How to deal with anxiety about actual health problems?
April 20, 2016 9:01 AM   Subscribe

I've got a new health condition of some kind to add to my pile of years-long preexisting conditions. Bloodwork and unwanted weight loss seem to point to a particular condition, but we're not 100% sure yet. It's probably not something that will kill me anytime soon, and in a majority of cases doesn't even cause any painful symptoms. So why am I wigging out about it?

Assume that I am well schooled in anxiety disorders in general, having dealt with it on and off for a long time, and that I have sought aid in a variety of forms (therapy, biofeedback, anxiety as a symptom of a condition, meditation). Some of those have worked really well. I understand, mentally, how to deal with anxiety when it seems to be GAD (which I rarely have these days, as far as I can detect). I understand how to deal with it when it has been caused by medications, or lack thereof. However, I'm really unsure how to frame it when I'm pretty sure the reason is - I'm having it about getting a comorbid condition, to go along with my already previously existing conditions - and which two months of recent bloodwork and an ultrasound seem to make likely. If I continue to take the best care of myself, as I usually do, and the tests are correct, it's probably something that plenty of people have and often doesn't progress.

This might be enough to throw people who have been otherwise healthy individuals for most of their lives, but maybe it would affect everyone the same. I don't know. I'd like to think that as somebody who's had a battery of symptoms and chronic illness most of his life, that piling on yet more stuff would just cause me to shrug.

However, I do know, though, that potentially as a result of new condition - we're not certain yet - I have been slowly losing weight over the last couple of months and can't seem to halt its progress. Obviously there's a point beyond which I may be critical. Do I genuinely think that's going to happen? Not yet. My docs are working with me as best we can to figure out what the hell is going on.

There's the possibility that it's the combination of factors - my preexisting Hashimoto's, the new condition (and I also offer low grade anxiety to the docs as another potential cause, just in case). Typically when my anxiety cranks up, everything speeds up in my digestive area, so keeping food in there gets to be a problem. However I'm currently on meds that keep that mostly in check, so that's not it.

Whatever the cause, watching myself slowly waste away is making me freak the hell out. I had an underweight problem before when my thryoid tanked with Hashimoto's years ago, but that's been checked and triple checked.

I'm not here this time on the green asking for theories as to the cause, since me and my doctors seem to be slowly eliminating things.

I'm asking what you do about getting anxiety (attacks) because you have no idea what is making you waste away to 20 lbs below your ordinarily already skinny weight, and you are doing everything you can to prevent this. I mean, I SEE every day when I look in the mirror, that there's a problem. I'm not imagining it. I can't tell myself "you are feeling this way to an irrational degree, because there's really nothing to worry about." I am pretty sure people I don't know, in public, (so why should I care?) are starting to stare at me because I've gotten so thin.

It's worst in the morning when I wake up, usually about an hour after, when the anxiety is there, but it's not there every day. I am nearly 100% positive it's because of me worrying about whatever's newly wrong with me, and not something else. I'm already on medication that is coincidentally helping with it, but it's obvious that when the anxiety gets above a certain level, it trumps the effect of that med. Sure, I could go on even more meds, but I would prefer not to as the rest of my day I'm usually pretty tired from the meds and the weight loss. I can't exercise much.

Since I feel I am being as proactive as I can, the worry, at least in terms of how it can physically affect me, seems like a waste. (Plus, stress and digestive woe are not anything I need to add to the pile).

Now taking suggestions. Thanks as always, MeFiters.
posted by bitterkitten to Health & Fitness (9 answers total) 2 users marked this as a favorite
Not sure if this will be helpful to you, but the following reframing has at least moderately helped me.

Completely different situation, but I had a period when I was getting really caught up on the distinction between "legitimate" and "illegitimate" anxiety. Like sure, anxiety over completely unlikely things was "unreasonable" and so I could sort of logic my way out of it. But what if the thing I was worrying about was real?! In my case it is/was not my own health situation, but the fact that my partner had/has a chronic medical condition that has very real risks and is not just my imagination running away with itself. So, since this is a reasonable thing to worry about (and indeed one that I think many people would be stressed about), how do I logic my way out of worrying about it? It sounds like you might be in a similar mental cylce here (apologies if that is not the case!).

The way my therapist framed it to me was basically that sure, these anxieties are about "real" things rather than hyperbolic fantasies, but nonetheless, what is the anxiety/worry contributing to the situation? To the extent that I can channel it toward positive ends that will improve the situation (say, educating myself about things so I can be more supportive of my partner in a particular way, or participating in a walk-a-thon related to his disease, or heck, donating blood to feel like I'm giving back to other people who are ill) that's a good thing. But to the extent my anxiety is not producing positive changes but is merely making the situation worse, it sort of doesn't matter whether it's "reasonable" or "unreasonable" -- because ultimately it is unreasonable to create all this worry/stress that is not changing things but just making me upset. Anyway. Don't know if that will resonate with you, but for myself it has been helpful for chanelling my anxiety into positive actions and reframing things in my mind when there are no particular actions to take.
posted by rainbowbrite at 9:15 AM on April 20, 2016 [6 favorites]

I'm a big reader and also the proud owner of a couple of auto-immune disorders, and so I have a couple of book recommendations that have helped me.

How to Be Sick

Sick and Tired of Feeling Sick and Tired

I have not read this one, but it's probably next on my list: How to Live Well

Overall, equanimity exercises have always been the most helpful for me. Here is a link to a recorded talk on equanimity by a teacher who has been very helpful to me.

And here is a link to a guided meditation on equanimity by Rick Hanson, who is a really interesting guy who is doing work with neurology and the teachings of the Buddha about creating pathways in the brain that lead more reliably to positive reactions.
posted by janey47 at 10:45 AM on April 20, 2016 [2 favorites]

If you already have productive tools that you use to deal with anxiety over "fake" concerns, you can use those to deal with anxiety over "legitimate" fear. Telling yourself that you are irrationally concerned is one of my least favorite ways people handle anxiety because it doesn't help at all when the fear is a rational response. As anyone who can become paralyzed by anxiety and fear knows, paralysis doesn't help you when it's time to escape from a bear or avoid getting shot in an active shooter situation.

This is why I like the AWARE technique. It allows you to experience your anxiety, accept it as part of you, but still act.

A - Acknowledge your anxiety. Don't try to push it away or ignore it. It's completely normal to have anxious feelings. Discomfort is ok.
W - Watch your anxiety. Rate it on a scale of 1-10. Be clinical and aware. My heart is beating faster. I'm sweating. My thoughts are racing.
A - Act through. Just keep on keeping on. Take some deep belly breaths, relax your muscles, drink some water, and then do whatever you would be doing if anxiety weren't happening.
R - Repeat as necessary.
E - Expect the best. Know that the anxiety and/or panic attack will end. Because it will.

The tl;dr is this. Anxiety is normal. It's ok to feel discomfort. It's avoidance of that discomfort that leads to dysfunction and physical illness. Feel your feels.
posted by xyzzy at 11:02 AM on April 20, 2016 [3 favorites]

I think all you need is situational awareness that you're almost experiencing already.
- There I go, worrying about my health condition again and feeling like I don't deserve to worry about it.
- I realize that I'm beating myself up for not dealing with this situation the way I believe I should, and that's causing negative impacts on my life.
- I'll take this moment and recognize that it's OK to be worried about my health, so I can help myself to move on to things that are more productive.
posted by treehorn+bunny at 11:32 AM on April 20, 2016 [2 favorites]

I used to be the biggest worrier, and had a lot of anxiety and frequent panic attacks. Some of it was about real issues, some of it was future projections or spinning out possibilities.

The thing I suddenly realized (in the middle of one of my daily anxiety attacks) is that worrying doesn't actually do anything positive to solve the situation, and will often make things worse for me. Genuine concerns or not, what mattered the most was could I do something about it RIGHT NOW?. If I could do something right now to address the concern, I would do it. If it wasn't something I could do anything about, I didn't need to continue to think or worry about it.

When I realized this, it was like all the anxiety drained out of my body. I know it sounds overly simple, and I'm not sure why that was the lightbulb moment that allowed me to step away from lifelong anxiety, but it worked. I haven't had an anxiety or panic attack since.

Best of luck, with your physical and mental health.
posted by ananci at 11:54 AM on April 20, 2016

Hashimoto's can cycle between hypo and hyperthyroidism and anxiety is a major symptom of hyperthyroidism as is the digestive issues and weight loss. Maybe have those numbers tested again to make sure the anxiety is your feelings and not a physical symptom of your thyroid hormones trending toward hyperthyroid.
posted by cecic at 12:34 PM on April 20, 2016

A little over a month ago I was experiencing daily panic attacks about my crappy health. My doctor put me on Lexapro and I don't think I've had a full-on panic attack since.

I am still scared and depressed, because I've got stuff going on you'd have to be nuts to not be scared and depressed about. But I'm no longer experiencing crushing terror for hours every day. Some of that may be me getting used to the endless uncertainty, some of that may be an improvement in my physical symptoms (knock wood), some of that may be me learning to cope better. But I was suffocating in dread and now I'm not so freaking afraid all the time, and I think the Lexapro is probably what's making the big difference there.

The emotions I want to feel don't seem repressed, I still have empathy and I can laugh and stuff. But it's like my terror was readjusted, so it's not my default state and when it does engage it doesn't go straight to 11. Instead of panic, I'm more likely to feel depression. I'll take it.
posted by Ursula Hitler at 2:45 PM on April 20, 2016 [2 favorites]

I've been in and out of therapy for more than 25 years. My list of psych diagnoses is outdone only by my list of physical health diagnoses. I've been dealing with chronic pain for more than 25 years, since I was 13. Over the last three years, I've acquired three new diagnoses - one psych, two chronic pain, and come down with WTF-itis. (I think I'm up to 17 docs, two physical therapists, an occupational therapist, and a speech language pathologist all going "I don't know what it is, but I know it sucks. Maybe you should go see an _other_specialty_ist_.)

With each of the last three new diagnoses, and especially with the WTFitis, I've had a fair amount of anxiety going on. How much more can I take, why are the gods doing this, is it because I complained too much about X hurting so now I can't do X at all, what did I do to deserve this, is it because I'm a horrible person, am I really that horrible of a person, and on and on and on. My current therapist has been the biggest help to me of any medical professional with whom I've ever worked. She's helped me force myself to actually answer those questions, and to provide evidence for them.

How much more can I take? Don't know. But my record of successfully dealing with bad days is 100% so far. Why are the gods doing this? Can't know. I can choose to have faith or not, and if I believe in supernatural beings running the universe, I have to believe that they know what they're doing. Is it because I complained too much about X hurting so now I can't do X at all? Correlation does not equal causation. What did I do to deserve this? Nothing. Shit happens. Is it because I'm a horrible person; am I really that horrible of a person? Where is the evidence that I'm a horrible person? Do I do horrible things? Do I treat people badly? Do I abuse animals? Do I scream at retail employees? Cuss out tech support people? Beat my kids? Litter? There is absolutely no evidence that I'm a horrible person. Ergo, I am not a horrible person.

The book she had me work through, and actually WORK through is Mind Over Mood. When I first started with the book, I thought it was trite and infantile. However, the further in I got, the more I realized how much it was helping.

The other thing my therapist pointed out that has helped immensely: Not all anxiety is because of Anxiety; some of it's just, y'know, anxiety. Everybody has anxiety. And new medical crap going on is an absolutely, positively, legitimately ok reason for anxiety. Even the most psychologically sound person is going to be anxious about losing weight for unknown reasons. There'd be cause for concern if you weren't having anxiety about a new health issue. You've got normal anxiety. Healthy anxiety. You're wigging out because you're supposed to be wigging out.

Feel free to Memail me, for commiseration if nothing else. All the best.
posted by The Almighty Mommy Goddess at 2:51 AM on April 22, 2016

A sincere question, TAMG: How does it help to know that you have legitimate reason to be anxious? Right now I have the kind of stress in my life that would drive anybody nuts, but KNOWING that I have good reasons to go nuts doesn't make me feel any better at all. (I'm not just asking for my own benefit. It would probably help the OP to know this too.)
posted by Ursula Hitler at 4:36 AM on April 22, 2016

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