Please help fix this hypocondriac
November 15, 2010 4:40 PM   Subscribe

Well, it's time I admit it. I'm a hypochondriac, have been for a long time, and it's finally starting to affect my life, finances, and relationships with friends and family. How do I deal with this?

You're not my therapist or doctor (thankfully for you). I've been concerned with my health for as long as I can remember. My mom was a notorious gossip, and tended to be most interested in other people's health. Growing up, I was subjected to daily stories about how [person I don't know] has lung cancer, or [other person I don't know] has blood poisoning. I'm not sure if that's the root of my problem, but for as long as I can remember, nearly every ache and pain I have sparks thoughts of which cancer I'm currently dying from. It's awful.

Several trips to the ER and numerous specialists for vague abdominal pains (which have lasted for years) have resulted in thousands of dollars in medical bills. Our insurance sucks, so I've ended up paying for the majority of this unneeded care out of my own pocket. I feel that if I weren't a hypochondriac, I might have an extra $10,000 rattling around in my bank account.

The onset of my hypochondria has been increasing over the years. In my early 20s, when I got married, I rarely complained about any health issues, but as the years drew on I started to get more and more unexplained aches and pains, and my stoic views on health began to deteriorate. My wife is rightfully frustrated with my continual whining, and I am too. I spend way too much time on webmd's symptom checker, and reading cancer symptoms on wikipedia.

So, how do I deal with this? I really do feel pain all the time, but my mind can't distinguish between somatic / stress-related symptoms and the real deal... mainly because, to me, EVERYTHING IS THE REAL DEAL! How can you tell someone that a five year abdominal pain isn't serious?! Yet here I am, with an unexplained five year abdominal pain.

Is there any hope for real treatment for hypochondria? I really don't have the money to see a therapist every few months, but if that's what I have to do, then that's what I have to do. I'd love to hear personal stories about how you may have overcome this debilitating mental issue. It's a strange feeling, being fully aware that I have a mental issue, and yet, in spite of my own realization, being completely consumed by it.
posted by anonymous to Health & Fitness (15 answers total) 6 users marked this as a favorite
I certainly am not your doctor or therapist, and I say that not to avoid liability but to warn you that I really have nothing but personal experience. That said, I have chronic stomach pains when I am especially anxious. Sounds like for you, that could turn into a cycle.
posted by i_am_a_fiesta at 4:46 PM on November 15, 2010

It sounds like there are two things going on--a) unexplained aches and pains, and b) catastrophizing about same.

Just because your aches and pains aren't cancer doesn't mean that they aren't something that needs treatment (or lifestyle modification, possibly)*. I would encourage you to see a doctor who specializes in functional medicine if that's at all possible.

As for the catastrophizing, you might be able to conquer it in a very few sessions with a cognitive behavioral therapist. If that doesn't feel possible financially, let me recommend Feeling Good and The Feeling Good Handbook by David Burns, MD, and Mind over Mood by Greenberger and Padesky.

*Because if you do have something like irritable bowel syndrome or a sensitivity to wheat or corn, that's something that can be effectively addressed with lifestyle modifications, and will result in an improvement of your overall health. If you can get past the catastrophizing, you might be able to deal with the fluctuations in your health status more effectively.
posted by Sidhedevil at 4:47 PM on November 15, 2010 [2 favorites]

Though not as bad as your situation, I also struggle with this from time to time. The most useful thing anyone ever told me was to remember that I have a proven track record of being bad at diagnosing myself. So now, when I find myself having pain or some other symptoms and find myself tempted to jump to conclusions, I remind myself: "I am very poor at diagnosing myself."

If a mysterious abdominal pain flares up (I get those too, in the same places over and over again, sometimes years apart. Also unexplained. And I haven't died yet), I remind myself: "It could be anything. I am bad at diagnosing myself." So I wait a few days or a week and if it persists or worsens, I call a doctor because I am in pain NOT because I have intestinal cancer.
posted by 256 at 4:53 PM on November 15, 2010 [4 favorites]

One of the most helpful things anyone has ever told me is, "You don't have to believe your thoughts." It sounds like you know that your thoughts about illness aren't reliable -- so don't believe them. Tell them nicely to go away. Take deep breaths. Do something to distract yourself.

I do think therapy is a great idea. You may not have physical illnesses, but you have anxiety, which is a very real illness of its own, and deserves treatment. Could you try to put the energy you put into looking up medical information into researching treatment providers in your area for hypochondria? CBT is well-regarded for anxiety treatment. It sounds like more traditional talk therapy might also be good for you to explore the family dynamics that play into your anxiety.

I don't have the full-blown hypochondria that you do, but when I'm stressed, I often start thinking that there's something physically wrong with me -- inspecting every mole, worrying that my heartbeat feels fast -- and having trouble sleeping or being distracted from the rest of my life because of it. I know that it's a response I have to stress, an avoidance mechanism really, and I don't have to believe it. Meditation and therapy both helped me get to this place, where I can kind of say, "hey anxiety, nice of you to come by, but I don't really want you. Why don't you leave now," and then continue on with my life. I don't know if that's too simplistic since it sounds like you're really struggling, but I hope it can help you even a tiny bit.

Good luck!
posted by zahava at 4:53 PM on November 15, 2010 [2 favorites]

This is fairly obvious but DO NOT look up symptoms on the internet!!! I (a fellow hypochondriac) visited a dr the other day who said he spent a great deal of his time 'undoing' internet research and dealing with extremely anxious patients as a result. Seriously, DO NOT look up symptoms. Also, definitely you need to find a different kind of 'center' or focus. There are various meditation books and classes give you a different perspective (and maybe to reduce stress). This said from someone visiting dr with hypochondriacal problem last week. So take it for what it's worth!:)
posted by bquarters at 4:54 PM on November 15, 2010

Anxiety meds might be an option to calm your hypochondria. IANAD, see your doctor, etc etc.
posted by pised at 5:06 PM on November 15, 2010 [1 favorite]

One defining feature of hypochondria is that what the sufferer perceives to be a symptom of something serious in fact isn't (although the minor ache or pain in question could still be an annoyance). Thus, a way to deal with the condition might be to remind yourself on a regular basis of the big-picture difference between overall decent health (which it sounds like you have) and genuinely serious illness. That is, perhaps spend some time around some seriously ill people (maybe as a volunteer caregiver in some capacity), and as you do so, notice the obvious differences between these two circumstances.

Yeah, I know that "health" and "illness" are cultural constructs, etc., as Susan Sontag and others have claimed, but nonetheless, there are some pretty stark distinctions between the two. I say this as someone that grew up with a father who suffered four heart attacks and had triple bypass surgery three times. Spending many years around someone I cared for with that illness helped me appreciate my own reasonably good health (no heart-related issues thus far for me). More importantly, I've never experienced anything like hypochondria, as far as I know, although I make a conscious effort to live a healthy lifestyle in the conventions ways.

With hypochondria it seems equally about the perspective the sufferer takes on his sufferings, the standards of judgment she/he invokes to explain each new ache or pain, and specifically how that perspective gets to be more and more idealized, both so far as unreasonably high standards as to what constitutes normal "good health" and unreasonably dire expectations when some ache or pain arises. In each case broadening this perspective away from just that of the hypochondriac to include a wider range of other people who experience various conditions of health and illness might help.
posted by 5Q7 at 5:08 PM on November 15, 2010 [1 favorite]

Working with a therapist on this is certainly a better option than asking random people on the internet. However, it might be worth it to explore (on your own) the possibility that your fears about your health are in large part because your mother gave you more attention when you were sick, or you perceived that you'd be a subject of interest to her if you were sick.

So, from that end, shut up already. Stop talking about your fears and your pains. If you feel sick, make an appointment with the doctor, but don't talk about it, bitch about it, or whine about it with your wife, your friends, or random people on the internet. That is, stop seeking attention/approval from being ill.

If you can get out of that habit -- if you can learn to stop talking about it with anyone who isn't a licensed medical professional -- then perhaps the attraction to being sick will go down a little. And you sure as hell need to stop going to those web sites, because I'm not a hypochondriac, and I can easily convince myself I have three rare diseases at any given moment. If you really have five years of abdominal pain, the perhaps it's something simple like the food you eat. Lactose intolerance and a bowl of cereal+milk every morning for five years is a much more likely candidate than [insert random rare disease here.]

In short: stop burdening everyone else with your woes, and stop intentionally researching names for the woes you have. Then all you'll have left is the physical feelings themselves -- at which point you should be looking for change. Chronic low-level abdominal pain that nobody thinks is anything? Safely ignore it. A sudden, marked increase in abdominal pain after a big meal? Safely ignore it. A progressive, clear increase in abdominal pain over a two-week period, and blood in your stool that you've never had before? Get to a doctor.
posted by davejay at 5:24 PM on November 15, 2010

Hypochondria is an obsession. I don't know if it responds to the antidepressants commonly used for OCD, but your doctor or therapist will. It's paradoxical, but I think you should schedule a visit with your primary care doc, and talk about this.

Talk to your doctor about the chronic pain, and set a schedule of followup visits, maybe at 6 month intervals. When you know that your next visit is on a specific date, you can keep some notes for your doctor. I'd try some elimination diets; I diagnosed my own lactose intolerance, and know 2 people who have responded incredibly well to gluten/wheat-free diets. Eliminating dairy and/or wheat is pretty safe.

Some habits respond well to being supplanted. Take up walking, tai chi, or some other form of regular exercise. Take up a hobby that will use up some of that internet time. It's sometimes easier to start doing something new than just stop a behavior. Zen Habits and Dumb Little Man are good blogs for life-change tips. Getting in better condition will help you get healthier as you move your focus from "OMG, I might be sick" to "I want to be healthier."

Thank your wife for putting up with you and helping you change, and ask her to go for a walk with you.
posted by theora55 at 5:59 PM on November 15, 2010

I have lots to say about this but can't really say it now; but please mefi mail me if you can.

More later.
posted by the young rope-rider at 7:31 PM on November 15, 2010

You also want to look up "heightened illness concern"

There was a great New York magazine article about it a couple of years back.
posted by the young rope-rider at 8:14 PM on November 15, 2010

I've been apt to self-diagnose the smallest ache and pain as something very serious. I think our society doesn't help matters much, with so many television, news, magazine articles pointing out the risks we face every day, and how everything can kill us. I know my anxiety increased in this regard when I lost both of my parents a decade or so ago, both reasonably young, due to cigarette related illnesses. I know that the closer I reach their ages, the more I find myself stressing about my own health, even though I've completely eschewed the thing that led to their demise. So I probably can't give you very great advice on top of what others have already offered, but I can offer you strategies and lessons that I've managed to come up with to cope that help me deal with it.

First, notice that there are plenty of other people around you who take worse care of themselves, and yet, they're still alive and well. I know a couple of guys who weigh a good 100-150lbs more than me, and they're in their late 60's or 70's. These guys hardly exercise, and they don't really watch what they eat. This tells me that the human body is more resilient than we're sometimes led to believe.

Next, make an effort to take good care of yourself. Eat right, and exercise. If you take active steps to live healthier, you can reassure yourself that you're probably not going to keel over right away, esp. compared to the geezers I just mentioned.

Also, trust your doctors. If they can't find anything, it's not necessarily because they're inept or making a mistake, especially if you've gotten multiple independent opinions. This isn't to say that your pain isn't real, but that it probably won't kill you.

Finally, come to grips with death. We've all got to go sometime, and being scared of dying is a big reason why we're afraid of our illnesses, too.

But I know as well as anyone that hypochondria is an irrational thing, so it's really hard to remain rational in the face of it. Talk to your docs about anti-anxiety drugs, and see if they aren't something that might help.
posted by crunchland at 9:29 PM on November 15, 2010

The only way you overcome it is you stop feeding it. You don't read anything about health online. Oh but what if... STOP. Oh but what if is your number one enemy. Oh but what if is the center and basis of your problem. You have to stop, you have to accept the discomfort of the uncertainty and the unknown, and you have to just live your life over the noise of your symptoms. And when the thoughts come, as soon as you are aware of them, as soon as you notice yourself going "ooh could this pain in my thumb be thumb cancer?!" you say no to yourself, you say, that isn't what's happening now. Stop whining to your wife, stop whining to yourself. It's just pain. Pain is commonplace, it doesn't have to mean anything.

Do the shit that is obvious. Get enough sleep. Exercise. Pay attention to what creates stress. Pay attention to your diet and make it better. Meaningfully occupy as much of your time as possible. Seek regular, rational preventive health care.

I dunno if you can get over the long-term, deep-set pattern of thought you describe without therapy, and probably a lot more than you feel like you can afford. But most of overcoming a tendency towards hypochondria for me boiled down to these basic techniques. Don't accept it, don't willingly dwell on it, and above all don't validate it by taking actions like research or needless doctor visits.
posted by nanojath at 9:35 PM on November 15, 2010 [2 favorites]

Also remember this: when the internet (and medical books) lists symptoms for the various ailments, they must be qualified. Like:

"abdominal pain, sweating, feeling of dread" that are strong enough that non-hypochondriacs go to the doctor.

This doesn't mean that I have abdominal pain, get feelings of dread and break out in a sweat. This means that normal people are minding their own business and start sweating profusely and feel like they got kicked in the gut and say "I've got to get to the doctor right now."

(This is by no means trying to diminish what is surely real pain you are experiencing. Just that it probably is not an aneurysm. Consider taking some psyllium with every meal.

It is hard to know what is serious or not. My only other advice is to find a physician that you absolutely trust, but who also isn't into tons of expensive tests. For most diseases/disorders, there are diagnostic criteria that rule in or rule out things. But many patients don't really trust that when the doctor pokes and prods their gut or asks them whether they have urinated in the last day, and then magically proclaims that their appendix hasn't burst, so doctors are getting trained by their patients to order bigger and better tests. That's not a bad thing, if someone can afford it. But not everyone can.)
posted by gjc at 7:15 AM on November 16, 2010


Well, first thing's first. I'm sure there's a lot of history you're regretting right now-- like, say, all that debt. But I want you to realize that there are some things to be grateful for too. It's easy for people suffering from abdominal pain to run into surgeons who find some slightly abnormal thing and try to fix it. I've met people that have ended up with a long list of abdominal surgeries, none of which ever does the trick, so I hope you can be grateful to get through this with all of your organs in the same cavity as when you were born :)

You're probably up to your neck in debt right now, but therapy is really a lot less expensive than hospital visits are. I would recommend talking about it with your wife, who I imagine has a stake in your finances, and who I imagine is going to be somebody you're going to draw on for a lot of emotional help. If she is certain that the two of you cannot afford therapy, then that's something you're going to have to at least take into consideration. But maybe she thinks that therapy is something important enough to get further into debt for?

I think it's reasonable to say that if you suffered from hypochondria, then that hypochondria filled a need that you have. If you just try and muscle through it without identifying that need, without finding a different way to treat that need, you're at a lot of risk of just trading hypochondria for a different bad habit.

So I think you need to ask yourself very carefully, and for a very long time: What did hypochondria do for me such that my pain was such an important part of my life? You're not going to get the answer just by looking into your head. You need to look at how you behaved, and wonder why you behaved like that. Your friends and family are probably a good source of hypotheses, if you can stand their judgment and analysis.

In the meantime, your abdominal pain is probably going to continue. I think that looking at your pain as chronic pain, rather than abdominal pain, might eventually lead you into the ways to alleviate it. If it's possible, I would seek out a pain clinic or specialist to help you out. There are a lot of ways that people have dealt with chronic pain successfully, and I think you might be in the unusual position of being able to realize that it really doesn't matter if a treatment is placebo or real. You're going to have to find the placebo that works for you, whether that be dietary changes or supplements, acupuncture, massage, meditation, medication.

(All of this is said in the assumption that you've been adequately worked up by competent medical professionals. It sounds as if you have been.)
posted by nathan v at 11:39 AM on November 16, 2010

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