Tuesday, January 24, 2017

Hypochondria and Health Anxiety OCD


Monsieur Charles Darwin (dessin de Sis)

About 15 years ago, I was in graduate school, and I had a sharp pain in my neck, ever so brief, and it didn't even register. Then it happened again when I was feeling more stressed, after having read about a bone marrow donor drive, and immediately assuming I needed to participate, in spite of all my anxieties about needles and surgery. This time, the pain in my neck panicked me. Was I having a stroke? What was wrong? Since the internet was still primitive, I did what I used to do, which was go to the library and look for books in the medical reference section. This time I stumbled across Susan Baur's Hypochondria: Woeful Imaginings. It was like seeing myself in the mirror, through the author's accounts of people in history who suffered from fears about their health.

It wasn't enough to make my OCD vanish, but it did give me a window of understanding about my anxieties about my body, and that other people had similar fears, even though the only other person I knew of with this kind of fear was my mother. Another book I found was about Charles Darwin and his health anxieties. He wrote often about his symptoms and fears. I was fascinated, since he is a larger than life figure in history, and yet so afraid. Recently, I read about another book, The Hypochondriacs: Nine Tormented Lives by Brian Dillon, which includes Charles Darwin, Glenn Gould, Michael Jackson and Andy Warhol.

Although the subtitles of these books are full of doom, I remember how much I suffered with my health fears before I had any ERP treatment. The difference now is that I did get Exposure and Response Prevention Therapy, and it is possible to get better, to move beyond torment and woe. Hypochondria, according to the DSM, includes a component of being convinced you have a disease, in spite of medical tests to the contrary. There are definitely similarities with health anxiety OCD, and some even argue they are really the same thing, but the part that differs for me is that I am never absolutely convinced I have a particular disease, but more that I want complete assurance that I don't have it, and my websearching and checking of my body are compulsions to reduce my anxiety. My obsessiveness also extends to getting stuck on whether I really have hypochondria instead of OCD(!), but I've learned that pursuing the fine distinctions makes me much worse. Paul Salkoviskis has done a lot of work with health anxiety, and he emphasizes that seeking reassurance for symptoms tends to make them worse.

Fear of being labeled as a time wasting hypochondriac in my doctor's office has complicated healthcare for me over the years, and caused a lot of angst. I understand doctors have a lot of pressures and time constraints, but health anxiety causes intense suffering, and can be treated, and the more general practice doctors realize this, the more possibility of alleviating the suffering.

Related Resource:
Jonathan Grayson's Freedom From OCD has a section on hypochondria/health anxiety
Script for Fighting Health Anxiety OCD
Skin Cancer Anxiety: Fear, Vigilance and All or Nothing Thinking

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