It starts with a flutter. Maybe it can be a heartbeat that just will not come, as you sit on the sofa, or a sharp pain in the temple, or an area of your skin that is numb. To the majority of them, these are the background sounds of a living body. However in your case the volume is set to maximum.
In a few seconds your head has gone out of the room. You are not feeling something; you are looking for a prophet. Is my heart failing? Is this a stroke? Is this what I read about last week?.the beginning of the disease. You start breathing faster, your palms are sweaty, and you even have the search engine open on your phone. You need not be a meddler to come to the end of the third medical discussion board without being convinced.
And, when this is familiar, I would have you take a deep breath. You are not mad, you are not hysterical and you are not dreaming. You are going through a condition called Health Anxiety and as much as this is a very tiresome way of living, it is a process that can be learned and eventually cured.
Anxiety about health is confused with the term hypeochondria which is burdened with an unjustified level of judgment. As it turned out, health anxiety is the condition of internal hyper-vigilance.
Imagine your head as a very advanced security. The alarm sounds only in most individuals when there is a recognizable and actual intruder in the form of a high fever, severe pain, or even a visible wound. The sensors in the brain of a person with health anxiety are positioned to the extreme level of sensitivity. Even now, the blowing of a leaf passing the window or a shadow in the corner arouses the sirens.
The impressions you experience are true. These chest pains, these light-headedness, these numbness, are not in your head but in your body. The difficulty is the way the brain interprets such signals. The brain has also lost the capacity of differentiating the feeling of a normal body sensation and a medical emergency related to health anxiety. It selects the most frightening explanation each time since it thinks that it is having you alive by being frightened.
Health anxiety is not something that occurs; it is cyclical. It is a boomerang which feeds itself on fear. We must consider the five stages of the cycle, in order to dissect it.
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It begins with a trigger. This may be a literal physical feeling (say, a twitch in the muscle), a newscast that someone hears about the sickness of some big-name celebrity, or even a simple thought that crosses the mind. In some cases, the symptom can be, in fact, due to stress such as a tension headache, but when you recognize it, the fire sets off.
This is where psychological magic trick occurs. Your mind picks up a sense that is somewhat ambiguous and gives it an apocalyptic name.
Feelings: A mildly troubled stomach.
Fretful Ideation: It is the beginning of a failure of the organs. I need to go to the ER."
This is what is termed in clinical terms as catastrophic misinterpretation. You are not merely observing your body, you are making a verdict that it is harmful.
You grab, to calm the fright, Safety Behaviors. You might:
On Google: Type in tingling in left arm until you get to the one that gives you the worst-case scenario.
Body Scanning: This is the constant touching, pressing, or feeling of an area of your body to determine whether it has changed.
Reassurance-Seeking: "Does this look normal to you" to your partner. or making an appointment with a third doctor over the same problem.
When the doctor tells you that you are okay, or even the Google search (miraculously) tells you that it is just caffeine, you are relieved. Your nervous system at last calms down. This is the most hazardous stage of the cycle since it is so good.
The relief is short-lived. Since you have rescued yourself through checking, your brain acquires a very specific and erroneous lesson, namely, that we are only safe because we checked. Accordingly, your brain gets even more awake. It feels its way more rigidly after the next feeling and when it succeeds in feeling a feeling, the fear becomes even more intense.
In the postmodern era, your health anxiety is fuelled by the smartphone you hold in your pocket. We have even developed a name Cyberchondria to define the downward spiral of symptom search over the internet. It is not the information itself that is the problem, it is the algorithmic preference of disaster.
The point of search engines is to provide you with the relevant results, and it is rather likely that, to an anxious mind, relevant means the gravest. When you enter the word headache in a medical site, a medical site has a legal and logical duty to show every option, i.e. dehydration or brain tumor. Even a nervous brain does not behold a list of probabilities, but behold, a list of certainties. It skips over the 99% probability that it is going to be stress, but concentrates on the 0.1 that it is going to be dead.
Moreover, the internet does not have clinical context. When a physician examines your age, history and lifestyle, a search engine simply examines your keywords. When you Google, you are really asking a librarian to diagnose you medically- they can give you books on the topic, but they cannot tell you which book is relevant to your life. This cycle must be broken with a "digital boundary" i.e. you should view your phone as a means of information, not diagnosis.
One typical feature of health anxiety is Body Scanning the practice of the mental scan through all body organs and limbs dozens of times a day. You may even be twitching your muscles slightly to find out whether they are sore, find yourself checking your pulse as you wait in line, or even looking in the mirror to see whether you have new marks.
This hyper-obsession produces an illusion called Sensory Amplification. When you put all your attention on your left big toe in three minutes, you will eventually experience something, a tinge, a warmth or a throb. This is not the case that there is something wrong, it is just that the brain is amplifying the information of the same sensory area.
We are heading to Body Neutrality in order to heal. We think of the body as a vessel, as alternatives to the body being a friend (it is too hard when we are scared) or as an enemy (which is a threat). It is a noisy biological system that is permitted. A body may creak, but it does not have to be in crisis, just like a house creaks at night, yet one should not expect it to fall. The final exercise of psychological freedom is the ability to feel something and to say, That is just my body doing body things without having to research it.
It is possibly the Intolerance of Uncertainty, which probably lies at its core, as a source of health anxiety. The nervous mind needs assurance: I must be sure that I am not ill by 100 percent. The ordeal is in the fact that medicine is a science of probabilities, not of certainties. Even the most superior tests have a narrow margin. To the majority, it is an occasion to rejoice that their scan is clear. To a health anxious individual, the 1 percent margin of error is now the new preoccupation. It is the What if they missed it? trap.
Healing does demand an extreme change: it is better to change the objective of seeking certainty into developing tolerance. We must be taught to live with the same good-enough assurance as when we cross the street or we are riding in an airplane. We have resigned ourselves to the fact that we can not control the future, but we can control our reaction to the present. You do indeed recover the health you are so much afraid of losing by preventing the quest after the ideal test or the ideal doctor. You cease to use your health on the dread of disease.
The worst thing about this process is that anxiety as a process is physical. Fight or Flightmode When you are scared your body will enter Fight or Flight mode that releases adrenaline and cortisol. This causes:
Blistering heart and tightness of the chest.
Shortness of breath.
Perry-like pains in the hands and feet (paresthesia).
Lightheadedness or being on cloud nine.
Butterflies (also called stomach churning).
Are such symptoms familiar to you? These are the very symptoms that people who have health anxiety dread the most. This forms a hyper-scary feedback loop, the more anxious you become about your health, the more your anxiety produces physical symptoms, which justifies to you that you are ill.
In case you have a health anxiety issue, then you must have felt that even the best test results, which seem clear to you, are not satisfactory. You may even feel better a day or two, then you start to think, What would happen in case the test is not correct? or What could the doctor have missed?
Reassurance is the equivalent of safety blanket of paper; it is warm until the rain. A reassurance-seeking safety behavior is also a way of staying ordinary according to the Cognitive Behavioral Therapy (CBT) view. It makes you fail to learn the most valuable skill in curing, Intolerance of Uncertainty. The ability to live knowing more than 100 percent certainly that you will never be ill does not bring recovery. Healing is found in the ability to say, I experience something, it is painful, and I am able to be fine without being able to correctly define what it is yet.
In case you are reading this and feel the burden of this cycle, I would invite you to ask yourself the following questions: not in condemnation, but with interest:
Am I aware of my alarm clock waking me up to the same sensations over and over? (e.g., do you always think that your heart is failing when you are stressed out?
Will my checking (Googling, measuring) behavior really have more panicking effects on me in the long run?
Am I making possible to be probable? (You see, because something can happen does not imply that something has happened.)
Should one of my friends experience the same feeling, would I be as concerned about them, as I am about myself?
The stress of having anxiety about health is draining. It robs you of your presence, your happiness and your vigor. But the process can be interrupted.
The process of healing starts with the shift in our relations with our bodies. We start perceiving a body not as a time bomb but as a loud, cluttered, and generally tough machine that is at times going to give pings and clunks.
With the help of therapy, namely, CBT, we get to learn:
Delay the check: Postpone Googling by a ten minute delay. Then twenty. Demonstrate to your brain that the emergency could be postponed.
Name the feeling: Rather than stating that you are having a heart attack, explain that you are feeling in your chest, which is a general sign of my anxiety.
Bend over the precipice: Embrace the fact that we cannot predict all the outcomes, and that we are okay at this point in time.
You have taken so much time to struggle to survive imaginary future that you have lost the present moment. The weight of What if is possible to be taken away. You can be taught to have faith in your body once again.
In health anxiety, it is usually not the symptom itself that is the problem- it is the fruits of fear that surrounds it. And cycles may be perceived, discontinued, and cured.
