Multiple Sclerosis Community
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Avatar universal

Health anxiety and OCD

Given a current and ongoing thread here, I thought it would be good to comment on psychosomatic symptoms.

People who suffer from anxiety often do experience very real pain, or spasms, or whatever. It hurts a lot, and of course is worrisome. But these problems are not organic--their minds have created them. The mind is much more powerful and clever than we think it is.

Often it starts with a real organic problem, such as an injury. A patient goes to a doctor, who uses medical terminology in describing it. A patient who suffers from severe health anxiety will perseverate on this, spending great blocks of time researching it online, picking up all sorts of related lingo, finding out what other conditions are related to the problem, researching those conditions, and on and on. Unsurprisingly, one day this patient suddenly has symptoms of that condition, overnight. And voila, more symptoms appear. Yes, these are very real, but they are caused by the mind, not by a bodily disease process.

Often when this patient is told that xyz symptom is not part of whatever disease he or she has self-diagnosed, that symptom magically disappears and is no longer mentioned. It just falls off the radar, because it doesn't add to the thesis the anxious patient is building.

Severe health anxiety is so sad, as it robs its victims of enjoyment of the here and now. We have seen medical students here who convince themselves they have whatever conditions they're studying, we've seen people who suddenly can't walk, we've seen loads of things in the years since this forum was started. It's just so unfortunate, and it's equally unfortunate that so many such patients either refuse mental health treatment or give only lip service to it. Medication may be needed, and if that isn't effective, maybe a stronger dosage would be. But from my understanding, the best treatment is intensive treatment using cognitive behavior therapy. That can achieve wonders if the patient is willing.

MedHelp has both anxiety and OCD forums where people can discuss these issues. But so many people strongly resist the treatment that can help them towards happy lives, free from catastrophizing over minor health problems. It's such a waste when the resistance is strong. Even when they actually do have MS or some other serious disease, they can be free from the terrible anxiety they also have.

These are just my thoughts for the moment. I hope others will add to them.

9 Responses
5887915 tn?1383382380
I have pretty much spent the first part of this year until now in hospitals and the one thing that I have noticed was the amount of patients in the emergency departments who have health anxiety. It is worrisome that the Internet has become a tool to self diagnose. This then this in turn evolves to our hospitals where the doctors are spending large amounts of time trying to convince people they are not having a stroke or MS etc.

The docs have to run all the tests to be sure nothing untoward is happening but the patients are so lost in the notion they are gravely sick that they can't believe what the doctors are saying when they send them home. Often the patient returns that same day or week with the same symptoms but they have not followed up with the recommendations from the ER to seek psychological help.This is the one thing I don't like the Internet for and its upsetting to see so many young people wasting their lives on worry and stress of a disese they will never have.

I have noticed this is only increasing over time and is taking its toll on the health system. I do believe that we all must take responsibility for our mental health. I also believe that as I've seen too many times in this community that we are often feeding people knowledge about things that is only adding fuel to the fire of their anxiety.

I think you are correct in what you are saying Ess and it's very sad that this has become so prevelant in our society. I know the symptoms are real because you just try breathing too rapidly yourself for a period of time and your fingers will go tingly. I get this when my asthma has been severe and I've been on oxygen.

11305938 tn?1418002133
Well said!! I sincerely hope it helps anyone in this situation!
5112396 tn?1378021583
Hear hear!

Too many people assume that if it's suggested that their issues are related to anxiety or depression that a doctor is telling them their experience isn't real. Not so! They are just presenting the possibility that they would be best served by addressing what appear to be non-organic issues.

Suffering with knock-on complications from mental health issues is genuine suffering, but refusal to at least try treatment in this regard is all too common and relief is never found.
987762 tn?1331031553
An additional point is that 'heath anxiety' typically runs in exhaustingly vicious cycles, and once in the cycle it is hard, very HARD to get out of it even with professional help, there's no quick fix, it takes a lot of work!

People who experience these types of anxiety or conversion are NOT fabricating, manipulating, purposely deceiving, attention seeking etc which is more in line with Munchausen or Malingering who get some personal gain eg financial, sympathy, attention etc.

There is a fine line between the normal process of seeking out clarification and or reassurances and the tipping point, which can take people beyond normal parameters and as their anxiety continues to escalate the more truly afraid they feel and the stronger the compulsion to search for answers,  reassurance and validation becomes.

People with health anxiety find their medical concern will easily start taking over their thoughts and if their anxiety has focused onto something specific (eg MS, cancer) the more hyper focused their thoughts, and the more reassurance and information they'll seek out and the more consistent their self checking behaviours get. Information and education is usually empowering and removes a lot of fear, giving back some level of feeling in control but if someone has health anxiety, education does the opposite it feeds their anxiety and escalates.

Which in turn generates more non specific symptoms, escalating their fear and pushing their behaviours further into irrational logic, which is all supporting and feeding their anxiety and fears that they definitely must have that disease despite any evidence or opinion that they don't. Psychologically caused symptoms develop faster, spread wider, and a person will usually physically decline at a much faster rate, with what they experience typically not consistent with the disease they fear they have.....

Health anxiety can have a flip side and instead of obsessively seeking reassurance, they find medical issues overwhelming and they can't face what they fear will be horribly bad news, so they avoid talking about or actually getting any help for suspected or even obvious medical issues, the difference is irrational avoidance.  

To me it's morally and ethically reprehensible for anyone to belittle someone who's in the middle of emotional crisis and make no mistake, their emotional bomb is ticking faster and faster as their thoughts spin and become more and more erratic. Berating and being angry at someone with health anxiety who's  in the middle of a cycle, works just as well as berating and being angry at someone who's got a phobia, bipolar, autism, depression, schizophrenia etc, it will 'never ever' make any positive difference but it will most definitely make their situation even worse!  

If anyone is dealing with anxiety or depression please please don't avoid seeking help, it's a legitimate medical condition that requires medical assistance!

667078 tn?1316004535
Even if you have MS you can still have anxiety. I take anti anxiety medicine and it make a big difference.

Avatar universal

This discussion has made me think of hypochondriasis. I haven't heard anyone called a hypochondriac in quite a few years, and I guess I always thought such people had a lifetime of illness perception, one thing after another. Often though, the complaints seemed to be pretty minor--just sort of 'sensitivity' to endless substances or situations. It turns out that this 'ain't necessarily so.' I did some Googling and found many interesting articles.

Wikipedia is where I started. Though I would never rely on that site for comprehensive health information, it usually provides lots of pointers and references. According to Wikipedia, though, hypochondriasis and health anxiety are synonymous. The point is emphasized that sufferers do feel and experience real symptoms, which is what we've agreed on here. People with this tendency tend to 'listen' to their bodies much more than others do, and then to focus and obsess, with consequences we sometimes see here. Other articles say very much the same thing.

The difficulty with this sort of obsession lies in convincing those afflicted that they indeed have this illness. If they don't believe it, they of course won't seek treatment. That reminds me of some of those who have schizophrenia--they stop taking their medication because they feel they don't need it, without recognizing that it's the medication that helps them towards the normal mental health they are experiencing, a circular argument. I am in no way suggesting that schizophrenia and hypochondriasis are equal in severity, but I am saying they may be equal in the denial factor.

Over the years we've seen many posts here from people who may or may not turn out to have MS, but what distinguishes a certain group is the hysteria with which they view the prospect that they do. Far from recognizing that MS is a serious illness which can be treated, accommodated and otherwise dealt with (though sometimes with difficulty), these people use phrases like 'my life will be over,' 'horrible side effects from medication,' 'I may as well die now,' and so on. I don't know whether they have reacted in such a manner to other issues in their lives, health or otherwise, but they certainly are catastrophizing in this instance. Not a good omen. When long-time MSers try to help them put things in perspective, such folks generally stop posting. They seem to want to hear that they are doomed. They won't hear that here.

JJ, you've made some excellent observations. Thank you, and thanks to others who are posting on this.

382218 tn?1341185087
All that said, it's also possible to have severe health anxiety about a real physical ailment that a person believes they have because they actually have it. As Alex points out, the two aren't mutually exclusive.  I was a basket case through much of the diagnostic process. Hysterical, inconsolable. Anxiety level climbing every day with every new symptom. It's not that I didn't want to hear that MS was manageable and not the end of my life, it's that I was fearful and I just didn't believe it. I had to work through it on my own to get to acceptance, which took about a year.

Hypochondriasis is a real phenomenon and must be torture for those living with it. Unfortunately too many patients, especially women, are written off by docs as hypochondriacs when they're truly suffering a physical ailment. I can't imagine how frustrating and isolating it must be knowing something is seriously physically wrong and being dismissed. I have no idea which is more prevalent, hypochondriasis or physical disease misdiagnosed as psychological, but if it's the latter it wouldn't surprise me based on how many anecdotes I've heard about women being dismissed by their docs. Avril Lavigne happens to be one currently in the news. She said for a year she had docs dismiss and infer she was crazy. Turns out she has Lyme disease. And this is a person of privilege with access to the best medicine.
Avatar universal
It's very true that some people do have serious illnesses that are undiagnosed. But as I said in my first post, 'Even when they actually do have MS or some other serious disease, they can be free from the terrible anxiety they also have.'


987762 tn?1331031553
Hypochondriasis was very old school, for decades the term generated hugely negative outcomes for patient care and recovery, it's been on it's ways out for a long long time and the latest Diagnostic and Statistical Manual of Mental Disorders (DSM-5) basically replaced-renamed-regrouped hypochondriasis and a few other similar conditions and basically took it out of general practice. Now there's technically only two classifications for many similarly related conditions (a) Somatic symptom disorder or (b) illness anxiety disorder.

There is always a lot of controversy with using umbrella terms instead of what things use to be labelled......I still have my knickers in a knot over Asperger Syndrome no longer being separately classified, all levels of Autism are now labelled Autistic Spectrum Disorder, which is not diagnostically helpful for the needs of an individual lol grrr lol knickers knotting lol grr

When ever interacting with someone dealing with extremely high levels of anxiety, you generally need to be very careful with your wording, because it's very easy to inadvertently feed someone's anxiety or be an unwitting target if your opinion doesn't support their thinking and they angrily react. Being online is open to many communication issues and with health anxiety, instead of providing a supportive educational platform, we can actually be enabling their obsession and adding fuel to an already burning fire.

So in order to be consistent with the aim to be a helpful, supportive and an educational community, I would strongly advice that no matter what you may suspect, to make a point to choose your words carefully when interacting with people who are afraid or highly anxious, just in case.....

Food for thought.........JJ  


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