Q: Hello Doctor!I am writing you in desperation, as I have essentially hit a crossroads with my health and the anxiety I have regarding it.I have suffered from OCD all of my life, but it was not until my early 20’s that I realized that most of my issues stem from my fear of death. And, when my physical health started to change last year, I developed an extreme case of health anxiety during the process. I found myself researching diseases obsessively in order to self diagnose my symptoms. One simple research would lead to a potential disease and so on and so forth, until I found myself imagining the worst case scenario.I have seen multiple doctors and have had multiple tests done, and although some have come back a little peculiar regarding my immune system (positive ANA, low Vitamin D, semi-low gammaglobulins) nothing has pointed to any definitive reason for my issues. I have had so many variables that took place when the physical symptoms started (a dental infection, stopping the long term use of antibiotics I was on for acne) that it is hard for me to know what is going on with my body and why. And, to make matters worse, they found Melanoma in my leg and I recently had to have surgery to dig it out. They got it all out, but now I am concerned it is somewhere else on or in my body since I had had past pre-cancerous spots on other places of my body. My symptoms have varied so much over the course of the past 9 months, but generally consist of the following:-Frequent migraines-Itchy Skin/Hives-Costochondritis/Chest wall tenderness-Random numbness and tingling (face and extremities)-Neck and throat pain, difficulty swallowing at times-Muscle/Bone aches and pains-Fatigue-Chronic runny nose-Random ringing/deafness in ears-Dry eye symptoms (itchy,pain, burning)-Vertigo-Bowel Issues-Classic anxiety symptoms such as panic attacks, racing heart and difficulty breathing deeplyThat is the best I can summarize the symptoms for you. I know some of them can be written off as anxiety related symptoms, but some simply cannot. Plus, I have suffered from anxiety all of my life and never had the majority of these issues until last year. I thought maybe it could have been from the dental infection spreading in my body, and could be related to an underlying infection…but it is hard to determine this when I have had a lot of the tests needed already to find infection. My CBC is always normal. I don’t run fevers. I have been tested for MS, thyroid issues, Diabetes, and many more things. I have had an MRI of my brain and cervical spine, and they are normal. I feel like I have had a million tests, but my anxiety and the continuation of my symptoms leaves me unsatisfied. I know there are still a ton more tests that could be done, and the amount of possible underlying issues are endless. This makes me very anxious, worried, and frustrated. I have read so many stories of people who had to see a ton of doctors before they finally found out they had a real medical disease. This makes me not want to just give up and instead to keep digging until I find the problem. But with this comes more anxiety. And, it is hard for me to know where a real physical issues ends and my anxiety begins. I am starting to feel hopeless. I know the anxiety over my health is not good for me, and I would like to get it under control, but it is hard not to worry or to simply give up on finding an answer when I am still suffering physically. I found a website for the Anxiety & Phobia Center in NY, but since I live in St. Louis…I would not be able to go. I did call though and that is when they recommended your book to me, Worried Sick? I have not ordered it yet, but I am going to. I am hopeful it can provide me some relief on this intense fear I have developed on death and disease. It might not take away the physical issues, but maybe it can help alleviate the anxiety that is accompanying all of this so I can see my situation more clearly and from a logical standpoint. I guess I am hoping that you will be able to provide me some advice for my unique and complicated situation. Thank you so much for taking the time to read this and I look forward to any response you can provide!
– Jenny G.
A: There is nothing unique about your situation. Of course, I cannot tell from this distance, with this information, if you have any obscure illness; but your complaints are no different from the dozens of people we see with health anxiety. Anxiety typically produces certain symptoms: stomach problems, headaches, other pains, etc. It does nt cause hives or some of the other symptoms you are talking about, but you do not realize how common these symptoms are. Certainly, the majority of men and women have had hives from time to time. Those who have health anxiety also are inclined to go to the web sites where sever hives conditions seem rampant. Then you will discover that out of the twenty or thirty causes for hives, some, like Lupus, are serious. Then you will focus on that most serious illness. If you read my book, you will recognize yourself on every page.
There are strategies you can take to get over this condition, but they are hard to summarize in one or two paragraphs. I will say, however, that the fear of death is not primary. (By the way, some people are afraid of the process of dying, some are afraid of being dead.) Under that fear are two other fears: the fear of helplessness and of being alone. Both can be treated in the present. There are also reasons why elderly people who are close to dying rarely worry about developing fatal illnesses. (relatively speaking.) Most of our patients are relatively young. You might get a better idea why this is true by reading the last chapters of “Worried Sick?
– Dr. Neuman