Health Anxiety: Coping Strategies for OCD Symptoms

Is it obsessive-compulsive disorder or hypochondriasis?

Hello, Doctor.
Since my mother was diagnosed with cancer eight years ago, I accompanied her through five years of treatment.
Now she no longer needs follow-up visits and is living a normal life, but my emotions have changed.
I constantly worry about my health; any slight change makes me fear I might have cancer.
I often look in the mirror or touch my body to check for asymmetry or lumps.
Even after seeing a doctor, I still can't feel at ease, and my life has become quite depressing.
I spend my days self-checking or searching online for information.
I consulted a psychiatrist who believes my condition is not severe yet and suggested I try self-adjustment without prescribing medication.
Later, I sought out a counselor and have had five or six sessions.
The counselor, based on my upbringing and interactions with others, thinks I have an anxious personality.
Can I improve just through counseling? I really miss my carefree days.
Should I suppress the urge to check my lymph nodes when I feel the need to touch my neck? If I can't resist and feel that my lymph nodes are different from before, should I remind myself that it's just excessive anxiety and refrain from checking again? Thank you.

Wen Zi, 30~39 year old female. Ask Date: 2018/08/19

Dr. Tian Xinqiao reply Psychiatry

Hello, thank you for your letter.
From your message, it is evident that after caring for your mother during her illness, you have become particularly concerned about your own health status.
It is completely normal to worry about one's health; many people still feel some anxiety even after seeing a doctor and undergoing examinations.
However, if you find yourself persistently anxious about your health or imagining that you have certain illnesses, which affects your daily life and social interactions, it is important to seek further evaluation from a psychiatrist at a hospital or clinic.

To manage excessive anxiety and worry, you can redirect your attention through regular exercise and hobbies.
A psychiatrist can provide psychotherapy or medication interventions.
Psychotherapy will teach you relaxation and stress-reduction techniques, helping you become less sensitive to health-related issues.
The use of medication will be tailored to your specific clinical needs as assessed by the physician.

It is important to cultivate patience and maintain confidence throughout these treatments, and to discuss any effects of the treatment with your doctor regularly.
I hope these suggestions are helpful to you.

Dr.
Tien Hsin-Chiao

Reply Date: 2018/08/19

More Info

Health anxiety, often referred to as illness anxiety disorder or hypochondriasis, can significantly impact an individual's quality of life, especially for those who have experienced trauma related to health, such as caring for a loved one with a serious illness. Your experience of heightened anxiety regarding your health, particularly after your mother's battle with cancer, is a common reaction to such stressful life events. It’s understandable that witnessing a loved one’s illness can lead to an increased focus on one’s own health, often manifesting as obsessive thoughts and compulsive behaviors, such as frequent self-checks for signs of illness.

Coping with health anxiety involves a multifaceted approach that includes psychological strategies, lifestyle changes, and possibly professional help. Here are some strategies that may help you manage your symptoms:
1. Cognitive Behavioral Therapy (CBT): This is one of the most effective treatments for health anxiety. CBT helps you identify and challenge irrational thoughts about your health. It can teach you how to reframe your thinking patterns, reducing the tendency to catastrophize minor symptoms or sensations.

2. Mindfulness and Relaxation Techniques: Mindfulness practices, such as meditation, yoga, and deep-breathing exercises, can help you stay grounded in the present moment and reduce anxiety. These techniques can help you become more aware of your thoughts and feelings without judgment, allowing you to observe them without reacting impulsively.

3. Limit Health-Related Research: While it’s natural to seek information, excessive research can fuel anxiety. Set boundaries for yourself regarding how much time you spend looking up health information or checking your body for symptoms. Consider designating specific times for these activities, and try to stick to them.

4. Engage in Healthy Distractions: Find activities that you enjoy and that can take your mind off your health concerns. This could include hobbies, exercise, socializing with friends, or engaging in creative pursuits. Physical activity, in particular, can help reduce anxiety and improve your mood.

5. Journaling: Writing about your feelings can be a therapeutic way to process your emotions. You can document your worries and reflect on them later, which may help you recognize patterns in your anxiety and develop coping strategies.

6. Support Groups: Connecting with others who share similar experiences can provide comfort and understanding. Support groups, whether in-person or online, can help you feel less isolated in your struggles.

7. Professional Help: Since you have already started seeing a therapist, continue to engage in those sessions. Therapy can provide you with tools to manage your anxiety and help you explore the underlying issues contributing to your health fears. If your symptoms persist or worsen, consider discussing medication options with a psychiatrist, as some individuals benefit from pharmacological support alongside therapy.

8. Self-Compassion: Be kind to yourself. Acknowledge that it’s okay to feel anxious and that recovery takes time. Celebrate small victories in managing your anxiety, and remember that setbacks are a normal part of the process.

Regarding your specific question about whether to suppress the urge to check your lymph nodes or other areas of concern, it may be beneficial to practice a technique known as exposure and response prevention (ERP), which is a component of CBT. This involves gradually exposing yourself to the anxiety-provoking situation (in this case, the urge to check) while refraining from the compulsion (the checking itself). Over time, this can help reduce the anxiety associated with those urges.

In summary, while self-help strategies can be effective, the combination of therapy and possibly medication, if needed, can provide a more comprehensive approach to managing health anxiety. Your journey toward recovery may take time, but with the right support and strategies, it is possible to regain a sense of normalcy and reduce the grip of anxiety on your life.

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