Hypochondria filter: striking the balance
October 15, 2022 7:11 AM Subscribe
I seem to have gone from someone who avoided doctors with a vengeance to someone who obsesses about every single little thing. How do people who have a normal level of health-related vigilance actually operate?
Recently I posted this question about health, and received the excellent advice about getting a good PCP and establishing a baseline for my health.
As a result, I had a full physical after many years of obsessive doctor avoidance, which revealed a few health issues that need addressing.
The problem is I have gone from someone who avoids thinking about health stuff at all to someone who records (e.g.) blood pressure readings twice daily and obsesses about food intake. I've started stressing out about social occasions where healthier choices might not be available to me, and imagining a life where I never eat sodium, dairy or sugar ever again. (This is very triggering because I am in recovery from an eating disorder.)
As I mentioned in my earlier question I'm caring for unwell relatives and I just don't want to get myself into a position where I'm sick and in need of care because I have no one to take care of me.
I feel like just as avoiding the doctor for years wasn't healthy, this level of vigilance and worry isn't healthy either. I just want to know how people who don't have any kind of health anxiety manage their health. Do you go for annual physicals? Do you keep charts? How strict are you about food? Do you weigh yourself everyday? How often do you check your blood pressure? etc.
I have access to the NHS so cost isn't an immediate factor.
I really hope this question doesn't come across poorly or blinkered by privilege.
Recently I posted this question about health, and received the excellent advice about getting a good PCP and establishing a baseline for my health.
As a result, I had a full physical after many years of obsessive doctor avoidance, which revealed a few health issues that need addressing.
The problem is I have gone from someone who avoids thinking about health stuff at all to someone who records (e.g.) blood pressure readings twice daily and obsesses about food intake. I've started stressing out about social occasions where healthier choices might not be available to me, and imagining a life where I never eat sodium, dairy or sugar ever again. (This is very triggering because I am in recovery from an eating disorder.)
As I mentioned in my earlier question I'm caring for unwell relatives and I just don't want to get myself into a position where I'm sick and in need of care because I have no one to take care of me.
I feel like just as avoiding the doctor for years wasn't healthy, this level of vigilance and worry isn't healthy either. I just want to know how people who don't have any kind of health anxiety manage their health. Do you go for annual physicals? Do you keep charts? How strict are you about food? Do you weigh yourself everyday? How often do you check your blood pressure? etc.
I have access to the NHS so cost isn't an immediate factor.
I really hope this question doesn't come across poorly or blinkered by privilege.
Best answer: I really hope this question doesn't come across poorly or blinkered by privilege.
Nah, this question just sounds like you're dealing with a lot of anxiety. Which is pretty usual these days, particularly around health stuff!
My general regimen:
- Annual physical, doc/urgent care if I have a fever or the signs of a sinus/ear/lung infection, which I get about every other year.
- Gyno checkups as recommended, mammograms likewise, since I have officially hit That Age
- I keep very rough tabs on my weight - I have a scale, I hop on it maybe every other month just to make sure it's not dramatically changing. Honestly this is more a depression diagnostic than anything - I do not, as a general rule, give a rat's ass about my weight as such.
- I exercise as much as feels good to me, ideally a short-ish walk every day and weightlifting a couple days a week, although when I was on my feet all day and moving heavy things at work, I did neither and it seemed fine.
- I have a pretty good idea of how different types and quantities of food make me feel, and I try to eat what will make me feel good, or plan ahead if I want a treat that's gonna make me feel icky. Getting here has been a lifelong process.
- I don't have blood pressure issues, so I never think about that.
- I have a psychiatrist to manage my anxiety (new since 2016, surprise surprise) and SAD (lifelong) and have a couple drugs to keep those under control
- I have an autoimmune condition which is currently in remission/managed by lifestyle, but when it's not I have regular rheumatologist checkups.
Basically there is nothing in my life that requires Vigilance!, I just keep my regular appointments and take my meds. If something weird happens, I take it to the relevant doctor. If you're not already seeing a mental health professional, I really strongly recommend it - anxiety doesn't have to be something that drives your thought patterns all day every day, and you're in an obviously stressful situation and might need a little more help (either talk-therapy support or straight-up chemical support) to keep an even keel.
posted by restless_nomad at 7:52 AM on October 15, 2022 [1 favorite]
Nah, this question just sounds like you're dealing with a lot of anxiety. Which is pretty usual these days, particularly around health stuff!
My general regimen:
- Annual physical, doc/urgent care if I have a fever or the signs of a sinus/ear/lung infection, which I get about every other year.
- Gyno checkups as recommended, mammograms likewise, since I have officially hit That Age
- I keep very rough tabs on my weight - I have a scale, I hop on it maybe every other month just to make sure it's not dramatically changing. Honestly this is more a depression diagnostic than anything - I do not, as a general rule, give a rat's ass about my weight as such.
- I exercise as much as feels good to me, ideally a short-ish walk every day and weightlifting a couple days a week, although when I was on my feet all day and moving heavy things at work, I did neither and it seemed fine.
- I have a pretty good idea of how different types and quantities of food make me feel, and I try to eat what will make me feel good, or plan ahead if I want a treat that's gonna make me feel icky. Getting here has been a lifelong process.
- I don't have blood pressure issues, so I never think about that.
- I have a psychiatrist to manage my anxiety (new since 2016, surprise surprise) and SAD (lifelong) and have a couple drugs to keep those under control
- I have an autoimmune condition which is currently in remission/managed by lifestyle, but when it's not I have regular rheumatologist checkups.
Basically there is nothing in my life that requires Vigilance!, I just keep my regular appointments and take my meds. If something weird happens, I take it to the relevant doctor. If you're not already seeing a mental health professional, I really strongly recommend it - anxiety doesn't have to be something that drives your thought patterns all day every day, and you're in an obviously stressful situation and might need a little more help (either talk-therapy support or straight-up chemical support) to keep an even keel.
posted by restless_nomad at 7:52 AM on October 15, 2022 [1 favorite]
Best answer: You are living with consistent anxiety and that can be helped with meds. Is that something you are willing to discuss with your GP?
posted by DarlingBri at 9:01 AM on October 15, 2022 [4 favorites]
posted by DarlingBri at 9:01 AM on October 15, 2022 [4 favorites]
Best answer: Another vote for asking your Dr for help managing this. I used to have a lot of medical anxiety. I went on anti-anxiety meds about 5 yrs ago for a different reason, and one of the unanticipated effects is that I now have a much easier time dealing with medical stuff. When I think about all the time and energy I spent monitoring my health and symptoms…I’m so grateful all that is over. It’s very freeing.
posted by bookmammal at 9:53 AM on October 15, 2022
posted by bookmammal at 9:53 AM on October 15, 2022
Best answer: Our public health here does not cover annual physicals, which suggests to me they've concluded there is not evidence supporting that they improve health outcomes overall.
All tests and monitoring come with the risk of false positives, giving rise to suspicion of medical conditions without justification for it. As I understand it, generally the advice is to let your symptoms be the guide and not for a healthy person to monitor themself as a matter of course.
posted by lookoutbelow at 11:18 AM on October 15, 2022 [1 favorite]
All tests and monitoring come with the risk of false positives, giving rise to suspicion of medical conditions without justification for it. As I understand it, generally the advice is to let your symptoms be the guide and not for a healthy person to monitor themself as a matter of course.
posted by lookoutbelow at 11:18 AM on October 15, 2022 [1 favorite]
Best answer: I am often very tuned in to signals from my body that I don't know how to interpret. My rule of thumb is if something is bothering me, I take something from the pharmacy for it. If that doesn't work & it doesn't go away, then I can show it to someone. That's the point where they want to see it.
posted by bleep at 11:37 AM on October 15, 2022
posted by bleep at 11:37 AM on October 15, 2022
Best answer: This is very triggering because I am in recovery from an eating disorder.
I hate to say this, but I don't think you are describing being solidly in recovery. I don't know how hard this may be on the NHS, but if you can get access to an eating disorder specialist - that might be a therapist and it might be some kind of food-related-advising-person but you should be extremely skeptical until they prove credentials and modern non-harmful interventionism - I think you need some support from that direction for dealing with what sounds like intrusive orthorexic thoughts at the very least, but if you're panicking about social situations or making your social decisions because of food choices that is not just thoughts, those are restrictions and they are food-specific anxiety.
You should also have a conversation with your regular doctor about this. So yes, in this case you should actually go see the doctor at the next available opportunity.
Certainly part of my ED recovery practice is knowing it is not healthy FOR ME to weigh more than a few times a year. I do not perform any routine tests on myself unless I feel a way that might reasonably be caused by something like blood pressure or covid. I try to see a doctor at the standardized benchmarks - yearly physical plus I'm into my mammogram/colonoscopy years - and then when something is not working right. I periodically do a refresher with a physical therapist for some ongoing mobility maintenance stuff, which gives me someone to bounce the occasional "hey, it hurts/goes numb/doesn't work when I do X" question off of, and I also have a quarterly telehealth call with my prescriber for antidepressant stuff where I can also touch on "is it weird if X happens?" questions.
I think the "normal" category generally falls into home troubleshooting first when something is bothering you, and if you can't improve it over some kind of reasonable time - which would be maybe hours for something bleeding that should not, days or weeks for suspicious but mild neurological symptoms, and months for the kinds of discomfort that generally have an identifiable cause you can attempt to accommodate (food intolerance, pain as a result of specific activities - the kind of thing where a doctor's first response is going to be "have you considered not doing that in the way you're doing it to see if that helps?"). That way you can inform the doctor what you've tried and what hasn't worked. If you are seeing a doctor without doing that legwork, I think it's pretty clear you are seeking something other than medical assistance, whether that is the comfort of reassurance or the other comfort of being granted some kind of "special" status even if it is in a bad way. There are less stressful - and less time-consuming - ways to treat anxiety!
posted by Lyn Never at 2:51 PM on October 15, 2022 [1 favorite]
I hate to say this, but I don't think you are describing being solidly in recovery. I don't know how hard this may be on the NHS, but if you can get access to an eating disorder specialist - that might be a therapist and it might be some kind of food-related-advising-person but you should be extremely skeptical until they prove credentials and modern non-harmful interventionism - I think you need some support from that direction for dealing with what sounds like intrusive orthorexic thoughts at the very least, but if you're panicking about social situations or making your social decisions because of food choices that is not just thoughts, those are restrictions and they are food-specific anxiety.
You should also have a conversation with your regular doctor about this. So yes, in this case you should actually go see the doctor at the next available opportunity.
Certainly part of my ED recovery practice is knowing it is not healthy FOR ME to weigh more than a few times a year. I do not perform any routine tests on myself unless I feel a way that might reasonably be caused by something like blood pressure or covid. I try to see a doctor at the standardized benchmarks - yearly physical plus I'm into my mammogram/colonoscopy years - and then when something is not working right. I periodically do a refresher with a physical therapist for some ongoing mobility maintenance stuff, which gives me someone to bounce the occasional "hey, it hurts/goes numb/doesn't work when I do X" question off of, and I also have a quarterly telehealth call with my prescriber for antidepressant stuff where I can also touch on "is it weird if X happens?" questions.
I think the "normal" category generally falls into home troubleshooting first when something is bothering you, and if you can't improve it over some kind of reasonable time - which would be maybe hours for something bleeding that should not, days or weeks for suspicious but mild neurological symptoms, and months for the kinds of discomfort that generally have an identifiable cause you can attempt to accommodate (food intolerance, pain as a result of specific activities - the kind of thing where a doctor's first response is going to be "have you considered not doing that in the way you're doing it to see if that helps?"). That way you can inform the doctor what you've tried and what hasn't worked. If you are seeing a doctor without doing that legwork, I think it's pretty clear you are seeking something other than medical assistance, whether that is the comfort of reassurance or the other comfort of being granted some kind of "special" status even if it is in a bad way. There are less stressful - and less time-consuming - ways to treat anxiety!
posted by Lyn Never at 2:51 PM on October 15, 2022 [1 favorite]
Best answer: It’s pretty normal to swing between extremes like this! Give yourself some reassurance that just because you are currently obsessing doesn’t mean you will always be obsessing. Go back to your ED recovery materials and tools and start implementing them. Remind yourself that what you are seeking is balance. I also agree that if you have access to someone to help with ED recovery that would be good. It sounds as though you need a refresher on that so you can stay the course.
posted by Bottlecap at 3:20 PM on October 15, 2022
posted by Bottlecap at 3:20 PM on October 15, 2022
Best answer: I keep a little paper notebook on my night table and if something physical is bothering me as I go to bed I write down what it is and anything I’ve done that seems relevant (causes, remedies).
Must be paper and slightly inconvenient! Nothing to mull over in bored or spiraling phone moments.
I can use this in two ways - very often I flip through it and notice how many things resolve themselves with rest, and sometimes I realize that something is getting worse and I’ve been adapting around it, and then i consult an expert. It has definitely helped to show the expert a calendar of events.
I have had scary symptoms that I got a lot of tests for that turned out nothing - but I’ve also ignored symptoms and turned them into something worse. Data without dwelling on it is the best I can do.
posted by clew at 12:03 PM on October 16, 2022 [2 favorites]
Must be paper and slightly inconvenient! Nothing to mull over in bored or spiraling phone moments.
I can use this in two ways - very often I flip through it and notice how many things resolve themselves with rest, and sometimes I realize that something is getting worse and I’ve been adapting around it, and then i consult an expert. It has definitely helped to show the expert a calendar of events.
I have had scary symptoms that I got a lot of tests for that turned out nothing - but I’ve also ignored symptoms and turned them into something worse. Data without dwelling on it is the best I can do.
posted by clew at 12:03 PM on October 16, 2022 [2 favorites]
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posted by Redstart at 7:50 AM on October 15, 2022