Health Anxiety: What It Actually Is And Three Things That Help

By Divya Robin, LMHC, LPC | Anxiety & OCD Therapist in NYC, Hoboken NJ, and Montclair NJ

I started seeing it spike during COVID and never really saw it come back down.

Health anxiety was already something I treated regularly in my practice; it's one of the most common presentations I see, especially among the high-achieving, self-aware, overthinking population I tend to work with. But the pandemic did something to it. It took a pattern that was already there in a lot of people and gave it a legitimate reason to exist. Of course you were monitoring your symptoms. Of course you were Googling. Of course you were hyperaware of every sensation in your body … something genuinely scary was happening, and caution felt rational.

The problem is that for a lot of people, that level of vigilance never fully switched off when the acute threat passed. The nervous system had learned a new way of operating. And what had started as a reasonable response to a real situation became something that was running on its own, scanning, checking, bracing long after it needed to.

That's health anxiety. And it's worth understanding what it actually is, because the way most people try to manage it on their own tends to make it worse, not better.

What health anxiety actually is … and isn't

Health anxiety is not hypochondria in the dismissive, eye-rolling sense that word sometimes gets used. It is a real, clinically significant pattern in which the mind becomes hypervigilant about physical sensations and interprets them as evidence of serious illness despite reassurance, despite normal test results, despite the rational part of you knowing that you've been down this road before and it was fine.

It's not about being dramatic or seeking attention. It's about a nervous system that has gotten very good at threat detection and has decided that your own body is a primary source of potential threat.

Here's what it actually looks like in real life:

You notice a sensation a headache, a twinge, a racing heart, a lump you're not sure was there before. Your brain immediately goes to the worst possible explanation. You Google. The Google results confirm your worst fear or introduce three new ones. After that, you seek reassurance from a partner, a friend, “Dr. Google” again (as I say to my patients), maybe your actual doctor. The reassurance works for approximately twelve minutes. And then the doubt creeps back in. What if they missed something. What if it's still early. What if this time it's real.

The checking and Googling and reassurance-seeking feel necessary in the moment. It might feel impossible to do anything else. They actually feel like the responsible thing to do. But my friend… they are compulsions and like all compulsions, the relief they provide is temporary, and the cycle they maintain is not.

Every time you check, you're telling your nervous system: this threat is real enough to investigate. You give it attention, which keeps the alarm running. Which generates more anxiety. Which generates more symptoms to check. Which sends you back to Google.

That's the loop. And understanding the loop is the first step to getting out of it.

Why COVID changed things and why health anxiety is more common than people realize

Before I get into what actually helps, I want to say a little more about what I observed clinically during and after the pandemic because I think it explains a lot about why so many people are struggling with this right now.

COVID created a set of conditions that were genuinely perfect for health anxiety to develop or worsen. We were being told, accurately, that physical symptoms could be dangerous. We were tracking symptoms in ourselves and others. We were surrounded by constant information much of it alarming about what was happening in bodies. Body monitoring went from being a quirk to being a public health instruction.

And then, for people who already had some health anxiety tendency the ones who had always been a little more attuned to physical sensation, a little more worried about illness, a little quicker to catastrophize a symptom COVID gave that tendency years of reinforcement. Years of practice. Years of the nervous system learning that hypervigilance about the body is appropriate, necessary, maybe even life-saving.

Unwinding that is real work. And it requires more than just telling yourself to stop worrying — which, if you have health anxiety, you already know doesn't work.

Here are three interventions I use in my practice that actually do.

Intervention 1: Defusion changing your relationship to the thought, not the thought itself

This comes from ACT, Acceptance and Commitment Therapy, and it's often the first place I start with health anxiety clients because it doesn't require doing anything scary. It requires doing something different.

When a health anxiety thought shows up what if this headache is something serious, what if that sensation means something is wrong the default response is to engage with it. To take it seriously as a piece of information that needs to be evaluated. To try to figure out whether it's true.

Defusion does something different. Instead of engaging with the content of the thought, you change your relationship to it. You learn to see it as a thought a product of an anxious brain, a pattern that has been running for a while rather than as a fact that requires a response.

In practice, this can look like: noticing the thought and naming it. There's the health anxiety thought again. My brain is doing the thing it does. Not fighting it, not reassuring yourself out of it, not Googling to disprove it. Just observing it with a little distance. Like watching a cloud move across the sky rather than grabbing it and trying to determine whether it's dangerous.

This sounds deceptively simple. It is not easy, especially at first, because the thoughts feel urgent and the pull to engage is strong. But with practice, defusion creates a gap — between the thought and the reaction that didn't exist before. And in that gap, a different choice becomes possible.

Intervention 2: Refusal to reassure and starting to breaking the compulsion cycle

This one is grounded in ERP (Exposure and Response Prevention), and it is the most uncomfortable of the three, but also the most directly effective.

The reassurance-seeking that health anxiety drives, such as Googling symptoms, asking partners or friends if you seem okay, going to the doctor for the third time about the same thing, checking the spot again just to confirm it hasn't changed … let’s name it for what it is: a compulsion. It maintains the cycle. Every time you seek reassurance and feel relief, you're teaching your brain that the threat was real enough to require checking, which keeps the alarm calibrated to go off again.

The intervention is response prevention: resisting the compulsion. Not Googling. Not asking. Not checking. Sitting with the uncertainty and letting the anxiety rise and then letting it fall without doing the thing that temporarily relieves it.

This is genuinely hard. The urge to check feels overwhelming in the moment. Your brain will generate very convincing arguments for why this time is different, why this particular symptom warrants just one more look, why responsible adults check these things.

What I help clients understand is that the goal of response prevention isn't to determine whether the symptom is real. It's to teach your nervous system through direct repeated experience, not through reasoning/logic/ruminating that uncertainty is survivable. That the anxiety will peak and then come down on its own, without the checking. That you don't need the reassurance to be okay.

Every time you sit with the discomfort and don't check, you're weakening the compulsion cycle a little. It doesn't feel like much in the moment. Over time, it's everything.

Intervention 3: Interoceptive exposure and getting comfortable in your own body again

This one is less talked about, and I think it's one of the most important for health anxiety specifically. And as a clinician… it’s one of my favorite interventions with clients.

Interoceptive exposure is a technique from CBT and ERP that involves deliberately inducing the physical sensations that trigger health anxiety- a racing heart, dizziness, breathlessness in a controlled way, to reduce the fear response those sensations generate. Yes, I’ve had sessions with patients where they purposely run up and down a hill to induce a racing heart, dizziness, and breathlessness to re-create the sensations of their health anxiety. And yes, people find real success in this approach.

Here's the rationale: a lot of what drives health anxiety is not just the fear of illness, but the fear of physical sensation itself. The heart rate goes up and the brain immediately interprets it as evidence of cardiac danger. The head throbs and the brain goes to worst-case neurological explanations. The body has become a source of threat rather than just a body.

Interoceptive exposure doing things like spinning in a chair to create dizziness, doing jumping jacks to elevate the heart rate, breathing through a straw to create the sensation of breathlessness teaches the brain, through repeated direct experience, that these sensations are not dangerous. That the racing heart is just a racing heart. That dizziness is just dizziness. That physical sensations do not automatically mean something is wrong.

This is work I do carefully and collaboratively with clients, paced appropriately and always with full understanding of what we're doing and why. But the results are significant because once the sensations themselves stop being threatening, the entire feedback loop of health anxiety loses a major source of fuel.

What actually changes when health anxiety is treated well

I want to paint a picture of what's on the other side of this work, because I think people who are in the middle of health anxiety often can't see it.

Life gets quieter. Not because the body stops generating sensations — it doesn't, it's a body, that's what bodies do. But because the sensations stop landing as emergencies. A headache becomes a headache. A weird twinge becomes a weird twinge. The automatic escalation from sensation to catastrophe the one that happens in seconds and used to be completely outside your control starts to have a pause in it. A moment where you can choose a different response.

That pause is what treatment creates. And for people who have been living in constant low-grade terror of their own body sometimes for years, sometimes since COVID, it can feel rational that pause is genuinely life-changing.

You stop planning your life around your symptoms. You stop avoiding situations that might generate physical sensations. You stop losing hours of your day to Googling and checking and seeking reassurance that never quite reassures. You start being present in your own life again in your body, not at war with it.

That's what's possible. And it's worth doing the uncomfortable work to get there.

If you're in New York City, Hoboken, NJ, or Montclair, NJ, and health anxiety has been running your life quietly or loudly, I'd love to connect with you and see if I can be of support. I offer a free consultation, and it's always a real conversation about where you are and what you need.

Divya Robin, LMHC, LPC is a Columbia University-trained licensed therapist in New York City, Hoboken NJ, and Montclair NJ specializing in health anxiety, OCD, ERP therapy, and anxiety disorders in adults and teens.