‘Health anxiety’ or ‘hypochondria’? Fear or phobia, it’s a killer…

healthanxietyPerhaps my title exaggerates; perhaps it doesn’t. All I know is that whether you worry at every possible sign of illness and go to the doctors, or worry about illness and avoid the medical profession until a crisis occurs, these are not issues to be sneered at.

‘Hypochondriacs’ are much maligned. In books, on tv and in the media anyone who seems to seat themselves in the doctor’s waiting room at every opportunity is a figure of fun or of derision. Admittedly, there are some who seem to enjoy a good old natter about their ailments and for whom a neighbour or friend’s misfortune is the subject of much hushed talk and gossip. But this is not about those people. This is about people – and I count myself one of them – for whom health anxiety is a horribly debilitating, restrictive and obsessive condition.

Often considered to be on the  Obsessive Compulsive Disorder (OCD) spectrum, many of those affected by health anxiety have ‘an obsessional preoccupation with the idea or the thought that they are currently (or will be) experiencing a physical illness.’ (Anxiety UK). The most common health anxieties tend to centre on conditions such as cancer,but the anxiety or phobia may fixate on any type of illness.

You have a headache – it is a brain tumour

You lose your keys – it is Alzheimer’s Disease

If you are the type of person who laughs at such thoughts, then I congratulate you on your balanced attitude to your health but I do not admire your sense of humour.

For me, health anxiety manifests itself as acute anxiety of some symptom or other alongside a phobia about going to the doctors. I don’t go unless I am genuinely fearing for my mental, rather than physical, health. It has to get to the point where any unfavourable diagnosis is preferable to the anxiety symptoms I am experiencing.

For others, the anxiety so convinces them that they have a physical illness, that they will go to as many doctors as they can until they get a diagnosis and undergo invasive testing in the attempt.  They ask for second, third and more opinions; but the irony is that even a full raft of reassuring results will not satisfy them and in serious cases the medical community as a whole is considered inept, so confirmed is the person of their own physical symptoms.

Whilst there is little doubt that these tests are a drain on health care providers, it simply isn’t fair to dismiss the behaviour as ‘attention seeking’. The fear is genuine.

The worst part of the obsession with one’s health is the irresistible need to check all the time. Is that a lump? Why won’t that sore heal? This cough has gone on a long time….. The anxiety itself leads to physical symptoms – palpitations, chest pain, dizziness  – which reinforce the sufferer’s conviction that their illness is a physical one. It is genuinely debilitating and there is often a genuine fear of going to the doctor’s; not just because the worst fears may be confirmed, but because there is a real fear of not being taken seriously.

But health anxiety must be taken seriously. Causes are uncertain but include:

  • a stressful, life-changing event such as a bereavement, or witness something traumatic
  • another mental health condition, such as depression or alcohol dependence
  • a physical illness, such as a thyroid disorder
  • taking illegal substances such as amphetamines, LSD and ecstasy
  • withdrawing from long-term use of some medicines, such as tranquillisers

For me, health anxiety has existed since my childhood but it has become much more difficult to deal with since my diagnosis with breast cancer in 2006. I wrote in Dandelions and Bad Hair Days of my feeling that all my long-term anxiety about disaster affecting myself or my family had seemed to come true with the finding of the lump. Even though I came through the treatment successfully with a good prognosis I let the fear of recurrence dominate my thinking.  My family has had to learn how to deal with my behaviour, common to many who are affected with this type of anxiety – a constant need for reassurance, help in checking or a ‘it will be alright won’t it?’ type diagnosis. It must be frustrating to say the least.

Mercifully, the symptoms of health anxiety are now better recognised and talking treatments such as cognitive behavioral therapy (CBT) might be offered and medication (such as anti-depressants and mild tranquillisers) may be prescribed. It is important to approach one’s GP with the anxiety itself though; not many doctors have the time to look at the wider picture when a patient presents with a number of physical symptoms and the nature of the disorder itself is likely to result in a patient denying such an explanation of their concerns. Those of us with health anxiety do not make life easy for ourselves.

anxietyAnxiety UK offers a ‘self-diagnosis’ of health anxiety and if you answer ‘yes’ to most, recommends you approach your GP:

During the past 6 months:

  • Have you experienced a preoccupation with having a serious illness due to bodily symptoms that has been ongoing for at least six months?
  • Have you felt distressed due to this preoccupation?
  • Have you found that this preoccupation impacts negatively on all areas of life including, family life, social life and work?
  • Have you felt that you have needed to carry out constant self examination and self diagnosis?
  • Have you experienced disbelief over a diagnosis from a doctor or felt that you are unconvinced by your doctor’s reassurances that you are fine?
  • Do you constantly need reassurance from doctors, family and friends that you are fine, even if you don’t really believe what you are being told?

With my cancer diagnosis I know I am not alone in being fearful. In a way it is natural and necessary to ensure that doctors are given the best possible opportunity to keep one healthy. However, I know many of my symptoms, if they do relate to something physical, are necessarily exacerbated by my mental response to them. To let the obsession with cancer recurrence take over one’s days is to allow the disease to rob you of years of your life in more than a physical way.

So if you recognise yourself in any of this, do seek help for your thinking as well as for all those aches and pains. I am having counselling now that, although painful, is bringing some recognition that whilst acknowledging I have gone through trauma that in some way explains my responses, I do not have to repeat old patterns of thinking.

I really can’t keep living in the past if I want to enjoy my future.

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4 Responses to ‘Health anxiety’ or ‘hypochondria’? Fear or phobia, it’s a killer…

  1. Viv says:

    Oh this is very familiar. The hardest to deal with is when there has been a real, serious condition in the past. With me, having had an emergency cranial event, I have to be very careful how I react to headaches, finding the line between “Ignore it, it’s me being me” and “OMG call an ambulance NOW”.
    Excellent post.

  2. Well said, and I’m glad you noted about the pairing with OCD. It is something I also share, most likely triggered, like my OCD, in childhood but exacerbated, like you, by genuine health problems (mine and my mother’s) as an adult. Beautifully written and I hope it helps those who need it and raises awareness and compassion in those who don’t. 🙂

  3. shakerattleanddroll says:

    Hello there – great article, quite an articulate way of looking at health anxiety. I know that when I mention hypochondria to people they don’t take it very seriously. As you say, people tend to roll their eyes or be glib because it’s not a real illness. The way I look at it is – if I had a bad back, you wouldn’t expect me to ‘suck it up’. I’ve got a ‘bad mind’ at the moment, and it will take time to heal!

  4. Project Calm says:

    “I really can’t keep living in the past if I want to enjoy my future.” – this. So true. Brilliant article. From another hypochondriac – thank you so much for sharing. x

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