Hypochondria - help

[br350]

I have posted here before...but not in a while. I have OCD manifested as hypochondria. I am on Zoloft, 50mg and though this does seem to help, I still have spikes in my fears. Right now I am fearing some problems with my throat and mouth. I try very hard to have a 'wait and see' approach with any physical symptoms that arise. I have got much better with this over the years. In my 20's (I'm now in my 40's) I used to make appts immediately when I had an odd symptom or noticed something amiss with my body. I have learned, over time, to resist this immediate urge. Still, the fear itself can be very paralyzing.

For me, the crux of the problem is this: if I wait and watch, what if by the time I go in to have something checked, it has spread or become either very difficult to treat or untreatable? In my OCD mind this always seems like an unacceptable level of risk. Yet, it is a risk that the majority of the population accept, easily, on any given day of the week. For me, being able to accept that risk is extremely difficult.

I have worked with CBT and have used various tools that address the rational vs. irrational fears related to having an illness. The tools do help to 'ground' the thoughts and get them out so that they are not just swirling around in my head. Still....this lack of ability to accept uncertainty is the never ending, nagging problem with hypochondria that I just can't seem to shake.

Any thoughts?

 

[Daniel E.]

Any thoughts?

When was the last time you saw your general practitioner, anyway?

I know for men they say that they should their GP for a checkup at least "4 times in their 40s."

 

[br350]

I saw him last year in the spring for my physical. I try to limit appts to my yearly physical if at all possible. I don't know why anyone would say only 4 times in their 40's. My GP (who is also my husband's) feels that a yearly appt, especially in the 40's, is important. At any rate.....

 

[David Baxter PhD]

First, 50 mg is a very low dose for Zoloft - you might want to discuss increasing the dose with your doctor.

Second, of course medication cannot do all the work. Whether the anxiety spikes are related to your OCD or triggered by something else isn't clear to me, but it is quite common for OCD symptoms to increase in severity at times of stress or with increases in general anxiety. Relaxation therapy, meditation, yoga, exercise, or anything else which reduces general anxiety levels will help with OCD symptoms to some extent.

Generally, CBT techniques work well for general anxiety and stress, and modified CBT approaches based on Jeffrey Schwartz's Brain Lock work well for OCD. Do you currently have a therapist or have you learned these techniques previously?

 

[Daniel E.]

A chart from Coping with Health Anxiety :



From a more OCD perspective:

OCD Chart (from How Do Obsessive Compulsive People Think?)

 

[br350]

Daniel, thank you very much for your thoughtful attachments. I will certainly take a look at these and hopefully glean some perspective from them. I have read both Dr. Schwartz book as well as John Grayson's book about OCD and have tried to use some of the CBT techniques suggested.

Dr. Baxter - yes, I realize that my Zoloft is a fairly moderate dose but I did not want to take anymore than was necessary. I have had a pretty good span of relative 'peace' with my OCD and this flare, I feel, has been building since the beginning of the change of seasons. I do feel as though I have some form of SAD as winter is, by far, the toughest time for me with my OCD and anxiety in general. I try to get as much direct sunlight as I can and have considered by a light therapy box, though they are very expensive. I am in touch with my prescribing physician and I am sure that he would concur that it would be a good idea to consider increasing my medication dosage. I had wanted to stay on a moderate dose so that I could be able to have something to work with in using CBT techniques. I feel as though I have been walking a line, for a very long time, with how much medication I am willing to take. I would very much prefer to be unmedicated but I'm coming to the realization (after 20+) years that this is not likely a good treatment approach for me. I have been medication-free more years than I have been on medication but I have been taking the Zoloft for about 4 years now.

I think what is so difficult about my health anxiety is that the fear is rooted in a natural and 'normal' one. We all should be concerned when something seems amiss with our bodies and it is prudent to have things checked out, when necessary. It's this normal response, warped and twisted by the fear and lack of acceptance of risk with OCD, that becomes overblown and out of perspective. It becomes a matter of being able to reign in this fear to a level that is 'normal' and more closely resembles concern or curiosity than outright sheer terror and fear of death.

Thank you again very much for both of your responses....I will have to think about the medication issue and try to do more to help myself. My anxiety is very much an agitated type of anxiety so I have found that meditation is something very difficult for me to do. I find more solace in soothing, repetitive motions like rocking in my living room rocking chair. I think if I could settle my body and agitation down enough that I could get a lot out of even just 10 minutes of some breathing excercises.

---------- Post added at 06:00 PM ---------- Previous post was at 05:32 PM ----------

Daniel, I have read the Health Anxiety PDF and it very much mirrors what I learned with a CBT practitioner. I like the forms that are in that PDF better than the ones I have as CBT tools and I will print these ones out. Again, thank you. I think I've had all the tools at my disposal that I need for some time, it's just a matter of really using them, regularly and consistently. CBT is all about consistency and consistency can be really difficult when you are in the throes of intense fear and anxiety. Thank you again!