How I learned to tame my hypochondria

Surrounded, as I was growing up, by mildly hysterical women (“How are you?” I once asked an aunt over the phone. “I’m on a mobile IV drip,” was the reply), I never worried about it. my own health. Anyway, there just wasn’t room for it, because someone was always sicker. How I laughed at my friend Mark when, in our 20s, he thought he was dying due to some rogue Bolognese. Even when I smoked and developed what would now be a worthy Google search – a searing pain in my lungs – I just lay on a tennis ball and massaged the spot. He was.

So when my, as I’ve come to call it, “late-onset hypochondria” hit my 40s, I wasn’t ready for it. And I didn’t know how terrifying it could be. In its own way, it’s a disease. (Strictly speaking, hypochondria and health anxiety are two separate malaises with overlapping characteristics.) The background to all of this was deaths—many of them. My cousin died, aged 51, her death shrouded in whispers and secrets; then a friend died, then another, then another. This last friend, Callie, felt fine, went to the doctor, and died two weeks later. All these friends were also 51 when they died, and in my mind, it seemed impossible to go beyond that age.

Then a family friend died, then my aunt, then my uncle. Throughout all of this I knew my father was sick too, on his own final flight path, but he didn’t want to be defined by his illness so he wasn’t and few people knew. Secrets and fear mixed together to make their own special kind of dynamite.

Somewhere in the middle of it all started. The symptoms. They varied, as did the “diagnoses”, but one memorable day I had Parkinson’s, liver cancer, and Paget’s disease (some members of my maternal family have it) all at once. It was a Thursday and I was catatonic with fear. All I could think about was, how could I do the school run while doing chemo? How would I deal with the tremors and tremors and the aches in my skull? I had two children, one still a baby, could I breastfeed her during chemotherapy?

The cycle would always be the same. I heard about someone getting sick, I asked a lot of questions. I would develop the symptoms. I would be terrified and wouldn’t be able to tell anyone, letting no light or perspective in, nor any hope of safety. I couldn’t go to the doctor because Callie was fine, went to the doctor, and then she was dead. In my mind, I was convinced that if I could avoid the diagnosis, I could avoid death. It was exhausting and terrifying. Eventually something would, I would be able to tell a person it would give me a reality check and I would have some rest, until the whole cycle started over. Of course, there were times when I realized that this must be my mind, being powerful but destructive. And the symptoms would disappear, until next time.

Then eventually one day my nipple started bleeding, a symptom so extreme I knew my mind couldn’t be responsible. The red of it all somehow got me noticed and back in my childhood home (for some reason it encouraged me) I was able to call not my current doctor but a removed doctor, my previous doctor who I kept contact. I told him my symptoms. He paused at the end of the phone as I rolled the bedroom net curtains between my forefinger and thumb, wondering how much time I had.

“I can’t tell you that you don’t have breast cancer,” he said very slowly, “but I can tell you that you need to see your doctor and you need to tell him about your health anxiety.” Health anxiety? Not only did I not know I had it, but I also didn’t know I could talk to my doctor about it.

My GP, luckily, was brilliant. He listened and immediately reassured me about some of the other ailments I was sure I had at the time and had me get tested for others, including my breast (which was fine, it was a rash and it cleared up, but I think of it as a godsend now). But crucially, he also put me on the list for a CBT course, cognitive behavioral therapy.

While I was waiting for CBT, my father died.

The body is a theater where we stage our internal conflicts

I was reticent about CBT, but my therapist, Jill, was extraordinary and wonderful and was the perfect solution. After taking my history, Jill challenged my belief that I was sick by asking for evidence. I can still hear her voice now asking for concrete evidence for my assumptions and it’s a technique I still practice. So the pain in my leg = cancer would be broken down to become, “It’s very unlikely it’s cancer, but if the pain continues, it’s wise to go to the doctor.” Sounds easy and takes a long time to actually work, but it worked for me. Restructuring my worry, making me face the fact that I had no hard evidence that I was sick, and restructuring the worry helped me deal with it in small pieces. I also learned to tell trusted people around me what was going on so they could help “pop” the worry (not advisable to tell another hypochondriac!)

Jill also stopped me from asking about people’s symptoms and taught me that it was okay to say, “I’m sorry to hear that,” if I heard that someone was sick/died, without also asking for a full medical history, which I did. would then digest and incorporate. (The combination of an ability to Google any symptom with a constant conveyor belt of new diseases and variants being offered to us in every news offering is a heady mix for those predisposed to health anxiety.)

Pedro Tyrer, teacher of community psychiatry at Imperial College London, has a special interest in health anxiety (it is called illness anxiety disorder in the US and is under the DSM-5 psychiatric classification) and has written several articles on the subject, one in british medical journal in 2016, who called it a “silent and crippling epidemic” that was reaching “epidemic proportions”. In a 2006 study at a few specialist clinics in northern Nottinghamshire (respiratory, gastroenterology, endocrinology), 12% had excessive health anxiety. Four years later, that had risen to 20% at the same clinics. Tyrer attributed this increase to “cyberchondria” and our addiction to Google searching. “People with health anxiety,” he wrote, “pay selective attention to the most serious explanation of symptoms, even if they are very uncommon.” It’s no use telling these people they have a 1 in 1,000 chance of being sick, he said, “it just convinces them that they really are that person.”

Tyrer further explained to me that some people, like myself, avoid and deviate from the body as a medical guarantee at all costs and of course it is “impossible to know how many of them there are”. And then there are those who need near-constant reassurance from doctors, who, however, are not trained in mental health and therefore provide resource-depleting test after test without providing a long-term solution. It doesn’t pull the problem in the bud. Tyrer is an advocate for CBT to help with health anxiety.

I told the psychoanalyst Alessandra Lemma my story. Lemma is someone I’ve worked with before and I’ve not only trusted her, but valued her insights into how my brain works. “What I recognize,” she said, “is a kind of architecture of hypochondria and often a real experience of illness, either from yourself or someone very close to you. It is very rare for health anxiety to come out of nowhere and it is this intersection of this encounter with vulnerability and mortality, moreover, it often comes at a transition point in life. So you often get that with young people about to go to university, or people retiring, etc. in fear of losing someone, we often identify with them and can assume their physical symptoms.”

But why couldn’t I just think, I’m worried about my father? Why this big drama?

“Because,” Lemma expanded, “as a general way of thinking about it, the body and our relationship to it is a kind of theater, if you will, in which we enact our internal conflicts and one of the main reasons why psychological conflicts become translated into bodily symptoms is when we still don’t have the words or even a conscious recognition of what it is that bothers us.”

Lemma explained that talking to someone — the doctor, a therapist, or a trusted friend — can help because you can begin to translate these symptoms into words, which can then begin to dissolve the worry. For me it was like starting to let the light into those dark corners, but at first it was so hard to talk about what was going on because I had this irrational fear that as long as I didn’t say it, nothing bad would happen. happen. The hypochondria literally felt like a monster in my body that I had to appease by being quiet.

It’s been six years since I’ve been free of it, and it’s been so long since I’ve been able to write about it. (And yes, I made it to 51!) I’m still vigilant and keeping myself in check. As I was writing this, I looked up the symptoms of Paget’s disease and immediately felt myself turning the corner into health anxiety again. So I stopped reading.

Although the monster in me now largely sleeps, it can wake up again when I’m anxious and need to feel in control. And one thing I’ve learned from all this is that, perversely, worrying about death is a weird way to try to feel in control.

Conversations with Annalisa Barbieri, Series 3, is now available (pod.link/1567190358)

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