Can Health Anxiety Improve? Somatic Symptom Disorder

Q: Can Health Anxiety Improve? Somatic Symptom Disorder

Hello, online friend： You have been under so much stress these past few years; it must be tough! I wonder if your psychiatrist has suggested inpatient treatment? Or recommended psychotherapy, relaxation training, or rTMS (repetitive Transcranial Magnetic Stimulation) therapy? In

Will hypochondria get better?

Hello, Doctor.
I apologize for the lengthy story...
Three years ago, when I was eight months pregnant, I suddenly started experiencing severe headaches that lasted until my child was two months old (a total of four months).
It's not an exaggeration to say that for those four months, I had a headache every single day to the point where I felt like I was going to die.
This was the first time I had ever experienced such pain in my life, and I thought there must be something wrong in my brain.
Initially, due to my pregnancy, I went to the emergency room asking for tests, but the doctors said that I couldn't undergo radiation (CT scans) while pregnant, so they couldn't perform any examinations.
I endured the pain daily, feeling very low and crying every day during those four months.
I even told my husband what I would want to say if I were to die because the pain was unbearable.
I visited outpatient clinics weekly, and although the doctors told me it probably wasn't a brain issue, I felt they didn't understand how much pain I was in.
I was convinced there was something wrong in my head, but due to my pregnancy, I couldn't undergo any tests and could only receive physical therapy (heat therapy, electrical stimulation).
Those four months were the most stressful and darkest times of my life.
After my child was born, I started feeling unwell everywhere, which led me to visit the hospital frequently, including multiple emergency visits.
I experienced symptoms such as tongue pain, lip numbness, chest tightness, back pain, dizziness, facial pain, throat pain, abdominal pain, otitis media, stomach pain, hair loss, a 20-kilogram weight loss, irregular menstruation, and many other discomforts that I can't even remember.
I underwent both self-paid tests and those covered by health insurance, but the results always indicated that there was nothing serious (similar to responses about gastric ulcers or gastritis that could be treated with medication).
Eventually, I reluctantly visited a psychiatric clinic, where I was diagnosed with autonomic nervous system dysregulation and hypochondriasis.
Over the course of two years, I had more than a hundred consultations, which is quite astonishing; even the health insurance bureau reached out to inquire about my situation.
However, I couldn't help it; I worried about being ill and believed in early detection and treatment, so I would see a doctor whenever I felt unwell.
Now, three years later, I feel exhausted and in pain.
During this time, I took psychiatric medication for a year, but I didn't notice much change and still experienced discomfort.
Recently, I went to see a doctor because I had abnormal menstrual bleeding for half a month.
The doctor performed a pelvic exam and an ultrasound and found nothing significant, telling me it was due to hormonal imbalance.
I asked the doctor if blood tests and urine tests were necessary, and the doctor responded, "What would blood tests reveal?" I inquired whether I might have any serious illness, and the doctor's response was impatient, suggesting that if I suspected something was wrong, they could arrange for a PET scan, which would cost over thirty thousand NT dollars.
They said they could also draw blood, but it would be out-of-pocket.
I felt hurt by this response...
Is it wrong for me to pay attention to my health? Doctor, I truly feel powerless and very uneasy.
How can I shift my negative thoughts about potential illnesses? I've had symptoms of back pain when eating for two years, and I can't help but wonder if I might have pancreatic cancer...
It's truly an uncontrollable thought.
Over the past few years, I've felt that doctors have been unable to identify my issues, and I am convinced that I must be ill.
The constant discomfort in my body has been very painful, and my heart is weary.
I just want to escape this vortex.

Miss Pan, 30~39 year old female. Ask Date: 2021/07/26

Dr. Wu Enliang reply Psychiatry

Hello, online friend: You have been under so much stress these past few years; it must be tough! I wonder if your psychiatrist has suggested inpatient treatment? Or recommended psychotherapy, relaxation training, or rTMS (repetitive Transcranial Magnetic Stimulation) therapy? In any case, there is always hope, and mental health issues can be treated.
Many people have improved after receiving treatment! Collaborating well with your doctor will surely lead to recovery.
Dr.
Wu En-Liang

Reply Date: 2021/07/26

More Info

Health anxiety, often referred to as illness anxiety disorder or hypochondriasis, can indeed improve with the right approach and treatment. Your experience highlights the complex interplay between physical symptoms and psychological distress, which is a hallmark of somatic symptom disorder (SSD). This condition is characterized by the presence of one or more physical symptoms that cause significant distress or impairment, and these symptoms are often exacerbated by anxiety and stress.

From your description, it seems that your journey began with severe headaches during pregnancy, which understandably heightened your anxiety about your health. The subsequent array of symptoms you experienced—ranging from pain in various parts of your body to gastrointestinal issues—can be overwhelming. It’s important to recognize that while these symptoms are real and distressing, they may not always indicate a serious underlying medical condition. Instead, they can be manifestations of anxiety and stress.

The first step in addressing health anxiety is to establish a strong therapeutic relationship with a healthcare provider who understands your concerns. It’s crucial to find a physician or mental health professional who listens to you and validates your experiences without dismissing them. Your feelings of being unheard or misunderstood by your previous doctors can contribute to your anxiety, making it essential to seek a supportive environment.

Cognitive-behavioral therapy (CBT) is one of the most effective treatments for health anxiety. CBT helps individuals identify and challenge negative thought patterns and beliefs about their health. For instance, when you find yourself thinking, "I must have a serious illness because I feel pain," CBT can guide you to reframe that thought to something more balanced, such as, "Many people experience pain for various reasons, and it doesn’t necessarily mean I have a serious illness." This reframing can help reduce anxiety and improve your overall mental health.

Mindfulness and relaxation techniques can also be beneficial. Practices such as meditation, deep breathing exercises, and yoga can help you manage anxiety symptoms and promote a sense of calm. Engaging in regular physical activity can also improve your mood and reduce stress levels, which may help alleviate some of the physical symptoms you experience.

It’s also important to establish a routine for medical check-ups without over-relying on them for reassurance. Setting boundaries around how often you seek medical attention can help reduce the cycle of anxiety. For example, you might decide to limit visits to the doctor to once every few months unless you experience new or worsening symptoms. This approach can help you regain a sense of control over your health anxiety.

Lastly, consider joining a support group for individuals with health anxiety or somatic symptom disorder. Sharing your experiences with others who understand what you’re going through can provide comfort and reduce feelings of isolation. Hearing how others cope with similar challenges can also offer new strategies for managing your anxiety.

In conclusion, while health anxiety and somatic symptom disorder can be challenging, they are treatable conditions. With the right support, therapy, and coping strategies, it is possible to improve your mental health and reduce the impact of anxiety on your physical well-being. Remember, you are not alone in this journey, and seeking help is a courageous step toward recovery.

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