
How Worrying Can Actually Make You Sick - hellofunk
http://time.com/4554795/hypochondriac-heart-disease/?xid=newsletter-brief
======
petercooper
I'm currently enjoying a book called _It 's All In Your Head_ by an Irish
neurologist called Suzanne O'Sullivan - review at
[https://www.theguardian.com/books/2015/jun/07/all-in-your-
he...](https://www.theguardian.com/books/2015/jun/07/all-in-your-head-review-
o-sullivan-suzanne-osullivan). Summaries of some of the clinical stories
themselves are at [https://www.theguardian.com/society/2015/may/16/you-think-
im...](https://www.theguardian.com/society/2015/may/16/you-think-im-mad-the-
truth-about-psychosomatic-illness)

It's mind boggling (no pun intended) how far psychosomatic illness can go,
even as far as resulting in blindness, seizures, and paralysis. I was never
familiar with the idea of repressed memories and psychological trauma causing
physical illness before and initially dismissed it as arm-wavey pseudoscience,
but the amount of evidence is striking even if our level of understanding is
poor. This also explains why so many people with undiagnosable pain disorders
seem to get referred to psychiatrists here in the UK - people misinterpret
this as doctors thinking their illness is all imaginary, it's not, but the
_cause_ of it often well can be.

~~~
cesarbs
> It's mind boggling (no pun intended) how far psychosomatic illness can go,
> even as far as resulting in blindness, seizures, and paralysis.

While I don't have physical symptoms as severe as those you listed, that's
pretty much how my health anxiety manifests. I don't just have obsessive
thoughts over being sick. I _actually feel_ things. And my anxiety is not
thoughts -> symptoms, it's the other way around. I start having a bunch of
symptoms, give it some time hoping they will go away, but they don't. So I
can't help but think something is seriously wrong. There are instances where
I've dealt with a set of symptoms for a whole year.

A few examples:

\- When I'm anxious over a brain aneurysm or brain tumor, it's because I
started having visual distortions, tingling, my mouth won't widen on one side
when I smile, etc.

\- I was once worried about carotid artery dissection, because I could hear my
pulse in one ear and it would stop when I pressed against my carotid on the
same side (a telltale sign of CAD). MRIs in the ER revealed nothing.

\- My heart acts up with PVCs every now and then, and they are so unpleasant
that it's nearly impossible not to think I have a serious heart condition.
PVCs can be common when people are really anxious or stressed out, but in my
case they just come about in my most serene moments it seems.

\- I start worrying about colon cancer whenever I get alternate bouts of
diarrhea and constipation, coupled with frequent abdominal cramps. This
particular anxiety gets to the point where I see blood when inspecting my
output in the toilet, only for it to disappear when I blink. Mind you, it's
not "hm I think that tiny spec might be blood". I actually see streaks of
blood when I first look at it.

\- At some point last year I started having sudden weakness in my right arm. I
couldn't hold parts of it flexed, and things just seemed heavier. I was sure I
had a degenerative disorder of some sort. But then it just went away after
several weeks.

I could go on and on and on. It's horrible. Friends and family don't
understand me, no matter how much I try to explain to them that I'm not just
thinking about being sick (I'm actually trying hard NOT to think about it),
but I'm really feeling a whole bunch of stuff. They _always_ revert to "stop
thinking about it and it will go away". So frustrating.

~~~
thomyorkie
You may want to consider the possibility that you have generalized anxiety
disorder. The symptoms are vast, constantly changing, and often different from
person to person. Some of the things you've described like PVCs, digestive
issues, muscle weakness, and obsessive thoughts are quite common symptoms. The
best way I know how to manage this without pharmaceuticals is cold showers,
believe it or not.

~~~
Nav_Panel
I developed something like this health anxiety starting back in April, after a
severe bout of flu/some unknown and moderately severe viral illness coinciding
with a bacterial skin infection. I had a very tough couple of months where I
would worry about every minor physical "deviation" that I noticed. I also had
constant heart palpitations, which caused more anxiety, thus triggering more
palpitations. I'd spend upwards of a half hour at a time on Google, looking up
symptoms and trying to figure out whether my headache was due to a common cold
or a brain condition...

One thing that personally helped me recover mentally was weightlifting. Part
of what helped was that I could relatively easily attribute any random (and
benign) ache/pain that I might otherwise worry about to "oh, well, I just
lifted recently, so my body's repairing/sore/etc" as opposed to some serious
condition I found on Google. Sticking with caffeine even though I was worried
about palpitations also helped me through some form of "exposure therapy,"
where I eventually (re)learned that caffeine is safe to consume.

Talking with my therapist helped. As did consciously reminding myself that,
for a lot of rare or potentially deadly conditions, the symptoms would be much
more severe than I'm experiencing, and that some symptoms (fast heartrate is a
big one) can be attributed to anxiety alone.

For example, last night while lying in bed, I felt a sudden twitching on the
left side of my chest at about twice my resting heart rate. I instantly jumped
to the conclusion that it was my heart having rapid contractions, which
triggered a burst of anxiety, but when I stopped and thought about it (the
twitching seemed to be intermittent and didn't feel _internal_ like a heart
problem might, it felt external), I successfully convinced myself that it was
my muscle twitching -- a totally benign occurrence. Maybe I was dehydrated.

Basically, I was able to help myself by using logic and trying to match the
severity of my personal diagnosis with the severity of the symptom I was
experiencing. I imagine this wouldn't be possible if I suddenly had symptoms
as severe as GP, but it can help me stem these threads of anxiety before the
anxiety itself causes more issues than the original problem.

~~~
amelius
> Sticking with caffeine even though I was worried about palpitations also
> helped me through some form of "exposure therapy," where I eventually
> (re)learned that caffeine is safe to consume.

However, it is a well-known fact that caffeine and anxiety don't blend very
well. Be careful.

~~~
Nav_Panel
Yeah, that's true for sure. If I feel extra anxious for whatever reason
(happens from time to time), I'll skip my cup or two that day. And if I have
more than two cups in a day, bad things tend to happen. But I was at a point
for a while where drinking a cup of _decaf_ would make me extremely anxious
(or having a green tea, I swear, even the tiniest bit of caffeine would set my
heart pounding), so I'm extremely glad to be past that.

------
vivekd
>In those 12 years, about 3% of people developed ischemic heart disease—which
includes heart attack—but 6% of people who had health anxiety did. “We found
there was a surprisingly strong association between levels of health anxiety
and the risk of ischemic heart disease,” Berge says.

Isn't it more likely that people had anxiety about their health conditions
because they were in poor health, and that is why they developed heart
disease? This seems like a very poorly constructed study.

~~~
stult
The very next sentence in the article reads:

>Even when the researchers controlled for established cardiovascular disease
risk factors, they found about a 70% increased risk of ischemic heart disease
in the years of followup.

Your point isn't invalid, but the authors do seem to have made efforts to
address it. Though admittedly it is difficult to evaluate the validity of
their controls without reference to the actual study.

Generalized anxiety has been shown to be a reliable predictor of coronary
heart disease[1], so it doesn't seem like a stretch that the subset of health-
related anxieties would as well.

[1] See, e.g.,
[https://www.ncbi.nlm.nih.gov/pubmed/22075746](https://www.ncbi.nlm.nih.gov/pubmed/22075746)

~~~
Noseshine
I think the problem lies in

    
    
       for established cardiovascular disease risk factors
    

As the great American philosopher D. Rumsfeld once famously pointed out [0],
there are known knowns, known unknowns but there also are unknown unknowns :-)

So I would not dismiss the argument at this point.

    
    
      Generalized anxiety has been shown to be a
      reliable predictor of coronary heart disease
    

What the parent said applies here too. A statistical "predictor" isn't a
statement about causation.

What would need to be shown is a _mechanism_. How is the brain doing all those
things that it is being blamed for? or is it really just sensing something and
reacting, instead of causing it as is claimed? Why are so many people in those
discussion satisfied as soon as the brain (or something much more fuzzy!) has
been "identified" as the actor causing the problem? How is that an explanation
for anything? I'm not in the medical field, but I've taken many medical
courses, including neuroscience courses (plural, because I found it so
interesting). I find those "explanations" baffling to say the least. All I see
is that they are just shifting the problem somewhere else and calling it a
day, sort of like Douglas Adam's "Somebody Else's Problem (SEP) field" that
makes things invisible. [1]

Also, that soooo many people take a statistical "prediction" as a real
prediction, meaning an established causation, without question, always in
similar discussions when people start citing stuff found on PubMed. Statistics
is more like blood test measurements: It's a tool, to get a diagnosis you use
it - but you don't base your result on it (just because a value is inside or
outside some "standard range" doesn't mean much by itself). Not unless it's
extreme, in which case you probably don't need statistics to begin with.

.

[0] Just for the fun and the memories:
[https://en.wikipedia.org/wiki/There_are_known_knowns](https://en.wikipedia.org/wiki/There_are_known_knowns)
and 35 seconds of video
[https://www.youtube.com/watch?v=QaxqUDd4fiw](https://www.youtube.com/watch?v=QaxqUDd4fiw)

[1]
[http://hitchhikers.wikia.com/wiki/Somebody_Else's_Problem_fi...](http://hitchhikers.wikia.com/wiki/Somebody_Else's_Problem_field)
and
[https://en.wikipedia.org/wiki/Somebody_else's_problem](https://en.wikipedia.org/wiki/Somebody_else's_problem)
for the more serious description

------
eth0up
Sorry, but... Fuck This. I went to my Dr last week because of acute and
chronic pain in the testes, ensuing insomnia, etc. He pulled the psychosomatic
card and suggested I was manifesting my own problems. I politely argued to no
avail, then politely and permanently dismissed him as my doctor. Two days
later I visited the ER, where it was confirmed that it certainly wasn't
psychosomatic. It may be difficult to understand, but someone who is truly
suffering and seeks help only to be told "it's in your head", can very well be
the victim of an external psychological disorder, not anxiety. For how many
years were innocent and otherwise perfectly healthy people persecuted,
neglected, or ridiculed when they complained of stomach pain, i.e. an ulcer?
Until Barry Marshall[1] came along and deliberately infected himself with H
Pylori to successfully prove the actual cause of most ulcers, probably far too
long. I advise that when pointing this self-righteous etiological finger at
others, do so cautiously. I know I didn't quit distance running, my job, and
adopt a life of sleeplessness to secretly spite myself and binge on artificial
misery.

\- Irritated patient

1\. [http://discovermagazine.com/2010/mar/07-dr-drank-broth-
gave-...](http://discovermagazine.com/2010/mar/07-dr-drank-broth-gave-ulcer-
solved-medical-mystery)

~~~
nickcoury
I think it's unfortunate when people ignore the possibility of psychosomatic
symptoms, but even more dangerous when they attribute every issue to it. It
should be a tool in the toolbox, a possible explanation/approach to ailments
that are sometimes simple and singular but often times complex and multi-
faceted.

My N=1:

I have chronic back issues. At best it's general tightness and fatigue, but
can also be sore and painful. In particular I had two incidents in 2011 (in a
matter of seconds) and 2012 (over a couple days) where my back spasmed and
left me crippled, unable to move without knife-stabbing pains and unable walk
down hallways without holding onto a wall. Both lasted almost a month, and
were followed by months of heightened soreness.

I was 23/24 at the time, with no preexisting health issues. I'm a regular
runner and in great health otherwise. I tried to fix this with deep tissue
massage and core/strengthening regimens, and largely those helped keep the
pain levels down but really only halved the symptoms at best. A friend had
been recommending Sarno's 'A Divided Mind' which is all about the
psychosomatic diagnosis since the first incident, but I had dismissed it.
Finally in 2013, as I felt a new round of the spasms coming, I gave it a shot.
Lo and behold, it became the single most effective tool I've found to manage
my back issues. I identified that each spasm came with a major emotionally
loaded event. In 2011 it was unrealistic pressure to compete at a big running
race I had been training for. In 2012 it was participating in the search and
rescue for a dear friend who was lost (and died) in the wilderness. In 2013 it
was a nasty falling out with my best friend (and brother) at the time.

I don't believe the mechanisms are fully understood, and I think Sarno in
particular does too much hand waving. But using his approach was the first
time in years that I had no discernible back issues. I liken it to getting
butterflies in your stomach. Your mind and emotions can trigger physiological
changes to blood vessels, nerves, muscles, etc. that in turn can cause real
issues. I also don't believe it's the only factor. I started an office job in
2015, and back issues have come back that I attribute 100% to the office
lifestyle. I've found no relief with the psychosomatic approach, but do better
with a sit/stand desk, breaks, and daily exercise.

Overall, I think a ton of people could benefit from approaching health issues
from a psychosomatic perspective as one of many possible diagnoses. I also
agree there are so many other possibilities that assuming it is always in your
head is ignorant, neglectful, and downright dangerous.

~~~
missed_out
I have bilateral pars defect at L5 with a grade I Spondylolisthesis. Local
doctors want to fuse L3-L5, or I will be in a wheelchair within 5 years. For
younger people that may be their only option. Non-local doctors do not
recomend fusion.

15 years later, no fusion, no wheelchair.

This is what I did and do:

1\. Educate myself a. search: stuart mcgill waterloo university. b. Understand
spinal stability and core excercises c. Walk! not stroll! (i do 6 miles at
least 3 times a week. Sitting is the new Smoking! 2\. Listen to your body! I
have learned to recognise that my back is close to a traumatic event. 3\. When
my back goes out, a short rest, but keep moving. 4\. Fully understand that
excercising will cause irritation, but it is tolerable versus when my back
goes out. 5\. Medications: Soma, flexeril, and tramadol (NSAIDs such as
ibuprohen trash my GI) After an event, I take the Soma and tramadol to help me
keep moving. Daytime, they both will keep me awake. At night, flexeril. It
works best on muscle spasms which exhausts the muscles which leads to pain.
And it puts me to sleep. I will use these meds for a short period of time
every 5-6 months! 6\. Streching and doing it correctly is very important. 7\.
Getting out of a chair, use your legs! DO NOT lean forward to pull yourself
upright! 8\. You may want to wear a simple lifting belt. Not for support but
to remind yourself not to put your lower back in a stressfull position. 9\.
Understand that "correct" posture sitting may not be a good idea for long
periods of time. 10\. If the problem is the lower back, educate yourself on
the function and stretching of the Psoas muscle. It is a fast twitch muscle,
and sitting contracts the muscle. Quick and sudden contraction puts tremendous
pressure on the discs. 11\. Try to keep your spine in its natural position,
maintaining symmetry is critical. Yeah, it is uncomfortable, but the lack of
symmetry will impede recovery. 12\. If you have imaging done, demand copies on
a CD. This will help you to seek additional opinions.

------
bertr4nd
After an extremely stressful half at work, I developed heart palpitations,
gastritis, insomnia, and a very distinct vitreous floater. All of these have
more or less resolved, except the floater, which, since there's no known
treatment, I get to keep as a constant visual reminder of one of the roughest
times in my life.

Of course, it could all be a coincidence. The brain is good at finding
patterns that aren't there.

------
mathw
I have no trouble believing that your mental state can influence your physical
health. It's happened to me repeatedly. Prolonged stress (usually at work)
seems to result in my immune system becoming less effective, and I start
getting colds, coughs, mild flu-likes and so forth, plus whirly stomach and
lots of toilet time.

Sure it's all in my head, but the thermometer says it's in my bloodstream too!

~~~
Al-Khwarizmi
I have had frequent belching and heartburn problems for many years, often
causing insomnia. After a lot of time trying to determine which foods were the
cause, I ended up noticing the elephant in the room: food actually matters
very little, my (subjective) stress level explains like 90% of the problem...
if I'm relaxed (e.g. on vacation) I can eat practically whatever I want
without getting problems, if I'm really stressed I'll get them even if I eat
like a Spartan.

In fact, having a partner is the single best thing that has happened to my
stomach and my insomnia. She reduces my stress levels and alleviates the
symptoms very noticeably just by being by my side. Sorry if it sounds corny,
but for me this is an observable reality.

The problem with all this is that, of course, stress is often something
outside our control. Knowing what I know I try to keep it at bay as much as
possible and take things easier than when I thought it was a food problem, but
if there's lots of work and deadlines it's not like you can just wave stress
away like you can avoid a given food...

------
shams93
In California it's an at will state with unemployment topping out at 900 a
month with the highest taxes and rent in the world. People die prematurely
here from the extreme level of anxiety imposed on professionals I can't
imagine how bad it gets if you have kids but worry is as big a contributor to
early death as addiction.

------
mckayb24
I didn't see any mention of controlling for people that are worried about
their health with reason. If a bunch of people in your family have health
problems you would be more likely to worry about your health and be more
likely to have health problems. This may be an issue of correlation not
causation.

------
amelius
Closely related effect, with scientific references: [1]

[1]
[https://en.wikipedia.org/wiki/Nocebo](https://en.wikipedia.org/wiki/Nocebo)

------
NumberCruncher
This are actually good news. If worrying can make you sick then worrying less
can make you more healthy. Stop worrying today! Everything will be fine!

~~~
vesak
[http://dudeism.com/](http://dudeism.com/)

