Opinions Please!!!!

[angela52884]

Ok, so I have always had worry issues but I have never ever thought about obsessive compulsive until I watched oprah yesterday and listened to some of the people on there! I have had panic attacks and believe I have panic/anxiety disorder. Anyways, some of my thoughts/fears are just stupid and I cant say why I think/fear the things that I do. On oprah there was this woman that examines her food and if she finds 1 spot on it thinks that the food is poisoned and wont eat it. I dont think that I am to that extreme, but I have had some of the same fears. One time I drove through Mcdonalds and got a cheeseburger, I did look at it and I had thought it had looked wierd, well then I think of all the sick people in the world and get to thinking that maybe someone working there did put something in it or poison it and I will eat it and die, so I didnt eat it. I am afraid to take medications and I always read up on all the info about it, I have a fear that I will have an allergic reaction or site effects or something so that scares me! It just really got me with the food thing because sometimes I do that and think something if on the food and I wont eat it. Also weird thoughts about household cleaning products, I freak out if I get any of it on my skin, or I smell it too long if I use it. I feel like Im so weird and I dont know why I think the way that I do. Also superstitious thoughts that scare me. I could go on and on, can anyone relate to me?? Can you have obsessive thoughts about health related stuff???

[britgirl04]

Yes you can and it is called Health Anxiety...
My fears are different but I can relate to the medicine thing. It took me a while to take medicine as I was using it to treat being scared of medicine! It doesn't make sense to anyone else but I am afraid that it will screw me up and make me crazy.....I will get a reaction, it will make my heart stop, the list goes on and on.
Everytime I feel unwell I panic and think this is it, it's my time to die. It is a scary place to be but through taking the very meds I am afraid of and going through therapy I have learned to cope a lot better and most of my panic attacks have gone away. I was even able to start taking a quit smoking med last weekend and plan to quit this Saturday.
The worse thing you can do is obsess over symptoms and side effects. Be educated about what you are putting in your body but do not get too caught up in horror stories you hear....it will prevent you from getting on the road to feeling better.
Good luck!

[ocdengineer]

It isn't health anxiety in my opinion.  Health anxiety is fears of being ill for rational reasons (symptoms) and having anxiety as a result.  OCD is when the reasons become irrational, like if I take out the dish soap I could accidentally put it in my food or someone else's and they or I would die.  There is a big difference even though many of the people here who have HA actually probably have an OC spectrum disorder.  If you think you have MS and no amount of rational data will dissuade you, then you may have an obsession.  Personally I went through "Health Anxiety" and I was just looking for what was wrong with me.  Now, the level of OCD is unclear here because it doesn't seem to be causing severe anxiety.  It could be just and Obsessive Compulsive Personality.  That is typical of sensitive analytical people.  OCD usually results in sever panic and anxiety whereas OCPD is usually something that you just notice and it doesn't cause any major problems in your life.

Take care,
OE

[Xalatimo]

It isn't health anxiety in my opinion.  Health anxiety is fears of being ill for rational reasons (symptoms) and having anxiety as a result.  OCD is when the reasons become irrational, like if I take out the dish soap I could accidentally put it in my food or someone else's and they or I would die.  There is a big difference even though many of the people here who have HA actually probably have an OC spectrum disorder.  If you think you have MS and no amount of rational data will dissuade you, then you may have an obsession.  Personally I went through "Health Anxiety" and I was just looking for what was wrong with me.  Now, the level of OCD is unclear here because it doesn't seem to be causing severe anxiety.  It could be just and Obsessive Compulsive Personality.  That is typical of sensitive analytical people.  OCD usually results in sever panic and anxiety whereas OCPD is usually something that you just notice and it doesn't cause any major problems in your life.

Take care,
OE

You probably know more about this subject than me..but, really, sometimes the line is really blended and you can't tell the difference.  You can have OCD, get a thought telling you that you have "cancer" and start feeling physical symptoms because of that, and then start obsessing over your health in a Pure O type of way.  I've done this before.  I went from 1 obsession that was about my health, to the next obsession which was about hurting other people and why I was thinking that when I am not a violent person.  And in between not have any health related worries.  Maybe this means you have both, I am not sure.  They are pretty similar though and probably somewhat related.  The other thing is, sometimes OCD thoughts aren't irrational.  Technically, it can be *any* thought that causes distress and your mind tries to get rid of it, like fear of getting sick because of germs.  It is hard sometimes to define between rational and irrational, because to the mind, it seems perfectly rational.  Just like someone with health anxiety or hypochondria thinking that their tingling their leg is due to a brain tumor.  It's irrational to some, but to them it's pretty real.  I guess if your obsessions focus on health, and symptoms, then its HA but if it includes other things, its OCD...but a lot of times people have both so its hard to determine, it's interesting.

[ocdengineer]

I'll give you two scenarios and let you decide whether there is a difference. 

There is person #1 who has an anxiety disorder who feels sick to her stomach all the time, gets frequent headaches and has at times felt heart palpitations and chills.  In an effort to figure out what is wrong, she surfs the internet for hours a day looking for the cause.  She refuses to believe that it is all in her head, but can't find a single disease or disorder that fits all the symptoms so the search continues.  She has been through hypoglycemia, celiacs disease, and a whole host of potential diagnosis, but the doctor has pretty much told her that its just anxiety.  This would be, in my opinion, health anxiety, which in my opinion, virtually all of us go through regardless of the anxiety disorder.

Person #2 believes that she has contracted the HIV virus from kissing her boyfriend for the first time.  She knows that it is impossible to contract the virus and has had multiple tests to validate that she is not infected, however the thought lingers on and causes her great grief and anxiety in her relationship and life.  No matter what she does, the thought, "you have HIV Aids", won't go away.  This is probably OCD.

Person #3 thinks that he may have ALS.  He shows all the symptoms of anxiety, but can't shake the thought that it may be ALS.  He has been to many doctors who give him a clean bill of health but the thoughts will not retreat from his mind.  He endlessly searches the internet looking for information that may help him regardless of the clean bill of health he has.  This is also probably OCD.

Now, just my opinion, but in my mind, the diagnosis is not really the key.  The answer is we all have an anxiety disorder of some sort that manifests itself in some way determined by experiences in life and maybe genetics.  The important thing is not to label your type of anxiety disorder, but to decide that anxiety is the problem and then accept it.  OCD or not, the solution is the same, healthy living and learning to alter your thoughts and behaviors so that fear doesn't rule your life.  It is much harder than it sounds and you can pretty much expect to deal with it on a daily basis for life unless you are one of the few people who has extraordinary success with medication.  I have not met such a person yet though.  Most people need a combo of meds and therapy (CBT) or meditation.  Doctors will say some drugs are better for some disorders, but that is garbage!  All medications work differently in everyone due to differences in the make up of our individual brains.  No two are the same therefore no drug will work the same for all.

Anyway, I have not been meditating in the last couple months and as a result my anxiety levels are higher.  I am more stressed out due to lack of sleep and stressful work environment, but these are all things that a person with an anxiety disorder has to learn to manage on a daily basis.  If you stop taking care of yourself, then expect to deal with more anxiety, if you take care of yourself, then your anxiety should decrease.

I don't know if doctors will agree with my separation of HA and OCD, but this is what I have observed.

Take care,
OE

[Xalatimo]

Some doctors might agree but there are probably some who also consider them very similar, or even the same.

If you asked me to see if I notice a difference between all three people, I would tell you that yes I do notice a difference, but the actual diagnosis is still very difficult to differentiate without taking into account each person's history.

But, I do see your point.  Person #1 is basing the worry on true feelings instead of just thoughts alone.  The person actually feels symptoms and so that person believes there is a serious disease that needs to be found.  The thoughts are based on real symptoms.

However, to me, person #1 and person #3 could be the same person.  Person #1 could just happen to be "in between" disorders.  Person #1 has anxiety symptoms and goes searching for symptoms, and no matter what the doctors say, will still believe that they have an unknown illness.  Person #3 has the same symptoms, but instead, has actually gotten around to finding a specific disorder that matches their symptoms.  They could then move on and look for more symptoms and continue the pattern of person #1, until they then find another specific illness they believe they have, again, based on the physical symptoms, which is the same as person #1.  I think personally, person #3 possibly would be OCD only if the person has a fear of ALS despite not having any symptoms.  If they are having physical symptoms then it is hard to label that as OCD, because typically OCD thoughts are based in the mind of the person, and not of reality.  Having physical symptoms can constitute as reality, so maybe person #3 is not OCD.  But then again, it is also how you interpret the physical symptoms so who knows?  I just think that if you can label someone OCD despite them having physical symptoms and thus, a basis for thinking they have ALS, that you should also be able to label someone with only physical symptoms who goes on and spends hours a day surfing the web as OCD as well.

Also, the definition of OCD involves more than just thoughts.  It is any intrusive "thought, impulse, or image."  It gets tricky if impulses can be considered OCD related.  Is the urge to surf the web 2 hours a day an impulse?  Does it cause significant distress?  Or Is it a compulsion?  What about the person that "feels" dirty, and then goes and carries out compulsions.  Example:  The people who feel compelled to wash their hands repeatedly, even when they are already clean.  Surely, their hands *are* clean, but they still have the feeling that they aren't.  Even though it's a feeling, it is still pretty much considered OCD.  Then there are the people who actually feel clean, but they are worried of germs and avoid contact with door knobs.  Well, then that is would everyone would call clear-cut OCD.  But, can it also be health anxiety?  Maybe the person doesn't want to get dirty because he doesn't want to panic about it and start experiencing any physical symptoms, which would then bring him into panic knowing that he will have to again go on a search to find out what is wrong with him, or which germ he got in contact with, due to the fact that he knows he is a hypochondriac, which is why a lot of people who are hypochondriacs would try to avoid caffeine..it brings out physical symptoms that they would have to analyze.  Or how about the person that feels clean, but just went to dinner and now feels he has deadly food poisoning.  Is this OCD or HA?  I mean, the thought is based on a real life event..going to a restaurant and possibly getting food poisoning and their health possibly suffering as a result.  It is just really cloudy and confusing to me as to what is OCD and what is HA sometimes, without considering the person's history, and even then it is very confusing and probably there is a lot of overlapping of disorders involved.

What if after person 2 realizes that they don't have HIV, they then start believing that they contracted botulism, followed by getting a symptom (tingling) and then also believing they have MS.  It might sound like OCD, but, is it possible to have health OCD?  Wouldn't this be considered HA?  All their worries are health related.  It gets complicated.  Someone with OCD I would think would have numerous intrusive thoughts that are varied in nature, not just health related worries.

I just happen to believe that HA, or hypochronia, is basically just "HOCD" or Health OCD.  A lot of people with OCD have probably had a health worry, and a lot of hypochrondiacs have probobly had some OCD related (non health) thoughts.  Then again, you can also have OCD about a health related subject..it can be quite confusing determining them apart.  But, again, a lot of people might disagree with me so I can't be sure.

So yes, I do notice a difference between all the cases, but a lot of them can be either/or which is why I have a hard time distinguishing between them and think they are closely related.  But like you said, it is not so much about the diagnosis itself, because many people have more than one anxiety disorder.  It is all about just getting treated for the anxiety.  CBT will work for both HA and OCD.

[Xalatimo]

I guess I could have just simplified all the above by just simply stating that:

Person #1 could still have OCD -- the intrusive thought could be the fact that the person feels that they have a disease, despite all tests proving otherwise, and the compulsion is trying to find out what it is by researching it on the Internet.  The compulsion is aimed at lessening the anxiety by finding the correct diagnosis.  It probably just depends on the person, and what the person is most distressed over..the fact he feels diseased and is taking up all his time researching, or the fact that he might have a disease that is going undiagnosed.  In the 2nd case it is less likely to be OCD, although, thinking having an undiagnosed illness *could* be OCD as well, and a compulsion to that could be something as bizarre as believing that staying locked in your room for two hours a day will prevent this from occurring.

[ocdengineer]

Lot of questions!  Some very good points as well.  Person #1 definitely could have OCD, but the symptoms I listed would not lead to that diagnosis.  For instance, I went through a stage where I felt horrible physically for a long period of time and I wanted, logically, to find out what the heck was wrong with me.  Was it obsessive, maybe, but this was before I knew of OCD.  When I did learn of OCD, the need to search pretty much went away.  Now, I still search for other things and sometimes for my family on the inet and sometimes if you are careful not to stumble onto a bad website, there is really good info out there.  I wouldn't be able to shake a true obsession that easily.

The other two definitely would be classified as OCD because logic has been ignored for the obsession.  Granted, none of these examples have compulsions, but maybe they search the internet trying to solve their problem as a compulsion.  Very possible.  I agree that there is a grey line and that is why it is important to worry less about the diagnosis and more on the prognosis.  Fix the problem, don't dwell on it I guess. 

You mentioned the possibility of the obsession changing.  This happens a great deal and it especially starts happening when you start getting rid of the negative thoughts.  For me, I get rid of the thoughts of harming people only to be plagued by other equally anxiety provoking thoughts.  So, could and obsession about HIV turn to an obsession about ALS?  Sure. 

I do agree that health anxiety is probably simply an extension of OCD.  Just another manifestation on the same disorder.  The only thing I want to point out is that there are people who are simply trying to find a solution to their anxiety disorder and haven't discovered that their physical pains are a result of the mental problem.  In this case it is a simple fix.  You just show them that they have an anxiety disorder, and prove they don't have ALS or HIV.  If proof makes them feel better and ends the need to search for a cure, then it definitely isn't OCD.  You know what I mean.  OCD doesn't give up that easy! 

If you look up the symptoms of HA you are probably right that they seem to fit right into the OC spectrum of disorders.  For some reason doctors decided to create a new disorder probably for a new drug.  Who knows why they do some of the dumb things in their diagnostics manual.

Now, the real problem!  HA is treated differently than OCD and therefor is probably always treated improperly.  Many people get AD's and find they don't work or make things worse.  Some do better, but they are the minority.  I think it is really dangerous to split up diagnosis into so many sub groups.  Anxiety disorder is anxiety disorder.  Trial and error is the only way to help with meds which won't solve the problem, just mute it for awhile or help to take the edge off.  Real mental health can only be achieved through physical and mental exercise in my opinion.

Remember, I am not a specialist.  Just a person with OCD like you, so my opinions are mainly based on what I have read and my observations of how I have personally felt at different times throughout my life.  I am definitely not a medical doctor.

Take care,
OE

[Xalatimo]

I definitely agree with a lot of things you say, whether or not you are a specialist doesn't matter -- you sound like one. :)
Your posts have personally helped me out many many times.

There is 1 thing that you mentioned.  That the obsessions in OCD don't give up that easily.  Yeah, having OCD myself I can definitely relate to that.  But like you said, once you realize it is OCD they do die down a little.  The thoughts themselves lose their meaning and strength once you find out it is just anxiety causing it all. 

I think that if you applied this same thinking to HA you could get results.  I think the only difference is that with HA, you are constantly reminded of it all because of the physical symptoms involved, so you tend to have a hard time actually believing it IS anxiety, thus, delaying correct treatment.  I think if someone with HA accepted that it was anxiety and that the thoughts/symptoms are only created out of anxiety, and mean nothing (like OCD) you could possibly start to get some results.  From what I'm reading HA is probably the most difficult to cure, and probably because it is not being treated correctly.  You mentioned that someone could go from disorder to disorder, from ALS to MS..and this proves it isn't OCD because obsessions don't die that quickly.  But, by the same token, if that person's main obsession was having a terrible disease, then it's possible it still could be OCD.  Like you said, people with HA sometimes feel better once offered proof.  However, many times, they ARE offered proof, and they STILL don't buy it, to the point where even multiple MRI still will not satisfy them.  This almost sounds OCD-related.  The obsession, instead of focusing on individual disorders, could be just be something broad, that they just feel like they have "an illness."  They only feel better temporarily until the next symptom hits (similar to the next intrusive thought in OCD) and move on to the next disorder to fixate on.

Sometimes I wonder if HA can even be considered as a phobia -- fear of illness/death.  Not that some people don't already consider it that...  The sufferer fears so much that their symptoms are related to an illness that they will spend years trying to prove they are healthy.  It's just that if it IS a phobia then treatment should consist of desensitization techniques.  Like you say, I am no expert, but I am basing it on my own experiences.  Once I accepted that I had or could have MS (even if I didn't) all my anxiety towards getting an illness decreased because I had already lived through it and came out stronger knowing that I could handle it.  I eventually brought myself to believe that I do not have any illness and that it is a product of my anxiety, pretty much the same techniques I used to overcome OCD helped me to ignore further symptoms, and that's another reason I feel they might be all related somehow.

[ocdengineer]

That is right.  If you face the fear, no matter what it is, a disease, a thought, etc.  It loses its power over your feelings.  Saying, "Oh well, maybe I do have ALS" could potentially diffuse the thought and create a cure.  It is at this point that OCD will pick up something else to bother you with and you simply apply the same methodology.  I definitely think that technique would benefit most if not all HA sufferers.

Later,
OE