Is It Anxiety or Hypochondria? Your Symptoms

Q: Is It Anxiety or Hypochondria? Your Symptoms

Hello Lia： It is advisable to first accept the fact that you have mild arrhythmia. <br>When discomfort occurs, reassure yourself that you have safely navigated through this multiple times before and that you will be fine. <br>Then, shift your focus to other things. <br>Even if wo

Is this situation related to anxiety or hypochondria?

Hello Dr.
Liang, two years ago, I suddenly woke up in the middle of the night during winter, feeling a heat in my chest and a rapid heartbeat, as if my heart was about to jump out.
This had never happened to me before, and it gradually subsided by morning.
I went to a nearby clinic, and the doctor diagnosed me with arrhythmia.
After taking the medication prescribed to regulate my heart rhythm, I felt much better.
Since that incident, I have felt anxious about sleep, fearing that I might experience a similar situation again while sleeping.
Sometimes I wake up suddenly, feeling a burning sensation in my chest and back, with clammy palms, and I know my heart rate is about to increase, especially during drastic temperature changes or cold weather, which intensifies my anxiety.
I have undergone two 24-hour Holter monitor tests, and the doctor said I have mild arrhythmia that does not require treatment.
However, I have become more sensitive to heart disease; when the weather turns cold or during cold fronts, I feel scared when I see news about sudden cardiac death, worrying that I might wake up and not be able to get up again.
I vividly remember last October when I learned that a friend's family member passed away due to an embolism caused by childbirth.
Upon hearing the news, I felt inexplicably anxious and scared, which led to a rapid heartbeat, shortness of breath, and sweaty palms.
The next day, I went to the clinic for an ECG, which showed no abnormalities, just elevated blood pressure.
I have been troubled by this issue for two years, and it has evolved into episodes of increased heart rate occasionally in crowded places like the subway or while walking.
Although the symptoms subside quickly, I feel genuinely scared in those moments.
Am I experiencing anxiety or health anxiety? How should I relax? Thank you for taking the time to respond amidst your busy schedule.
Thank you.

lia, 30~39 year old female. Ask Date: 2018/02/10

Dr. Liang Sunyuan reply Psychiatry

Hello Lia: It is advisable to first accept the fact that you have mild arrhythmia.
When discomfort occurs, reassure yourself that you have safely navigated through this multiple times before and that you will be fine.
Then, shift your focus to other things.
Even if worries return, it’s okay; just redirect your attention again.
The calmer you feel, the quicker the discomfort will resolve.
Conversely, if you are more anxious and unsettled, the discomfort may last longer, but it will eventually subside.
However, if you continue to feel very troubled, you may seek assistance from a psychiatrist or a mental health professional.
Wishing you a swift return to calmness.

Reply Date: 2018/02/10

More Info

Based on your description, it seems that you are experiencing symptoms that are characteristic of anxiety, particularly panic attacks, rather than hypochondria. Panic attacks can manifest as sudden episodes of intense fear or discomfort, often accompanied by physical symptoms such as rapid heartbeat, sweating, and feelings of impending doom. Your experience of waking up in the middle of the night with a racing heart and a sense of heat in your chest aligns with this. The fact that these episodes have led to a heightened sensitivity to your heart health and a fear of potential heart issues, especially after hearing distressing news, further supports the idea that anxiety is at play.

Hypochondria, or illness anxiety disorder, involves an excessive preoccupation with having a serious illness, despite medical reassurance. While you do express concerns about your heart health, your symptoms appear to be more related to anxiety responses rather than a persistent fear of illness without significant physical symptoms. The panic attacks you describe, especially in response to stressors like temperature changes or distressing news, indicate that your body is reacting to anxiety rather than a genuine belief that you are seriously ill.

To manage your anxiety, consider the following strategies:
1. Cognitive Behavioral Therapy (CBT): This is a highly effective treatment for anxiety disorders. CBT helps you identify and challenge negative thought patterns and beliefs that contribute to your anxiety. A therapist can guide you through this process, helping you develop coping strategies.

2. Mindfulness and Relaxation Techniques: Practices such as mindfulness meditation, deep breathing exercises, and progressive muscle relaxation can help you manage anxiety symptoms. These techniques promote relaxation and can reduce the physiological responses associated with panic attacks.

3. Regular Exercise: Physical activity is a powerful stress reliever. It can help reduce anxiety and improve your overall mood. Aim for at least 30 minutes of moderate exercise most days of the week.

4. Healthy Sleep Hygiene: Since you mentioned anxiety related to sleep, establishing a calming bedtime routine can be beneficial. This might include activities such as reading, taking a warm bath, or practicing relaxation exercises before bed.

5. Limit Stimulants: Caffeine and nicotine can exacerbate anxiety symptoms. Consider reducing your intake of these substances to see if it helps alleviate your symptoms.

6. Seek Professional Help: If your anxiety continues to interfere with your daily life, consider seeking help from a mental health professional. They can provide a comprehensive assessment and recommend appropriate treatment options, which may include therapy or medication.

7. Support Network: Sharing your experiences with trusted friends or family members can provide emotional support. Sometimes, just talking about your fears can help reduce their intensity.

In summary, while your symptoms are concerning and understandably distressing, they appear to be more aligned with anxiety rather than hypochondria. Implementing coping strategies and seeking professional help can significantly improve your quality of life and help you manage your anxiety more effectively. Remember, you are not alone in this, and there are resources available to support you.

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