Article re Swedish Study on Health Anxiety by Stephen Hughes, "The Conversation"

MATD · Mar 25, 2024

As I said, it’s a delicate balance. I’m not an advocate of dismissing anything as anxiety until proven otherwise. Read my posts. Avoiding screenings can be detrimental for one’s health. Read my posts. Every case of anxiety is an individual case, based on the thought patterns of each individual. Running to the doctor for every little symptom that turns out to be anxiety related is also detrimental, and we do become known as a “ frequent flier.” Thus we become a victim of our own folly. Acceptance is not meant to take the place of common sense, but common sense has been replaced by fear in a lot of folks with anxiety. Acceptance is practiced to relieve the fear and therefore common sense can be regained. Acceptance is not going to stop one thing from happening to us outside of our control. It is a delicate balance, there are no answers to the dilemma. Life is not a happily ever after fairy tale, things happen, no guarantees that we will be fine, it’s just the way it is. All anyone can do is their best at any given time under any given circumstances. One thing I do know for certain, practicing acceptance has helped me see things more in tune to reality, and it’s my choice to fight and fear reality or accept it as it is and choose to keep going forward and learning. If I die tomorrow, I’ll know I died trying instead of letting fear win.

blueberries · Mar 25, 2024

What a great article (I googled it - it looked interesting). Neither the title nor your post triggered me. The article says a lot of what I think, it's really important to get symptoms checked out. I remember years ago I saw a book in the bookstore titled "Even Hypochondriacs Get Cancer" amd unfortunately that is so true. I am so tired of seeing posts (not just here but other sites as well) where someone mentions a symptom, such as palpitations or nausea or shaking, and the responses tell that person it's anxiety and they need to "accept" it and once acceptance comes they can get on with their life. Well it might be anxiety and it might not. That list of 100 (or 200 or 500 depending on where you look) symptoms of anxiety is ridiculous as everyone has symptoms on the list and probably more than 5 or 10 of them. Could be anxiety, could be normal body rhythms, could be heart disease, could be ALS. And the symptoms listed are so similar to other lists such as PMS, thyroid disorders, vitamin B12 deficiency, magnesium deficiency, chronic fatigue syndrome, chronic lyme, gluten intolerance, etc.) It's not fair to label someone with anxiety until everything else has been ruled out, and even then it still might not be anxiety but something the doctor hasn't looked into. Unless someones symptoms are very obvious, such as a heart attack or strep throat that's confirmed with a throat culture, doctors often assume the least case scenario and go the wait and see route, for both with those with HA and those without.

The article did make note of a couple of reassuring things - hypochondriacs had increased risk of dying from heart attacks and respiratory disorders but not cancer (good news for us cancer-phobes); lifestyle factors may play a part in this as those with anxiety generally smoke and drink more than those without; the main cause of unnatural death in those with HA in this study was by suicide (4 times than that in the non HA group), this of course is preventable and also accounts for a good piece as to why the death rate is higher in those with HA.

I wish every doctor would read this article and take it to heart. They are so rushed and under so much pressure and that makes it so much easier to dismiss patients. When so many symptoms can be either that of anxiety or that of something more serious, it's hard for a doctor to know which way to go.

One intersting thing he wrote - he uses the term IAD, short for illness anxiety disorder. So we've gone from hypochondria, to health anxiety to IAD. I never heard of it refereed to as IAD (I like that term) but upon googoling it I see it's now the accepted term in the psych world.

MATD · Mar 25, 2024

blueberries said:
Back when I started having major a & d symptoms, I was put through quite a few tests, including EEG and a lot of blood work searching for physical causes. I don’t know if that’s still done now or not. But in my opinion it was beneficial to rule out other causes beforehand. Then there isn’t such a dilemma about how to deal with the issue. There is also the issue of educating the patient, or the lack of it. I would hazard a guess and say that the doubt/inability to believe on the part of the anxious patient is the biggest obstacle in treating that anxious patient. It would have to account for the vast majority of repeat patients in the ER and doctor’s office. A little knowledge could go a long way. Unfortunately the system isn’t geared toward educating the patient. Digressing here but it’s all connected in the big picture.

bigjetplane23 · Mar 26, 2024

Wow! Interesting.

Jonathan123 · Mar 26, 2024

Neither MATD or I have ever advocated acceptance without first getting medical advice. I wonder why acceptance is regarded as something so complicated? If the doctor has ruled out any type of physical illness then it must be anxiety. Why is this simple fact so difficult to understand?
Why would acceptance be a'big mistake'? What is the alternative? Medication can never 'cure' anxiety. No one should ever suggest the symptoms are not real but 'imaginary'. The pain felt and the emotional response is only too real, but it is not a physical but a mental one. For anxiety to occur there must be a conflict in the mind, a tug-of-war going on. resolving the conflict is what good counselling is about. I do know for a fact that acceptance combined with mild medication and, if possible, good counselling can work wonders.
It is really a case of take it or leave it. I would never suggest acceptance is for everyone.

Iugrad91 · Mar 26, 2024

Acceptance doesn’t mean avoidance, ignorance, or inaction. Its the mindset that leads us toward an appropriate response to our thoughts or sensations, accepting that we are having these issues and it is what it is. When our thoughts run away to the worst case scenario after feeling/thinking something (headache=brain tumor) that’s when we get into the anxiety spiral. Training your mind/body to have the appropriate reaction to a thought or sensation thru acceptance is how we free ourselves from the anxiety loop. Instead of skipping over all the most likely possibilities and fixating on the worst case scenario, we can stay in a rational mindset and take appropriate action when warranted.

MATD · Mar 26, 2024

Health anxiety suxs said:
Taken together, these findings illustrate a paradox, whereby individuals with hypochondriasis have an increased risk of death despite their pervasive fears of illness and death. In this study, most deaths could be classified as potentially preventable. Dismissing these individuals’ somatic symptoms as imaginary may have dire consequences,” the researchers concluded in their study.

This refers to people "accepting" the "fact" that they have anxiety causing their symptoms. This results in one of two things: Either the person doesn't see their family physician, or they do, and the doctor dismisses their symptoms as anxiety when in fact a true health issue exists.

How does this quote have anything to do with “accepting” the fact that we have anxiety symptoms? What I could read in it is that the article is talking about folks with anxiety avoid doctors/screenings. Look at the posts on here of folks who avoid the doctors out of fear of what they might be diagnosed with. How many of them go frequently to the doctor because of “symptoms”? How many of them are probably considered frequent fliers, not being taken seriously by their doctor? How many have been diagnosed with anxiety but cannot believe their doctor, insisting there is something else wrong, especially a very serious illness? The paradox is not about those who “accept” their symptoms as anxiety. It is about those who fear going to doctors and doctors who fail to take frequent fliers seriously. That is what I take away from the quote. Again, it is a delicate balance and has nothing to do with acceptance. Fear has replaced common sense in folks with anxiety. That is the real paradox. Fear keeps us from using common sense and logic. Instead we allow fear to dictate our choices. That’s how we become a victim of our own folly, we literally damn ourselves.

blueberries · Mar 27, 2024

I think it's a big problem that doctors don't take symptoms seriously or that there is a medical error somewhere along the line. This is the major reason why I can't just "accept" that the doctor is right and move along with my life. IF what the doctor says is without a doubt 100% correct, and IF I'm told what I have isn't serious and there is no need to worry about it than I could accept that and get on with my life. BUT doctors are wrong, many times, and often very wrong.

Triggers below - times the doctors were totally wrong in my own life

1) Several years ago I was told mammogram was fine, no problems. Next year when something showed up on my mammo they looked back a year to compare and saw that I had the problem the previous year and it has since grown. Diagnosis of breast cancer given (good news is that it was caught early and I'm supposedly okay now).

2) At doctor visit I told him I needed a prescription renewed. Picked it up and came home to discover he had put the prescription in for twice my normal dosage.

3) Doctor ordered abdominal ct scan for ongoing problems, he said he's putting in the order to include barium to drink beforehand and while I'm there, contrast solution and one other thing (can't remember what that was). For whatever reason he only ordered it with the contrast solution so who knows what was missed on that scan.

4) Had deep pounding headache for several days, PCP said it definitely wasn't a migraine and sent me to neurologist. Neurologist said it definitely was a migriane. One of the two has to be wrong.

5) Was in the ER (not for influenza but I happened to have it at the time). Told the doctor I think I have influenza (this was in peak flu season), gave him symptoms of 5th day of temp 102+, headache, sore throat, cough, respiratory symptoms, everything hurts, feel like I'm dying. He said I couldn't possibly have influenza as I have no symptoms at all of it. I asked what the heck symptoms don't I have? He said my fever isn't high enough and I'm not vomiting. This was plain stupid of him to not know the symptoms of influenza.

6) I've suffered from ongoing severe vertigo issues and have received various diagnoses - meniere's, atypical meniere's, it's not meniere's, vestibular migraine, virus, labrynthitis, delicate vestibular system, etc. I don't think I have all of these so at least one of the doctors has to be wrong.

7) Called PCP because I was the sickest I've ever been with fever of 103+, multiple symptoms, could barely move, he told me to go to ER. After 3 negative covid tests, negative flu and RSV test, blood work, I was told my blood work is fine, I have a virus, go home and take aspirin. This is despite me telling er nurses and doctor several times that I think I have a tick born disease as I was hiking in a heavily tick infested area the previous week. Doctor told me that is very rare, highly unlikely and I have no symptoms of a tick disease (I had every symptom). I come home, look at the blood work and see that 1/3 of the items were off, particularly those that are consistent with a tick disease. Went to PCP, sure enough I had anaplasmosis and needed antibiotics asap.

8) Went to urgent care for chest pain, thought it was a pulled muscle but wanted to make sure. They did blook work, I was told some items were seriously off and I need to see my PCP asap. I looked at the blood work and see they were off almost to the point where I would need to be hospitalized. Went to the doctor, he looked at it, scratched his head and said "huh, I've never seen this except in the case where someone has had their (?) removed." So he redid the blood work and everything came back fine. He said they either mixed my blood up with someone else or the machine was broken. All I could think was there was a elderly man in the waiting room looking very unwell. And if my blood was mixed up with his he probably went home thinking he was fine.

9) Another time some blood work was off (not as bad as up above). Doctor wanted to repeat it and had me f/u in 2 weeks. Went back and he checked my heart, bp, asked a couple questions, etc, and then stands up to leave and tells me to come back in 6 months. What about my blood work I asked? Turns out the lab never sent it to him, he had no note that that is why I was back for a f/u, he didn't check before my appointment to make sure he had the blood work. Blood work was fine this time but if it hadn't been that would have been a problem especially if I was the type of person to trust the medical system.

I could go on with even more. When things like this happen to me over and over and over it gives me good reason to mistrust doctors and feel the need to question everything and personally look at my test results. Doctors are people and they make mistakes. This is what needs to be accepted, not that everything they say is right.

Missy · Mar 27, 2024

Iugrad91 said:
Acceptance doesn’t mean avoidance, ignorance, or inaction. Its the mindset that leads us toward an appropriate response to our thoughts or sensations, accepting that we are having these issues and it is what it is. When our thoughts run away to the worst case scenario after feeling/thinking something (headache=brain tumor) that’s when we get into the anxiety spiral. Training your mind/body to have the appropriate reaction to a thought or sensation thru acceptance is how we free ourselves from the anxiety loop. Instead of skipping over all the most likely possibilities and fixating on the worst case scenario, we can stay in a rational mindset and take appropriate action when warranted.

Well said!

MATD · Mar 27, 2024

Missy said:
Well said!

Agreed!

PieFan · Mar 27, 2024

I wonder just how much this discussion has to do with the fact the anxiety disorder is not taken seriously by many people? Tell someone you have a cancer diagnosis they will react very differently than telling them you have anxiety disorder...yet both are life-changing and potentially life-limiting.

MATD · Mar 27, 2024

PieFan said:
I wonder just how much this discussion has to do with the fact the anxiety disorder is not taken seriously by many people? Tell someone you have a cancer diagnosis they will react very differently than telling them you have anxiety disorder...yet both are life-changing and potentially life-limiting.

I can certainly vouch for the life limiting in that it has limited me to live a better quality of life, although I do have good health, the only med I take is a very low dose antidepressant. At 65, that ain’t bad at all. Mental illness/ disorder has only recently came out in the open as compared with physical illness. Mental patients were often shipped to sanitarium’s, hidden from public, etc. And that was only back in the 50’s or so. God only knows how folks were dealt with before that. I’m not up to snuff on that information but I can only imagine the horrific treatment they probably endured.
I can’t say for me personally that I wasn’t taken seriously by any doctor but it’s not a far stretch to see how one would not be taken seriously. I’m grateful that I didn’t have to deal with that issue. My biggest complaint in the mental health area is the lack of professionals who don’t seem to understand that a little education for the patient would go a long way in benefiting the patient. And this could be said for physical illness as well. Of course our mental and physical health facilities are more geared toward acting as a business, an assembly line if you will. Not enough time for each patient. In and out in under 15 minutes. I found that in order to recover, I had to educate myself with what information I can find. I thank God every day that I found Dr Claire Weekes.

Iugrad91 · Mar 28, 2024

Blueberries, there is never going to be a time where something is 100% correct or you know without a doubt that you are fine. That’s life, so to speak. They can be as sure as they can be at that very moment. But something sinister can start happening the next hour, day, week, month. There is no way to ever be 100% certain, and that uncertainty is part of what we have to accept. There is no way around that and fighting it is futile.

Jonathan123 · Mar 28, 2024

Health anxiety suxs said:
Taken together, these findings illustrate a paradox, whereby individuals with hypochondriasis have an increased risk of death despite their pervasive fears of illness and death. In this study, most deaths could be classified as potentially preventable. Dismissing these individuals’ somatic symptoms as imaginary may have dire consequences,” the researchers concluded in their study.

I totally disagree that people with anxiety have a greater risk of death. This is not bourn out by fact. My father had anxiety for most of his life and was 93 when he died, as did his mother who was 101 when she died. On the contrary, it has always seemed to me, bourn out of experience, that anxiety sufferers often live long lives, but sadly not very happy ones. What facts suggest that this suggestion is valid? Some of these so called 'studies' really annoy me. They usually come from those with no experience of anxiety, and being so are no way capable of comment. I have never given birth, obviously, so for me to comment on the pains of labour would be presumptuous. So many so called 'experts' and medics so often dismiss it as 'all in the mind'. Of course it is, where else would it be? But that does not stop it being described as an illness like any other. People will give you 'an organ recital' about physical illness, but when it comes to anything mental they usually clam up. Physical problems are usually easy to understand, mental problems are not so easy to contemplate so that when discussing these matters people tend to shy away because of fear.

PieFan · Mar 29, 2024

Jonathan123 said:
I totally disagree that people with anxiety have a greater risk of death. This is not bourn out by fact.

It depends what you mean. Studies show that anxiety disorders increase the risk of cardiovascular disease (and also that people with cardiovascular disease suffer greater anxiety disorder symptoms)

Anxiety as a Risk Factor for Cardiovascular Diseases

www.ncbi.nlm.nih.gov

Anxiety disorders and cardiovascular disease

Anxiety and its associated disorders are common in patients with cardiovascular disease and may significantly influence cardiac health. Anxiety disorders are associated with the onset and progression of cardiac disease, and in many instances have been ...

www.ncbi.nlm.nih.gov

Anxiety as a risk factor for cardiovascular disease independent of depression: A narrative review of current status and conflicting findings

The aim of this paper is to summarise and evaluate the empirical support for the association between anxiety and cardiovascular disease (CVD) and to address challenges related to method and study design. We review results from meta-analyses and more recent ...

www.ncbi.nlm.nih.gov

There are hundreds of studies and it was a 2017 Harvard Medical School article which pointed out the 'complex connection'. Because a small burst of adrenalin or cortisol starts off as motivating, invigorating, but a pattern of excess stress hormone responses is like a pattern of any other accelerated hormone or other biochemical response: it no longer produces beneficial/useful effects and leaves the brain and the body with a bunch of toxins to diffuse and excrete.

The truth is all 'mental illness' is actually a 'physical illness'. The brain is a physical organ. Our human experiences via the brain are subjective at the level we interpret them, as computers with a screen, a camera, a central processing unit, a database...silly metaphor but it's true. We are at our baseline human experiences a bunch of complex biochemical and electrical reactions and interactions. When we examine amoeba or plants or even early apes we apply analytical approach to our metaphysics, and it makes better 'scientific' sense, but the products of our infinitely more complex chemistry, language, imagery, metaphor, memory etc give us a level of 'reason' which really isn't reason except on its one level. That's why it's so hard to turn 'soft' social science into 'hard' science.

*

Do medics dismiss childbirth pains in our era? If you know of any in the civilized world let me know and I will write and enlighten them!

*

God is not meant to be defined, really. Spirituality is the gap between mental interpretation and physicality. Oh goodness, the more I think about this, the more I could start writing a philosophy thesis! Sorry @Jonathan123

Jonathan123 · Mar 29, 2024

I do see what you mean, but I still question whether anxiety can cause early death. We can overthink and turn the whole of the suffering into a thesis that most universities do. I have said before and I make no apology for saying it again, unless you have been there all the essays in the world will not help one bit. Can I ask a question? What good does all this talk do for sufferers? We can get into profound conversations about 'IT' but that does not help at all.
Our thought processes are the cause of anxiety, but I have always felt that the mind is separate from the brain which, after all, is only an organ like any other, but does respond to its master, the mind. What is the mind? Ah now that is where we enter the metaphysical realm. When we say 'I am suffering' who is it that is suffering? ME! But who is ME?
ME is a bundle of emotional feelings laid on us by our contacts in this world where we are subjected to ideas and concepts that are mostly erroneous. In other words we are brainwashed into beliefs that have no basis in fact.
So we develop personalities that are unique to each individual. That is the 'ME' that suffers. But is that really me or is there 'the ghost in the machine'?
Most therapies today are all about mind and body, but I always add that indefinable word Spirit. It's what separates us from the animals. The lack of the spiritual dimension in therapies means they are incomplete. This is not about religion, which to me just causes more problems than enough, but that something in mankind that gives us empathy, caring, understanding and the ability to help others. It's not that others don't have it, we all have, it's just that it's not recognised. How many of these so called 'studies' involve a large number of people. University students are not pollsters and have access to a limited number of people. I notice that the word 'may' be causing the problem is used, 'not is' but 'may be'. Hedging our bets?
Thanks for your post. We can always agree to disagree in an amicable way.

MATD · Mar 29, 2024

God is not meant to be defined, really. Spirituality is the gap between mental interpretation and physicality. Oh goodness, the more I think about this, the more I could start writing a philosophy thesis! Sorry @Jonathan123
[/QUOTE]
I have to respectfully disagree. God can easily be defined. He wants us to know who He is and what He is. We have proof of that in His letter to us, the Bible. As a matter of fact, he wants us to know all about Him. “Let us create man in our image” is the first indication. If we are created in His image, then we obviously have the capability of defining who and what God is. His Image is not limited the physical appearance. All through His Words to us He gives us great information about Himself. He is full of love, He gets angry, He gets jealous, He is regretful, He is vengeful, he desires perfection, He demands order, He is forgiving, full of patience, gentle, compassionate, I could go on. He shows us his character all through his Word. We share the same traits He has. He is our creator, He wanted us, therefore He created us out of that desire. He loved us enough to give us free will, to have the choice to return that love. That tells me that He wants to be loved too. Just like we want to be loved. And while we may not understand all about Him, I think He gave us enough evidence to be able to define who He is and what He desires. That’s what spirituality is. Being personal with our Creator and growing to understand who He is and returning our love to Him. It’s not really such a big mystery.

blueberries · Mar 30, 2024

Iugrad91 said:
Blueberries, there is never going to be a time where something is 100% correct or you know without a doubt that you are fine. That’s life, so to speak. They can be as sure as they can be at that very moment. But something sinister can start happening the next hour, day, week, month. There is no way to ever be 100% certain, and that uncertainty is part of what we have to accept. There is no way around that and fighting it is futile.

Right, nothing is ever 100% certain. What I’m saying is that some posters say they were told by a doctor that they are fine, yet they still worry. And the responders tell them they need to accept what the doctor says as truth. The problem is, doctors can be wrong, doctors can be dismissive, doctors don’t always take patients seriously, especially “frequent fliers.” I wish it weren’t so, I wish I could have more faith in my doctors, but I’ve been dismissed too often and have had way too many medical errors to be able to “accept.”

Iugrad91 · Mar 30, 2024

But what would it take to finally make you feel ok with what the doctor says? If you are looking for absolutes, you’ll never get it. So you keep pushing and pushing to get a diagnosis for something that isn’t there, which keeps your anxiety going at the same time. So either you accept that you can’t be 100% sure or you keep looking for answers to an unanswerable question. If there’s nothing wrong with you, no amount of testing can give you peace because you’ll always doubt it.

Article re Swedish Study on Health Anxiety by Stephen Hughes, "The Conversation"

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