I am repeating a post from a few weeks back as there seem to be a lot of folks here who are new and showing the usual signs of distorted thinking that characterizes health anxiety. I hope it helps someone.
Overall philosophy.
Heatlh anxiety is a thought disorder in which people misinterpret usually benign physical symptoms and other stimuli. That means that the treatment of the disorder must be primarily at the thought (and behavioral) level.
Key concepts.
1. While people with health anxiety react with fear to bodily symptoms and sensations, it is critical to understand that anxiety itself can cause an incredible variety of bodily symptoms and sensations that are benign in the sense that they are not related to any organic illness. For example, anxiety very commonly causes muscle tension (which can result in pain, feelings of heaviness, etc.), GI issues, tingling, fast heartbeat, palpitations, twitches, a sensation of shortness of breath, fatigue, and so on. Over and over again on this forum, one sees the question, could this really be anxiety? In the vast majority of cases, the answer is yes.
2. When anxious people focus on their symptoms with fearful attention, it almost inevitably ampllifies them, which in turn ratchets up the fear reaction. It's a vicious cycle.
3. When symptoms migrate from side to side, or place to place, or system to system, or they come and go, that is almost a sure sign that they are being caused by anxiety. Most organic illness do not present with inconsistent, shifting symptoms.
4. An escalation in symptoms is frequently associated with additional or new stress in people's lives, but people with health anxiety often fail to make that connection. One sees this here over and over again. It is always important to examine what is happening in one's life when new symptoms appear or old ones worsen.
5. It is almost always a mistake to research symptoms on the internet. One can find a catastrophic explanation for almost any symptom or set of symptoms online. The internet is full of unverified anecdotes and blatantly false information. People with health anxiety tend to suffer from confirmation bias -- that is, the tendency to pay attention to information that vallidates a pre-existing belief and to ignore information that contradicts that belief. This is why a googler will seize on one little nugget that comes up in an online search, most likely from an unreliable source, and obsess about it to the exclusion of all contrary information.
6. It is almost always a mistake, absent a medical condition that requires it, to monitor symptoms such as heart rate and blood pressure. It only feeds the cycle of health anxiety. The body will work just fine without monitoring. In fact, as I like to say, the body works best when the mind gets out of the way.
Reassurance.
A special word about reassurance, because this is, in my opinion, the hardest thing for people with health anxiety to understand and the biggest mistake they make. Reassurance, whether from doctors or others, feels good. There is no question about that. But here is the problem. Reassurance does not help people develop the tools they need to address their health anxiety. Rather, it makes them dependent on others. And worse yet, it actually perpetuates health anxiety, much the same way as a fix helps the addict temporarily feel better but prolongs his or her addiction. One sees it time and again -- people whose principal method of coping with health anxiety is to seek reassruance eventually will start to reject the reassurance they have received, especially medical, and to seek more and more of it. They don't trust the tests, they worry that the doctor missed something, etc. If they get to the point where they are reassured about the current fear, another fear will crop up in its place, they will seek reassurance for that fear, and the cycle of testing, doctor and ER visitis, and online reassurance-seeking behavior continues.
Things to do.
1. Accept test results and medical opinions. See the discussion of reassurance above. This is critical. People must learn to tune out the what if thoughts -- what if the doctor missed something? What if they misread the tests? What if they didn't do enough tests? What if something's changed since I had the tests? Doctors are not perfect, of course, but the chances that a capable doctor is going to miss a sign of heart disease, MS, ALS, or any of the catastrophic illnesses people worry about are very very very low.
2. Stop seeking reassurance from others. See the discussion of reassurance above.
3. Put away the monitors. See above.
4. Stop the internet research. See above.
5. Seek out a cognitive behavioral therapist, or if you can't pay for one, buy a workbook or find an online resource.
6. Practice the following, the most basic of cognitive behavioral therapy exercises. Take a piece of paper and divide it into two columns, one saying, I have X (whatever you are fearing), and one saying, I don't have X. Write down all the objective evidence (that is, evidence that would be meaningful to a rational person such as a friend) in support of each proposition. Then study the results.
7. Read up on cognitive distortions. There are good lists online. Learn to recognize these distortions in your own thinking.
8. Try to learn from the past. For example, if you are in the grip of your latest fear, think about, and write down, all the things you have feared before that turned out to be false alarms. Focus on the list. Recognize the pattern. Confront the fear.
9. Educate yourself. There are many very helpful books about anxiety and panic attacks. Example, Claire Weekes Hope and Help For Your Nerves, David Burns When Panic Attacks.
10. Don't feel sorry for yourself or see yourself as a victim. You have a thought disorder. That's just the way it goes. Don't ask why you have it, do something about it. The good news is that it's treatable, with effort. While it's natural to feel sorry for oneself, in the end it does no good and just perpetuates the condition.
11. When in doubt, breathe -- breathing exercises are a great antidote to panic and stress. It's easy to find descriptions here and elswhere online.
12. Exercise. This is very important, especially for people with cardiac anxiety who have been given medical clearance. Exercise relieves stress, and inactivity worsens it and reinforces cardiac anxiety. Take a leap of faith and start with just a minimal amount -- eventually you will desensitize and it won't provoke a fear reaction.
13. Reduce sugar, junk food, etc. These only make one feel worse in the long run.
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Topic: Advice for new posters (Read 267 times)
October 15, 2006, 04:47:31 PM
