How I Learned to Cope with My Health Anxiety
I grew up thinking I was dying, and now I don’t.
In this time of COVID, it’s no surprise that people are experiencing health anxiety (previously known as hypochondria) at a greater intensity and frequency than before (National Institutes of Health). This is a pandemic, after all.
I know health anxiety all too well — I spent my entire childhood and adolescence with it. Seventeen-year-old-me would have never believed that twenty years later, she would live through a pandemic without freaking out 110% of the time.
In fact, I’m not really freaking out about COVID at all. I’ve had some symptoms, two tests, and somehow — no worries about any of it.
But this is not to say that I’m not freaking out in general. Plenty of intrusive thoughts, like these, are plaguing my mind these days:
UGGH I’m such a failure of a writer — I should have been done with this article a million years ago! I’ll never crank out enough content for an income stream!
OMG I shouldn’t be here at Albertsons wasting all this time. I should be out doing impactful things instead of obsessing about what I should or shouldn’t buy. I’m such a wreck, such a failure to God; I can’t even grocery shop like a regular person!
According to the Mayo Clinic, when it comes to anxiety disorders, “Worries can shift from one concern to another and may change with time and age.” I think that’s what happened to me — my anxiety shifted from health to almost anything. I was diagnosed with generalized anxiety disorder at 23.
I need to tell you this at the beginning because I hate it when people assume to possess a secret “cure” for my anxiety struggle simply because theirs was cured in some particular way. (More on that here.) Suffice it to say, this is not a “How I overcame my health anxiety, and you can too!” article.
I am simply sharing my story to remind us all that we’re not alone. One of the greatest gifts we can give each other is the reminder that our human experience, as bizarre as it can be — is a shared one. And so, my friends, I hope this resonates with some of you. We’re in this together, and we’ve been in it together long before COVID showed up on the scene.
My medical history— according to my health anxiety
The first time I told my parents I was dying, I was in fourth grade. I made my grim discovery in a hotel bathroom during a road trip to Utah with my grandparents. It was a great adventure until I noticed it.
Standing in front of the bathroom mirror, my eyes narrowed in on the horrifying thing I held between my fingers. It was evidence that my body had mutated; a part of me now belonged to the same family as third arms and cyclops eyes and radioactivity. It was a lock of my wild brown hair — strands divided and shot around at all sorts of rakish angles, like a nightmarish work of abstract geometric art.
“It must be cancer!” I reasoned.
I wasn’t ready to face the hospitals and the yellowy liquids that would be pumped through my veins. I wanted to prolong the inevitable. If I told my parents now, they would no doubt buy me a plane ticket home to California, ASAP.
I knew my illness required the most urgent attention, but unprepared to turn my family’s life upside down, take on chemotherapy and ruin my grandparents’ vacation, I kept my grave discovery to myself until we arrived back home in California.
When I finally showed my mom and dad my deformed hairs, I burst into tears.
It was the first of many identical episodes.
Here’s another hair story. Or, well, lack thereof. In fifth grade, I discovered the little bald spaces behind my ears. TV taught me that cancer makes people bald; therefore, I knew that I had cancer.
Examining my baldness in the mirror, I was transported to a new setting. I saw myself lying in a dim hospital room, with those metal bed-bars between my heartbroken parents and I. Their despair was my fault. I wasn’t so much afraid of death as I was ruining the lives of those I love most.
A year later, on a Saturday afternoon, I wandered into my parents’ bedroom, and started this conversation:
“Dad… I found this bump on my shin. I think it’s a tumor. WAAAHHH!”
“Kiddo, no, that’s crazy!”
“WAAAAH!”
“Do you know what the odds of that would be?!?”
“WAAAAH!”
“Kiddo, I assure you, it’s not a tumor.”
“WAAAAHHHH Then what is it?!”
“I don’t know — it’s probably a bruise! Or an ingrown muscle. I have one like it in my arm.”
“WAA — wait, really?”
“Yes! Look! Mine’s right here!”
I inspected his arm.
“See? I’m fine! You’re fine!”
He brought me in for a big hug, wishing I wouldn’t freak out so much. But over the years, I kept freaking out.
I had headaches more nights than not during the winter of eighth grade. So brain tumor, obviously. Every new headache was another brain cancer scare. Worrying became a nightly ritual. My parents were so patient — they continually comforted and reassured me.
That following summer, my throat felt lumpy. Despite his attempts to convince me that all throats are like that, my dad didn’t understand that mine was abnormally lumpy because I was growing a huge throat tumor.
Entering high school, it got more ridiculous. One warm summer night, I noticed my heart beating. It was just beating — but it felt harder than usual. My parents were already in bed. I woke them, because heart attack, obviously. I tip-toed into their room:
“Um, Mom? Dad? There’s something wrong with my heart. It’s beating really hard.”
I cried. They reassured me. Again.
My hands started tingling on a family vacation in Hawaii. We were at a luau. Despite the exciting Polynesian entertainment and exotic buffet, I mostly recall pacing nervously in the tropical darkness, because of diabetes. On the plane ride home, my hands were still tingling.
I felt even guiltier than usual, because this time, my horrific illness would be entirely my fault:
I should have lost those 15 pounds. I should have listened to my mom. This will grieve my parents so much, and their sorrow is on me.
A few days after getting home, my family doctor, Dr. Fole, told me it wasn’t diabetes; it was hyperventilation. When I didn’t believe him, he brought out a paper bag for me to breathe into fast and hard. Sure enough, my hands tingled.
I decided I had diabetes again a couple of years later because the tingling returned. This time, though, it was due to ridiculously tight back and chest muscles. Dr. Fole gave me several shots in my back to loosen things up and put me on muscle relaxers. I returned for routine pain massages until eventually, the tingles subsided.
At twenty years old, I found myself thinking and behaving just like I did in fourth grade. Once again returning from a trip, I carried the impossible dread of delivering grave news to Mom and Dad. This time, I was coming home from a summer mission trip to Croatia, where I had become convinced that I was experiencing heart failure.
My voice shook as I shared my terrifying secret:
“Mom? Dad? I think there’s something wrong with me… When I was in Croatia, my heart started doing bad things… like it stops and then it pounds really hard for a couple of beats, and then misses beats… there’s something really wrong with me…”
The chest-chokes commenced. My dad brought me in for a long hug and said:
“Kiddo, it’s probably nothing. I can’t tell you how many times I’ve had weird things happen to my body. I’m sure this is nothing.”
But just in case, and because arrhythmias run in our family, my mom scheduled me a doctor’s appointment.
In the waiting room, I tried unsuccessfully to cherish the last minutes of life before I officially began dying. I imagined the words “heart disease” in my doctor’s voice. I envisioned the operating table I’d lay on and the incredible force required to crack my ribcage open.
“Tiffany?”
The nurse led me from my dark imagination to the exam room where I awaited my doctor for sentencing. Sitting on the exam table’s crinkly paper, I morphed into a medical experiment as Dr. Fole appeared and taped sticky pads and wires all over my chest.
A moment later, he was examining the results. I held my breath.
“Well, this looks okay! It’s heart palpitations!”
“Wait, heart what? Aren’t those bad?!”
“No, no. They’re not a big deal. Here’s what I want you to do: Quit caffeine for six months, get more sleep, and relax. Okay?”
It faded away.
Many of the diagnoses I received as an adolescent are actually symptoms of generalized anxiety disorder: the hyperventilation, the tense back muscles, the heart palpitations. It’s too bad the puzzle wasn’t put together sooner.
When I came to him at 23, I watched Dr. Fole’s lightbulb turn on as I described my crumbling mental and emotional state — I was barely functioning in my professional and personal life.
He remarked, “Ooooh, you have always been hyper!”
By that, he meant nervous. In fact, the doctor’s appointments made me so nervous that I had to have my blood pressure taken at the beginning and end of exams. The difference between the two readings was the difference between a death sentence and a new lease on life.
Thank God, he referred me to a cognitive behavioral therapist that day.
When I was actually on an operating table
I suspect that my health anxiety might stem from one of my very first memories.
I was four. My parents woke me up when it was dark outside. I said I was hungry and they gave me ice. That was weird. I remember arriving at the hospital and sitting in a little room with my parents and a doctor. And then I remember lying on an operating table. I especially remember IV bags and bright lights hanging above.
A nurse tried to put the gas mask on my face. I fought him. I had my stuffed rainbow bunny with me. The nurse put the mask on Bunny’s face. Then he said,
“See? She’s okay!”
He was right — Bunny was okay.
So I let the nurse put the mask on my face, too. I remember waking up to my parents in the hospital and eating a rootbeer popsicle. And that was the last of my adenoids.
Risk factors
According to the Mayo Clinic, one of the risk factors for developing health anxiety is “a serious childhood illness.” While having my adenoids removed hardly qualifies as “a serious childhood illness,” I suspect that my experience, mixed with the interplay of genetics and personality, probably played a part in sparking my health anxiety.
Growing up, my family routinely drove over the San Francisco Bay Bridge to visit our extended family for Thanksgiving and Christmas. The bridge’s lights always creeped me out; they reminded me of yellow, glowing IV bags, backlit by surgical lights. So, I suppose my surgical experience left an impression on me.
The real stuff and why I didn’t freak out about it, maybe.
My siblings love teasing me with this phrase: “Tiffany, you’re such a disease!” This is equal parts inspired by a line in Home Alone, my chronic bronchitis, and the more legit diagnoses I got as a young adult: H. pylori and inactive tuberculosis. Oddly enough, I didn’t get anxious about either of those.
Perhaps it is because I contracted them while doing ministry overseas, so I considered them to be valid consequences of self-sacrifice. Unlike diabetes and heart disease, I couldn’t blame myself. I remembered Jesus saying, “Take up your cross and follow me.” I remembered His cross. I figured if the cost of following Jesus included some weird diseases, then that was the cost.
Or maybe I didn’t freak out because I finally internalized my dad’s reassuring logic. Maybe it’s because I had accumulated a wealth of experiential evidence that my self-diagnoses are never accurate. Or maybe it’s because my anxiety simply was taking on a new form — looking back, I can see GAD was developing all along the way.
Or maybe it’s none of those things or all of those things. We humans and our bodies are far more complex than we realize.
Logic that reassures
If any sort of practical knowledge may be gained from my experience, I think it lies in my dad’s reassurance. A few truths, in particular, helped calm me down when I was in the thick of it.
If you or a loved one has health anxiety, perhaps recalling these truths might help as well. As a disclaimer, these are truths that worked for me and might not work for everyone, but you know your loved one best:
‘I can’t tell you how many times I’ve had ____, and I’m fine!’
This is the same logic that the OR nurse used to calm my fear of the gas mask. This reasoning says: Hey look, it’s happening to Bunny, and Bunny’s okay, so I’ll be okay too.
When my dad says, “Hey, your symptom has happened to me before,” and I can clearly see him standing in front of me — not dead and all — I can conclude, “Hey look, it’s happened to him, and he’s okay, so I’ll be okay too.”
‘The odds of dying in a car accident are higher than the odds that you have ____.’
This helped bring me back to rational thought. I recalled that I’ve been in a car 23,292,930 times, and each time, I was okay. I’m not afraid to get in cars, so why should I be afraid of a headache being caused by a brain tumor?
‘Remember all the times you’ve freaked out like this, and it was nothing?’
As I got older, my dad added this to his arsenal of reassurance. It helped me see that my emotions have never been good predictors of reality. I slowly learned to put less and less trust in my anxious thoughts.
Cognitive behavioral therapy
Counter-evidence is gold in the fight against anxiety. In retrospect, it’s no surprise that my dad’s arguments regularly helped calm me down. Unbeknownst to him, he was helping me apply an aspect of cognitive behavioral therapy (CBT), an approach that is known to be particularly helpful in the fight against anxiety.
In 2013 report in Cognitive Therapy and Research, Hofmann et al. did a meta-analysis of CBT’s efficacy. They found, through an analysis of primary literature, that CBT is a reliable first-line approach for anxiety disorders and that CBT provides immediate symptom relief.
“For generalized anxiety disorder, CBT was superior as compared to control or pill placebo conditions,” the authors say.
If you or a loved one are experiencing the kind of anxiety that I did, I urge you to reach out to a doctor or CBT therapist. I didn’t see one until I was 23, and I wish I had earlier. She gave me the tools I need to pull myself out of anxiety’s relentless cycle and stop depending on my parents for reassurance.
I still get anxiety attacks, but now I have the tools to fight back on my own, and when I need extra back-up, I know who I can call.
