Ask the ADAA Experts: I'm Scared to Death I'll Catch a Deadly Disease

In this edition of Ask the ADAA Experts, ADAA members Gordon J.G. Asmundson, Ph.D., University of Regina, and Bruce Lydiard, Ph.D., M.D., Southeast Health Consultants, address a question from a reader who is chronically worried about becoming infected with a deadly disease. If you have a question for a future Experts column, email webfeatures@adaa.org.

I'm constantly worried that I'm going to contract some deadly disease. When I turn on the news and hear about flu season starting up, the Bird Flu and all of these other epidemics that could come to the U.S., I can't get it out of my mind. Every time I learn about a new disease, I think I'm at risk for catching it and worry that I came in contact with someone during the day who had it. I'm paranoid about every little symptom I have and am always looking up diseases and their symptoms on the Internet. Is it normal to worry like this all the time? How can I stop thinking these thoughts?

Gordon J. G. Asmundson, Ph.D., University of Regina:

These are very good questions. The truth is that that we all have some degree of worry about being exposed to and catching diseases (like the Bird Flu or Mad Cow Disease) from dangerous germs, and about body sensations and changes. The question is "How much worry is too much?" If you are concerned about the amount of time you spend worrying - if it is pretty often - this is a good indicator that you may be worrying more than most people. In your case, it appears that the worry is daily and constant. However, the amount of time spent worrying is not the only thing we need to consider. Why? Because we also need to know if your worry is out of proportion to your actual risk of catching or having a deadly disease, and if it impacts on your ability to do the things you need to do on a day-to-day basis.

Thus, you need to answer a few additional questions. Are you at greater risk of exposure to dangerous germs than most people, perhaps because of your job or living circumstances? How often do you go to your doctor about the same concerns, despite repeated assurances that you are not physically ill? How much time do you spend on the Internet and checking other information sources about diseases and their symptoms? Does this interfere with you ability to get other things done? Have you stopped doing things that you enjoy doing, or need to do, because of the worry about catching or having a deadly disease? For example, do you avoid going to the movies or eating certain foods for fear of caching something? Are your worries interfering with your ability to work?

If you are not at greater risk than most other people, if you've seen your doctor several times about the same symptoms even though the doctor says there's no evidence that anything is wrong, if you're spending so much time worrying that your house is a mess, you relationships are on the rocks, your other interests have been abandoned, and your work is of poor quality or simply not getting done, then you are worrying too much. In some cases it may be necessary to visit a mental health professional in order to get this worry in check; however, the good news is that there are several things that you can try on your own.

With regard to one of your specific concerns - How can I stop thinking that I am in danger of catching something? - you might try replacing the patterns of thinking that are fueling your worry with ones that are more positive. There are several ways to do this. The one that my patients find most useful is putting themselves in the shoes of a doctor that they admire; for example, their long-time family physician or one of the docs from Grey's Anatomy. It is often easier to question someone else's worries. Taking the doctor's position allows you to do this. What would you say to a person presenting with the worry that they will catch a deadly virus by going shopping? You might say, for example, "You went shopping earlier. So did thousands of other people. The chances of being exposed to a deadly virus are very, very small. Life is precious and worth living fully, rather than worrying about rare diseases. I recommend you go do some of the things that make you feel happy." Try this with some of your other specific worries. The strategy does take practice, but can help you break free of the emotion of your worry and, in doing so, lead to the discovery that specific worries are assumptions that can be challenged - they are not facts.

A similar strategy can be used for worries about the bodily changes that you believe are symptoms of disease. You might also consider the possibility that, much like a noisy refrigerator or car that is otherwise working just fine, it is possible to have a noisy body that is healthy. Our bodies make noise - often perceived as symptoms of disease - for all sorts of reasons that have nothing to do with disease. Worry itself can cause this noise, as can changes in diet, changes in sleep, minor ailments (like the common cold), and the many little hassles and challenges we have to deal with on a daily basis. Is it possible that your "symptoms" are not the result of some deadly disease but, instead, one of these more likely explanations? Again, taking your doc's position and examining the alternative explanations should help to reduce your worry.

Gordon J. G. Asmundson, Ph.D. is a Professor of Health Studies and Psychology at the University of Regina, an Adjunct Professor of Psychiatry at the University of Saskatchewan, a Canadian Institutes of Health Research (CIHR) Investigator, and one of the first recipients of the ADAA Young Investigator Research Award in 1998. Dr. Asmundson holds several editorial posts, including North American Editor of Cognitive Behaviour Therapy, the Behavioral Medicine Section Editor for Cognitive and Behavioral Practice, and serves on the editorial boards for the Journal of Anxiety Disorders, the Journal of Behavior Therapy and Experimental Psychiatry, and the Clinical Journal of Pain. He has published over 160 journal articles and book chapters regarding anxiety disorders, chronic pain, and the overlap between the two, as well as 5 books, including It's Not All in Your Head: How Worrying About Your Health Could Be Making You Sick and What You Can Do About It.

Bruce Lydiard, Ph.D., M.D., Southeast Health Consultants:

The vast majority of people experience one or more physical symptoms (musculoskeletal pain, gastrointestinal distress, fatigue, sleep disturbance, headaches, etc.) over the course of a year. Most don't worry excessively or seek medical evaluation for them.

Your response is to worry that the symptoms represent a terrible illness; you are understandably distressed by these persistent concerns. When worry interferes with your ability to function normally in some aspect of your life or causes significant distress, it is no longer a normal concern, and may be an anxiety disorder. If this is the case, you should know that there is effective treatment available.

As a first step toward controlling your worry, obtaining an evaluation by a qualified professional would be very useful in determining the best treatment. Cognitive-behavior treatment has been shown to be an effective treatment for controlling excessive worry. Anti-anxiety medications have also been proven to be effective. The choice of treatment should be individualized to obtain optimal results.

Dr. Bruce Lydiard is the Director of Southeast Health Consultants, a private research site in Charleston, S.C. He has been a member of the ADAA since 1984. As both a researcher and clinician, he has focused on ways to improve the treatment of anxiety disorders.