Overcoming Health Anxiety: Breaking the Cycle of Obsessive Worry

Illness Anxiety Disorder with Obsessive Thoughts

In high school, I was an athlete and felt invincible.
I would let a cold or even a fever close to 40 degrees Celsius run its course without seeking help.
I probably visited the doctor no more than five times during high school, even insisting on practicing while having influenza A.
It wasn't until last year that I discovered a 2-centimeter tumor in my left arm.
Thinking it was bothersome, I went to a plastic surgeon to have it removed.
The doctor initially suspected it was a common lipoma, but after testing, it turned out to be a rare borderline vascular tumor (which I believe is medically referred to as an Atypical Fibrous Histiocytoma, or AFH).
The recurrence rate is 15%, but only a 1% chance of metastasis.
The doctor advised me to continue monitoring it but not to worry too much.
However, from that moment on, I felt devastated, constantly worrying about being part of that 15% who might experience a recurrence or the 1% who could have metastasis.
I had just started college and had just turned 20; I couldn't help but think about what would happen to my parents and grandparents if something went wrong.
Later, I went to a larger hospital, and they reassured me that they would manage any changes, which provided some comfort.
However, since that incident, I have become overly anxious about even minor illnesses.
For instance, if I have a headache, I worry about a brain tumor; if I feel chest tightness, I think of a myocardial infarction; if I have diarrhea, I fear stomach or colon cancer; and if I notice tiny black lines on my toes, I panic about melanoma.
Essentially, any slight symptom leads me to Google my concerns and see a doctor.
In March alone, I visited the doctor seven times, including three visits for my toe.
In April, I was so worried about a brain tumor due to headaches that I paid for a CT scan, which came back normal.
Later, I read that CT scans have lower resolution for the brain compared to MRIs, so I ended up paying for an MRI, which also turned out normal.
Altogether, I spent nearly 10,000 NT dollars.
A couple of months ago, I visited a psychiatrist and started medication.
The symptoms have indeed become less severe than before, but I still often find myself engaging in compulsive thinking.
For example, when I run and my feet feel numb, I worry it could be a tumor or a stroke, and then I Google it, creating a vicious cycle.
I know this behavior is unhealthy, but I can't seem to control myself.
This way of living is truly painful and exhausting.

Hsuann, 20~29 year old female. Ask Date: 2023/07/08

Dr. Li Guanying reply Psychiatry

Dear Sir/Madam,
From your letter, it is evident that you are experiencing discomfort and distress.
With the recent surge in the pandemic, the Centers for Disease Control and Prevention (CDC) has defined the symptoms resulting from acute COVID-19 infection as "Post-COVID Conditions," also known as "Long COVID." Recently, daily confirmed cases of COVID-19 have exceeded ten thousand, but current public health policies are leaning towards coexisting with the virus.
This includes the need for awareness of "Long COVID" symptoms, even among asymptomatic individuals, as the resulting physical and mental stress can easily lead to the recurrence of anxiety, depression, and other mental health issues, which should not be underestimated.
Clinical findings indicate that, in addition to moderate to severe cases, individuals with mild or asymptomatic infections may also experience Long COVID, sometimes lasting up to four months.
According to outpatient statistics, the most common Long COVID symptoms are respiratory issues, followed by fatigue, and cognitive dysfunction, commonly referred to as "brain fog," which ranks third.
This can lead to impaired memory and difficulty concentrating, subsequently affecting work and daily life.
Sometimes individuals are unaware that they have Long COVID, and the impact of cognitive dysfunction can lead to a decline in work performance, increasing mental and physical stress, and triggering the recurrence of mental health disorders.
Some individuals who experienced only mild respiratory symptoms, such as coughing, recovered within a week through telemedicine consultations and adherence to medication.
However, they later encountered difficulties in clearly expressing their thoughts and a decline in physical stamina.
Athletes often feel overwhelmed, fearing that their performance may be hindered, leading to insomnia.

Individuals recovering from COVID-19 may still face mental and physical stress due to the imbalance between family life and work arrangements, with ongoing symptoms such as insomnia, fatigue, restlessness, anxiety, depression, and cognitive dysfunction, which should prompt consideration of Long COVID.
Moreover, among patients experiencing Long COVID symptoms, women are more susceptible to complications related to mental health, emotions, endocrine issues, and fatigue.
Maintaining a regular exercise routine, normal sleep patterns, adequate rest, and practicing self-relaxation can help alleviate concerns about the duration of Long COVID.
However, if related symptoms persist for more than a month without improvement, it is advisable to seek professional medical assistance to prevent the emergence of more complex issues, especially for those with pre-existing mental health conditions, as they may be more prone to relapse.
Therefore, the worsening of your condition cannot exclude this factor.
In addition to medication and psychotherapy, repetitive transcranial magnetic stimulation (rTMS) is a non-invasive treatment method that does not require anesthesia, has a high safety profile, and does not necessitate hospitalization.
It can improve anxiety and depressive symptoms, showing significant improvement in patients with treatment-resistant depression or those unable to tolerate medication side effects after rTMS therapy.
Our clinic offers outpatient services from Monday to Friday, both in the morning and afternoon.
I recommend considering a visit to allow a physician to personally assess your symptoms and collaboratively discuss the best course of action for you.
Wishing you good mental and physical health.

Reply Date: 2023/07/08

More Info

Overcoming health anxiety can be a challenging journey, especially when it becomes a cycle of obsessive worry. Your experience reflects a common pattern where a significant health scare triggers a heightened sensitivity to bodily sensations and an overwhelming fear of serious illness. This is often compounded by the accessibility of information online, which can lead to misinterpretation of symptoms and further anxiety.

Health anxiety, also known as hypochondria, can manifest in various ways, including excessive worry about having a serious illness, frequent medical consultations, and compulsive research about health conditions. In your case, the incident with the tumor has understandably shifted your perspective on health, leading to a heightened state of vigilance regarding your body. This is a natural response to a traumatic experience, but it can become problematic when it leads to constant worry and impacts your quality of life.

Here are some strategies to help you break the cycle of obsessive worry:
1. Cognitive Behavioral Therapy (CBT): This is one of the most effective treatments for health anxiety. CBT helps you identify and challenge irrational thoughts and beliefs about your health. A therapist can guide you through exercises that help you reframe your thinking and reduce anxiety.

2. Mindfulness and Relaxation Techniques: Practicing mindfulness can help you stay grounded in the present moment and reduce the tendency to ruminate on health fears. Techniques such as deep breathing, meditation, or yoga can help alleviate anxiety and promote relaxation.

3. Limit Health-Related Research: Set boundaries for yourself regarding how much time you spend researching health symptoms online. Consider designating specific times for this, or better yet, avoid it altogether. Remember that the internet can often provide misleading information that exacerbates anxiety.

4. Focus on What You Can Control: Instead of fixating on potential health issues, redirect your focus to aspects of your life that you can control, such as maintaining a healthy lifestyle through balanced nutrition, regular exercise, and adequate sleep. Engaging in activities that bring you joy and fulfillment can also help shift your focus away from health concerns.

5. Seek Professional Help: Since you have already consulted with a psychiatrist, consider continuing this relationship or seeking a therapist who specializes in anxiety disorders. Medication can be helpful, but therapy often provides the tools needed to manage anxiety long-term.

6. Journaling: Keeping a journal of your thoughts and feelings can help you process your emotions and identify triggers for your anxiety. Writing down your worries can also help you see patterns and recognize when your thoughts are becoming irrational.

7. Support Groups: Connecting with others who experience similar feelings can provide comfort and understanding. Support groups, whether in-person or online, can be a valuable resource for sharing experiences and coping strategies.

8. Gradual Exposure: If certain situations or thoughts trigger your anxiety, consider gradually exposing yourself to these triggers in a controlled manner. This can help desensitize you to the fear and reduce its power over time.

9. Educate Yourself: While it’s important to limit excessive research, having a basic understanding of health issues can empower you. Focus on credible sources and aim to educate yourself about health in a balanced way, rather than from a place of fear.

10. Practice Self-Compassion: Be kind to yourself during this process. Acknowledge that overcoming health anxiety is a journey, and it’s okay to have setbacks. Celebrate small victories along the way.

In conclusion, overcoming health anxiety requires a multifaceted approach that includes cognitive restructuring, mindfulness practices, and professional support. It’s essential to recognize that while your fears are valid, they do not have to dictate your life. By implementing these strategies, you can gradually reclaim your sense of well-being and reduce the burden of obsessive worry. Remember, you are not alone in this struggle, and seeking help is a courageous step toward healing.

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