Health Anxiety In Pregnancy & After Birth

What Does Health Anxiety Look Like?

Health Anxiety occurs when an individual is preoccupied with being seriously ill, or becoming seriously ill at some point in the future. People with health anxiety tend to be anxious a lot of the time, and more often than the average person. Health anxiety can cause a substantial impairment in day to day life because the health concerns can interfere with interpersonal relationships, family life and occupational performance. For new mums, health anxiety can be focused around you being or becoming unwell, and/or your baby/children.

What Are The Signs To Look Out For?

  • The need for excessive reassurance from others when worried about an aspect of health. The reassurance can be from a healthcare professional, such as your GP, Midwife, or Health Visitor, or it can be from a family member or friend.
  • Often, the reassurance does not alleviate the individual’s concerns, and may heighten them
  • The excessive worry about health can become frustrating for others and may results in considerable strain within the family
  • Feeling more irritable than usual
  • Problems with sleeping due to health worries
  • Being more focused internally on physical symptoms and changes
  • Excessive googling/internet searching to get certainty about health worries
  • Avoidance of medical appointments or enduring them with significant distress 

The Role of Thoughts in Health Anxiety

In Cognitive Behavioural Therapy (CBT), we look at the link between how you think, how you feel, and what you do in what are known as “vicious cycles.” Typically, if you have more anxious thoughts, you tend to feel more anxiety, which leads to engaging in more unhelpful behaviours like those listed above.

Someone with health anxiety will tend to have lots of anxious thoughts about illness. Thoughts can sound like, “What if I get a brain tumour, I have something seriously wrong with my heart, worrying this much about my health is going to make me end up getting sectioned.” The worries can also be around your baby/children and may sound like, “There is something wrong with my baby and no-one has picked it up, what if my child gets a sickness bug, my baby is going to pick up a disease and will get dangerously ill.” Anyone having thoughts like this would understandably feel anxious! It must be so scary to truly believe there is something wrong with you (or your baby/children). In pregnancy, the worries might be around the health of your baby in utero.

And What About Behaviours?

When you are worried about something being wrong with you or your child (like in the examples above), you will likely start (or continue) to engage in certain unhelpful behaviours. These might be things like, excessively bodily monitoring/checking, googling symptoms, ringing NHS 111 or contacting a healthcare professional, requesting scans or examinations for clarity/certainty, or asking a friend or family member what they think (usually because they may help you to feel less anxious).

Again, these behaviours make sense if you are particularly worried about health-related things, however, what we know is that the behaviours can actually keep you more worried about health because one, you tend to be more focused on your (or your child’s) body, which in turn may lead to more anxious thoughts and feelings. Two, the reassurance only tells you what isn’t wrong, and doesn’t tell you what is wrong, and three, the behaviours can make you struggle more with the uncertainty of what is or isn’t wrong. Struggling to tolerate uncertainty is a huge factor in the role of worry, so behaviours such as checking and reassurance seeking only make your ability to tolerate the unknown worse. It is also important for you to beware where you get your information from, and ideally stick to one helpful and reliable source.

What Treatment is Available For Health Anxiety

The NICE Guidelines recommend CBT for the treatment of health anxiety, and therapy is an opportunity to discover what the problem is. Treatment will involve identifying and breaking the vicious cycles that can occur in the maintenance of health anxiety. If your symptoms are particularly intense, your GP/Midwife may recommend taking some antidepressants to try and help bring your symptoms under control. If you are currently pregnant or breastfeeding, you can still take anti-depressants, learn more here in my blog about taking anti-depressants in pregnancy.

If your health anxiety is linked to a previous stressful experience where you or someone close to you were particularly unwell, Eye Movement Desensitisation and Reprocessing (EMDR) Therapy can be useful to go back to the memory/memories that may have triggered the health anxiety. An example of this might be if you have experienced a traumatic birth, and became preoccupied with your own or your babies health postnatally. EMDR can be utilised to address the initial experience that caused the health anxiety to develop. In some cases, both EMDR and CBT can be used – EMDR to process the initial traumatic experience, and CBT to work on identifying and managing health anxious thoughts and behaviours that are keeping the health anxiety going.

CBT is available for free on the NHS, and you can refer yourself to your local Talking Therapies Service to be assessed. EMDR may not be available on the NHS – it depends on what provision is available in your area. Waiting times will depend entirely on the area you live, and some are longer than others. If you have health insurance privately or through your workplace, or if you have the option of paying for your own therapy, you can access CBT and EMDR much quicker.

Useful Links

https://laurahanstherapy.co.uk/therapy/what-is-cognitive-behavioural-therapy/

https://laurahanstherapy.co.uk/therapy/all-you-need-to-know-about-emdr/

https://laurahanstherapy.co.uk/therapy/excessive-reassurance-seeking-anxiety/

https://laurahanstherapy.co.uk/perinatal-mental-health/what-is-birth-trauma/

https://laurahanstherapy.co.uk/therapy/is-paying-for-private-therapy-worth-it/

https://www.nhs.uk/mental-health/conditions/health-anxiety/

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