Overcoming Health Anxiety: Strategies for Managing Excessive Worry

I need help?

Hello Doctor: I am very afraid of getting sick.
When I catch a cold, I worry it might turn into something severe; when I get a cut, I worry about infection.
However, this is not what troubles me the most.
The most painful part is that I constantly check myself.
I read online that I should check my neck lymph nodes for swelling every few months, so I started to feel my neck lymph nodes, and it turned into a daily habit.
Eventually, I began to check multiple times a day, pressing hard to confirm if there were any deeper issues I hadn’t noticed.
Sometimes, when I feel small lumps, I get very anxious, wondering if they are lymph nodes and if I need to see a doctor.
After a few days of worrying, I tell myself to just see a doctor and then I won’t check anymore.
After visiting the doctor and being told everything is fine, I go home and start to wonder if the doctor really did a thorough examination.
Did they check the areas I mentioned? Sometimes, due to my anxiety, I even go to see a second or third doctor.
Then, after a while (it could be a few weeks or a month), I feel the need to check my lymph nodes again and discover another area that feels strange.
Even though the doctor examined my entire neck a month ago, I start to think that this new strange area must have appeared since then, and I feel the need to see the doctor again.
Besides the lymph nodes, I also check my tonsils, and if I notice any unusual protrusions, I get anxious and go to see the doctor.
The doctor reassures me that everything looks fine, but after a while, I look in the mirror again and find another area of my tonsils that seems different (it might just be that I didn’t notice it before).
Then I go to see the doctor again.
This cycle has been ongoing for over a year; every day I either worry about my lymph nodes or check my tonsils, and I always find something that seems off.
After seeing the doctor, I repeatedly think about whether they missed checking a specific lymph node or a certain area of my tonsils.
After feeling reassured for a while, I start to worry about other lymph nodes and tonsil areas.
Over a month ago, I started seeing a psychologist, who prescribed me fluoxetine and mentioned that, given my age, I should only need to see a doctor once a year (they believe that my normal health concerns only require annual check-ups, but I can’t help myself).
They also advised me to establish a regular daily routine for meals and sleep.
However, despite this, I still have countless anxious thoughts.
For example, I saw the doctor about my tonsils yesterday, and today I still feel worried about them (the doctor said if I’m very concerned, I can come back to see him every six months).
This way of living is so painful.
Besides medication, is there anything I can do to help myself? I’ve seen online that mindfulness and meditation can help, and there are two methods to combat this kind of thinking: one is to shift my focus whenever I feel anxious; the other is to acknowledge the worry as just a thought and not let it affect me.
Which method would be more suitable for someone like me? I always think that if I don’t check myself, there could be serious consequences, like discovering a problematic lymph node simply because I didn’t check.
Is all of this excessive worrying causing me to confuse fantasy with reality? Thank you, Doctor.

Niming, 30~39 year old female. Ask Date: 2017/08/09

Dr. Ding Shuyan reply Psychiatry

Hello, you should continue taking your medication and cooperate with your physician.
Since your symptoms are quite distressing, various effective treatment options are worth trying.
The compulsive symptoms are very persistent; every issue you are currently thinking about feels incredibly important and life-threatening.
However, one day when you recover, these concerns will seem trivial, much like walking out of a dark movie theater into the blinding sunlight after watching an intense film.
The gripping plot will pale in comparison to the warmth of the sun and the hunger for a good meal.
Mindfulness is a good approach, and both methods you mentioned can be used; there's no need to choose just one.
Use whichever method feels more comfortable and effective for you.
The mindset should not be to fight against or eliminate these thoughts, but simply to redirect your attention away from the compulsive checking and thoughts, allowing yourself some mental breathing space.
This will help interrupt the accumulation of stress and prevent falling into a vicious cycle.
It is natural to return to those compulsive thoughts initially; there's no need to blame yourself, but you also don't have to let them control you every time.
You can remind yourself that these physical issues are important, but surely I can practice mindfulness or muscle relaxation training for just 10 seconds, right? It's only 10 seconds; there's no reason not to do it! With multiple 10-second practices each day, you will gradually become more familiar with shifting your attention away from compulsive thinking.
We all wish for youth, beauty, and constant health, and for everything to go as we desire, but that is impossible.
We may need to learn to accept that things will be imperfect and constantly changing, regardless of our willingness to accept it, whether we accept it easily or are forced to accept it with tears.
We can practice viewing the imperfections in ourselves and our surroundings with a bit of humor and a relaxed attitude.
I often joke about my hair loss or my repeated failures at dieting, which helps me care less about them.
Wishing you all the best,
Dr.
Ding Shuo-Yan

Reply Date: 2017/08/09

More Info

Overcoming health anxiety can be a challenging journey, especially when it manifests as an obsessive need to self-check for symptoms and a persistent fear of serious illnesses. Your experience of constantly checking your lymph nodes and tonsils, coupled with the anxiety that follows each self-examination, is a common symptom of health anxiety, often referred to as illness anxiety disorder. This condition can lead to a cycle of worry and compulsive behavior that can significantly impact your quality of life.

First, it’s important to acknowledge that your feelings are valid. Many people experience similar anxieties, especially in a world where health information is readily available online, often leading to misinterpretation and increased fear. The cycle of checking and reassurance-seeking from multiple doctors can provide temporary relief but often reinforces the anxiety in the long run.

Strategies for Managing Health Anxiety
1. Cognitive Behavioral Therapy (CBT): This is one of the most effective treatments for health anxiety. CBT helps you identify and challenge irrational thoughts and beliefs about your health. Working with a therapist, you can learn to reframe your thinking patterns and reduce the compulsive behaviors associated with your anxiety.

2. Mindfulness and Meditation: Practicing mindfulness can help you stay grounded in the present moment and reduce the tendency to ruminate on health concerns. Techniques such as deep breathing, progressive muscle relaxation, and guided imagery can help calm your mind and body. You mentioned interest in mindfulness and meditation; these practices can be particularly beneficial in managing anxiety.

3. Limit Self-Checking: Set boundaries for yourself regarding self-examinations. For instance, you might decide to check your lymph nodes only once a week instead of multiple times a day. Gradually reducing the frequency of these checks can help break the cycle of anxiety.

4. Focus on What You Can Control: Instead of fixating on potential health issues, redirect your focus to aspects of your life that you can control. This could include maintaining a healthy lifestyle through balanced nutrition, regular exercise, and adequate sleep. Engaging in activities that bring you joy and fulfillment can also help shift your focus away from health concerns.

5. Journaling: Keeping a journal of your thoughts and feelings can help you process your anxiety. Write down your worries, but also note any evidence that contradicts those worries. This practice can help you see patterns in your thinking and recognize when your fears are unfounded.

6. Educate Yourself: While it’s important to be informed about health issues, excessive research can exacerbate anxiety. Consider setting limits on how much time you spend researching health topics online. Focus on reputable sources and avoid forums or websites that may amplify your fears.

7. Support Groups: Connecting with others who experience similar anxieties can provide comfort and understanding. Support groups, whether in-person or online, can offer a safe space to share experiences and coping strategies.

8. Medication: While you mentioned a reluctance to rely solely on medication, it’s worth discussing with your healthcare provider if your anxiety remains unmanageable. Sometimes, medication can provide the necessary support to engage more effectively in therapy and other coping strategies.

Conclusion
Your journey toward overcoming health anxiety will take time and patience. It’s essential to be kind to yourself and recognize that progress may come in small steps. The strategies mentioned above can help you manage your anxiety more effectively and regain a sense of control over your thoughts and behaviors. Remember, seeking help from a mental health professional can provide you with tailored strategies and support as you navigate this challenging experience. You are not alone in this, and with the right tools and support, it is possible to find peace and balance in your life.

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