Health Anxiety and the Chronically Ill: Oh So Many Faces Has She.

AnxietyYesterday I had throat cancer …. It was horrific.

You can’t possibly imagine all your worst fears coming true.  Just imagine if your doctor said those awful words to you ….. “Look … I’m sorry … it’s … C….” heart racing, shaking, stomach churning, the world closing in.

My mind is stunning … within a few minutes of this realization I have run through every possible scenario; the worst slowest most painful ending. I am a detail person … when it suits … and sometimes … exactly when it doesn’t.  I had my funeral planned, the speeches sorted.  I even have a vague sense of the ‘costumes’ of the, oh so many, guests.

You may or may not be pleased to know – I am cured.   Before we celebrate too much, I would like to explain that I had ovarian cancer the week before.  Now I shan’t bore you with the specifics accept to say, the trauma is much the same as all the other cancers I get, at the rate of about three major cancers a week (with say kidney or heart disease thrown in monthly).  This order makes no sense as I am actually on yearly kidney checks for blood in my urine, so why is that one lower down the panic list?

As my regular readers well now I live with many real chronic illnesses.  Why when I have so many legitimate diseases, oh why, might my beautiful mind throw others at me?

Facing your FearWhat I know is this: because of my many illness and ever evolving symptoms I get tested for a range of cancers etc. more regularly than your average bear.  This should make me immune you might think? This should make it BAU for me.  I am sad to say the exact opposite has become true.  I feel like a cat.  Like all good cats, I know that I have used every single life I have and am on borrowed time.  So each ‘scare’ rather than calmly going, “OK, been here before, doctor needs to do due process, let her have”  … on the contrary I think “well this is it, I can’t possibly get another get out of goal free card, my time must be up”.   So the fear (actually I think I might better call it terror) escalates.

Long before any of this health related anxiety started, I had your run of the mill anxiety. I almost miss that.

I remember one particular time, I was sitting in my lovely shared house back garden, up in the green suburban hills of Wellington New Zealand, smoking a cigarette (it was last millennium, people did).  Out of the stunning sunny day, sheer terror descended upon me.  In a way the terror was worse than the time I called friends as I had an actual intruder.  The intruder turned out to be a feral animal and all was well. The terror I felt then, with a real threat, was in a way preferable to the terror I felt sitting on the sun on my front step.  The night of the ‘intruder’ my friends arrived with baseball bats in hand (actually baseball isn’t very big here so from memory they actually had tennis rackets, which would not scare even a referral animal). I was ‘rescued’, we laughed, and all was well.  Although those same friends loved me, although if I had asked them to come flaccid tennis rackets in hand that day in the sun, they would have come and I may have felt better.  I would just have felt silly, so I did not phone, and hence they did not come, and hence I did not feel better.

I am going to share a dirty word now ……..ready…………hypochondriac.

Is there anything you would like less to be?  My fears of hypochondria are so deep that recently when the Doctors office told me I needed an ambulance, I refused to call one, preferring instead (so it would seem) to be dead than accused of being a Hypochondriac.  That will show them.

I will share a lesser known fact, an all pervasive sense of foreboding about certain death or deathly illnesses is not actually hypochondria: It is health anxiety.  It is in the foot hills of hypochondria.  It is more a dreaded private secret than a weekly visit to the doctor to be laughed at and ridiculed.  Actually I don’t believe this has been clearly understood or well researched and I don’t wish to know more about the demarcations.  For too long I have comforted myself in the knowledge that I am not one of those ‘crazy hypochondriacs’.  Which given I have likely multiple DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) issues going on is a bit rich no? To be so obsessed with not be crazy when clearly by many measures I am “bat shit crazy” (to quote my dear cousin who says so with love and respect) is itself a little insane – no?

The good news is health anxiety peaks in middle age (Sunderland, Newby et al. 2013) … so there is hope for me … perhaps …. after the peak must come the down hill … surely? Perhaps I will drop down the other side of the peak into a bed of Roses?

Is there hope for you?

Yours as ever,

The bat shit crazy WellbeingatWork(nearly)Dr,

References

Sunderland, M., et al. (2013). “Health anxiety in Australia: prevalence, comorbidity, disability and service use.” The British Journal of Psychiatry 202(1): 56-61.

 

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