Putting off check-ups for years in case something is found? Learn the causes of the fear of going to the doctor and ways to break the avoidance cycle.
Two years ago, because you had turned fifty, your family doctor suggested you have a screening test. The referral form is still sitting in the kitchen drawer. Last winter a wheeze started in your chest, and you said, "It's just a cold." Whenever your partner says "Go and get checked", you change the subject. And when a test result notification pops up on your phone, you delete it without opening it. A voice inside you says, "If you go, they'll find something." The subject of this article is the quiet, rarely discussed face of health anxiety: the fear of going to the doctor. That is, avoiding examinations, tests and check-ups out of fear that there may be an illness. We will talk about how this avoidance works, why it grows stronger over time and the small but effective steps you can take to get out of this cycle.
What Is the Fear of Going to the Doctor?
When people hear "health anxiety", most think of people who constantly go to hospital and have test after test. Yet anxiety also has a reverse side: in some people the same fear leads, on the contrary, to staying away from health services. The underlying emotion is similar in both pictures: the possibility of a serious illness is perceived as an unbearable threat. One person tries to manage this threat by constantly checking, the other by never looking.
The fear of going to the doctor is sometimes directed at a single area. Some people fear the dentist, some needles, some the smell and sounds of the hospital environment. In this article I am mostly talking about the fear of "receiving bad news", that is, avoiding knowing itself. In this kind of avoidance, the person is actually trying to escape not the doctor, but the sentence the doctor might say.
There is a logic within this behaviour: as long as I don't know, I can live as if that thing doesn't exist. In the short term it really does bring relief. But the price of this relief is that the uncertainty never ends, and the risk that a possible problem is noticed late.
People around them often see this behaviour as negligence, laziness or indifference. Yet the avoiding person stays away not because they do not care about their health, but, on the contrary, because thoughts about their health feel unbearable to them. Seeing this difference allows both the person themselves and their loved ones to approach it with more understanding.
Signs of Avoiding Check-Ups
You may notice the following behaviours in yourself or in someone close to you:
- Postponing recommended screenings and check-ups for months or years
- Picking up the phone to book an appointment and giving up, or not attending an appointment that has been made
- Not looking at test results, not opening notifications in systems such as e-Nabız (Turkey's online personal health record)
- When noticing a symptom, finding explanations that downplay it: "It's my age, it's tiredness"
- Staying away from conversations about health and from news about illness
- Not asking about, and not wanting to learn about, health problems in the family
- Feeling uneasy even when walking past a hospital
- When forced to go for an examination, being unable to sleep for days beforehand, and experiencing nausea or palpitations
- During the examination, giving the doctor short answers and describing symptoms as milder than they are
The last point is particularly important. Even if a frightened person does go for an examination, they may minimise their symptoms "so that nothing is found". This defeats the purpose of the examination.
Why Does the Fear of Going to the Doctor Develop?
Painful memories connected with hospitals. Losing a loved one in hospital, going through a long wait outside intensive care or having a difficult hospital experience in childhood can pair health services with loss and pain. The sentence "My father went for a check-up and was never the same again" is heard in many families.
Beliefs passed down through generations. In some families, sayings like "If you go to the doctor, you'll get ill" or "Once you go into hospital, you don't come out" are repeated often. Especially in generations who grew up when access to healthcare was difficult, going to the doctor only when it was far too late may have become an ingrained habit. These experiences create a strong link between the hospital and bad news.
The expectation of "being strong". Saying "there's nothing wrong with me" and putting up with pain, especially for men, is an attitude often praised in Turkey. For someone who provides for the household, falling ill can be perceived as letting the family down. This expectation makes asking for help look like weakness.
Fear of losing control. An examination is a moment when a person hands their body over to someone else. For someone with a high need for control, this surrender can be even harder than the news itself.
Financial worries. The thought that a diagnosis will mean job loss, treatment costs and disruption to family life can make not knowing more tempting at a time when the cost of living is a burden.
Negative experiences in previous examinations. For someone who, in a brief consultation at a crowded outpatient clinic, could not ask their questions, felt their symptoms were not taken seriously or learned of a diagnosis in an unexpected and harsh way, the consulting room can be coded as an unsafe place. These experiences cast the shadow of that moment over every subsequent appointment.
Fears of needles, blood and medical procedures. Experiences such as fainting when blood is taken or panicking at the sight of a needle also feed the avoidance of examinations. The article on fear of needles and blood may offer guidance on this.
The Avoidance Cycle: Why Does Postponing Make the Fear Grow?
The most challenging aspect of the fear of going to the doctor is that it sets up a self-feeding cycle. Let's think it through step by step:
- A symptom is noticed or a check-up falls due.
- The thought "What if something bad is found?" raises the anxiety.
- The person postpones the appointment; the anxiety drops immediately.
- This relief leads the brain to learn that "postponing works".
- But the uncertainty does not end; as time passes, the thought "I've left it so late, now it's bound to be bad" is added.
- The anxiety grows even more, and going becomes even harder.
Let's say there was a screening you put off two years ago. Today, when you think about going for that screening, you are afraid not only of a possible illness but also of the question "Why did you wait so long?", and of the anger and shame you feel towards yourself. In this way, every month that passes makes the door a little heavier.
This cycle draws in not only the person but also the family. Every evening at dinner the partner asks, "Have you booked the appointment?", the person brushes it off, and the tension at the table grows. Adult children try to persuade their father over the phone, and sometimes the argument ends with a slammed door. The more the person feels this pressure, the more they keep the subject closed; health becomes the topic that cannot be talked about at home. Yet openly naming the fear, being able to say "I don't want to go because I'm afraid of what they'll find", is often the first sentence that unlocks this.
What Can You Do to Cope with the Fear of Going to the Doctor?
Make the step smaller
The goal "I'm going to have all my check-ups done" can be frightening. Instead, set a single small step: today, just log into your family doctor's appointment system and look at available days. Tomorrow, book the appointment. The next step is going. Climbing a big mountain step by step is more achievable than doing it in one go.
Find a travelling companion
Having someone you trust come to the appointment with you can make the fear easier to carry. This support is especially valuable for the first visits. Over time, reducing this support and being able to go on your own can also be one of the goals.
Choose a familiar starting point
Starting with your family doctor, who has seen you before and knows you, rather than the crowded corridors of a large hospital, can lower the threshold. The family doctor can determine which check-ups are really necessary and refer you on in stages. A familiar face reduces the fear created by the unknown.
Write your questions down in advance
Prepare a list beforehand of the symptoms that get forgotten in the stress of the moment, downplayed or never mentioned in the examination. Saying to your doctor, "I'm a bit anxious, so I'm going to read from my notes," is completely ordinary. Many doctors are willing to explain the process step by step to anxious patients.
Make a plan for the moment of the results
Instead of reading the results alone, at midnight, on a phone screen, you can choose to go through them with your doctor. Make a small plan for results day too: whom will you call, what will you do afterwards? This plan reduces the uncertainty of the question "What will I do if I get bad news?"
Think the worst-case scenario through to the end
Avoidance keeps the feared scenario always stuck in the first scene: "If they find something..." Try completing this sentence: if something is found, what happens, whom will I get support from, what options will there be? Very often, the completed scenario is less frightening than the one left half-finished. Remembering that many health problems noticed early can be addressed with more options can also balance this thought.
Approach yourself with compassion
Blaming yourself with "Why didn't I go all this time?" increases shame and therefore avoidance. Instead, try saying, "I put it off because I was afraid; that's understandable; now I can take a small step."
When Should You Seek Professional Support?
Getting support from a mental health professional may be helpful in the following situations:
- You have been postponing necessary examinations and screenings for a long time
- You cannot go to the doctor out of fear even though you have noticed a symptom
- The thought of a hospital, an examination or a test creates intense anxiety or panic
- Matters relating to your health have become a constant source of tension with your partner or family
- Avoidance has started to put your health at real risk
An important note is needed here: psychological support does not replace medical assessment; its purpose is to make it easier for you to reach that assessment. If there are emergency symptoms such as chest pain, breathlessness, confusion or sudden loss of strength, call 112 (emergency services) without waiting, whatever your fear.
How Is the Fear of Going to the Doctor Approached in Therapy?
In therapy, the story of the avoidance is understood first: when did it start, which experiences is it connected to, what does avoidance give the person and what does it cost them? Sometimes beneath this fear lies an unprocessed loss, and sometimes the belief "I have to look strong."
Within the framework of cognitive behavioural therapy, the work usually includes the following:
- Seeing the avoidance cycle: Making concrete the relationship between the short-term relief of postponing and its long-term cost
- A gradual approach plan: Creating a personalised ladder of steps that runs from looking at the appointment system to going for the examination
- Working with catastrophic thoughts: Weighing up the evidence for, and alternatives to, the thought "If I go, something bad is bound to be found"
- Tolerance of uncertainty: Strengthening the skills to cope with the uncertainty brought by both not knowing and knowing
- Emotional preparation: Talking in advance about the resources for coping with possible bad news
The aim of therapy is not to force the person to hospital; it is to ensure that decisions about their health are guided by their own values rather than by fear. For many people this value is tied to a concrete dream, such as "seeing my children's weddings" or "spending time with my grandchildren". This dream acts as a compass that makes taking a step meaningful in difficult moments.
Each step taken during the process, such as being able to book an appointment or look at a result, is reviewed together in sessions, and the next step is planned in light of that experience. If needed, a session is scheduled after the first examination so that the feelings of that day can be talked through together as well.
Not knowing protects you for a while but never gives you peace; peace begins on the day you can walk through the door despite the fear.
If you feel that hospital appointments themselves are a separate source of stress, the article on hospital appointment stress may also do you good. You can find more information about individual work on the individual therapy page.
Frequently Asked Questions
Is avoiding the doctor also a type of health anxiety?
Yes, very often it is. In some people health anxiety appears as a constant search for checks and tests, and in others, on the contrary, as staying away from health services. In both cases what lies beneath is an intense fear of the possibility of a serious illness.
How can I persuade a loved one who won't go to the doctor?
Trying to persuade them by frightening or blaming them usually increases avoidance. Instead, it is more effective to say that you understand their fear and to offer help with concrete steps such as booking an appointment and going together. Letting them feel that the decision is theirs reduces resistance.
My blood pressure is always high at the doctor's; could this be anxiety?
In some people the tension created by the examination setting can raise readings temporarily; this is popularly known as the "white coat effect". However, only your doctor can decide whether this applies to you, if necessary with readings taken at home or at different times. That is why it is important to talk to your doctor rather than putting the readings down to anxiety and ignoring them.
I'm embarrassed to go to the doctor because I've put it off for years; what should I do?
This embarrassment is very common and is one of the important factors that keep avoidance going. Doctors meet many people who have put off examinations because of fear; what matters is not the time that has passed but the step taken today. Even sharing your embarrassment with your doctor can make the conversation easier.
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Eda Erkan Alapala
Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.
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