How I Beat Hypochondria
Like depression or anxiety, hypochondria is a recognized psychiatric disorder. Hypochondriacs exist on a continuum, from people who simply worry excessively about their health to those who are completely debilitated by fear.
I descended into hypochondria at age 39, when I found a tiny lump in my breast. Normally, I wouldn't have worried. My breasts are naturally very dense and lumpy, and my doctor had never seemed concerned. But this particular lump appeared during the most difficult time of my life——in the midst of watching my father die of cancer. Right after I found it, I went with my family to Dad's oncologist's office, where we would find out whether a hellish bout of radiation and chemo had killed the cancer growing in Dad's esophagus. While we waited, I looked at one of those plastic cards that explain how to do a breast self-exam. I was still holding the card when the doctor came in and clipped some x-rays to a light board. He pointed to a small dark spot on my fathers liver. The cancer was spreading.
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When I could stop crying, I realized I was still clutching the breast-exam card. It seemed like a sign. I went home and Googled “breast lump,” and what I read made my hands shake and my heart race. Suddenly, I couldn't think of anything else. In the shower, at the dinner table, driving the kids to school, all I could think about was dying.
After that, I really was sick——just not with cancer. Hypochondria might seem like a joke, a label you pin on a friend whose health dramas never amount to anything. But like depression or anxiety, hypochondria is a recognized psychiatric disorder (it affects an estimated 1 to 5 percent of Americans). And, like those disorders, it exists on a continuum, from people who simply worry excessively about their health to those who are completely debilitated by fear. True hypochondriacs don't just make up fake symptoms and imaginary pains in a bid for attention. Instead, every time a genuine symptom appears, they believe that something is terribly wrong. When a test turns up nothing, a hypochondriac worries anyway, sure the next test or doctor will uncover a serious or even fatal illness. I didn't imagine the lump in my breast. What made me a hypochondriac is that no reassuring mammogram, ultrasound, or MRI could ever convince me I wasn't dying.
After that first, panicky Google search, I went straight to my OB-GYN's office to get the lump checked out. As a nurse gently prodded and kneaded, I chatted with her, trying to calm myself down. I was probably overreacting, I said, and explained that my father——the one person who could make me feel both completely protected and completely sure of my own strength——was dying. As close as Dad and I were, it was hard to separate what was happening to him from what was happening to me. The nurse nodded kindly. Then she said, “Oops, there's a mass.”
A word like “mass” has a way of stripping all logic from the conversation. The nurse said it was probably nothing, but I needed a mammogram and an ultrasound to be sure. She told me repeatedly that this mass did not feel like cancer to her, that 80 percent of lumps, even the really suspicious ones, don't turn out to be cancer, that it was “not time to start planning my funeral.” But to a woman with a mass in her breast and a dying father, the word “funeral” works like a dirty bomb, exploding into fragments that lodge deep in the brain.
The tests only confirmed that I have extremely dense breast tissue——the kind that makes it nearly impossible for a radiologist to see anything in a mammogram or an ultrasound. The next step? A biopsy. That turned out fine, and the cheerful surgeon reported that he wasn't worried about me at all. But then he said I needed to return for another ultrasound in three months. Was he hiding something? If there was nothing amiss, why did I need to come back?
As it turns out, dense breast tissue is a risk factor for cancer, which is why neither that surgeon nor one I consulted for a second opinion would give me an all-clear. Three times that first year, I returned for scheduled exams. On two other occasions, I showed up with new lumps I was worried about. Every time, my test results showed nothing wrong. But instead of feeling relieved, I would brood about the cancer in hiding, the one the doctor didn't catch.
I got so worried I could hardly work. I canceled dinner parties, refused to plan for the future. When decorations went on sale after the holidays, I'd think, “I might not live to see next Christmas,” and buy nothing. Meanwhile, my parents came to stay with me and my family, so I could help Mom care for Dad. One of my sons, trying to understand his grandfather's illness, said, “You aren't going to get sick, too, are you, Mommy?” He looked up at me trustingly, and the fear rose up in my throat so thick I could hardly breathe.
Before long the stress led to more symptoms that seemed to warrant follow-up: insomnia, heart palpitations, irregular periods, a constant stomach-ache. Over the next few years, I had pelvic ultrasounds, a colonoscopy, an endoscopy, a colposcopy, an EKG, and countless blood tests——and nothing was wrong. Most of the tests, I suspect, were ordered by my amazingly patient doctors to quell my fears. But the more testing I had, the more worried I became. Good test results were no solace during the three years it took my father to die, and the grieving year afterward.
For people debilitated by hypochondria, antidepressants and therapy may help. But I never considered these options, because, like so many hypochondriacs, I didn't realize I was one. What “cured” me is the fact that I didn't die. Time passed after my father's death, and I began to recognize the connection between my fears and my grief over his loss. I realized that even if I couldn't banish that fear entirely, I could take steps to keep it from spiraling out of control. Eventually, I stopped thinking of my body as a time bomb and began, finally, to think of it as the very thing that lets me live a happy life.
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These days, I sleep better, and I laugh more. Checkups still make me nervous, but I talk myself out of the tree by remembering all the tests and biopsies that turned out fine. I no longer Google every little ache and pain because of the inevitable caveat: “Rarely, these are also symptoms of a more serious condition.” Instead, I take a wait-and-see approach. I'm more likely to worry if I'm exhausted or stressed, so I get eight hours of sleep, and I never skip my workout. I have a happy marriage, healthy children, deep friendships, interesting work. That's always been true——by themselves, such blessings are no protection from hypochondria. But I now understand that a constant fear of death is the surest way to ruin my own blessed life. And in its own way, my bout with hypochondria has turned out to be a gift. The daily irritations that used to drive me to distraction——traffic delays, flaky coworkers, cancelled appointments——hardly touch me now. Im too busy feeling grateful to be alive.
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