the Cycle of Frequent Doctor Visits: A Mental Health Perspective

Constantly seeking medical attention?

Hello, Doctor: I would like to ask about my ongoing medical issues.
I had surgery when I was young, but it didn't significantly affect my life, and I have been regularly following up with the surgeon (about 3-4 times a year).
My family has always taken good care of me, so I have a low sense of urgency regarding my health.
It wasn't until early last year that I noticed some changes in the surgical area (which were concerning), and I realized the potential seriousness of the situation.
After consulting with the surgeon who performed the operation, he said it was just a normal phenomenon and that I should continue with my regular follow-ups.
However, I still feel uneasy and have started to see different doctors repeatedly.
Whenever I feel something is off (like pain), I go to see a doctor.
To be honest, I have seen nearly 30 doctors in the same specialty over the past year, even paying out of pocket for tests, but each doctor has said everything is stable and that I should continue with regular follow-ups.
Some doctors even believe that checking every six months is sufficient.
Gradually, I began to suspect that the doctors in this area might be communicating with each other, saying there is a girl who keeps coming in without any issues, so they all just tell me "it's stable, continue to follow up." I also worry that I might be criticized by the health insurance bureau for wasting medical resources, so I now approach my doctor visits with a sense of guilt and shame, just hoping to hear "it's stable, continue to follow up." However, if I don't see a doctor when I feel unwell, I become extremely anxious, feeling like "I'm about to die," and if I don't go, I worry that my condition might have changed and that I could miss something critical, which would be irreversible.
As a result, repeatedly seeing doctors has become a part of my life.
During the day, I can attend classes and appear normal (no one knows about my surgery), but my evenings are spent visiting doctors.
I even feel like I manage to balance studying and health well.
However, I know this is quite unhealthy.
I have considered seeking help from the school's counseling center, but there are too many people, and I couldn't get an appointment for free counseling.
Later, I decided to visit the psychosomatic department at a hospital, even though I had to pay for counseling, because I really want to resolve this issue.
However, after seeing three different psychosomatic doctors, they all felt that I didn't need counseling or medication and advised me to adjust my mindset and lifestyle.
I felt a sense of rejection from the hospitals...
So, I continue my routine of attending classes during the day and seeing doctors at night.
My family is unaware of my situation because I don't want to worry them.
What I really want to know is what my next step should be.
I know I won't seek help from the school's counseling center again because I study psychology, and this year, my juniors are interning there, so I don't want to go in.
Did I not communicate well with the psychosomatic doctors, which led to this feeling of being turned away? What should I do? Will adjusting my mindset and lifestyle really make things better? It has been a year, and I feel like nothing has improved, and I have spent a lot of money on doctors.
Thank you, Doctor.

Kate, 20~29 year old female. Ask Date: 2014/03/05

Dr. Ding Shuyan reply Psychiatry

Hello, I see that your journey in seeking medical help has been quite challenging.
It is evident that there is an underlying sense of anxiety that has driven you to invest so much time and money in seeking assistance.
Firstly, if over 30 physicians in the same specialty have assessed your condition and determined that there are no significant issues, I believe you can confidently reassure yourself that your health is indeed okay.
While no medical diagnosis is 100% accurate, in today's societal context, a physician who assures a patient that there are no problems must have at least a high level of confidence in their assessment.
If you understand statistical probability, the chance of misdiagnosis by any single physician is less than 0.5; therefore, the probability of 30 physicians misdiagnosing simultaneously is less than 0.5 raised to the power of 30.
You can calculate this probability yourself to see how unlikely it is.

Of course, it is possible that you understand this rationally but still struggle with it emotionally, which leads us to the next issue: the psychological aspect.
You may want to visit a nearby teaching hospital or medical center's psychiatry department, where they might have limited appointment slots for teaching clinics that can listen to your concerns more attentively and evaluate your situation.
If you find a physician you feel comfortable with, it is important to follow up with them consistently rather than frequently switching doctors.
This continuity of care is crucial.

Additionally, during your free time, try to engage in activities that force you to reduce the frequency of medical visits, interact more with others, and participate in activities that bring you joy.
This can help you gradually detach from this psychological predicament.

Wishing you all the best,
Dr.
Ding Shuo-Yan

Reply Date: 2014/03/05

More Info

Your situation reflects a complex interplay between physical health concerns and mental health challenges, particularly anxiety. It's understandable that after undergoing surgery, you would be vigilant about any changes in your body. However, the cycle of frequent doctor visits you've described can often lead to increased anxiety rather than alleviating it. Let's break down your concerns and explore potential steps forward.

Understanding the Cycle of Frequent Doctor Visits
1. Anxiety and Health Anxiety: It seems that your anxiety has manifested as a compulsion to seek medical reassurance. This is not uncommon; many individuals experience health anxiety, where the fear of illness leads to excessive checking and doctor visits. Each time you seek reassurance, it may provide temporary relief, but it can also reinforce the cycle of anxiety. The brain learns that the way to alleviate anxiety is through seeking medical attention, which can lead to a pattern of behavior that feels necessary but is ultimately unhelpful.

2. Cognitive Distortions: You mentioned a fear of being perceived as a "girl who has nothing wrong but keeps seeing doctors." This thought pattern can be a cognitive distortion known as "catastrophizing," where you imagine the worst-case scenarios. It’s essential to recognize that the majority of doctors have confirmed that your condition is stable. The likelihood of multiple doctors being wrong is statistically low, and it’s crucial to trust their professional assessments.

3. Guilt and Shame: Feeling guilty about utilizing healthcare resources is common, especially in a system where healthcare access can be limited. However, your health concerns are valid, and seeking help is a part of taking care of yourself. It’s important to reframe your thinking; you are not wasting resources but rather ensuring your well-being.

Steps Forward
1. Therapeutic Support: While you’ve sought help from various doctors, it may be beneficial to find a mental health professional who specializes in anxiety disorders. Cognitive Behavioral Therapy (CBT) is particularly effective for health anxiety, as it helps individuals challenge and change their thought patterns and behaviors. If school counseling services are overwhelmed, consider looking for private therapists or online therapy options.

2. Mindfulness and Relaxation Techniques: Incorporating mindfulness practices, such as meditation, deep breathing exercises, or yoga, can help manage anxiety. These techniques can ground you in the present moment and reduce the overwhelming feelings of fear and worry.

3. Limit Doctor Visits: Set a limit on how often you will visit a doctor for reassurance. For instance, if you feel discomfort, try to wait a set period (e.g., a week) before deciding to see a doctor. This can help break the cycle of immediate checking and allow you to assess whether the discomfort persists.

4. Open Communication: If you feel that your communication with healthcare providers has not been effective, consider preparing for your appointments. Write down your concerns and what you hope to achieve from the visit. This can help you articulate your needs better and ensure that you feel heard.

5. Engage in Activities: Find activities that you enjoy and that can distract you from your health concerns. Engaging in hobbies, socializing with friends, or participating in physical activities can provide a positive outlet for your energy and anxiety.

6. Educate Yourself: Understanding your condition and the normal healing process can empower you. Knowledge can reduce fear and help you differentiate between normal bodily sensations and those that require medical attention.

Conclusion
Your journey through health anxiety is challenging, but it’s important to remember that you are not alone, and help is available. By addressing the underlying anxiety and developing healthier coping mechanisms, you can break the cycle of frequent doctor visits and find a more balanced approach to your health. It may take time, but with the right support and strategies, you can achieve a sense of peace and confidence in your health management.

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