For all the therapy I have had over the years and for all the improvements I have made with anxiety, the one thing I have found very difficult to crack in terms of solving is that of health anxiety.
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| Last time I did this, I was found to be alive |
Granted, much of what I have learnt is how to deal with anxious symptoms, with an overarching acceptance that I will always have anxious feelings to some degree. But having the tools to deal with these feelings is hugely important and this is what I have learnt over the years. Naturally, what happens if you have the tools to deal with and react more strongly to anxious symptoms is that the cause of the symptoms becomes less too. A good example here is my experience with panic disorder, which used to prevent me from doing certain things such as presenting, socialising or eating out. Whilst, sometimes, these things can still present challenges, having the tools to deal with any anxieties that these things throw up (no pun intended) gives you more confidence to tackle the original causes and do them anyway - and even enjoy them. I cannot emphasise enough how much I revel in eating out with a friend and actually enjoying it. A positive of anxiety - you don't take for granted small wins that perhaps other people don't even register as significant. So, tackling the symptoms also helps to tackle the cause and eventually a hugely anxious and near-to impossible situation becomes doable or even enjoyable.
Sadly for the health compartment of my anxiety, the success of this cognitive behaviour change has not been realised in quite the same way. Yes, I am now able to deal with the symptoms of health anxiety better - i.e., when I get a physical pain or discomfort and automatically associate it with immediate death or life defining illness, I am better able to rationalise and say to myself 'you're being stupid,' and come up with alternatives to the problem other than cancer, a brain hemorrhage or equivalent. But the problem is, I still automatically associate any pain with these sort of horrendous problems - in the case of health anxiety, tackling the symptoms and dealing with them better has not really changed the way I perceive a physical discomfort in the first place. This differs from other 'types' of anxiety, particularly panic disorder, as described above.
What this shows is how powerful sensational and unrealistic thoughts can be. I know, KNOW, that when I get a small pain somewhere, the chance of it being anything other than a natural small pain that anyone could get at anytime is close to zero. And I do KNOW this. But my brain automatically sensationalises it into something absurd and, yet, believable. Usually, the pain I feel could, theoretically, turn into something more sinister. But the odds are so great that most people whose brains are wired with the correct circuitry are able to manage it rationally.
Now, you may be thinking that this heightened health awareness and negative interpretation could be a good thing - after all, many people who do have the misfortune to develop a serious health problem do so because they failed to seek help for potential symptoms early enough. With a health anxiety condition - or hypochondriasis if you'd like the medical term - the automatic thoughts of imminent death and disease surely, at least, makes early diagnosis of anything bad almost certain. Indeed, some people with particularly severe health anxiety pay frequent visits to the doctor, almost as a form of OCD (see below!); they cannot help but get a professional opinion on whatever it is they are experiencing as a way of reassuring themselves that they are okay. In extreme cases, people will get multiple opinions from multiple doctors. This must be a very frustrating and time consuming practice, one that I am glad to say I don't have.
However, the down side of not being like this is that I now have a problem whereby, despite my brain tricking me into thinking I have an extreme problem even though I KNOW that I don't, means I don't go to the doctors and instead assume it is health anxiety and try and deal with it accordingly. So far, it always has been health anxiety. The problem is, what if I get symptoms that I put down to health anxiety but are ACTUALLY something more sinister? Could the thing that I fear the most end up being the reason for a mis- or late diagnosis? It would be the ultimate anxiety irony. It makes subtle symptoms very difficult to differentiate between hypochondriasis and a real health problem and due to experiencing the former for nigh on 20 years, my brain will automatically assume it is health anxiety. How twisted is that? I automatically think that a pain is a major health disaster, triggering a reaction that makes me assume it's health anxiety, meaning I do nothing about it and instead just deal with the symptoms of health anxiety. What if I actually need to deal with the symptoms of a real physical health problem?
The other irony with health anxiety (anxiety generally is one big labyrinth of irony, I've discovered) is it can make you more physically ill in the first place. For example, when I had very bad panic disorder, I was obsessed (literally) with checking my heart rate. Checking for symptoms, generally, is one common annoyance that comes with health anxiety, showing again how it is also closely linked with OCD - one can become so fixated on checking that something is wrong that something can become wrong! So back to the panic disorder example - not surprisingly, when I had panic disorder, my heart rate was often higher than you'd expect (whatever that actually was!). Now, what health anxiety did is automatically associate this high heart rate with an imminent heart attack. Even though I knew it was 'just' the anxiety, I still assumed that my heart was about to burst and kill me. So, what did I do? Keep checking my heart rate, to 'make sure I was ok.' Naturally, almost everytime I checked it, my heart rate was high, and in realising this, checking it made it higher and higher, which led to stronger health anxiety feelings regarding a heart attack. All of this anxiety can of course make you physically ill - imagine the strain all this nonsense is putting onto your body. I often had pains in various places (that made the health anxiety worse, of course) which were caused by a constant state of panic.
Anxiety is just one big vicious circle.
I am happy to report that, generally, the days of this utter absurdity are behind me. Of course, I worry about jinxing it when I write this. But that's the reality. However, it doesn't alter the fact that I simply cannot get that original thought process to stop. PAIN = IMMINENT DEATH. I think it will be something that I will always have to put up with and be, as a result, called a hypochondriac. As long as I can deal with this behaviour more sensibly and rationally, I will be satisfied.
This is not necessarily the topic for it, but I would like to wish all my readers a Merry Christmas and a Happy New Year. May the year 2017 be better for all of us.
Best wishes
Al
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