How I learned to tame my hypochondria

Ssurrounded, growing up, by somewhat hysterical women (“How are you?” I once asked an aunt over the phone. “I’m on a mobile IV,” was the reply), I never worried about my own health There was no room anyway because someone was always sicker. How I laughed at my friend Mark when, at age 20, he thought he was dying from a splattered bolognese. Even when I smoked and developed what would now be a Google search worthy—a searing pain in my lungs—I lay on a tennis ball and massaged the spot. Went.

So when I got to say, my “late onset hypochondria,” at age 40, I wasn’t ready for it. And I didn’t know how terrifying it could be. In its own way, it is a disease. (Strictly speaking, hypochondria and health anxiety are two separate ailments with overlapping characteristics.) The background to all of this was deaths, lots of them. My cousin died, at the age of 51, her death surrounded by whispers and secrets; then a friend died, then another, then another. This last friend, Callie, had been feeling well, went to the doctor and died two weeks later. All of these friends were also 51 when they died, and in my mind it seemed impossible to get past that age.

Then a family friend died, then my aunt, then my uncle. Through it all, I knew my dad was sick too, on his own final flight path, but I didn’t want him to be defined by his illness, so he wasn’t and very few people knew. Secrets and fear mixed together to create their own special kind of dynamite.

Somewhere in the middle of it all it started. The symptoms They varied as did the “diagnoses”, but on one memorable day I had Parkinson’s, liver cancer and Paget’s disease (some members of my maternal family have this) all at once. It was a Thursday and I was catatonic with fear. All I could think was, how could I do school while I was having chemo? How would I deal with the shakes and the shakes and the pains in my skull? I had two children, one was still a baby, could I breastfeed with chemo?

The cycle would always be the same. I would feel someone get sick, I would ask too many questions. I would develop symptoms. I would be terrified and unable to tell anyone, letting in no light or perspective, no hope of reassurance. I couldn’t go to the doctor because Callie had been fine, gone to the doctor, and then she was dead. In my mind I was convinced that if I could avoid the diagnosis, I could avoid death. It was exhausting and terrifying. Eventually something would give, I could tell someone who would give me a reality check and I would have some respite, until the whole cycle started again. Of course, there were times when I realized that this must be my mind, being powerful but destructive. And the symptoms would fade away, until next time.

Illustration of a woman running, looking behind her at a large red cross
‘One memorable day I had Parkinson’s, liver cancer and Paget’s disease. I was catatonic with fear’: Annalisa Barbieri Illustration: Nathalie Lees/The Observer

Then finally one day my nipple started bleeding, a symptom so extreme I knew my mind couldn’t be responsible. The redness of it all somehow made me notice and back in my childhood home (for some reason this emboldened me) I was able to call not my current GP but another one, my previous one doctor I had kept in touch with. I told him my symptoms. He paused at the end of the phone as he rolled the net bedroom curtains between his finger and thumb, asking me how long I had left.

“I can’t tell you that you don’t have breast cancer,” she said very slowly, “but I can tell you that you need to see your GP and talk to him about your health anxiety.” Health anxiety? Not only did I not realize I had this, I didn’t realize I could talk to my doctor about it.

My GP, thankfully, was brilliant. He listened and immediately reassured me about some of the other ailments I was sure I had at the time and sent me for other tests, including my chest (which was fine, it was a rash and clarified, but now I think of it as a gift from God). But most importantly, he also put me on the list for a course of CBT, cognitive behavioral therapy.

While waiting for CBT, my father died.

I was reluctant about CBT, but my therapist, Jill, was extraordinary and wonderful and was the perfect solution. After doing my story, Jill challenged my belief that I was sick by asking for proof. I can still hear his voice now asking for hard evidence for my assumptions and it’s a technique I still practice. So leg pain = cancer would be broken down to, “It’s very unlikely to be cancer, but if the pain continues, it’s reasonable to go to the doctor.” It looks easy and takes a long time to actually work, but it worked for me. Reframing my worry, facing the fact that I had no hard evidence that I was sick, and reframing the worry helped me deal with it in small chunks. I also learned to tell trusted people around me what was going on so that they could help ‘lift’ the worry (not advisable to tell another hypochondriac!)

Jill also got me to stop asking about people’s symptoms and taught me that it was okay to just say, “I’m sorry to hear that,” if I heard someone was sick/died, without also asking for a history complete clinic, which I would then digest and embody. (Combining the ability to Google any symptom with a constant conveyor belt of new diseases and variants thrown at us at every news feed is a heady mix for those with a predisposition to health anxiety.)

Peter Tyrer, teacher in community psychiatry at Imperial College London, has a special interest in health anxiety (called illness anxiety disorder in the US and falls under the DSM-5 psychiatric classification) and has written several articles on the subject, one in the British Medical Journal in 2016, who called it a “silent and disabling epidemic” that was reaching “epidemic proportions.” In a 2006 study of certain specialist clinics in North Nottinghamshire (respiratory, gastroenterology, endocrinology), 12% had excessive health anxiety. Four years later, in the same clinics, this percentage had increased to 20%. Tyrer attributed this rise to “cyberchondria” and our addiction to Google. “People with health anxiety,” he wrote, “pay selective attention to the most serious explanation for symptoms, even though they may be very rare.” There’s no point in telling these people they have a 1 in 1,000 chance of being sick, he said, “it just convinces them that they really are that person.”

Tyrer further explained to me that some people, like myself, are a medical reassurance by avoiding and diverting the body at all costs, and of course it’s “impossible to know how many of these there are.” And then there are those who need near-constant reassurance from doctors, who, however, are not trained in mental health and therefore provide resource-draining clinical trial after trial without providing a long-term solution. It does not remove the root problem. Tyrer is an advocate of CBT to help with health anxiety.

I told the psychoanalyst Alessandra Lemma my story. Lemma is someone I’ve worked with before and I not only trusted her, but I valued her insights into how my brain works. “What I recognize,” he said, “is a kind of architecture of hypochondria, and often a real experience of illness, either of oneself or of someone one is very close to. It is very rare that the health anxiety comes out of nowhere and it’s this intersection of this encounter with vulnerability and mortality, and it often comes at a time of transition in life. So you often get it with young people about to going to college, with people retiring, etc. For you it was this terrible concern for your father, this proud, strong father who was struggling with something that was beyond him, and when we The fear of losing someone we often identify with her and can assume her physical symptoms.”

But why couldn’t I just think that I’m worried about my father? Why this big drama?

“Because”, Lemma expanded, “as a general way of thinking about it, the body and our relationship with it is a kind of theater, if you will, in which we stage our inner conflicts and one of the main reasons by which psychological conflicts are found. translated into bodily symptoms is when we still don’t have the words or even a conscious acknowledgment of what worries us.”

Lemma explained that talking to someone—your doctor, a therapist, or a trusted friend—can help because you can begin to put these symptoms into words, which can then begin to dissolve the worry. For me it was like starting to let light into those dark corners, but at first it was really hard for me to talk about what was going on because I had this irrational fear that as long as I didn’t tell, nothing bad would happen. to pass. Hypochondria literally felt like a monster in my body that I had to appease by keeping quiet.

I have now been free of it for six years and so long that I cannot write about it. (And yes, I made it to 51!) I’m still watching and staying in check. As I was writing this, I looked up the symptoms of Paget’s disease and immediately felt like I was turning the corner back onto health anxiety street. So I stopped reading.

Although the monster I have now is mostly asleep, it can reawaken when I’m anxious and need to feel in control. And one thing I’ve learned through all of this is that, perversely, worrying that you’re dying is a weird way of trying to feel in control.

Conversations with Annalisa Barbieri, series 3, is now available (pod.link/1567190358)

#learned #tame #hypochondria

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