Experiencing 'Health Anxiety'
Confessions of a 20-something 'Hypochondriac', and did CBT help with my 'Health Anxiety'
It’s worse at night. It’s 11pm, I’m lay in bed reading a book, alarm set for eight, and suddenly my brain connects my recent fatigue, a sore throat, and choking on the quorn nuggets I ate for dinner (which FYI are delicious) into a fear that I may have some sort of incurable cancer. I open google, which is never a good thing yet I convince myself I’m being responsible checking on my health, and my mind spirals out of control when the symptoms I’ve been experiencing lead me onto the NHS page for oesophagus cancer. I’m overwhelmed, scared, panicked. I need someone to help me stop this disease but the doctors aren’t open, nobody is awake, nobody can help. What if the endoscopy I had 6 months ago missed something? What if I’ve been ignoring symptoms and it’s too late? What if the doctor won’t send me for tests due to coronavirus?
These are some of the thoughts that pass through my mind when I’m having a health induced panic attack. Let me put in boldly, health anxiety sucks. There’s no positive spin I can put on it, simply put, it sucks. It has affected nearly every aspect of my life at some point, friends, education, dating, work performance, life events, but in the last year I’ve managed to take some control over my thoughts and fears revolving around health, the first step, acknowledging what I experience is an anxiety.
Recognizing my thoughts and fears are an anxiety remains a big step to help manage my brain from spiraling out of control. I’ve learnt that health anxiety is different for every person. I hope that reading some of my experiences can aide in recognizing anxiety within health, and will aide you in knowing that you are not alone.
My anxiety comes in phases, these can last from a few hours, to more consuming phases that can last weeks, months, and more severely, years. I have never worried about getting a cold, or a throat infection, or breaking my arm, my anxiety is sparked by diseases that are fatal. They are sparked from various triggers, hearing about a disease for the first time, finding out the reason for somebody’s death was an incurable illness, watching medical TV dramas, finding symptoms.
When experiencing a phase my mind feels out of control. I find a lump under my armpit, or I realise that my bowel pattern has altered, I play out the events in my mind of what could happen if I have a disease Google has so kindly told me I have. This opens the floodgates of thoughts that race across my mind…. Did I catch it too late? How will I tell people I love? Why isn’t anybody taking this serious? I can’t fully control my health, that sparks panic in me. I can control what I eat, I can control curing tonsillitis with antibiotics, but I find it hard to comprehend there’s even the slightest possibility that my chest pain could be a heart attack and there’s nothing I can do about it.
Last year I decided to try CBT for my Health Anxiety. I reached out to a fantastic young person organization in Manchester called 42nd Street for support. I felt stupid at first, like this wasn’t a real issue, like I didn’t deserve to be taking up somebody’s time. Often my anxiety was dismissed by others when I started talking openly about my dark thoughts as silly or with someone claiming they’re also a ‘big hypochondriac’. It was hard to explain that I can’t concentrate on an assignment right now or the reason I’m a little quiet tonight is because I’m scared that the cough I have is the starting of lung cancer, without feeling like I was being ridiculous. I couldn’t convey how consuming and lonely the feeling is. I’d trick myself into thinking I’m overreacting for a brief moment, then stay up all night looking into the details of a disease that I can’t possibly even have because I’m not over sixty and female. CBT was the first time I was able to openly explore what I was feeling and rationalise my experiences out loud with someone guiding me through my thoughts.
We looked back at when I first remembered experiencing my fear of getting a serious illness. Two vivid phases stand out in my mind. One where I feared I had a heart murmur or something was wrong with my heart. I was probably fourteen at the time, I remember checking my pulse excessively throughout the day, leaving class in school to check that my heart beat felt normal, when I had a slight pain in my chest the only thing that would comfort me was going to A&E. I’d panic my parents and we’d drive to the hospital, sometimes even just sitting in the car park at the hospital would calm me down and I’d tell my concerned parents that I’m ok. Another time I was having headaches in Year 11, the headaches were bad, I googled and the only possible solution was I had a brain tumour. There were several triggers that sparked this phase, a phase that lasted over a year, including a scene on Waterloo Road where a girl who was having headaches developed an incurable tumour that resulted in her death, an in-depth story from a classmate on how her father recently passed away from a brain tumour, and a nurse who said she was ‘heavily concerned’ when I told her I’d been having headaches. It consumed me. I was convinced I was dying. I was frustrated that I wasn’t being taken seriously and nobody was sending me for tests. I took time off school loosing motivation for exams that I felt no longer mattered, I distanced myself from friends, I spent the majority of the day thinking about what could happen, all at the age of fifteen – that’s a lot of a fifteen-year-old to carry on their shoulders. It was only when after numerous doctors’ appointments one doctor asked me why my hair was so wet that he suggested seeing if the headaches went away with a simple blow dry – which they did.
I discovered my biggest fear in these sessions. Turns out my biggest fear is realising I have a disease that I didn’t catch in time. I cried a lot when I first said that out loud. I’d never said those words out loud before. My counsellor didn’t make me feel like that was stupid, didn’t tell me how to change what I was feeling, she empathised “that must be a hard burden to carry on your shoulders, I can’t imagine how hard that must be for you.” Someone realised how this was affecting me. This feeling is real.
Another thing I explored is when a phase went away. I made a diary of every serious illness I’d feared that I could have, and what happened that made that overwhelming feeling evaporate. Although it was different for each experience, I found that the most frequent occurrence was knowing I’m getting help. Feeling like I’m being tested would ease my panic often before even knowing the results. My irrational thoughts sometimes immediately evaporated as soon as I got the NHS letter through the door for a CT scan. I know that action is being taken, and somehow realise how irrational I’ve been almost overnight. It clicked, sometimes I’m not necessarily scared of the symptoms of a disease or even the disease itself, I’m panicked that I’m not being taken seriously enough. When you’ve convinced yourself that you have a potentially fatal disease and a doctor brushes it off as a virus you suddenly feel powerless. Nobody is helping me and my world is falling apart. Something as simple as an out of hours’ test couple be the difference between life and death, so why aren’t they sending me for tests? Save me. I sometimes wish that I could be tested for every disease possible on a regular basis, I get frustrated still that this is out of my control.
I told my councillor at 42nd street that I’m scared that I’m never going to be able to overcome my heath anxiety because there’s always something that could be something. As soon as one lump clears, a pain develops elsewhere. We did some exercises that helped with symptoms. One was focusing on different parts of my body, and recognising that when I’m excessively focused on a symptom, for example constantly touching and examining my throat for tonsil cancer is bound to cause some irritation to my throat, creating a symptom (FYI I have very big tonsils and it’s not a pretty sight – sorry to all the doctors who’ve had to endure extensive examinations). Focusing so intensely on symptoms of a disease can create them. Your mind is powerful.
A big problem I still struggle with is acceptance, I discussed this a lot in my CBT. Accepting that, no matter how minute, there is a possibility of getting seriously sick. I’m not completely able to settle with this, but I can do things to help. Now I realise that what I suffer with health anxiety, just knowing this sometimes settles my mind. I don’t try to push away the thought, I can sit with it a little better knowing that I’m experiencing anxiety, and hopefully it passes. Often, it doesn’t, and I can easily spiral into a phase. To avoid this I limit habits, or at least attempt to. Big habits for me I realise include Googling symptoms and/or diseases (never Google anything, ever), excessively trying to get reassurance from friends that I’m ok, worrying that I either a) haven’t been sent for a test, or b) the test somehow got mixed up and I didn’t get the right result. These habits are symptoms of a serious illness, and that illness is health anxiety.
Something I still don’t know the answer to is what is normal and what isn’t normal. It’s important to check things for your health, I know more than anyone. I sometimes feel like I could pass an exam to become a junior doctor with the amount of research time I’ve put in. But when is too much? When are you ignoring every probability that you are absolutely fine and obsessing over the fraction of possibility that you have something worse than a general cold? I don’t know the answer, that’s something I struggle with. That is hard. I can’t ignore my health completely, all I can do is try to manage my anxiety in a way that it doesn’t affect my quality of life, like I know Health Anxiety can.
I live a busy life. A doctor once told me something that often reassures me: “Cancer moves fast, so the fact that your symptoms aren’t getting worse is a good sign that this isn’t anything serious.’ Sometimes time is on your side, and eventually enough time has passed for you know you don’t have something serious, or for you to forget to focus on your symptoms completely. Sometimes my midnight fear that I have a pain in my groin clears when the following day I rush around a rehearsal all day, get home, and realise that I haven’t had a pain at all since I’ve not been prodding the area in a search for lumps.
A game changer happened to me in the past year. For the first time in my entire life, I discovered I had something. Through all of the years of phases and fears, appointments, and late night online forums, none of my fears ever resulted to be even remotely close to true. I came back from a trip to Korea (South of course), and upon return, I vomited some blood. I actually wasn’t worried, but my mum took me to A&E to be on the safe side. I was sent for a test called a gastroscopy, which is a tube that has to go down your oesophagus and examine your stomach. It’s pretty grim, and if you ever have to have one, I implore you to get sedated – which is also kind of fun when you’ve done it and aren’t googling the fatality rate in outpatient sedations. I found out that I had a hernia in my belly and had severe GERD. My oesophagus was scarred, and my stomach wasn’t in a good way. I was told if I wouldn’t have had the procedure when I did then I could have had an internal rupture in the next few years. I couldn’t believe what I was hearing. I’d had symptoms for a long time for GERD and a hiatus hernia. After going for meals I’d often vomit, I’d have to stay up at night often because of acid reflux, yet this was the one thing I’d never been concerned about. It was almost normal after experiencing it for so long. It was only when I starting treatment that I realised what it was like to have a meal and not feel like you need to be sick for the next six hours. In fact, I actually had to call the doctor because I thought there was something wrong which clearly was the opposite, clearly not heathy to be sick after every other meal. I spoke with a friend of mine about it, and something clicked, my friend suggested maybe the anxiety I’d been feeling towards searching for an illness that I didn’t have was my body’s way of telling me that something wasn’t quite right, and I was vesting that in the wrong places. This was a big turning point for me. Knowing that my worst fear was coming true, I had something that could be serious, didn’t feel as scary as I thought it would, it was being dealt with, I am ok.
Throughout my adulthood my health anxiety has affected many aspects of my life. In relationships I’ve obsessed over partners’ sexual health, I’ve quit jobs during phases where I don’t want to waste any time, I’ve cut off friends who brushed off dark periods as an overreaction. Health anxiety has always been with me, I’ve accepted this is something that can’t be wiped away, but I’m in control now, I can accept my thoughts, I can recognise my anxiety and cut out habits without being neglectful to my health. I’ve been lucky that my phases have become less frequent, there’s been months and months where I haven’t been worried about my health, but I’ve been changed by understanding how lucky I am to be healthy and well. I now realise the gift of being a so-called ‘hypochondriac’ (a phrase that seems to be joked by often), the gift is appreciating the time I have when I have overcome a phase, I realise the luxury I have that many don’t have to be able to feel everything is ok.