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by Ken Goodman, LCSW

As she stares at the ceiling, trying to fall asleep, Dina ruminates on one statement from her doctor, “Brain tumors can grow at any time. Come back in six months if you’re concerned.”   She tosses and turns, “Why did he tell me that? If there was nothing wrong, why would he say come back in six months?”  More questions race through her mind, “Why do I keep getting headaches and dizziness? What if the doctors missed something? Why did he tell me to come back if there was nothing wrong?”  Dina feels so anxious she gets out of bed and searches the web for answers.  As she rereads the same articles about symptoms of brain cancer she begins to feel lightheaded.  “Why do I keep feeling this way? Do I really have brain cancer? Is this really happening?”  

The good news is, Dina does not have brain cancer or a brain tumor.  Dina has a health anxiety.  There are two types of health anxieties: Somatic Symptom Disorder and Illness Anxiety Disorder, formally known as hypochondriasis.  Many people with health anxiety are often unable to function or enjoy life due to their fears and preoccupations.   They obsess over bodily functions (breathing, heartbeat), physical oddities (skin blemishes), and physical discomfort (headaches, stomach aches, lightheadedness). They might worry about a specific organ (brain, heart) or a disease they heard about on the news or at work (MS, diabetes).  They are preoccupied with the belief that they have, or are in danger of contracting, a serious illness. Many will purse doctors and tests repeatedly for reassurance, but are reluctant to seek mental health treatment since they believe their condition is medically based.   

Why does health anxiety persist despite reassurance from doctors?

Although some refuse to be examined by their primary care out of fear of discovering the worst, seeking reassurance from doctors, insisting on repeated medical tests, and visits to the ER and urgent care, are more common in health anxiety. Being reassured by the doctor that there is no serious medical illness brings relief -- temporarily.   The vicious cycle quickly resumes as new thoughts and physical sensation surface, followed by interpretations of danger, anxiety, and more visits to doctors to resolve the uncertainty. Soon the cycle ignites again with the next alarming thought.  

The False Alarm

Car alarms are set off when a criminal breaks in but imagine how problematic it would be if the siren blared each time a pedestrian walked by.  The car alarm would be misinterpreting innocent people as dangerous criminals. 
With health anxiety there is the misinterpretation of discomfort and normal bodily sensations as dangerous. The body is very noisy. Healthy human bodies produce all sorts of physical symptoms that might be uncomfortable, unexpected, and unwanted, but not dangerous. 

Normal sensations in the body that can produce fear and worry include changes in visual acuity, heart rate, blood pressure, saliva levels, depth of breathing, balance, and muscle tone,  just to name a few.  These are normal and harmless bodily changes, but when a person believes they are symptoms of a terrible disease, it causes anxiety.  The sensations are real, but the beliefs are false.

Why do people misinterpret sensations in their body and overestimate danger?  

Sometimes misinterpretation is due to assumptions about an illness. For example, “My cousin died of cancer. It’s only a matter of time until I get it.”  Or, “viruses sped easily. People in Africa are dying of Ebola. It could easily spread to the U.S.” People with health anxiety might hold rigid definitions of good health, perhaps believing that any discomfort whatsoever means bad health. 

Anxiety is a protective mechanism and scanning the body for an illness seems like the right thing to do to protect ourselves. However, when we are preoccupied with something, we tend to notice it.  Last month when I was looking to purchase a new car, I suddenly began to notice every car on the road; the make, model, and the color.  Previously, I didn’t pay attention.  Looking for symptoms makes you notice subtle sensations you might otherwise ignore. When you become preoccupied with bodily sensations, those sensations become amplified and last longer. 

This is when it gets tricky.  

Each scan of the body produces uncertainty and doubt, giving the imagination opportunity to create stories.  As you imagine the worst, your body’s alarm system sounds off in the form of symptoms of anxiety (racing heart, tightness in the chest, difficulty breathing, jitters, tingling, lightheadedness, nausea, stomach discomfort, sweating, headaches, etc.) giving your imagination additional fuel to create great works of fiction.   The symptoms are real. The thoughts are false. 

The Most Effective Treatment is Cognitive-Behavioral Therapy

Since it is possible to suffer with anxiety and a serious medical condition, medical problems must be ruled out with a thorough physical exam. Once this is accomplished, Cognitive Behavioral Therapy (CBT) is the most effective treatment for any form of anxiety including health related anxiety.

CBT is a therapy model that focuses on our cognition, the way we think, and our behaviors, the way we act. The main concept behind CBT is that our thoughts about a situation (the fear of ALS) effect how we feel (afraid and anxious) and how we behave (scanning the body, going to the doctor). We tend to assign meaning to specific situations (tingling means we have MS).  It’s not the actual situation causing our anxiety, but the meaning – accurate or not. And, when you have anxiety, you give your thoughts a lot of meaning, and thus, a lot of power.  

CBT aims to help you overcome fears by correcting irrational thoughts and changing problematic behaviors.  By acquiring a certain mindset, you can learn to approach anxious situations differently and learn to tolerate discomfort and uncertainty. Health anxiety can be overcome with the help of a skilled anxiety specialist and CBT.  Find a therapist on the ADAA website.  

Also by Ken Goodman:

Additional Resources:
Health Anxiety Is Way More Than Being A Hypochondriac — And It’s Way More Common Than You Think


About the Author

ADAA_Ken-Goodman-websize-1.jpgKen Goodman, LCSW, treats anxiety and OCD in Los Angeles.  He is the author of The Anxiety Solution Series: Your Guide to Overcoming Panic, Worry, Compulsions and Fear, A Step-by-Step Self-help Audio Program., and Break Free from Anxiety, a coloring, self-help book for anxiety sufferers. Ken Goodman is an ADAA board member and Clinical Fellow. Visit his website.

 

So I've had this for about 7 years since I was 12. And it just never ends. I literally go to the doctor every single month with something new thinking it's some kind of cancer or some rare terminal disease. I'm only 19 and the past 7 years I've been living convinced that I'll die in like a month or so and I literally cannot help it. It's kind of embarrassing how insane I sound to my doctor sometimes to the point she had to put me on anxiety medications which I haven't started it.

I had my first panic attack when I was 20 (now 33). I thought I was having a massive heart attack and about to die. I had these attacks monthly for years. Some years would be a little.better than others. 9 months I was diagnosed with heart failure, probably caused by a virus. Even though my cardiologist said I have recovered I am afraid daily that something is seriously wrong with my heart. In that 9 months I have been to the ER several times with
massive chest pain/squeezing and shortness of breath, I've gone with pain so severe in my neck and head that I thought I was dying of a stroke. I have convinced myself I have dvt, pulmonary embolism, severe blockages in my coronary arteries, multiple sclerosis. I check my heart rate several times a day and often feel chest discomfort and or shortness of breath. I have a wife and two young kids. I feel like I'm not living a life; terrified to die, but afraid to be alive. I have tried medications and cbt briefly and will try it again. I just can't convince myself that I'm ok no matter how many tests are done on me (many blood tests, echocardiogram, ekgs, ultrasound of neck and legs, and way too many ct scans, also two MRIs...)

Has anyone ever had neck pains, headaches to the point you get dizzy and nauseated often?? I’ve concvied myself it’s cancer when all mds say it’s just anxiety and it has all worsened since being on Zoloft. Im just worried sick and can’t love bc the anxiety consumes me!

I suffer a lot with health anxiety, I focus a lot off my attention on my heart and my breathing, I worry I will forget how to breath, or my heart will stop. I’ve recently been put on beta blockers, they do help. But I don’t want to reply on them for to long, anyway my new thing is “brain tumour” or a bleed on the brain. I started getting a mild headache yesterday barring in mind I don’t really get headaches, I still have it today. I’ve been googling and I’m convinced something isn’t right. I feel like a ticking time bomb like something is going to rupture in my brain. Then I focus more on the headache witch feels like it’s gets slightly worse, I’m sure something is wrong why else would I have a headache this long? I also come over lightheaded befor I even started worrying about all this. So I’m putting headaches and lightheadness together & thinking the worse. HELP!

So my mom this past summer was diagnosed with ovarian cancer, although she beat it now, ever since I get severe anxiety and panic attacks from worries about my own health. In October I had something very common like the flu or a cold and I searched the symptoms and lead myself to believe I had a brain tumor and keep in mind I’am a 15 year old. Later on I got better from my flu but then just recently I got a strep infection never had one before but I went to the hospital I got antibiotics and feel much better but yet I let my own self believe I had thyroid cancer at first then I canceled that out and believed that I have leukemia even though I lack most the symptoms but one and it interfered with my life. I feel better now that I don’t have strep but I look for any little excuse to lead me to believe I have a serious condition. I constantly search my body for any rashes and check my body temperature with a thermometer to reassure myself, and panic when it’s half a degree of my normal body temperature. I’am also constantly looking at web md or Mayo Clinic to search for symptoms. It’s gotten very bad and it keeps affecting my everyday life. I don’t know what to do I have talked to my mom and sister about it but I’am still not convinced where to go from here to eliminate my fears. I have gotten close to my own religion and faith and that has helped me as well.

I was just looking around and went across this thread. I was diagnosed to have severe depression 4 years ago and tried almost everything out there that "could" help. The only medication that worked best for me is medical cannabis. I
perfectly understand that it's not legal everywhere. At first I was doubtful so I started doing my own research and read articles about marijuana. I found out that each marijuana strain has different uses for different diseases. Like this
strain https://www.gyo.green/short-cannabis-strains.html.html This one is very effective when it comes to stress and anxiety.

I've had enhanced general anxiety ever since I was a little kid. I've had severe battles with health anxiety as an adult. I find that any big stress factors can indirectly cause health anxiety. For instance, I one had a long 2 year back and forth argument about my wife with my parents. During that same period I was having dull pains near my rib cage almost every day. I swore I had some kind of bone cancer. Anxiety over that led to more symptoms which fueled my fears even more. Tensions eased about 5 years ago. I'm still here so clearly my health fears were all in my head.

But it's a new year so of course my mind is exploiting another health issue for me to be up all night googling about.

This explains exactly how I'm feeling. I suffered a miscarriage going on six weeks ago and have major anxiety that something is very wrong with me. I have been checked the past week by 4 different doctors 2 ECGs and blood test and have been told I'm completely fine but still always think there's something wrong. And the pains in my chest feel almost amplified and the dizziness feels way worse all because I'm constantly focused on it. This article really really helped!

When I was 16 years old, I was diagnosed with a ASD heart defect, a somewhat rare one. Each step along the way from the symptoms to the eventual open heart surgery, I was told by doctors "don't worry, its probably not X but we are checking to be sure". Yes, the serious problem got fixed, and I had been able to live normally for a number of years. After having kids of my own 4 years ago, I have begun having health anxiety issues. In the past year I have self diagnosed myself with cancers of almost every part of the body (Stomach, Brain, Liver, Spleen, Colon, Testicular, Prostate, Penial, blood, Lymphnode) and heart attack. Two months ago, I had abdominal pain, and was given and ultrasound to check all internal organs. This revealed the spleen was (slightly) enlarged. The doctor asked me to check again in two months, and assured me it was likely some kind of viral infection i was fighting. Of course, I am unable to believe this, and fear the worst. I think it goes back to the childhood heart problem, and lack of trust that the "it's probably not this", actually won't be the worst fear. In the back of my mind, I know its probably nothing, but it always creeps in that, in my case, it has been serious in the past, and its only a matter of time before something reoccurs.

First, in case bpm worry people, let me tell you something. If you're the type to skim over scary parts that might cause a panic attack, worry not. Deep down I know that panic attacks are harmless (but do damage to your mental health) when it comes to bpm. See, your body puts on a ton of stress when it exercises and what not. Resting heart rates (according to my mom who is an RN) range from 60-90 resting. It depends on a lot, mainly your thyroid. Which is the thing that basically controls your weight and heart rate and a lot more but that's beside the point. 120-180 is natural for exercise btw) Mine started after I smoked weed with a friend. It increased by heart rate to 130 resting and he made me nervous when we almost ran over a cop. That struck a nerve, especially with that strain known to cause high paranoia. That caused my first panic attack. It's 5 months later and I started to worry about passing out, which calmed the worries of my heart rate because I had something else on my mind. I know it triggers people, so I won't say WHY I fear passing out. But it helped, that's what calmed the heart rate fear. I thought that I was getting over my anxiety, I thanked God for the relief. But that changed last week, I was with my boyfriend and his friends. One of them had a thyroid problem. Mine has always been irregular and high, but I'm incredibly skinny and my resting heart rate ranges from 85-95. So given that someone who goes through something similar with his thyroid made me nervous, because what if I have a problem that I'm not helping? What if my heart rate is faster than everyone else? I can panic at will. I can increase my heart rate to 130-140 whenever I please. That's worrying, because then I think "what if I'm exercising and panic? How fast will it be then?" (My heart rate goes to 150 bpm when exercising) or "what if I just panic my whole life and force myself to leave it at a high speed for a long time? (Like 180) so I basically worry myself over theoretical bull crap(and reminding myself that it is, I fact bull crap helps. It's silly stuff, but it's not silly st all when you worry about it) The last time I ever looked something up about heart rate is when I was asking about exercise bpm. I saw a suggested question as "what heart rate causes a heart attack?" And that made my mind go crazy. Thinking that I can die from that, the fastest I got to was MAYBE 150. If even that. More like 145. And that was when I swore that my body was killing itself. I thought that I was going to give myself a heart attack. But everyone lives through panic attacks. If my family thought that it was anything serious they would have rushed me to the hospital. See, I worry about outrageous things that I could do to myself like staying up for days because of panic attacks or overdoing my heart. But guess what? I'm still here. So why do I keep worrying about it? Because even though I know for a fact that none of that is going to kill me, I think that I'll do it harder the next time or throw unreasonable scenarios in my head. And I have to stop, because I find myself crying all the time and getting aggressive towards people that I love. I look back on who I used to be and think "I could never find the peace that I used to." Or "nobody nearby has gone through this as bad as me... am I crazy? Why do I obsess over it?" (Panic runs in my family) or "if I ever get pregnant, how will I ever be able to go through the 9 months? I put too much stress on myself, I'd miscarry." Or "I wouldn't want this on anyone, especially my child. I can't pass something like this down to them." It's really sad... you know? I know there's a reason for everything, don't get me wrong. If anything, there's supposed to be panic in the world. I just wish that I knew what I know now when it started, so that I wouldn't be in an endless loop. It's bipolar by this point. I'll give myself positivity (and it has made me a lot more positive. Since I have to maintain it so often to keep calm) and 30 minutes later I start worrying about it again. I want it to end. I'm afraid to take pills because of the side effects. My mom takes depression meds and when she's off it, she gets really mean. So I don't want to deal with that either. Besides, panic is a natural feeling. You can't just take that away without convincing yourself that it's okay and it's safe. You feel attacked (in my case, thinking I can die or ruin myself) so that causes the panic. Because you feel like you're in some sort of danger. The only thing you have to fear is fear, but what happens if you fear fear?
Anyway, what brought me back into worrying about my heart was two days ago (literally back to normal in just two days... with 2 weeks of a break in 5 months.) When I finally opened up to my stepsister about my panics. Thyroids were brought up and she said "yea, I know a kid who's thyroid was high. It caused his heart rate to be in the 90's resting." (But I think she meant blood pressure or a chemical imbalance because she said something about how it would cause wounds to lose blood easier) and that made me worry. Because that's the second time in a week that a thyroid was mentioned. Then, yesterday I got to thinking about calling my grandmother. She was at the gym and taking a rest when I called. She's 78 and her heart rate got to 175. That made me think ALL DAY LONG about bmp. So I finally asked my mom if that's safe. It is. But she mentioned that she went to the gym before and it got to 183. I told my brother that today and he said "yea. It can get higher than that." SO ME, being the type of person to worry about pushing my limits, has worried about that. All. Day. Long. I'm in a ged course and broke down because I'm getting bad again... I thought it would get better. I really did. But now I'm back in this seemingly endless loop thinking about it. I just want it to go away. I know it's harmless but I can't help but worry. Nothing else bothers me, diseases and health problems don't because I can't control that. So why worry about it? But when it's something I can control, for no reason at all, that bothers me. Especially since I have a tendency to cause it. But, I know that I'm getting better. I used to be afraid during showers because the hot water increases blood pressure. Now, I can jog and not worry about it. I got back to smoking weed and it actually makes me less worried. Just depended on what I have. And not all weed increases the heart rate, but I test on my boyfriend. Without him noticing because I don't want to scare him. I rest my head on his chest when we hug or cuddle and see if it's any faster than normal. If it is, I know to avoid that strain. But I definitely know that what people have mentioned lately has been for some sort of cause. I had two weeks of rest and things suddenly appear in two days, it has got to be something. Maybe it's time for me to learn how to break that tendency. Whatever it is, I hope that it doesn't last forever. I don't know how much longer I can last with this. But, if anyone has taken their time to read this, thank you. If you have anything that might help, please let me know. This was meant to be a short helpful thing but, it came to be a venting session.

3 years ago i fainted 2 times in the span of 20 mins.
Got checked out and found that my heart beats slightly erratic. I’ve got a slow heart beat as well.
Or fast, it’s confusing.
I’ve had test after test reassuring me that I’m ok.
Before I fainted I had slight health anxiety, but ever since I passed out/ fainted all I can do is worry about why this happened and will this happen again.Nobody really knows , can’t get real answers.
Now I’m light headed most the time with a racing heart beat that make me more dizzy with a flushing
Painful feeling that finds it’s way up my throat.
I hate it.
What helps? Keeping busy, doing something I enjoy. When in this state, I forget about my anxiety
and poof no issue.
But it always quickly returns when I’m with me.
A saying I heard the other day.
“Everywhere I go there I am” other then all this I’m normal.
Ps. I’ve got 4 kids as well and my anxiety also spreads with worry about them.
Super frustrating with this condition.

My anxiety started a few years ago. I started having gastro issue to now i have pvc and my heart feels like its skipping beats all the time. I'm constantly worrying something seriously wrong with me and I'm going to die. I cant even take meds for anything because at some point i developed these weird phobias of taking medication. I wish there was a secret fix for this awful condition because it can make you so ill. I really miss my old life and just waking up feeling normal and not whats wrong with me today.

I go to bed and wake up in the morning obsessing over not having a panic attack. Which then causes me to think about it and over analyze everything I’m feeling (muscle tightness, heart beat, light headed ness, random aches in pains) which results in me having a panic attack. My shoulder is in a CONSTANT stage of tightness and discomfort. But I know it’s anxiety. Because as soon as my mind is distracted by something else or actually allows me to stop obsessing over having a panic attack, all the symptoms go away. I’m PRAYING that I can find a better way to control it. But once I have a bad panic attack, I’m back to square one for the next couple of weeks. It’s like my mind links the most random things to panic attacks. I fear that I’m having a heart attack alllllll the time. But again, I remind myself that I felt this the day before and was completely fine. I actually started writing down my symptoms while I’m having an anxiety or panic attack and it gives me ease. I look back at it when I’m having one and connect that I have felt this way before and everything is okay. Good luck to you everyone! You’re not alone!