Anxiety worsening hypochondria

Hi.  I've had a mild form of hypochondria since I was a young child.  When I was in my early 20's, I started suffering more severe panic attacks where I became convinced that every little ache or pain meant a serious physical ailment.  The attacks subsided for a number of years until my early 30's when they came back in the same manner.  Every little thing wrong becomes a life-threatening illness.  I should add that during this time every one of my annual physicals presented nothing wrong with my heart, lungs, blood chemistry, or anything.  I went into therapy for about a year which helped a lot.  Through those sessions we determined that stress was my main problem and what set me off on my attacks.

In the last few weeks the panic attacks are back and I've been in an ER at least three times in the last two months complaining of symptoms that cause them to hook me up to an EKG or take x-rays and pronounce me fine.  I've been having dizzy spells, tension headaches, pain in my arm, all the usual stuff.  Not surprisingly, this has coincided with an increase in my stress level at work.  However, this time it seems like the attacks are worse.  While I try to rationalize, the hypochondria keeps interfering and triggering new attacks.

I'm usually able to work my way through the panic attacks but it takes a lot out of me and it is seriously affecting my ability to do my job.  I have never been on any kind of medication, but I'm wondering if perhaps that's the only way to treat this problem without it constantly recurring.  Do you have any thoughts on this?

Thanks.

P.S.  I am starting therapy again later this week.

[Roger Gould, M.D.]

I think the combination of medication and psychotherapy is exactly the right formula for you.