Worry, anxiety, panic..?
Hello Dr.
Liang, please take a moment to listen to some things that have happened to me.
About four years ago, during a routine health check, the ultrasound technician mentioned that there seemed to be something in my kidney, possibly a tumor.
Since then, I have often found myself in a state of anxiety.
I researched a lot about tumors online and learned that it could be cancer.
I used to be very optimistic, but that sudden bad news changed me, making me prone to expecting the worst in every situation.
Although further examinations later revealed that there was actually nothing wrong, I couldn't return to my former optimistic self.
I later discovered the strong correlation between smoking and cancer (I had secretly been smoking for 16 years without my family's knowledge).
The guilt I felt, combined with the panic over the fear of cancer, drove me to desperately try to quit smoking.
For about three months, I did not smoke, but every day I was preoccupied with my health.
A headache made me suspect brain cancer, a sore throat led me to think of throat cancer, a cough made me worry about lung cancer, and diarrhea had me fearing colon cancer.
To make matters worse, I found a lymph node on my neck, which heightened my anxiety about having cancer.
During that time, I underwent numerous tests.
Eventually, I started smoking again.
I tried to tell myself that life is finite, so I should cherish each day, live happily, and accomplish many things, including helping those around me.
Gradually, I began to move on.
Just last week, while stuck in traffic, I felt fatigued and massaged my shoulders, only to find something near my clavicle.
When I got home, I kept pressing on it.
The next day, I immediately went to an ENT clinic for an examination.
I asked the doctor if he felt anything, and he confirmed he did.
(The thing I felt could only be detected with my arm raised, which I hadn't done at the time.) The doctor performed a nasopharyngoscopy and found nothing unusual.
He then mentioned that the lump in that area is mostly due to lung metastasis and said he would be consulting at a certain hospital in a few days, providing me with a referral for a CT scan.
At this point, the feelings I had a few years ago resurfaced! I began to suspect cancer in various places again, desperately trying to quit smoking, feeling increasingly anxious and helpless.
I would like to ask the doctor, how can I return to my optimistic self? How can I happily and gradually quit smoking?
Note: I later found something on the other side of my clavicle that could only be felt with my arm raised, which I believe is the subclavius muscle.
Yesterday, I visited a thoracic medicine department at a regional teaching hospital.
The doctor said he did not feel anything above the clavicle, but suggested taking an X-ray just to be sure.
After comparing the X-ray with last year's, the doctor said there should not be any issues.
However, I find myself sinking back into anxiety.
Can you help me? What should I do?
Xiao Ke, 30~39 year old female. Ask Date: 2017/11/14
Dr. Liang Sunyuan reply Psychiatry
Hello, Xiao Ke: Quitting smoking is the right choice.
During the process of quitting, it is normal to experience some discomfort, but you can alleviate the withdrawal symptoms by attending a smoking cessation clinic.
Feelings of pessimism and excessive worry are sometimes unavoidable; these reactions are meant to help us prepare in advance.
However, since you have already undergone an examination and the specialist believes there is no cause for concern, it is advisable to redirect your thoughts to other important and meaningful aspects of daily life.
The more time we invest in work, family, leisure activities, and personal growth, the less we tend to worry excessively.
Wishing you all the best.
Reply Date: 2017/11/14
More Info
Overcoming anxiety, especially after health scares, can be a challenging journey. Your experience highlights a common struggle many face when confronted with unexpected medical concerns. The initial shock of a potential health issue can trigger a cascade of anxiety, leading to a cycle of worry and fear that can be difficult to break. Here are some strategies to help you navigate this difficult terrain and regain a sense of optimism.
Firstly, it’s essential to acknowledge that your feelings are valid. The fear of illness, particularly after a health scare, is a natural response. When you were told about a possible tumor, it understandably shifted your perspective and made you more vigilant about your health. This hyper-awareness can lead to what is often termed "health anxiety" or "hypochondria," where minor symptoms are magnified into serious health concerns. Recognizing this pattern is the first step toward managing it.
One effective approach to combatting anxiety is cognitive-behavioral therapy (CBT). This therapeutic method focuses on identifying and challenging negative thought patterns. For instance, when you find yourself worrying about a headache being a sign of brain cancer, you can ask yourself: "What evidence do I have that this is true?" Often, you will find that the evidence does not support such catastrophic thinking. Keeping a journal of your thoughts and feelings can help you track these patterns and work through them more effectively.
Mindfulness and relaxation techniques can also be beneficial. Practices such as meditation, deep breathing exercises, and yoga can help reduce anxiety levels. These techniques encourage you to focus on the present moment rather than worrying about potential future health issues. Apps like Headspace or Calm can guide you through mindfulness exercises, making it easier to incorporate these practices into your daily routine.
Physical activity is another powerful tool in managing anxiety. Regular exercise releases endorphins, which are natural mood lifters. It can also serve as a distraction from anxious thoughts. Aim for at least 30 minutes of moderate exercise most days of the week. Whether it’s a brisk walk, cycling, or a dance class, find an activity you enjoy to make it sustainable.
Regarding your smoking habit, it’s commendable that you recognize the need to quit. Smoking cessation is a significant step toward improving your overall health and reducing anxiety. Consider seeking support through smoking cessation programs, which often provide resources and counseling to help you quit. Nicotine replacement therapies, such as patches or gum, can also ease withdrawal symptoms and cravings.
Lastly, it’s crucial to maintain open communication with your healthcare providers. If you have ongoing concerns about your health, don’t hesitate to discuss them with your doctor. They can provide reassurance and help you understand the results of any tests or examinations. Building a trusting relationship with your healthcare team can alleviate some of the anxiety associated with health scares.
In conclusion, while it may feel overwhelming, there are effective strategies to help you regain your sense of optimism and manage your anxiety. By challenging negative thoughts, practicing mindfulness, engaging in regular physical activity, seeking support for smoking cessation, and maintaining open communication with your healthcare providers, you can work toward a healthier, more balanced mindset. Remember, it’s a journey, and it’s okay to seek help along the way. You are not alone in this, and with time and effort, you can find your way back to a more positive outlook on life.
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