I am a hypochondriac, which is to say I’m constantly and acutely obsessed with the idea that I’m suffering from, or I’m about to be diagnosed with, a serious medical condition. For as long as I can recall—I was born in 1985, and so possess at least somewhat vivid memories dating back to late ’89, early ‘90, such as hitting a baseball off a tee; singing “Let’s Talk About Sex” to the girls on the playground in kindergarten; shitting my pants on the bus en route to a field trip to Plimoth Plantation, MA—the specter of disease has hung over me like a pall. It’s not great.
Pinning down the origin of my health anxiety has been difficult. Was it the asthma attack that landed me in the hospital on my fifth birthday? Was it watching my grandmother as she withered away to esophageal cancer when I was seven? Or was it meeting my cousin’s friend—he five and I eight—who’d been diagnosed with leukemia, a disease I was convinced he must have transmitted to me simply because we had played tag together for a few hours in a playground? Eight year olds are not aware that cancer is not communicable.... or that most diseases aren’t passed on through skin to skin contact to begin with.
While the term hypochondriac is often invoked as a colloquial pejorative—i.e. “Terrence is convinced his headache is a brain tumor. He’s such a fucking hypochondriac.”—it’s been defined as an actual pathology by the Diagnostic and Statistical Manual of Mental Disorders. The nomenclature has changed, with “hypochondriasis” being replaced with “Somatic Symptom Disorder” and “Illness Anxiety Disorder,” but the sometimes crippling nature of the disorder remains. To criticize a hypochondriac for his or her hypochondria, then, is as absurd as criticizing a manic depressive for his or her shifts in mood. To the carefree among you: stop doing this. And, quite frankly, fuck you for your repose! From where does your blithe nature originate? Do you not read the news?
Like with any disorder, the afflicted must adopt a series of defense mechanisms and tell himself or herself a series of lies to get through each day. This can be tiresome, but it’s not impossible. Here are some things that I’ve done/that I still do, each of which has helped (or hindered) my efforts to combat hypochondriasis in varying degrees.
Don’t look at WebMD. Ever. On the internet, stomach aches turn into stomach cancer, muscle fatigue turns into multiple sclerosis, canker sores turn into mouth cancer, and everything else turns into HIV. WebMD disguises itself as a legitimate source of medical information, but shouldn’t we be wary of a site where the lead article is often tagged with a headline like, “Are Hoverboards Worth the Risk?” or, “Do You Know Your Health Better Than Your Doctor?” Articles like these are endemic of what’s wrong with our healthcare system as a whole. The fact that it costs a lot of money to go to the doctor leaves people to scroll through the Internet where disingenuous (maybe even dangerous?) sites like WebMD say a lot of nothing while menacing at something greater. Minor issues then morph into major issues—which big pharma obviously loves—and for what? That seemingly innocuous headline on WebMD has the ability to spin your symptoms into something that is anything but.
Rest assured that the New England Journal of Medicine isn’t writing about the perils associated with hoverboards, and no, you don’t know more about your health than your doctor. Unless you’re a doctor, in which case I’ll shut my smart little mouth.
Another thing that our healthcare system fails at is the lack of emphasis placed on the importance of preventative care, and the recent trending upward of insurance companies offering Health Saving Accounts (HSAs) as an alternative to the more expensive PPO. You can imagine that boardroom pitch, and the slime covered, Martin Shkreli-looking suit making it: “Listen guys. There are these things called millennials, and they’re all pretty poor because inflation has outpaced salary growth. Their youth however convinces them of their infallibility, and even though their social media avatars insist they’re all good little socialists, everyone’s a capitalist at the end of the day, and so the cheaper HSA plan will be pretty attractive to them.”
HSA plans are certainly less expensive up front—you’ll see less money taken out of your paycheck—but with higher premiums and higher out of pocket maximums, the consumer (a grotesque word to have to use when talking about health) ends up paying an awful lot more if something goes wrong. My fellow millennials, I implore you: opt for the PPO. Unless you’re rich or clairvoyant, it’s the socially responsible thing to do. Paying an extra 60 or so bucks a month for health insurance might suck, but remember: you’re subsidizing the older, sicker, and less fortunate among us. The socialist ideal is that everything comes around. Paying a little more on this end means paying a little less on the other. Just, like, stop getting a triple venti caramel beef tongue macchiato EVERY day. (Two a week should be fine.)
Finally, don’t just open that HR email regarding your health plan to eliminate that pesky little parenthetical from your inbox. (If you’re intense about your health, odds are you’re also intense about making sure you have ZERO UNREAD EMAILS. Right? Am I right?) Open it, read it, print it out, commit it to memory. Know how much your copays are (because you’ll be paying for a lot of them), know what your premium is (and if you don’t understand the concept of a premium, figure that out, too), and know what your out of pocket maximums are. Having even the most basic understanding of your health plan, and the health care system generally, can and will alleviate at least some of your anxiety. Knowledge is power.
Have the conversation with your doctor or mental health care provider. She or he probably already knows that you’re a hypochondriac because she or he sees you, like, eight times a year. My health anxiety was so out of whack in my early 20s that my primary care physician and I decided a low dose of citalopram was in order. Several trips to the emergency room with a resting heart rate of 180 beats per minute—despite perfect EKG results—indicated something else was going on. I had some success with citalopram—a selective serotonin reuptake inhibitor (SSRI) meant to increase the level of serotonin in the brain’s synaptic cleft—until I didn’t. After six months of relative bliss (which means I only thought about meningitis three times a day instead of every three seconds), I started noticing a dip in my libido.
Sexual dysfunction is listed as a rare side effect for SSRIs, and I’ve always wondered if its manifestation was the result of something physical or if the mere suggestion in the fine print that erections might be less frequent and less impressive was enough to convince me of a problem. Whatever it was, I decided having sex with my loving and beautiful girlfriend was more important than squashing my cancer hallucinations, and so I discontinued treatment.
I did this without consulting my doctor. I do not recommend doing this. Nothing bad happened to me, but bad things can happen. If the pills aren’t doing the trick, or if the side effects—whether sexual or otherwise—are too adverse, talk with your doctor. He or she will help figure out how to wean you off whatever pills you’re taking. Remember, we don’t know better than our doctors.
This is a cliché, but working out promotes the uptake of serotonin and the production of dopamine in your brain. It’s like you’re rolling on that molly shit you all seem to love so much, only instead of having to meet some tank top wearing, man bun sporting, third wave club kid behind a porta-potty at Bonnaroo to score a vile of white powder of questionable origin, all you’ve got to do is hit the gym a few times a week.
Going to the gym isn’t your thing? I get it, it’s not really mine either. The gym is full of untrustworthy strangers excreting various body fluids, and you’re a hypochondriac who’s terrified of the various body fluids of untrustworthy strangers. No one wants to hop on the stationary bike after Steroids Jones rubs his shriveled little balls all over the seat. Also, foot fungus. Also, herpes probably. Try popping your headphones on and going for a walk instead. You’re outside, you’re breathing fresh air, you’re rocking out to your favorite Tay Swift song. That’s a good day anyway, so it’s just a bonus if it helps tamp down your health anxiety.
Another obvious one, but eating well actually does make a difference. Dad’s in the city for the night and offers to buy you dinner? Anything you want, his treat? Feeling the city’s best new burger joint, son?
You had a burger and fries last night, man. You do not need another burger and more fries. You definitely don’t need to dip those fries in mayonnaise (although, I mean, I get it). Opt for a piece of fish and some veggies, but if you insist on getting another burger (because you’re a feckless glutton), sub the fries out for a side salad.
Poor dietary habits can lead to some pretty horrible diseases in the long run—diabetes, heart disease, colon cancer, you get the point—but they can also result in symptoms in the short term such as gastrointestinal discomfort and heart palpitations that will have you convinced you’re already suffering from those horrible diseases. Eat your greens, eat your grains, keep the bacon intake to a minimum, and learn how to cook for yourself like the grown ass man you keep telling everyone you are.
Have you ever watched The Wire? What about The Sopranos? Six Feet Under? Breaking Bad? Downton Abbey? (Yes, I watch Downton Abbey. You should too.) Those five shows alone have combined for 322 episodes, or approximately ten full days of exceptional storytelling. You’re living through the Golden Era of television, and there are few better ways to forget your own problems than by watching Tony Soprano work through his own with his psychiatrist (he’s way more fucked up than you are). I’m not suggesting Mary Crawley’s staid aristocratic sexuality is the anecdote to your hypochondria, but marveling in it for a few hours a week can’t hurt.
Also, books. You’re reading this right now, so perhaps you like to read. Figure out what it is you’re into, Google “good books about topic X,” go buy one of those good books about topic X, and lose yourself in the pages. The act of reading requires at least enough concentration on the part of the reader that he should be able to, at least for as long as he’s reading, forget about the looming cessation of breath. Maybe don’t read Elisabeth Kübler-Ross’ “On Death and Dying,” though.
This one is classically “chicken or the egg?” Are you anxious because you’re up all night, or are you up all night because you’re anxious? Whichever it is, you’ve gotta figure out a way to get those seven to nine hours of sleep each night, otherwise your brain is going to function as a much lesser brain. Being active each day should help tire you out, but binge watching several television series might end up contributing to those long nights. You’ll have to strike a balance here.
And remember: The less time you spend awake, the less time you have to think about that tumor you’ve got growing in your lungs. Stock up on melatonin, friends.
Illustration by Sam Woolley.