Overcoming Death Anxiety: Navigating Mental Health After Trauma

Death anxiety

Dear Dr.
Liang,
Last July, shortly after completing my postpartum confinement, my mother underwent surgery due to a ruptured cerebral aneurysm, which caused me significant worry and anxiety.
About a week later, one evening, I suddenly experienced shortness of breath and chest tightness, which eased after taking a deep breath for about ten seconds.
After my mother was discharged, I was concerned about her recovery and began to worry about my own health.
I feared inheriting a cerebral aneurysm (which led me to undergo an MRI), and due to chest tightness, chest pain, and numbness in my arms (I had an ECG and chest X-ray, both of which were normal).
I understood that these symptoms were likely psychosomatic (psychosomatic disorder? post-traumatic stress disorder?), and initially sought tests for reassurance.
Later, I experienced gastrointestinal discomfort, and a gastroscopy revealed that I had developed a gastric ulcer.
This made me realize that excessive anxiety can indeed lead to illness, so I started taking gastrointestinal medications (PPIs).
During this time, I also consulted with a psychiatrist but hesitated due to the noticeable side effects of the medication (for example, feeling extremely happy in the morning but profoundly depressed in the afternoon, leading me to feel that I could no longer be happy).

Consequently, I turned to reading many self-help books, tried to exercise, chatted with friends, and practiced Tai Chi to learn relaxation techniques...
In short, I wanted to navigate this difficult period without relying on medication.
However, after three months, a follow-up gastroscopy showed that my gastric ulcer had only improved but was not yet healed.
The doctor believed it was due to excessive stress.

Actually, my mood has improved recently, and my mother's recovery is going well.
However, I still find myself worrying about health issues (concerning my father, husband, and children), and I am particularly sensitive to any discomfort in my body, easily thinking negatively and constantly worrying about my health, especially since I have aging parents and young children.
(The thought of the law of attraction makes me even more fearful.) Recently, I have been experiencing gastroesophageal reflux, chest tightness, chest pain, and frequent eyelid twitching.
I know I am still in a state of physical and mental imbalance, but I struggle to regain my previous health quickly.
Therefore, I have no choice but to continue taking medication while pondering why my stomach has not healed and whether I should revisit the psychiatrist...
(After all, every time I recall my mother's sudden illness, I can't help but cry in fear, yet the issue is that my mother is doing well now.)
I have seen the responses you provide to other patients, which feel very warm, so I know you must be a caring doctor.
Could you please give me some advice? Thank you for taking the time to respond.

chelle, 30~39 year old female. Ask Date: 2013/01/30

Dr. Liang Sunyuan reply Psychiatry

Hello, during the process of pregnancy, childbirth, and postpartum recovery, women undergo significant changes physically, psychologically, and hormonally.
Therefore, the postpartum period is a time of increased vulnerability and sensitivity, where the impact of negative events may be amplified.
However, the challenges faced come with great rewards, as watching your child grow day by day is one of the happiest experiences in the world! Sometimes anxiety stems from worrying about what to do if negative events occur.
It is advisable to first think through what actions I can take in response if such an event were to happen.
If you have a plan in mind, even if it does occur, you will be better prepared and less likely to panic; moreover, it may not even happen.
Once you have clarified your thoughts, focus your attention on other important matters.
If you find it difficult to adjust, it is recommended that you consult a mental health professional to discuss your situation in person.
If you have experienced side effects from previous medications, please discuss with your doctor the possibility of switching to other medications.
Seeking professional help is aimed at finding resources for improvement, and your doctor will also discuss whether medication is necessary, so there is no need to worry excessively.
Wishing you all the best!

Reply Date: 2013/01/30

More Info

Overcoming death anxiety and navigating mental health after trauma can be a challenging journey, especially when compounded by personal experiences of loss and health concerns. Your situation reflects a common struggle faced by many individuals who experience significant stressors, such as the health crisis of a loved one, which can lead to heightened anxiety and physical symptoms.

Firstly, it’s important to acknowledge that your feelings of anxiety and physical symptoms, such as chest tightness and gastrointestinal issues, are valid responses to the stress you have experienced. The connection between mental and physical health is well-documented; psychological stress can manifest in various physical symptoms, often referred to as psychosomatic symptoms. This means that your anxiety about your mother’s health and your own can indeed contribute to physical ailments, such as the gastric ulcer you mentioned.

In your case, it seems that you are experiencing a cycle of anxiety that is exacerbated by your fears about health and mortality. This is not uncommon, especially after traumatic events. The fear of losing loved ones or experiencing health issues can lead to a heightened state of vigilance regarding one’s own health, which can create a feedback loop of anxiety and physical symptoms.

To address your concerns, here are several strategies that may help you navigate this challenging period:
1. Cognitive Behavioral Therapy (CBT): This therapeutic approach is effective for anxiety and can help you reframe negative thought patterns. A trained therapist can guide you in identifying irrational fears and replacing them with more balanced thoughts. This can be particularly useful in managing health anxiety and fears related to death.

2. Mindfulness and Relaxation Techniques: Practices such as mindfulness meditation, deep breathing exercises, and progressive muscle relaxation can help reduce anxiety levels. These techniques encourage you to focus on the present moment rather than worrying about potential future events, which can be particularly beneficial in managing anxiety related to health concerns.

3. Physical Activity: Regular exercise has been shown to reduce anxiety and improve overall mental health. Engaging in activities you enjoy, whether it’s walking, yoga, or tai chi, can help alleviate stress and improve your mood.

4. Support Systems: Connecting with friends, family, or support groups can provide emotional relief. Sharing your feelings and experiences with others who understand can help you feel less isolated in your struggles.

5. Limit Exposure to Triggers: If certain thoughts or situations trigger your anxiety, it may be helpful to limit your exposure to them when possible. For instance, if reading about health issues exacerbates your anxiety, consider taking a break from such content.

6. Professional Help: Since you have already consulted with a mental health professional, it may be beneficial to revisit this option, especially if you feel that your current coping strategies are insufficient. Discussing your concerns about medication side effects with your doctor can lead to adjustments or alternative treatments that may be more suitable for you.

7. Journaling: Writing down your thoughts and feelings can be a therapeutic outlet. It allows you to process your emotions and can help you identify patterns in your anxiety.

8. Gradual Exposure: If certain situations (like thinking about your mother’s health) trigger anxiety, consider gradually exposing yourself to these thoughts in a controlled manner, allowing yourself to process and cope with them over time.

9. Education: Understanding the nature of anxiety and its physiological effects can empower you. Knowledge can help demystify your experiences and reduce fear.

In conclusion, while it’s understandable to feel overwhelmed by anxiety and health concerns, there are numerous strategies available to help you regain a sense of balance and control. It’s crucial to be patient with yourself as you navigate this process. Healing takes time, and seeking support from professionals and loved ones can make a significant difference. Remember, you are not alone in this journey, and there are resources available to help you find your way back to a healthier state of mind and body.

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