless loop of checking.

So when the urge to search comes, stop your hand and, instead, write just a few lines and close it. "Right now my chest is bothering me. I'm scared. But I can't judge this tonight. If it keeps nagging, I'll get it checked." Write that, and close the screen. The trick is not to try for an answer — leave anxiety as anxiety and set it outside you. Your only job tonight is not to reach a diagnosis, but to set down what's in your head for now.

Signs it may be worth seeing someone

As a starting premise, the symptom itself should be discussed with a medical provider rather than decided by yourself. Writing to settle down and hesitating over needed care are two different things. If you have strong pain, a sudden change, or a symptom that feels different from usual, see a medical provider without hesitation.

On top of that, if anxiety won't go away even after tests come back clear, if you can't stop checking or searching, and if because of it you can't sleep or it disrupts life or work — when such a state continues, it's generally considered a sign to talk to a mental health professional. Consulting someone about the anxiety itself is never an overreaction.

Venting as a "curse" is allowed too

Think positively, try not to mind it — some days those routines just don't work for health anxiety. Being told "you'll be fine" when you're frightened can leave you feeling brushed aside instead.

Noroi Nikki is an app for those days. We built it as a place where you can let out anxiety and fear about your body in exactly the words you have — no need to dress them up. What you write is seen by no one and stays only within you. Put the anxiety that won't leave your head into words tonight and set it outside yourself for now. And take anything that worries you to a professional while it's daylight.

References

• James W. Pennebaker, Opening Up: The Healing Power of Expressing Emotions (Guilford Press, 1997). A foundational body of research on the effects of writing out difficult experiences and emotions, known as expressive writing.