Can health anxiety be treated?

[DrHouse]

Yes, but the tendency to have exaggerated health anxiety might not completely vanish (after all it is normal to fear cancer). You can learn to realize that you have anxiety for a diseases. To realize that you have health anxiety does not cure you but it is an important first step.

How is hypochondria treated?
(Meta) Cognitive-behavioural treatment. Hypochondriacs often choose the most serious, but often least probable, explanation. Headache is not migraine or stress but brain tumor, chest pain is not caused by tense muscles but is serious heart attack and so on. Often patients with hypochondria have beliefs like: It is normal to feel completely well all the time - A physical symptom is a sign that something serious is wrong in my body - You can be 100% sure that you are completely well - Doctors often misdiagnose cancer. Reassurance (even on a Internet forum) does not help hypochondriacs.

So, what helps?
One of my main questions to the patient is this: What is your project? Most people are not aware of their project, but it is important to identify it. When this is done, you can evaluate it, reflect on it and even change it. Thoughts and behavior which might seem irrational are usually quite logical and understandable in light of the project. Typical projects in hypochondria are not to die now (later might be OK) or to get rid of uncertainty (I must be 100% certain that I don't have cancer or heart disease).

The problem with controlling death is that you don't know how and when you are going to die. So, what will you focus on? The heart, cancer, a car accident.... If you try to control something which is in principle uncontrollable, your are bound to run into big problems. It is doomed to fail, and extremely tiring and energy-consuming. Another problem is that focusing on symptoms of imagined cancer tend to increase the symptom load.

How about being 100% certain? Is that possible? Only one thing is 100% certain in this life: one day we are going to die. All other decisions must be taken when still in doubt. You might as well learn how to. About 30% of us get cancer during our lifetime (70% do not, and die of something else). Of patients with real cancer, 50% survive. What is the most important factor deciding whether a person with cancer will live or die? Many people think it is the timing of the diagnosis. The sooner the better. However, there is one factor which overrules everything else. It is not the will to live, checking the body, detecting the cancer early etc., but what type of cancer you get. If you get the wrong kind of cancer it doesn't help being a hypochondriac or desperately wanting to live, you will die anyway. On the other hand, if you get a cancer type which seldom spreads there is no need to diagnose it early, you will survive anyway. So, the main factor in cancer survival is taken out of our hands.

If your project is trying to control something which is uncontrollable like death and which diseases you will get you can choose to reject it. You can put it aside, and find a project which is not doomed to fail and is more compatible with living a good life. Such projects are: tolerate uncertainty, spend your energy on living and not on not dying etc. After you have found your new project, you will have to spend time and energy on meaning it. One of the best ways of changing, and meaning something new, is to behave as if you mean it.

Some people feel it is unsafe to leave their worries behind. Does worrying prevent bad things from happening? If they do, how? The best option might be to live as happily as you can, knowing that anything can happen, but waiting until the problem becomes real. I ask my patients to consider the difference between real problems (A doctor diagnosed a real disease) and imagined problems (I think I have a disease).

My suggestion is: do not take on too many imagined problems. Maybe the best preparation of a real disaster is to live a good life until it happens. Make sure you are not too exhausted and depressed when bad things happen. It is fascinating to see how fast a person can change when they realize that their project is doomed to fail and in a sense meaningless. It did not help to pursue it with dedication and lots of energy, it even made things worse. When people dare to live, become mortal, decide to trust their heart etc., they experience a new freedom. Most people who get real, serious diseases notice it. They don't have to pay attention all the time. If you suffer from hypochondria there is hope. I will suggest that you talk this over with your GP, who might be able to refer you to a cognitive therapist.

[sandraqwest]

This was an awesome post. Thank you.

[hbukovsky]

Wow, This was fantastic, very helpful.... Thank you

[Ash0709]

Wow, thank you very much for this post! I feel much better after reading it.