Severe Health Anxiety. Is it possible to ever overcome this?
July 2, 2014 5:52 AM   Subscribe

I feel like I've tried everything and am at my wits end.

I am female, 40 yrs old, single and from the uk.
I have suffered HA for the past 5 yrs now, and it seems to be only getting worse. It first cropped up in my early twenties, but I managed to overcome it after about a year when I began a college course.

I have had my fair share of trauma, an event in childhood, as well as several upsetting life events (bereavement, loss, sexual assault) in adulthood, although I did seek help for these issues and dealt with them the best I could. I am certain that one or many of these issues may have led to the health anxiety arising in the first place, but that knowledge does not seem to assist me in solving the problem.

Two years ago I completed some long term cognitive (CBT) therapy and was told at the end of my sessions that I was to be passed on for deeper therapy because she thought my problems were too deep seated to tackle via CBT alone. I then had 5 months psychodynamic therapy which basically felt like treading water, with no great effect, until the therapist just up and left me to start a new job elsewhere. I complained, but was told I had been given enough therapy (NHS) and would have to go private if I wanted more. In fear of seeming ridiculous and needy, I just walked away.

My problem: I am utterly terrified of my body. So terrified I can barely describe it. It is a constant terror, a sense of not being safe, as if my entire body is falling apart with disease every minute of the day. When I manage to fight one fear off, another replaces it. My particular type of fear is malignancy, something that may entail a slow or agonizing death - but I do not exactly fear sudden death, infection, or the concept of death itself.

I fear taking a shower, getting changed or seeing any part of my flesh. Often I will dress quickly and only look very fleetingly in the mirror in case I see something that scares me. This could be a spot, rash, mole, bump, asymmetry, and can involve every area of my body. I try to fight this by telling myself that it is the anxiety fooling me and that I am highly sensitized to it all, but then my body will 'deliver' something real for me to freak out over, like a small rash, or an odd mark, or what feels to be a lump. Most of these turned out to be nothing, the worst being a temporary ganglion on my wrist, but the cycle is constant, and I can't even soothe myself by saying it's all in my head - for every slight thing I see is real.

For example, if I went to my doctor about every single fear, I would be there three times per day, every day, always. I go through periods where I can't eat, sleep or function at all, although for the most part I am plowing forward, managing to function, but it is a very low quality of life.
My doctor is extremely helpful and encouraging, so that's one good thing, but I am absolutely at my wits end with this and wonder how I can go on.

Every waking moment of my life is terror. I don't even know anymore what is worth worrying about or worth ignoring. Every bodily symptom is a danger alert for me, and it happens on the unconscious level, well before I can inject logic and calm into the equation! I am not doing this on purpose and am so scared that I will never be free of it. It does seem that things that are 'visible' are my weak spot (like I said about moles, stuff I may see when getting changed, etc). Yesterday I thought I had breast cancer because I thought there was more wrinkling on one breast than the other (can see this when temp changes, stuff like that), then later it wasn't visible - yet most of my day was swallowed by this fear. Then it's weakness, a weird blemish, a sore thigh (so it must be sarcoma!), heartburn (esophageal cancer), a dark mole, a flash in corner of my eye (brain disease), lumpy bone in one leg, is there a mass behind my my shoulder ache actually lung cancer....and so on. My mind. An endless slideshow of hell.

I have tried everything, from CBT, some meditation, group therapy, childhood trauma therapy, medication (did not help and I won't try it again so please don't suggest this, it's a no go for me). Is there anything else I can do? I appreciate that we are all ultimately alone with this, that disease is entirely possible, even inevitable, and death of course will follow at some point, but whatever philosophy I try to apply to my own problem, the constant panic won't go away. I am intelligent, have a lot of personal insight, but can't get to grips with this. It's like my own pet monster that needs feeding constantly.

It's as if my body is a sort of separate entity that only exists to terrorize me. Whilst I KNOW this is wrong, I can't shift the feeling. I have tried all manner of self help techniques, but to no avail. This is so powerful, I can't seem to fight it. I don't want to live in the past or keep seeking therapy, I just want some semblance of a regular life. I just want to feel as if living in this body isn't like running through a field of landmines wondering which one will explode next. I want to get out of it, punish it, make it all stop.

Lifestyle - I have recently made positive changes to my life which were long overdue (a bad relationship in the past, unhappy living circumstances, etc), and now I have this new beginning and a lovely new home, and so much that could be positive. I do need to build a social life, as I work from home building a small business, but I am trying. That is all I can say.

Is there any way out of this?
(Thanks for reading).
posted by noella to Health & Fitness (20 answers total) 5 users marked this as a favorite
There is, but I think you may have to be a little stricter with yourself. CBT and other therapy for obsessive/anxiety disorders requires a ton of self-discipline, self-talk, and being very conscious about not allowing yourself to "give in" (as it were) to the compulsions and rituals. Your body-checking sounds very ritualistic to me, and as someone who had a slew of rituals that interfered with everyday life, I somewhat understand (every mind is different, of course) the dread you feel if you don't do them or indulge in them, but you have to allow yourself to feel the discomfort, let it run its course, and realize that you're still okay.

I would go back to therapy and (I know you said this is a no-go, but I'm going to say it anyway) perhaps open the door up to other medication options that may exist. Self-help can take you pretty far, but someone to help guide you through things and remind you that your fears are just fears is of great help.

Good luck.
posted by xingcat at 6:04 AM on July 2, 2014 [3 favorites]

have tried everything, from CBT, some meditation, group therapy, childhood trauma therapy, medication (did not help and I won't try it again so please don't suggest this, it's a no go for me). Is there anything else I can do?

There may be other answers, but since therapy and medication are the proven standards to treat mental illness, I feel like it would be helpful if you could provide more information about why therapy and medication are not potential answers. This sounds like such a severe problem that you really do need more than what you've been able to do so far (unclear how long you were in therapy for in addition to the 5 months time, or how many medications you tried and why they did not work out for you).

Adding a bit more information on this might help prevent you from getting many answers you don't want to hear (i.e. "I know you said this wasn't an option, but - therapy and medication"), or a lot of people being uncertain on how they can address this question within your boundaries and not answering at all, which was my first inclination.
posted by treehorn+bunny at 6:06 AM on July 2, 2014 [7 favorites]

I think that Xingcat is on the right track here.
You say that you've tried everything, but have you really?
How long did you give CBT?
How long did you give Meditation?
How long did you give group therapy?
How long were you on medication?

My gut feeling is that you gave them maybe a week, then moved on to something 'easier' or that 'sounded better'.

Pick one.
I would choose CBT, because that's what worked for MY anxiety issues.
Let's go with 90 days of strict adherence to this one method.
At the end of 90 days, EVALUATE where you were with where you are now.
THEN decide if perhaps you should give it another 90 days or move to something else.

You must be strict with yourself.
You must NOT cut yourself a great deal of slack, whereby you get to just give up and move on because it doesn't suit you that day or that moment.
You must hold yourself ACCOUNTABLE day in and day out.

It's time for the tough love.

When it comes to my health anxiety, I have come to the point where I just keep living and if something happens, I'll DEAL WITH IT THEN, not worry about it beforehand.

Another hint: EXERCISE. Get out of your brain and into your body.
Again, hold yourself accountable.

It definitely gets better.
posted by John Kennedy Toole Box at 6:11 AM on July 2, 2014 [3 favorites]

Treehorn + Bunny is absolutely correct. You have a serious mental illness, and you need to be treating it in a number of modalities.

You say medication is a no-go, but that may be your mental illness talking. Just as a hoarder considers every old, mouldy pizza box a necessary treasure, your brain is telling you that medication is not the answer for you.

Our brains are very tricky things, and they are lying liars who lie. For years I thought I could tackle my anxiety, it took SO MUCH ENERGY to keep a lid on my fears and anxieties. Finally, after an escallation of panic attacks, I had no other options. Now I'm on anti-anxiety medication and while it's not perfect, it's improved my quality of life ten-fold. So I'll put up with some weight-gain because to me, the trade off is worth it.

Mental illness is a bitch to deal with because you're making your decisions with a brain that's deliberately trying to keep you unhealthy.

So your instincts about medication are all fucked up. Just like your fears are all fucked up. Your instints about therapy are all fucked up.

So go back to your doctor, and tell her that your quality of life is nil, that you're obsessing all the time and that you need the best treatment you can get for this, up to and including in-patient care, if there is such a thing for this.

I wish you luck.
posted by Ruthless Bunny at 6:33 AM on July 2, 2014 [5 favorites]

Treehorn + Bunny and Ruthless Bunny have some really solid advice. Medication often doesn't "fix" the problem with anxiety, but it takes the edge off enough that you can be present to really benefit from the other treatment you select. It may be helpful to think of it as a tool that will allow space in your mind to work on this. It's also a very, very common experience that it takes work to get to exactly the right medication and exactly the right dose to work optimally for you. I wonder if you were experiencing side effects and that magnified your health anxiety? Working to find a more managable side effect profile would help with that.

CBT is really, hands down, the most effective modality of treatment to address things like this, but as others have said, it takes lots of work and lots of practice. The fact that you are still finding yourself engaging in "safety behaviors" like quickly dressing to avoid seeing yourself in the mirror tells me that you have not yet quite gotten to the point that you have enough practice to work on those thoughts in the moment. That isn't a failure on your part or the therapy's part, you just haven't had enough good practice yet.

Another thought is that adding a component of mindfulness practice to your therapy arsenal might be helpful. It 's a gentle way of centering yourself in your body and might have the added benefit of providing a graduated way of exposing yourself to bodily sensations that might feel anxiety provoking.

I'm sorry you are suffering and that you are struggling to hold out hope. I have hope for you, and it sounds like there are lots of others here who do to. Sending you hope and strength.
posted by goggie at 6:41 AM on July 2, 2014

While I suggest this in addition to a combination of (probably CBT) therapy and medication, it might also be helpful on its own: exercise. Specifically, goal-based exercise, whether that's a couch-to-5k program or a weight-lifting regimen or Zumba twice a week. I know that my experience of my body is SO DIFFERENT when I am exploring what it can do, versus what it looks like or what might be wrong with it. Learning what your body can do may help to recenter your experience of it.
posted by chesty_a_arthur at 6:45 AM on July 2, 2014 [2 favorites]

In fear of seeming ridiculous and needy, I just walked away.

Nope. Don't fear this; you won't seem ridiculous and/or needy if you insist on getting the care you need. You are, if anything, even more sane and reasonable for pursuing treatment here.

A lot of what you describe sounds like it could be in the OCD family (IANAD/P, etc.), and--speaking from experience as a mildly OCD hypochondriac--OCD responds well to cognitive behavioral therapy applied with a lot of discipline and under the care of a professional.

Medication: you say you've tried it and that it's a no-go, but I would urge you to reconsider. If the first drug/s you tried didn't work well, there are so many more, and your doctor should be sensitive to any concerns you have about side effects or efficacy. A low dose of an SSRI indicated for OCD can be a lifesaver.

Finally, you say you're building a business from home. It may not be helping to spend your days at home and as isolated as you want to be. Can you set up a workspace in a library or coffee shop a few days a week? It could help just to be away from the echo chamber of your mind in solitude.

Good luck with this; it's not fun, and it's not easy. But it doesn't have to last forever.
posted by magdalemon at 6:49 AM on July 2, 2014 [2 favorites]

I can tell you my own experience. I suffered from HA for over 20 years and no amount of counseling or medication seemed to work. I was afraid to take medication because I wrapped that up in my HA and imagined it would do all sorts of terrible things to me. Then about 5 years ago it became unmanageable and I found a psychiatrist who was known to be good with complicated situations and she prescribed some medication for me. It didn't seem to work. Then she adjusted the dosage, and it worked. My hypochondria vanished. I don't mean to suggest that your issues could be flipped off like a switch but I urge you to reconsider medication. There are so many options out there and the effects can be different at different dosages so it's something you have to be persistent at. You may find that you need a combination of meds + counseling are needed. Also, CBT doesn't work for everyone. It didn't for me. There are other styles of counseling available that may better suit your issues. I really feel for you, I know how debilitating it can be. But there absolutely is hope.
posted by mattholomew at 6:53 AM on July 2, 2014 [2 favorites]

Response by poster: Just to answer a few questions.

I am not opposed to therapy, I'm very pro- therapy. I am not sure how that came across???

I have received 2 sets of CBT, once several years ago following trauma, and another year long set for my health anxiety more recently. When it ended (I had no choice) I was told it wasn't working. Each therapist has wished me ,luck and said I engaged very well. What can I do?

I have also had 8 months Psychodynamic therapy with a therapist who up and left suddenly, and have been told I ought not to pursue more. When I asked why, the person who assessed me told me I had 'had a lot of therapy', and just gave me the impression I was not welcome.

I am considering going private but it will be a struggle on my income.

I am also in mindfulness group therapy, once weekly, and have been for past 2 years.

Not sure if it seems like it, but I do try very hard and have been very engaged with my therapists.
I do feel a bit let down, but that might be more an NHS thing than a therapy thing altogether.

I have tried anti-anxiety medication and anti-depressants in the past, for several yrs at a time. I did not like the way I felt, which was very numb and unmotivated. I have also watched anti-D's turn a close friend into what appears to be an emotionless robot for the past 10 yrs so am fairly set against them. I'm sorry about that, but I can't reconcile it. I am willing to try anything other than brain affecting drugs - and yes, I know my brain is screwed !

Thanks so much for the answers. Tough love is ok!
posted by noella at 7:03 AM on July 2, 2014 [1 favorite]

Response by poster: Sorry to pop back, but I think my question, although posed pretty ambiguously (sorry!) is mostly concerning what tips you might be able to give me in the meantime, like how 'you' overcame it, or something similar. I do intent to seek further help.
posted by noella at 7:04 AM on July 2, 2014

I would echo the wonderful advice in this thread, with the exception of NOT cutting yourself slack. I think an easier way to approach the process of treatment is to realize that it's often just that- a process, and one that you have to trust and give yourself over to completely, but not in a way where the question of success or failure becomes a zero-sum game and a test of will. You can force yourself to do something for only so long. Eventually, approaching something like CBT with that sort of attitude will set the bar for success so high that it will NEVER seem to work for you, no matter how many incremental goals you've reached, because you grow to resent it.
My suggestion is to take things one day at a time, allow for bad days ( even with therapy), and reframe your experience: X happened, and it sucked, BUT I managed to do Y, so overall it's a win day. That BUT is so, so important. I know from experience.

TL;DR Stick with one thing, but respect and appreciate the nuances of that thing and love yourself throughout.
posted by marsbar77 at 7:10 AM on July 2, 2014 [2 favorites]

Best answer: I want to share this quote from Socrates that I hope will help you to get out there and push yourself and exercise. Our body is so amazing, so strong, so flexible, capable of so many great things.

I hope that you will grow to love your body instead of fear it.

“No man has the right to be an amateur in the matter of physical training. It is a shame for a man to grow old without seeing the beauty and strength of which his body is capable.”

I also keep this long quote from Abraham Hicks on my phone so I can read it at all times:

"That is so essential: making your body your friend. Most of you are afraid of your body. Your body feels like something that might trick you. It might get run over, or it might make the wrong decision, or it might die too early, or it might get a disease in it, or it might do something, after all, it has all kinds of mysteries. You can't look into your body. You can't see metabolism. You can't see what's happening with the cells. You don't really understand your body. And your body frightens you in most cases.

We would like to help you to know that your body is oh, so well meaning. Your body is so well orchestrated. You see, your body is trillions of cells that are vibrationally interacting with Source Energy. And if left to their own without a lot of static in your vibration, your body would only thrive.

In other words, the basis of your body is one of true and utter thriving. It has no reason to frighten you. It is the greatest evidence of Well-being that exists anywhere in your physical experience. It is an extraordinary mechanism that's come together from great deliberate intent from so many Non-Physical and physical creators.

And every one of you who stands in your body, continues to enhance the experience of the physical body. This is an evolution of a species that is extraordinary. Your bodies are not to be feared. Your bodies are to be revered. Your bodies are to be applauded. Your bodies are to be maybe even amazed at. But they are never to be feared.

Your bodies are not vulnerable. They're not fragile. They are resilient. They are flexible. You have the ability to come into alignment again and again and again, and if anyone in the Universe understands that, it's the cells of your body.

Befriending your body is the only way we know of coming to understand that your body is resilient and that it knows what to do, and that it will be whatever you ask it to be. But you have to ask it to be that in a place of nonresistance. It's the most significant information that we have ever expressed relative to your physical body and food. You must love your body, and then lovingly give it the food. And when you love your body and lovingly give it the food, it matters not what food you give it."

Excerpted from an Abraham-Hicks ( workshop in Asheville, NC on Sunday, October 29th, 2000

posted by John Kennedy Toole Box at 7:14 AM on July 2, 2014 [16 favorites]

I absolutely don't want to be that guy who won't listen and keeps pushing things that you've ruled out. But CBT plus medication is really what typically works best. I hear your concerns, so let me suggest that not all CBT is alike and not all drugs are alike.

Both may require a few tries before one that helps you is found. To take the drugs, for example: there's a really wide spectrum of things that they can try. Some may work and some will not. Some may make you feel like a zombie, and some will not. But the variation is so great from person to person that it can be a process of trial and error. Even within types of drugs there's variation. Please, don't reject the idea of all medication just because drug A did nothing, and drug B made you zone out. Likewise, don't reject CBT because one program or two didn't make much headway.
posted by tyllwin at 7:20 AM on July 2, 2014 [1 favorite]

Response by poster: Just to add emphasis - I am very much open to therapy, whether CBT or something else. I intend to pursue more, and will do my best even if the NHS won't fund it.

As for medication, I do appreciate that you are all quite correct, but I don't want to pursue that at the moment. If something is suggested by a future therapist I will certainly give it thought.

I really want to concentrate right now on my current perceptions, anything to add insight or get me through until my next step. Thanks again, so much!
posted by noella at 7:27 AM on July 2, 2014

Best answer: As a former health-anxiety sufferer, I know full well how much it sucks. I really hope you find a way to live your life without this level of fear eventually. There is no one-size-fits-all solution, but what helped me the most ended up being a combination of (a) time, and (b) committing myself to out-logic-ing the terror. More to the point, I got extremely fed up with feeling like I was missing out on life due to horror of some insidious malignancy. So I set time points for myself, saying "if I am not dead or ill one month from now, I'll know [x] is unlikely." And then the month became 2 months, and so on. It took a few years to get to what I would consider a normal type/level of health concern. Ultimately my brain managed to grasp the fact that if I wasn't dead YET, clearly all my worrying had been over nothing, and that permitted me to start seeing the everyday quirks and asymmetries of my body as a baseline. Again, I can't promise this will work for you, and it was certainly much more of a complicated slog than I am relaying here. But given you don't want to take medication, I just thought you might appreciate knowing that it is at least possible for some people to recover from HA without it.

I don't oppose medication when it actually benefits a person but for me personally, this "flavor" of anxiety really seems to be part of a deep-rooted thinking/perceptual glitch that no medication would be able to touch. You seem to have a good level of self-awareness as far as realizing your anxiety-driven thoughts don't make sense, and that is actually huge. Good luck!
posted by aecorwin at 7:57 AM on July 2, 2014

Best answer: In addition to the excellent answers here, I would like to add that not all CBT is created equal. I couldn't just do the worksheets and goals and self-assessment with my therapist--I actually had to do some exposure therapy to get behind the wheel of a car again because my anxiety about driving had essentially progressed into panic and phobia territory. Even now, years and years later, I still find myself having to re-engage with my CBT practice when I feel the anxiety about driving start to roil up like a Lovecraftian entity. CBT specifically for anxiety is literally the only therapy I've ever done that has worked for any one of my 32423434 mental health problems, but I had to be utterly committed to the entire process, even the bits that felt supremely stupid and embarrassing. Especially those bits, actually. Hyperventilating while sitting behind the wheel of my car while my therapist asked me about my anxiety level is not one of my fondest memories. Admitting, out loud, to another person, that one of my greatest fears was getting lost and having to ask a stranger for directions was almost physically impossible. My throat felt literally closed. Going even further and admitting that I was really afraid that the stranger might assault or harm me in some way involved hysterical, panicked sobbing in a tiny room full of bad art and underwatered violets. Yeah, none of this was fun, and the whole time I was thinking, "how can all this trauma possibly be helping me?"

But it really was helping me. Even though I was constantly testing my limits and being forced to endure extremely high levels of anxiety, I was eventually able to address my thinking errors and feel some small amount of pride in my accomplishments. My biggest obstacle, really, was my own intellect. I had convinced myself that fears I knew intellectually to be irrational should be easily dismissed, but somehow missed the fact that I was still terrified. I had to actually do the things that I thought were dumb and beneath me to get anywhere. It couldn't just be an intellectual exercise for me. So I had to do the things. I had to ask strangers for directions to places I knew and didn't know. I had to drive for several miles on unfamiliar roads. I had to get lost without my GPS. I had to drive at night. In the rain. In the snow. I had to constantly assess and address my anxiety as I did these things. I had to learn to accept that I wouldn't always have the answer to any conceivable problem that might arise while driving and develop coping strategies to address my anxieties about the unknowable and unforeseeable. I had to keep logs and report back. It was exhausting and sometimes a terrible experience, but totally worth it in the end.
posted by xyzzy at 8:04 AM on July 2, 2014 [3 favorites]

For sure.. what we focus on gets bigger. Your 'presentation' sounds pretty complex. If you were to ever to go back to (private) therapy I'd think about looking for someone ideally with experience of phobia and possibly ptsd (your post indicates a degree of 'hyper-vigilance'). CBT has it's place, but it ain't the deepest.. I think it was positive they took the view you needed help to go deeper even though things feel a bit of a stalemate right now.

CBT has it's place when people are ready and able for change. That said if you go to the Australian Clentre for Clinical Interventions site, I believe they still have a free workbook specifically on health anxiety - so more 'tailored' work (although solitary) may be more helpful to you than that generalist CBT if that makes sense. It's great that you have the insight you do, it sounds very tough.
posted by tanktop at 8:16 AM on July 2, 2014

Best answer: So I was on meds and in therapy and it was great - I got the tools to deal, and the meds took the wind out of anxiety's sails, when I had gotten so exhausted battling it on my own. I left therapy with the blessing of the counselor and carried on with a maintenance dose of medication.

Then I did something stupid: I quit taking my pills, and anxiety came galloping back.

But I learned a useful thing. With its original focus topic no longer effective as a scare tactic, I learned that anxiety will latch on to anything. Because suddenly my focus was all about some other completely unrelated thing that hadn't bothered me before! Anxiety is opportunistic. Deny it one source of fuel - say there were a magic wand that made you immune to cancer - anxiety would cast around for something else to work with - say, building a phobia about being ill in public.

It's not picky.

I went back on my meds and gently scolded - "yeah - cold turkey will do that!" But I came away knowing that anxiety is a paper tiger. It's a plastic ghost that pops up and says BOO! It's not a thing about your health, at least not the way you suffer and agonize over: it's a thing about your hair-trigger adrenaline going off all the time and needing recalibration. It's the breathlessness and racing heartbeat and churning belly cramps. The health stuff is just the sheet it dresses up in for the BOO.

You will, one way or another, find a way to pluck the sheet off the ghost and fold it back into the linen closet where it belongs. It will try to wave it's arms at you and you'll be able to just roll your eyes and turn away. I was able to feel the anxiety trying to cramp my belly up, and flutter my heart, and I was able to say 'oh... This thing. Let me ride it out and it'll be out of my system in five minutes.' It had become a purely physical sensation because I didn't believe in the frightening part anymore. Not that my frightened was less real than yours - just that I had acclimated to a normal-person degree of detachment from it.

For me, when it started working originally, the waves of fear would still come. But the big crescendo, I could hold that off and keep it together - like keeping a horse walking when it would previously have bolted. I learned that half of my fear was not of the triggering topic, but of actually having a panic attack. If I could tamp down the physical response - which for me came in the form of meds - it gave me room to develop different techniques of approaching the troubling thoughts intellectually, so that I could dismiss them with greater authority as time went on. Eventually I got to the point where I could entertain the original trigger and honestly say, "you know what, fuck it. The odds of it happening are so remote. But even if it did happen, I could deal." And it was true.

After my silly episode post-quitting my pills, I had internalized that process so effectively that it was nothing to get over once the drug issue was sorted out. I am off them now, having tapered responsibly, and all is well.

I know you'll find the path to well-being that suits you. I know it's VERY hard work you're doing to face that monster every day. But I hope it's a help to remember the monster's true nature.
posted by Lou Stuells at 8:26 AM on July 2, 2014 [11 favorites]

Best answer: I feel like I've gotten into my own history a bit too much in my recent Ask Metafilter answers... but in this case I do think my history is relevant.

OP, I am basically one of your worst-case scenarios. When I was 21 I got sick for a year, and since then I've never really been well again. Just endless health problems, most of them relatively minor but many of them things that people have freaking support groups about. Lots of pain, lots of niggling little horrors, most of the time. This year, I got colon cancer. I'm home now after having a chunk of my guts hacked out a few weeks ago.

I've become a bit of a hypochondriac. I mean, anybody would be paranoid about their body, after the shit I've been through. I get a nagging cough, and I never know if it's a bit of postnasal drip or some god damned thing that will destroy the next five years of my life. So, I do sometimes obsess over tiny symptoms, and drive my loved ones crazy when I won't shut up about a weird mole or whatever.

I'm getting the impression that you haven't experienced a lot of actual, serious physical illness. (Please correct me if I'm wrong.) So, imagine if a bunch of those times when you checked your body for symptoms, something was actually wrong. Welcome to my life!

This has probably sounded pretty self-pitying so far, but I've only gone on like this so you'd know where I'm coming from when I say that you can still have some fun in life, even if your flesh hates you. You can have fun despite your flesh, and you can have fun with your flesh. Your flesh is the boss of you (after all, it gets to decide when you die) but while you're on this planet it's up to you what you do with your meat suit.

My advice:

Get your ass into therapy. Stat. No excuses. THERAPY.

Find a good medication. You really need something to take the edge off your anxiety, and hopefully make you less obsessive. I can tell you from experience, a good med can make a huge difference. I've had happy pills to help me through this cancer, and I don't even want to think about doing it without them. You need good meds, as much (if not more!) than you need therapy.

If something doesn't hurt, force yourself to not pay so much attention to it. If something hurts, OK, that's damn hard to ignore. But if you have a weird mole on your leg, OK, you need to get that checked out... but otherwise, just be glad it doesn't hurt and try to focus on anything more productive and/or fun. I know it's hard. I know. Do it anyway. You don't have to be great at it. Just keep trying, and when you think you've tried all you can, try some more.

Have some fun with your flesh. Your nerve endings aren't just there for pain. Some folks like jogging or whatever, but I've always preferred the teaches of Peaches: fuck the pain away. Find ways to make yourself attractive to yourself, get dolled up, dance and stay out late. I was really inspired by Sick: The Life and Death of Bob Flanagan, Supermasochist. (NSFW.) That guy's body was an agonizing shitpile, and he still found a way to make pleasure happen for himself.

I'm not saying you need to get into BDSM or anything of the sort. But I am saying that the way you are living now is a choice, and other people have managed to have fun with some really sickly bodies. Get therapy. Find some good meds. Go outside and play.
posted by Ursula Hitler at 2:29 PM on July 2, 2014

Best answer: One other thing. Nighttime is really fertile ground for anxieties to loom large. It's always been so damn consistent for me, those 3 am fantasies of worst case scenarios. Ever since I was little!

But the consistency itself is a clue that it's more about the quiet dark loneliness, the inaccessibility of distraction or comfort. It's the ideal time for the Night-Mares to break out of the barn.

So if you're haunted by your most terrible thoughts in the night, know that it's the context making them cast huge shadows, where in daytime they'd be so much smaller, more insignificant, and silly.

Take advice from Napoleon Bonaparte: "Throw off your worries when you throw off your clothes at night." I don't mean that in a 'snap out of it! cheer up!' sense - I know how unhelpful and patient-blamey that is. I mean it in the sense that, when stuff is scary and you can't sleep and you feel so small and alone, you can know that Napoleon of all people knew about that situation, and made a rule about not entertaining thoughts of heavy significance after a certain time of night. (10 pm? maybe. 3 am? DEFINITELY.) That's not sensible time, that's crazy-thinking time, and nothing your brain cooks up in those hours is worth entertaining. You're allowed to discard it - for me, putting it in terms of permission was somehow helpful. You can always revisit the topic over breakfast or lunch, and see how it holds up in the sunlight.

Now I can start down that thought-path as I lay in the dark, get a little concerned, and click off the topic like a switch. I can be thinking, ' here's the top twenty ways I look like an idiot and everyone secretly hates me. --Wait a minute, not at night, that's useless-worrying time because the perspective's all distorted. Pick it up later. Now, what color should we paint the house?"

I hope this is of some help. Keep in mind that if you're in Aus, it's daytime for us in North America. If it would help to talk, do please send me a message to my inbox. The upside to having gone through 20 years of panic attacks and anxiety is the hope of helping someone else to know that it can be gotten through.

This thing isn't 'you', this isn't your identity. It doesn't eclipse the cool stuff about you, your awesome quirks and interests and talents. That stuff is more valid as 'you' than this thing. This is a thing that happens to you, it's not your fault and it really sucks. It is treatable, but finding the combination of elements to accomplish it is trial and error, and waiting for appointments, and sometimes facing people (with medical authority!) who don't get it, who can't help, and treat you poorly or dismissively (this is a thing!) It is a grind, especially when you feel you are already using more resources than you have just to face each new day.

But the peace is worth it, and you can discover that combination of treatment that brings you the peace.

I was agoraphobic for 2 years by the time I got treated. I asked the lady "So... how hard is this going to be?" She gave me an answer that brought tears. "Hard," she said. "But not as hard as what you've been doing."
posted by Lou Stuells at 4:13 PM on July 2, 2014 [5 favorites]

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