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Illness anxiety disorder: how to become more rational? 2020-01-03T21:05:34.703Z · score: 10 (5 votes)

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Comment by completely_irrational on Illness anxiety disorder: how to become more rational? · 2020-01-04T17:01:43.436Z · score: 1 (1 votes) · LW · GW

I starting feeling anxious about left chest pain about 18 months ago. I would say I started touching/feeling lumps maybe one year ago, and I started being really concerned (touching more) six months ago.

Number/size/distribution

  • #1 and 2: they're both soft, smooth, connected in a chain, movable and more elongated than round. Size: kind of a cylinder of length approx. 1cm and diameter 5mm (each).
  • #3: also soft, smooth, movable, but solitary and length is more like 2-3cm.
Comment by completely_irrational on Illness anxiety disorder: how to become more rational? · 2020-01-04T13:59:16.298Z · score: 1 (1 votes) · LW · GW
You’ve had two doctors look, and you have had your chest imaged.

To give a bit more context, whenever I had the GPs "touch" the parts that I feel were alarming, they never managed to "feel it" or "grab it" the way I do. So I don't feel like I gave them enough evidence. And for the "chest being imaged", it was about one year ago (things might have changed since then), and the doctor did it quickly looking at my heart, not really looking precisely at the part that I'm concerned about.

(I know that I sound a bit like "the medical evidence is wrong, they didn't find anything because they weren't doing it right, I know what I truly have", but that's how I honestly feel).

your aliefs are misaligned. Those are harder to change. More evidence isn’t going to do it though.

I didn't know about the concept of alief, that's really cool, thanks!

Do you have a psychiatrist or a therapist?

Not now, definitely needed. I feel like someone specialized in illness anxiety would help more with the anxiety than a psychiatrist, but the psychiatrist would know what's psychosomatic and what's not.

possible that you’ve injured yourself causing some scar tissue in the muscle, with possible inflammation

I'm unsure how much you could injure yourself from just probing daily (with different levels of intensity) for like 6 months. That's definitely something I considered. When I probe my right chest, it's painful for like 10-20m, but I almost never do it. When I saw the first GP, he told me the region I was pointing at was near a tendon in the "pectoralis major".

If you probe the location often, have you considered covering it with some rigid material to block unthinking probing?

Interesting. I haven't reached the point where I do it every hour. For now, it's maybe 10m in bed, so not too constraining. I also have enough self-control to not do it during the day (even more now that I wrote this post).

For anxiety like this, cannabis can be an option.

Word. I'm the kind of person to develop new anxieties with cannabis though.

Comment by completely_irrational on Illness anxiety disorder: how to become more rational? · 2020-01-04T13:37:24.136Z · score: 1 (1 votes) · LW · GW

Thanks for the comment! It really helps to know that other people are in a similar situation.

My childhood went fine. I did spend the past 3/4y midly-to-severely depressed/anxious and saw a CBT therapist for about 6 months this year though (stopped it last month). We mostly worked on how to build self-confidence and avoid self-loathing through the three columns technique. I also did the exercises from "Feeling Good". We did not focus on my illness anxiety (never mentioned it to her to not sound too crazy and because we had other things to fix first). Never heard of ACT, will check it out and think about doing a therapy more anxiety focused.

alleviating your fears of being either invalidated or condemned to die

I really like how you phrased this, especially "invalidating" (never thought of it that way).

"It is entirely possible that all you need is some skills you can learn through CBT or ACT for your quality of life to markedly improve. [...]
It also looks like you are ready for "debugging your mind", so your odds of success are above average."

Thanks for the optimism. When I apply CBT techniques right now and try to fix my biases, I still have this creepling anxiety telling me: "hey, if you don't act now you're likely to die in the next months/year. It's probably already hopeless". It's like if both my body and mind were already convinced that something was happening in my body. Whenever I look for new evidence (by touching etc.) my mind adapts the reality to match its story (e.g. the thing I'm feeling in my chest MUST be cancer because it would explain what I feel). I feel like the only way to be completely alleviated would be to do a full scanner/ultrasound.

Comment by completely_irrational on Illness anxiety disorder: how to become more rational? · 2020-01-04T13:00:02.403Z · score: 1 (1 votes) · LW · GW
Action cures fear. Stop ruminating and do the thing.

Thanks, that's the boost I needed.

In the longer term, one thing that has helped me is to list all my nagging fears

Sounds super useful for the long run, will start today!