Hypochondriasis
Hello Dr.
Chiu, I had a heart attack nine years ago and received a stent.
For the first six months, everything was fine, and I felt rejuvenated, almost like I was several years younger! However, one day, my long-absent Meniere's disease reappeared, and a few days later, I suddenly felt tightness in my heart.
After multiple examinations by a cardiologist, they identified the issue as premature ventricular contractions (PVCs).
The doctor said it was not a concern and that I likely had this issue all along but just didn't notice it before.
As for my Meniere's disease, I have essentially given up on treatment and will return to the neurologist for a continuous prescription when necessary.
The doctor often comments on my "tuna belly" (after the heart attack, I became hesitant to engage in activities, leading to my previously robust physique turning into that of a tuna that doesn't swim well).
Regarding the missed heartbeats, it has been quite troublesome.
I have undergone all necessary tests, and the doctors say everything is still within a reasonable range and not concerning.
However, my triglycerides are slightly elevated, so I need to pay attention to my diet and lifestyle.
The symptoms associated with the missed beats linger in my mind, and I often worry about experiencing several episodes again, especially when I see media reports or hear friends casually mention strokes or sudden cardiac death.
These thoughts keep circling in my mind.
Strictly speaking, the missed beats do not occur daily; sometimes, there are intervals of two to three months, but the severity varies.
I came across the term "health anxiety" and have been seriously reflecting on whether I might be experiencing this.
I can find the answer within myself, yet I still doubt it...
What if I really do have an illness? I used to be an optimistic person, but I often get caught up in trivial matters that others might not consider significant, or I dwell on past mistakes or shortcomings.
I don't share these thoughts with anyone; they just circulate in my mind.
Is health anxiety really that difficult to manage? I appreciate your time and hope you can provide some clarity.
Thank you.
Mr. Zhang, 50~59 year old female. Ask Date: 2021/11/21
Dr. Qiu Junda reply Psychiatry
Hello.
The correspondence reveals an anxious reaction regarding your health condition.
Whether or not it is hypochondriasis, there are at least symptoms of anxiety causing distress.
Physical ailments, such as heart issues, may be a source of stress (anxiety).
It is recommended that you take the time to consult with a psychosomatic medicine clinic, which should help alleviate your concerns.
Reply Date: 2021/11/21
More Info
Illness anxiety, often referred to as health anxiety or hypochondria, is a condition where individuals experience excessive worry about having a serious illness, despite medical evaluations showing no significant health issues. Your experience, particularly following a history of cardiac issues and the resurgence of Meniere's disease, is a common scenario for many who have faced significant health challenges.
After a cardiac event such as a heart attack, it is natural to become more attuned to bodily sensations and changes. This heightened awareness can lead to misinterpretations of normal bodily functions as signs of serious illness. For instance, the premature ventricular contractions (PVCs) you mentioned are often benign and can occur in healthy individuals, but they can cause anxiety, especially in someone with a history of heart disease. The fact that your doctors have reassured you that these findings are within a reasonable range is important, yet it may not alleviate the anxiety entirely.
The connection between anxiety and physical symptoms is well-documented in medical literature. Anxiety can manifest in various ways, including increased heart rate, palpitations, and even gastrointestinal discomfort. It can create a vicious cycle where the fear of having a serious illness leads to increased anxiety, which in turn exacerbates physical symptoms, leading to further anxiety. This cycle can be particularly pronounced in individuals with a history of health issues, as they may be more sensitive to bodily sensations.
Your mention of Meniere's disease and its impact on your health perception is also significant. Chronic conditions can contribute to a sense of vulnerability, making individuals more likely to worry about their health. The fear of potential complications, such as stroke or sudden cardiac events, can be overwhelming, especially when these topics are discussed in media or social circles.
It's essential to recognize that while your concerns are valid, they may not reflect the reality of your health status. Cognitive-behavioral therapy (CBT) is often recommended for individuals struggling with illness anxiety. This therapeutic approach can help you challenge and reframe negative thoughts about your health, develop coping strategies, and reduce the frequency and intensity of health-related worries.
Additionally, mindfulness practices, such as meditation and deep breathing exercises, can be beneficial in managing anxiety. These techniques can help ground you in the present moment and reduce the tendency to ruminate on health fears. Regular physical activity, a balanced diet, and adequate sleep are also crucial for overall well-being and can help mitigate anxiety symptoms.
If you find that your anxiety continues to interfere with your daily life, it may be beneficial to consult a mental health professional who specializes in anxiety disorders. They can provide tailored strategies and possibly explore medication options if necessary.
In conclusion, while your concerns about your health are understandable given your medical history, it is crucial to differentiate between genuine health issues and anxiety-driven fears. Engaging in therapeutic practices, maintaining open communication with your healthcare providers, and seeking support from mental health professionals can significantly improve your quality of life and help you navigate these challenges more effectively. Remember, you are not alone in this journey, and there are resources available to support you.
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