In my small office in Sydney, I have noticed a significant increase in health anxiety amongst my clients. It may be that there are more awareness campaigns on our TV screens or it could be that the increase in screening technology has made it easier to get reassurance from our doctors that our symptoms are mostly benign. Obviously increased awareness in all health matters is a good thing and early detection of illness and disease is beneficial, but we do need to make sure we don’t all become anxious wrecks.

TV advertisements often give out a repeated warning – If pain persists, see your doctor. When it comes to pain, it’s relatively easy to follow this prescription. There are other symptoms that cause rational alarm in most people – lumps, chest pain, unexplained bleeding, and visual disturbances for example. Such symptoms warrant immediate investigation. But how do we know if concern for our health is bordering on health anxiety?

Most people who have health anxiety obsess about their health. That is, they have intrusive thoughts such as: How do I know that I don’t have cancer? or What will happen to my children if I die?  In other words, even without symptoms, they obsess about their health. Significantly, the intrusive thoughts interfere with their ability to enjoy life.

Secondly, health anxiety often triggers many trips to the GP. And here’s where a cycle can begin. Any good doctor is not going to ignore your concerns and will therefore send you for tests to rule out “anything nasty.” The GP’s initial reassurance and lack of panic feels good and the negative test results prompt a rush of relief. Unfortunately that relief can wear off. It may last a week or a month, but new or recurring symptoms triggers memories of those reassuring results and so it’s off to the doctor once more. When AIDS was first discovered, some anxious people fronted up every three months for that reassuring blood test. Yes, it was good to get the all clear, but the cycle of anxiety→negative test results→relief→anxiety became established.

Following the recommended guidelines of screening procedures (pap smears, mammograms, bowel checks etc) makes it easier. Seeing your doctor if pain persists, or if any dramatic symptom appears is a good idea. The hard job is to manage the persistent worry that something might be wrong and the compulsion to seek reassurance. Having insight into the problem is the first step. Mindfully surfing the waves of anxiety helps. In other words, know that anxiety builds up, plateaus and comes down again. If you are to seek reassurance, try to do it when the anxiety is on the way down. Planning regular check-ups reduces the likelihood of compulsive visits to the doctor.

Lastly, if your health anxiety persists, consider seeing a psychologist.

How often have you been told “not to get your hopes up.” There’s this idea that if you expect the worst, you won’t be disappointed. In reality, we can’t really prepare for disappointment, just as we can’t prepare for grief, rejection or physical pain. Such feelings are triggered by circumstances – losing someone we love, not getting a job, or having surgery for example.

At the very least, having hope gives us confidence when we go for a job interview and in really tough times, hope can keep us alive. Can you imagine Madeleine McCann’s parents trying to exist without hope that their daughter is still alive? I’m sure they’ve lost count of how many times they’ve been told not to get their hopes up.

Strangely, it can be easier to move on after a broken heart if you accept the fact that a little bit of hope of reconciliation will remain for some time. When well meaning friends tell you that all hope is lost – he or she is never coming back – the resulting grief can be overwhelming. Whereas allowing that pilot light of hope to quietly burn while you get on with your life will often enable you to recover more quickly. Over time, the need for that hope fades. That’s when you know you are over your ex.

The hardest part of grief is the lack of hope that follows the death of a loved one. If death comes after a long illness, there would have been a trail of hope-filled paths that you had been navigating. Doctors encouraging affairs to be sorted and families being warned to prepare for the worst. But throughout the journey, hope remains. Hope that they will be saved, hope that they will be given as much time as possible, and then hope that the end will be peaceful. Although the hope dies along side that person, its very existence makes the process easier to bear.

Bronnie Ware, an Australian palliative care nurse has written a book called The Top Five Regrets of the Dying. I have yet to read her book, but I was deeply moved by an article on her powerful observations. It surprised me to learn that the most common regret of the dying was that they wished that they’d had the courage to live a life that was true to themselves, not the life that others expected of them. She describes how many people approaching the end of their life realise that they have not fulfilled even half of their dreams. Why is this?

Obviously, responsibilities weigh us down at times. We can’t pursue our every dream when we are looking after young children for example. Many would argue that having the children in the first place is pursuing a dream. Always focusing solely on ourselves would be considered selfish, especially if others suffered as a result.

But there are many opportunities that we let slip by because we worry too much. We worry about money. We worry about our careers. We worry about letting other people down. And all this worry creates one giant obstacle blocking our dreams.

Bronnie Ware makes the powerful statement: “Health brings a freedom very few realise, until they no longer have it.” Many people who have survived a serious illness report having a changed perspective on life. But for those who are not going to survive, they don’t have the time to reap the benefits of a new outlook. How can we enjoy the freedom that health brings us?

• Remember that it’s not selfish to consider your own needs
• Don’t always give yourself the burnt chop – share it around
• Regularly make a list of your dreams
• Be aware of the self-imposed obstacles
• Don’t wait for illness to give you a wake-up call
• Realise that when children see you fulfilling your dreams, they will be learning to do the same
• Don’t let your upbringing define you
• Remember that there are always choices to be made

There seems to be an epidemic of perfectionism sweeping the western world. Everyone is striving for excellence for themselves and for their children. Rather than increasing confidence and happiness levels, perfectionism causes general feelings of inadequacy.

“Good enough” is often thought of negatively as meaning second best. Firstly, I’m not exactly sure what’s wrong with second best. And secondly, how can we possibly hope to achieve perfection?

Many people struggle with thinking that they are not good enough – mums and dads get so concerned that they will damage their children if they are not perfect parents. Kids are feeling inadequate if they don’t excel at something. Teenagers are not feeling good enough if they don’t have amazing experiences to display on facebook. When relationships break down, we are quick to question why we weren’t good enough. When we are made redundant or fail to land a dream job, we are full of self-doubt. All these normal challenges in life are seen as evidence of our inadequacies.

How can we reduce perfectionism and feel good enough?

• Set realistic goals based on what’s important to you
• See yourself through others’ eyes – especially for the introverts out there
• Accept that rejection is a normal part of life
• Embrace the challenge that is learning from our mistakes
• Remind children not to aim for perfection
• Remember that gratitude and altruism brings a lot more happiness than success