Dear Tanya

I am a 38-year-old, happily married, father of two. I have a job I love and feel happy and lucky with my life. I am, however, plagued by anxieties about my health to the point that it is affecting my focus and concentration.

My wife is now telling me to get help as she is feeling ground down by my preoccupation with checking my body and my panic at the slightest thing I find.

I notice every ache, spasm and pain, and instantly think that they are serious.

Occasionally, for example, I get a shooting pain in my head and convince myself that it is a brain tumour. I sometimes get pins and needles in my legs and a numbness in my feet and then worry for hours that I have multiple sclerosis.

I do visit my GP a lot, have had comprehensive health screenings and always leave with a clean bill of health, but I soon start to worry again.

Recently my GP suggested that I might be a “worried well” — that I have a health anxiety condition. I can see the logic in this but what if I am actually ill and everyone else just isn’t seeing it? If I ignore it as well, and just see myself as someone with anxiety, I might die.

At the moment I am suffering from a tightness in my chest, which makes breathing difficult and I am convinced I have lung cancer. This is terrifying me and I am not sleeping well. My wife and I are on less cordial terms and I have less patience at work and with my children. Is this because I am tired and stressed or because I have brain tumours? Please help.

Simon

Tanya replies: I often meet people with health anxiety after they have done the rounds of every medical department. Like you, despite being given clean bills of health, they continue to panic at every ache and pain.

Indeed it is often difficult to engage the “worried well” because taking the leap from believing that the problems experienced are in the body, to accepting that they are in mind, is huge. Clearly it is important to be vigilant about our health but not to the extent that it affects our quality of life.

The symptoms you describe are classic indicators of anxiety. Tightness in the chest, head pain and numbness in limbs reflect the physiological changes that occur when we go into fight or flight mode. In fact the anxiety of being excessively preoccupied with health worries can induce such symptoms.

So why are you anxious? Many of the “worried wells” I meet have stressful lives or have a history of someone close being unwell or dying. Some see their checking as a way of keeping themselves well, while others spend hours online researching illnesses and then miraculously discover that they seem to have the same symptoms. Anxiety can also lead people to avoid any information about health and illness, including TV programmes.

To address this problem, you must first accept that your problem is psychological not physical. Start by keeping a diary of your thoughts, feelings and behaviours that are triggered by a pain or a fleeting mention of illness. You will establish key triggers, patterns of behaviour and the automatic and negative thoughts that precede the anxiety reaction. The idea is to find ways to catch the negative automatic thoughts as they occur. Some people wear a tight band on their wrist and ping it as they recognise an anxiety thought — this pushes the thought into their conscious mind where strategies to manage it will be waiting.

If you know that you are anxious you can find a rational voice to challenge the anxious one: “these are normal physical body changes”; “these feelings are the result of me sitting in one position”; “I am experiencing the result of long hours at a screen, inducing a tension headache”.

Alongside this, start evaluating and recording the evidence for your excessive concerns. You will find many more realistic explanations for your feelings — usually that anxiety is generating them.

Then master Progressive Muscle Relaxation (PMR). This enables a focus away from anxiety (through a technique of clenching and relaxing muscle groups) and into relaxing the body. You are then taken through a series of imagery exercises to enhance wellbeing. With practise these techniques become our automatic response to anxiety. You can buy or download PMR recordings.

Distraction is also a useful cognitive technique but works only once you accept that your mind, not your body, is responsible for your health anxieties. As you catch that negative thought, grasp it and then discard it with distraction methods: count backwards in threes from 100; sing Abba songs; recite the periodic table.

Stop checking, stop seeking reassurance and stop avoiding anything that puts health issues in front of you. Trust that you will properly know when you need medical advice, teach yourself to manage your anxiety with aplomb and ask friends and family for box sets of ER and Holby City for Christmas.

If you have a family problem, e-mail proftanyabyron@thetimes.co.uk

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