Health Anxiety Is Way More Than Being A Hypochondriac — And It’s Way More Common Than You Think
On a spring day in 2015, I woke up to the news that a reporter had died of a brain aneurysm. Shortly after completing an assignment, she had collapsed in front of her team, and despite being rushed to the care of a top neurosurgeon, she died from intracranial hemorrhage. Here is what happened to most people who saw the news: They recognized the tragedy of it, empathized with the reporter's grieving loved ones, and moved on.
But because I have health anxiety, here is what happened to me: I got stuck. My generalized anxiety disorder's insidious, nonsensical logic sharpened into a form I hadn't encountered before. It decided that because the woman who'd died was a journalist, and I was a journalist, that was probable cause for there to be an unburst aneurysm nestled in my brain right that very second. In fact, it went beyond probable cause, my anxiety told me. Having an unburst aneurysm lurking inside me wasn't just a likely possibility — it was a 100 percent certainty. And sooner or later I was going to die from that aneurysm. Probably sooner. No, definitely sooner.
Of course, none of that is true. I don't have an unburst aneurysm. I'm not about to die. Like an estimated 1 to 3 percent of the population, I live with health anxiety, which you might know as hypochondriasis, illness anxiety disorder, or somatic symptom disorder, according to the Anxiety and Depression Association of America (ADAA). ("Hypochondriasis," FYI, was removed from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, in part because "the name was perceived as pejorative and not conducive to an effective therapeutic relationship," according to the American Psychiatric Association.)
health anxiety is so WILD, i don't know why i go from "oh its just a weird feeling" to "IS IT APPENDICITIS? AM I DYING" SO F A S T— (@siobhanchiffon) #
The fact that the genesis of my health anxiety was triggered by a specific event, according to Ken Goodman, a licensed clinical social worker and author of Quiet Mind Solutions, makes me a fairly typical case. The onset of health anxiety is "usually [due to] a confluence of issues happening, where maybe you have a predisposition to being anxious and at some point in your life, say, two people die," Goodman tells Bustle. "And then you see a television show about someone who has ALS, or you see a news piece about ALS, and you note the symptoms. And because you're kind of anxious because you lost these two people, [...] you start wondering. Usually there’s a kind of genetic predisposition that was just waiting for something to bring it to the forefront. And it could have been at any time in your life, but it just happened to be at that moment, when those things were happening."
In spring 2015, I was in my final year of college, and struggling to pay off what I could of my student loans. After I saw that news story, my health anxiety turned on and never shut off. Goodman explains, "When you have illness anxiety, you become preoccupied. So you just can’t stop thinking about it. There’s an endless amount of questions that you have. And it’s mostly the same questions over and over."
Those questions — Do I have this illness? Will I get it? How soon am I going to die from it? — turned themselves into a loop, and I couldn't escape it. I am in general an intelligent, rational, realistic person. But it was like a switch in my brain — my horribly diseased brain, as my anxiety had erroneously convinced me — had been flipped. I literally could not stop myself from Googling everything I could about the reporter's death, and when new information about her stopped coming, I turned to case studies and WebMD. I became an expert on signs of aneurysms, unburst and recently burst.
This, too, is typical of people with health anxiety, Goodman says. Because so many people with health anxiety are afraid to go to the doctor for fear of being dismissed, or are afraid to go because they think the doctor will confirm their fears by diagnosing them with an illness, many sufferers turn to the internet. It also helps — or, in our cases, doesn't help — that all the worst medical information in the world is readily available.
"The quickest way to find out answers is to go online," Goodman says. "And that actually causes more anxiety because then you read things and you focus on the things that are the most scary. When you go online, it lists every possible disease associated with a symptom. And when you have anxiety, your eyes tend to gravitate toward the worst. And instead of being a mole, now you're reading that it's cancer."
I sometimes get pains in my head or in my heart and think I'm going to die but health anxiety can cause these sensations.— (@depressionnote) #
Health anxiety can manifest not just in intrusive thoughts, but, as with other kinds of anxiety, physical symptoms as well. Dizziness or lightheadedness, racing heart, tingling in your extremities, stomachaches, or even chest pressure have been known to happen because of health anxiety. This can exacerbate feelings that you are experiencing the disease or disorder you're afraid of, but they can be treated along with your anxiety.
What finally made me stop the cycle of worry wasn't the hundreds of sleepless nights, nor the fact that my fixation on aneurysms had, thanks to Googling, widened to include blood clots, breast tumors, and flesh-eating infections. What finally made me stop was medication.
After months of obsessing, I went to my family doctor. I expected to be challenged, but she swiftly agreed I had health anxiety — just one of the many presentations of generalized anxiety — and prescribed me medication. And then she stayed with me and patiently went through a list of common aneurysm symptoms. I had none of them. Once she had led me into establishing I didn't already have an aneurysm, she told me how rare they were, and how unlikely it was I'd develop one in the future. Though my logical self knew all of this from my spiral Googling, for my anxiety self, the information was somehow different coming from her.
A patient and accepting doctor can be a huge boon to a patient's recovery, Goodman says, "along with therapy." Health anxiety is commonly treated with cognitive behavioral therapy, which aims to help patients change their harmful thought patterns, and thus change the behaviors that result from those thought patterns.
Goodman also adds that along with getting therapy, patients with health anxiety shouldn't be hesitant to get serious physical symptoms checked out by a doctor. He stresses that patients can have both health anxiety and legitimate medical issues simultaneously, and that people shouldn't avoid getting things checked out. "[You] want to be sure doctors don’t dismiss you because you have anxiety," he says. "Anytime someone comes to me with physical symptoms, let’s say in their heart, [...] I’ll ask them, 'Have you been checked out? Is your heart okay?' I want to rule out any medical issues."
People who feel like they might suffer from health anxiety should talk to their medical doctor about ruling out any possibly physical ailments, and also about speaking to a therapist or psychologist who can help you manage your anxiety. The ADAA has a tool to help you find a therapist in your area, and other resources about health anxiety that may be helpful.
It would be nice to be able to wrap up here by telling you my medication and understanding doctor made my health anxiety go away. Nice doesn't equal reality, though. The truth is, there are still days when I feel my anxiety's finger on the switch in my brain. There are days when it flips again and I become fixated. Lately the fixation is rabies. Do I have it? At this exact moment, while I'm stable, I can tell you: Of course not.
But later I will wonder: Or do I?