Irrational vs rational

[KayeS]

I was just having some thoughts on something, and thought I'd share.

I feel like there is a distinction between someone who suffers mainly from irrational health anxiety, and someone who suffers from more rational health anxiety, but has difficulty in managing the 'worry'.

What I mean here is, for example, someone with irrational health anxiety may do things like imagine symptoms, not trust what doctors tell them, second guess test results, be utterly convinced they have something, and then when symptoms eventually go, it's almost as if they completely forget what they were like.

I don't feel I fall into that category. I was thinking about all the times I've had health anxiety over the years, including currently, and I've never really been like that. My health anxiety has, 90% of the time, been triggered by REAL symptoms, that just turned out to not be serious in the end. Now, I am guilty of one thing, I will hold my hands up to it. I do assume the worst. For example, last year I was having all sorts of neurological symptoms and I thought I had a brain tumour, or MS, or ALS etc... and underwent every test under the sun. Once I had all of these tests however, and everything was ruled out, I was happy with that and I accepted that it can't be these illnesses. HOWEVER, to this day, I STILL HAVE the symptoms. Something odd is most certainly going on with my body, however I am confident that it's nothing life threatening and I can live with it.

My point is, my symptoms didn't disappear after certain conditions were ruled out. So I wasn't imagining them. They were real, but just turned out to not be what I thought they were indicative of. I feel that my problem is that I worry too much about things that are genuinely there, and until I find out what's causing it, or at the least rule out the worst, then I can't relax or focus on anything else. But I VERY RARELY actually imagine symptoms.

I've been recently posting about a mole I've been worried about. Ive been worried about this type of thing in the past. But the thing is, like with a mole I had checked out last year, it had GENUINELY changed. Absolutely no doubt about that. And it would have actually been naive of me to ignore that. It turned out to be fine, however the advice is that any mole that has changed, should be looked at. Again, my problem is that until I'm told all is well, I get complete tunnel vision about what I'm worried about and can't think of anything else.

I think sometimes anxiety is warranted, and actually NORMAL. Some people however can put their anxiety to the back of their mind and get on with things, whereas I for example cannot.

[countrygirl]

I have always said that if I didn't have any symptoms I would not have health anxiety because its the symptoms thats cause the panic and I was told that everyone has symptoms its the way we react to them that makes a person with health anxiety. So for example my husband will get a headache and other than feeling annoyed to have a headache and needing to take painkillers it will never enter his head that the headache could be from something like a brain tumour. If anyone on here gets a headache I bet everyones first thought even if only for a second is " omg what if this headache is because i have a brain tumour". This is health anxiety.

There are people who make up symptoms to get attention but this isn't my definition of health anxiety to me its more like munchwhatsists syndrome.

[KayeS]

True in some cases, but I believe there are also people who might see or hear about a disease, and then before they know it, they think they have it.

[Alamie]

I'm the exact same as you. Always told I'm creating it etc but honestly I worry about real symptoms. Like I have three lymph nodes constantly swollen in my neck was convinced I had lymphoma seen a haematologist etc the lumps are still there but I'm no longer worried. My new wprry is also from real symptoms and I'm shitting my pants but I now think this is the time I definitely have something wrong :(

[misskittie]

Yes exactly and that's why I get so frustrated and go to doctor after doctor to try and get some diagnosis!!! I had a pain in my leg for 2 months that yes I blew out of proportion swearing it must be a blood clot but when you go to 6 different doctors and they're all like no it's just your anxiety take these pills so then I put up the money to see a physical therapist who has me walk a few steps and goes oh that's easy you tore your soleus muscle. It takes away my faith in doctors as well to have them brush me off like I'm not actually feeling what I'm feeling. The past 6 weeks now I've been dealing with abdominal pain really bad. Can hardly eat and am scared when I can if I'm just going to be in pain afterwards for days. Now I'm being told it's just my stress levels and I should learn to relax and I would feel better. Why because I have anxiety am I not allowed to have an actual ailment?

[MyNameIsTerry]

Some people are so convinced that people may consider them delusional but thats not the case since someone with delusions wouldn't be on here as they wouldn't be questioning the fact of whether they had something, they would believe it 100%.

Health Anxiety is a term you won't find in either of the 2 major diagnostic manuals. It can be categorised as an aspect of GAD or be a standalone disorder where it starts falling into the Somatoform Disorders category (if you are using the WHO manual) and these don't talk about delusion. BUT they do mention a tendency to keep asking for tests and not believing doctors.

I reckon when it comes to the difference on here between those who understand it's just anxiety but still have the worry of something more sinister vs. those who cannot see it probably comes down to severity level in some cases but there are clearly people more severe that also seem to realise it but don't fully accept it as well. I can't see a distinction in the manual I have read to try to get a better understanding of this which makes me think about severity.

The thing is, the same can be observed in OCD. I've seen it on here. Some people know its anxiety and others cannot accept it and keep asking the same questions and creating more threads. From my own experiences with OCD, some of these people are certainly severe but I don't think all of them are.

So, maybe its not only severity but aspects of personality? I can look at the key traits in Personality Disorders and pick the odd one out of several of them. I can pick the minimum 4 out of OCPD, but I know I don't have that as I don't fit the required mindset. But perhaps some people have certain personality issues that don't make them have a PD but it does add to the belief in their obsessions?

[percythetrain]

Hiya KayeS, I'm not sure I understand what you mean in the sense that my understanding of health anxiety doesn't involve delusions as in a person who has no symptoms, say a person who imagines they have a rash but there isn't one. I think what you're describing there is something closer to a psychosis with a health theme attached to it.

In my understanding, health anxiety predisposes a person to blow their actual symptoms out of proportion, to imagine the worst, and to seek reassurance through doctors and exams. According to my therapist, as a human being we're all going to feel physically ill once in a while. We're all going to vomit, have diarrhea, get rashes, have aches but while most people are able to remain calm and objective, the anxious person will basically freak out and remain in that mode for a long time. That doesn't mean that the initial symptoms were a figment of their imagination.

For example, I've been having very conspicuous muscle spams where my calves would visibly move on their own and it was impossible to miss by any observer and just freaky. The neurologist did not feel they were related to a terminal illness, but he did acknowledge them as real and prescribed B12 as well as upped my clonazepam because he felt they might be caused by stress.

[Justanutter]

Hypochondria is the persistent conviction that one is or is likely to become ill, often involving symptoms when illness is neither present nor likely,and persisting despite reassurance and medical evidence to the contrary.

Health Anxiety is an exaggerated fear of physical illness.The principal feature of this condition is the tendency to attribute ordinary physical symptoms to some obscure but serious illness. Reassurance by doctors provides no comfort, but rather serves paradoxically to maintain,even worsen,those fears. When someone is seriously affected,he or she may go from doctor to doctor, distrusting what they say,yet demanding more and more attention and laboratory examinations.They distrust their physicians' advice. They are fearful of medication. They are resistant especially to a psychological explanation of their symptoms. Their behavior may seem ridiculous to others,even to themselves,but their distress is considerable. Their preoccupation with their physical condition often worsens to such a degree that their social and marital lives suffer and their ability to work is impaired.

Got this from the internet as I also sometimes fail to understand the difference and get annoyed when my family call me a hypochondriac....:weep:

[damianjmcgrath]

Can I add my 2 cents in? I find the definitions difficult to understand, because:

I have chest pains. They are probably caused by anxiety but obviously there's a 1% chance it's caused by a heart problem that has somehow evaded tests. Chest pain brings about justifiable fear. It's normal to be afraid of a heart attack. That would be reasonable fear.

I'm not sure if that counts as hypochondria because I don't think I'm going to be ill, I genuinely do feel bad.

I'm also not sure it counts as health anxiety because I haven't exaggerated the symptoms, I know exactly how bad they are, and that's whats causing me fear. I also don't think it's an obscure illness, I think it's a bog standard heart attack. I know of some people who had normal test results and still had heart attacks, so it's possible, so it's not that obscure.

The only bit of the definition that fits me is the distrust of doctors advice. I accept that I should believe him. But in my head, doctors need to work on averages, and if someone my age (30) with no history and normal test results comes in, he goes with the normal diagnosis of anxiety. There will inevitably be people outside the average that have genuine problems that he's missed. Being afraid of that definitely isn't useful, helpful or worthwhile, but I don't think it's that unreasonable.

[percythetrain]

Hi justanutter, that was helpful. I wasn't aware there was a difference between health anxiety and hypochondria. Although hypochondria does seem to have uglier connotations, I guess because people tend to joke around about it.

Hi Damian, I know what you mean. I have a similar issue. For example I've been having very bad head pressure and neck palpitations, so I used one of those online medical advice services and the doctor who answered my question was concerned! He said it could be my carotid and I need evaluation and imaging ASAP. Then the doctor I saw locally said he wouldn't worry about my carotid. But who am I to believe, the online doc or the offline one LOL But yeah there's nothing imaginary about my symptoms either :doh:

[Fishmanpa]

Can I add my 2 cents in? I find the definitions difficult to understand, because:

I have chest pains. They are probably caused by anxiety but obviously there's a 1% chance it's caused by a heart problem that has somehow evaded tests. Chest pain brings about justifiable fear. It's normal to be afraid of a heart attack. That would be reasonable fear.

But a 1% chance is not a reasonable fear especially in light of clear medical exams and tests.

Positive thoughts

[damianjmcgrath]

I think if there's a chance of something happening, it's reasonable to be afraid of it. Like fear of flying or fear of being bitten by spiders. Or the fear of a bungee cord snapping. All of those are unlikely, probably less than 1% likely but it's still normal to be afraid of them. In my opinion, it's normal to be scared of chest pain, especially persistent and progressive pain which anxiety tends to give me.

I wouldn't classify myself as being a hypochondriac. I don't think I've got every illness. I'd classify myself as having pains from an unknown origin, that I worry about. I'd probably call that health anxiety, as in, I'm anxious about my health. Either justifiably or not, I'm still anxious.

I'm probably talking rubbish. My opinions are probably why I still suffer from the anxiety. But I think my reaction of worry is normal based on the symptoms I get. Test results take away some of that worry but not all, because I haven't had all tests.

If there was a test that completely ruled out all heart problems, my worry would stop tomorrow. It wouldn't move onto another area. I'm not anxious generally. I'm anxious specifically.

[Fishmanpa]

I think if there's a chance of something happening, it's reasonable to be afraid of it. Like fear of flying or fear of being bitten by spiders. Or the fear of a bungee cord snapping. All of those are unlikely, probably less than 1% likely but it's still normal to be afraid of them. In my opinion, it's normal to be scared of chest pain, especially persistent and progressive pain which anxiety tends to give me.

I wouldn't classify myself as being a hypochondriac. I don't think I've got every illness. I'd classify myself as having pains from an unknown origin, that I worry about. I'd probably call that health anxiety, as in, I'm anxious about my health. Either justifiably or not, I'm still anxious.

I'm probably talking rubbish. My opinions are probably why I still suffer from the anxiety. But I think my reaction of worry is normal based on the symptoms I get. Test results take away some of that worry but not all, because I haven't had all tests.

If there was a test that completely ruled out all heart problems, my worry would stop tomorrow. It wouldn't move onto another area. I'm not anxious generally. I'm anxious specifically.

Taking your logic... are you afraid of being in a car accident? (1 in a 100) What about getting arthritis or getting the flu? (1 in less than 10) I'll take 99% chance of nothing over a 1% chance of something any day!

Your post definitely has some denial in there. You're justifying your fears. Our bodies are noisy. It's totally normal to get aches, pains and other things and the older you get, the more there are! It's our reaction to them that dictates whether it's irrational or rational. I have heart disease. I get chest pains. Not every stitch or ache is a heart attack. I've had two so I know. I actually have a much greater than 1% chance of having another one or get cancer again but I've learned to quell and deal with the negative thoughts and worry over it.


Positive thoughts