Are my COVID-19 symptoms real? How to know when anxiety is to blame

We're all feeling a lot more anxious than normal, but you can determine whether your symptoms are real or not with this simple test.
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  • Feel a little tickle in the back of your throat? Worried that your cough is happening a bit too often? Feel a bit hotter than usual?

    You may be dealing with coronavirus-based health anxiety.

    Though the symptoms of coronavirus are obviously very real, and can be incredibly serious, constant news on the pandemic and reports of people’s experiences of it can easily trigger psychosomatic symptoms (when a physical illness is caused by a mental factor).

    Put it this way – for lots of people, the more you hear about an illness, the more you suspect – or convince yourself – that you have it. Sound familiar?

    The psychology behind why you might imagine symptoms

    A Professor in Health Psychology at the University of Surrey, Jane Ogden, explained this phenomenon. She said, “In 1982 David Mechanic described a syndrome called medical student’s disease, which illustrated how medical students often ‘caught’ the disease they were studying in class.

    “So they experienced chest pain when studying cardiology or breathlessness when in respiratory classes. A few years ago I also carried out a study on the social contagion of symptoms and found that when watching films of head lice or people jumping into icy water, participants either itched or shivered.”

    How often has someone mentioned head lice in a conversation, and you’ve instantly started itching your head, convinced that there is in fact an itch there to scratch?

    Now, Jane has suggested that this could well be happening with some people at the moment, who may be convincing themselves that they are in the early stages of the coronavirus infection when they are in fact experiencing normal bodily sensations.

    Why might we be mistaking normal bodily sensations for early coronavirus symptoms?

    She said, “Much as the serious symptoms of COVID-19 are clearly indisputable, those experienced in the early days following exposure to the virus are all too familiar, and open to all the biases of symptom perception that influenced our daily lives way before this recent pandemic hit us.

    “And this process of symptom perception isn’t always helped by the constant bombardment by the media – which can lead to health anxiety and hyper vigilance which in turn make any symptom worse.”

    For many people, Jane said, symptoms can be caused, or made worse, by stress and anxiety – two emotions that so many of us are likely experiencing at the moment. And it means that for those people, the pandemic could well be causing all kinds of unnecessary fear.

    “Symptoms are clearly modified by mood (anxiety makes them worse) and cognition (being distracted make them better),” Jane explained. “And in today’s world of coronavirus, who can’t help but watch their body for changes, worry about their tickly throat and check their forehead for any hint of a fever? All of which will also make these symptoms feel worse than they are.”

    So how can you tell if your early symptoms are the beginning of COVID-19, or in your head?

    Firstly, it’s important to know the actual symptoms of coronavirus.

    COVID-19 symptoms include:

    • a high fever/temperature – this means you feel hot to touch on your chest or back
    • a persistent cough – this means coughing a lot for more than an hour, or 3 or more coughing episodes in 24 hours (if you usually have a cough, it may be worse than usual)

    Other symptoms have been speculated to be coronavirus symptoms (such as a loss of taste and smell), but these have not yet been confirmed by the NHS or the government.

    Of course, there undeniably reaches a point during any illness where you are certain about whether or not you are ill. But in the very early stages, what may just be normal bodily sensations, or symptoms of anxiety, hyper vigilance, and checking, could easily be mis-construed as signs of the virus.

    Jane shared a technique to try and help identify the reality.

    Try this test to try and determine whether your symptoms are real or not

    She explained, “Every year I carry out a study with my students to illustrate how symptoms are perceptions, not sensations. They all take part in a leg raising task.”

    How do you perform this test?

    • Sit down with backs against the chair, and lift a leg up horizontally for one minute whilst the other is relaxing
    • Then describe how it feels while distracted, chatting about your weekend, etc. – and then, how it feels whilst doing nothing
    • Then rate how much it hurts each time. Professor Jane said, “every year it works a dream – pain is significantly greater when they focus on their leg than when they are distracted”

    So if you’re worried that your slightly scratchy throat could be the beginnings of coronavirus, try a similar method.

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    Perhaps spend 10 minutes really concentrating on the ‘symptom’, and rate the pain or irritation during and afterwards. Then, spend 10 minutes distracted by something else – a gripping book, or a binge-worthy TV show, and see how painful or irritating your symptom has been during that time where you’ve actively tried to forget about it.

    Professor Jane explained that while it’s obviously vital to be aware of any symptoms of coronavirus in order to self-isolate, it’s also important to bear in mind that your worry over potential symptoms may in fact be bringing them on, to an extent.

    “We live in strange times when we need to know whether we are ill or not to protect those who are more vulnerable,” she said.

    “But this process is not without its problems and whilst telling people to be vigilant of their symptoms may well help identify real COVID-19 symptoms, it may also exacerbate a whole load of more minor symptoms which would have been better ignored. This may lead to unnecessary self-isolation and pressure on work places such as schools, when people stay at home.”

    Of course, if you experience a persistent cough and a fever (high temperature), you should immediately self-isolate and seek medical advice. 

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