Health Anxiety: The Disordered Guide to Health Anxiety (Episode 136)

SPEAKER_01 0:18

Welcome to Disordered. This is episode one three six entitled Health Anxiety: The Disordered Guide to We're celebrating today because we have a lovely special announcement. Our first co-written book in the Disordered Series has been completed. And it is called The Disordered Guide to Health Anxiety. Today we're going to talk about all things health anxiety. I'm one of your the co-hosts, Joshua Fletcher, also known as Anxiety Josh. I'm a therapist, writer, evidently, you know, because there's a book out. And um a previous sufferer of a lot of health anxiety.

SPEAKER_02 0:57

And I'm joined by Yeah, I am Drew Linsolata, also a therapist and writer, allegedly, uh specializing in treatment of anxiety and anxiety disorders. Health anxiety is a big one, so I'm glad we're talking about that today. And yeah, I've been through all the stuff that we talk about in this podcast too. So this is really great. It's an exciting day with a big announcement. It deserves a little bit of fanfare. How about this one? Oh my god. That is the most pathetic fanfare ever. But it feels appropriate.

SPEAKER_01 1:27

It's the kind of thing you hear when like a loving parent attends a recital and you know it's not going to be great, but you're there for love and support.

SPEAKER_02 1:34

That's exactly right. Like the kids are doing the best they can. That's us. We're doing the best we can, people. Just give us a break, all right?

SPEAKER_01 1:40

Um back when I was in the middle of my health anxiety, I wish I had this book because it is a belter. I really enjoyed writing it with you, Drew, and I'm really happy that it has now been unleashed on the world and listeners. So if you want to get your hands on it, the Disorder Guide to Health Anxiety. It's there. Nice blue book, lovely cover, lovely illustration. Um, really easy to access book. I'm really proud of it. I don't know. Are you proud of it, Drew?

SPEAKER_02 2:13

I'm very proud of it. Um, let's talk about the cover for a second. The cover has a thermometer on it because people with health anxiety often check their temperature. The cover designer is British, so the thermometer says 36 degrees. That's a dead person in the US.

SPEAKER_01 2:26

Yeah. Oh, yeah, absolutely. We love it. That's okay. That's that that's that's us in summer.

SPEAKER_02 2:32

Yeah, yeah, that's okay. Um, yeah. Funny story about health anxiety. Like, when I first started having panic attacks and I didn't know what they were, like I wound up in a situation where I went to my doctor and he did all kinds of blood work. You know, that's always your first stop. This is the 80s, mind you, 1980s. And I get a phone call from the doctor's office who says, The doctor wants you to come in. He needs to talk to you. We'll see you in a week.

SPEAKER_01 2:58

Oh no.

SPEAKER_02 2:59

So health anxiety, that was my first like experience with what it feels like to become obsessed and fixated on a health thing. Now, a lot of people would have been triggered into that, but I was in overdrive and I was a hundred percent certain that he was gonna say, We checked you for some sort of anxiety thing, but you clearly have. Who knows? And you have three months to live. I for sure that was coming. It was a nightmarish week.

SPEAKER_01 3:29

Yeah, the ruminations. I've had really bad health anxiety in the past.

SPEAKER_02 3:34

Yeah.

SPEAKER_01 3:34

Uh, you know you got health anxiety when, and let's do a to and fro, yeah, um, you're constantly checking that thing that made you feel weird. Maybe there's something on your skin or a sensation that you didn't like.

SPEAKER_02 3:47

Yeah, you know you got health anxiety when you continually insist that health is the most important thing in the universe and must be tended to daily.

SPEAKER_01 3:58

I knew I had health anxiety when I'm talking to friends and loved ones, but my attention was actually inwards, and I was worrying and ruminating and keeping an eye on this current worry that I had.

SPEAKER_02 4:09

You know how you have health anxiety when you look in the mirror multiple times a day to see if one side of your face is drooping because you had a stroke and didn't know it.

SPEAKER_01 4:16

Ah, so that's a sneaky one. You know you got health anxiety when your best friend is Google and Chat GPT, and you're just constantly seeking reassurance, and yeah, it gives you a bit of temporary relief, but lo and behold, you know, you're back here again.

SPEAKER_02 4:32

Yeah, never last. You know you have health anxiety when you really, really want to ask a doctor, but also don't want to hear what the doctor has to say at the same time.

SPEAKER_01 4:42

Yeah, yeah, because I I I've had it both types of health anxiety, and we talk about this in the book. There's some people that will constantly pester their doctor, and some that were just utterly terrified to not even bother going. Um, yeah, uh mine was uh asking for reassurance from loved ones. Are you sure have you noticed anything different? You know, monitoring and things like that. That was that was a health anxiety one for me.

SPEAKER_02 5:08

Yeah, 100%. I think uh you also know you have health anxiety when you spend a lot of time in the comment section or a Facebook group or Reddit asking, does anybody else ever which is common in all anxiety disorders, but health anxiety. Anybody else? Oh, yeah, you see that. Does anybody else anybody else ever notice the like bumps on their tongue and it becomes like that's your two-week fixation?

SPEAKER_01 5:28

Yeah, uh, we're fixating on little things as well. So I had like IBS alongside health anxiety. So I would just like I mean not to share too much info, but I would obsess over like urination and toileting and bowels and stomach and digestion and stuff, because I thought, well, there must be something wrong. So if I keep an eye on all these variables, then I'm staying one step ahead of imminent disaster.

SPEAKER_02 5:54

Yeah, you know you have health anxiety when this is true, when you decide to eat a beet salad, B-E-E-T, you know, the veggies, superfood, and then things come at the other end red because that's what happens when you eat beets and you are done, stick a fork in you for a week because you cannot accept the explanation that you just had a beet salad, and you know, that happens.

SPEAKER_01 6:16

A beet salad?

SPEAKER_02 6:18

That sounds like a yeah, not it's by the way, don't eat those too often because it's it's good, but not that good. Just saying, like yeah, yeah.

SPEAKER_01 6:25

So this book, there's different phases, there's many phases of health anxiety, and we've uh we've written a lot a few case studies and stuff for you to give examples because people's anxiety and health anxiety presents in a different way. Um, the first one we wrote about, Drew, is someone called Sanjay, isn't it? We do and Sanjay is the resource gatherer. What is the what is it what is the resource gatherer in health anxiety?

SPEAKER_02 6:48

Uh the resource gatherer is the person that is constantly and forever researching, googling. Now we can ask AI LLM models, you know, constantly gathering information, resources, tips for avoiding, like whether or not they need to know the symptoms of various symptoms that they're or uh diseases or maladies that they might fear, or they just need to know like these are the good tips for avoiding those things. This is how you make sure you don't get cancer. Constantly gathering those resources, always.

SPEAKER_01 7:15

Yeah. Then we got Maisie, who is the avoider, won't go near the doctor, terrified of what she might learn. The idea of getting checked feels more dangerous than the symptoms themselves. Uh, and to so to kind of stay on top of that, she ruminates and just scans at home. Yeah. We write about Maisie and that as well.

SPEAKER_02 7:35

Yeah, I had a client tell me the other day, like, clearly I'm dying, but I am not going to fix it with the doctor. I'm going to just solve it in my head for the next two years. It was such a good statement.

SPEAKER_01 7:44

Yeah, love very self-profit. Oh, yeah. Yeah. Uh, what about we've also written about Rachel the Protector? What's the protector?

SPEAKER_02 7:49

Oh, Rachel the Protector is really interesting because some people will experience health anxiety that isn't focused on them, it's actually focused on their family members or loved ones or friends or even pets. I know people who have had health anxiety focused on their pets and they think they're protecting the people they love.

SPEAKER_01 8:05

Yeah. Rachel's the kind of person who spends some of her time interacting online with like other people who have the same problem and constantly telling her that the problem uh is this and stuff, and yeah, it kind of gets uh get it gets a bit uh hand. Yeah. Uh then we've got I see a lot of this, you know, my feelings on self-optimization culture, uh, because where there's a vulnerability, there's a commodification. Um, hence why we're releasing a book. Um, Adam the Optimizer. Who's who's Adam the Optimizer? What does the health anxiety optimizer look like?

SPEAKER_02 8:38

Oh, the health anxiety optimizer is a sneaky presentation because it might not even look like health anxiety. It is I I am going to make sure that I am perfectly optimized with the perfect amount of sleep, sunlight, ice baths, supplements, you know, all the rituals that are designed to absolutely keep my body in peak condition because I I must be that way to stay healthy. I cannot allow myself to slide into a different state.

SPEAKER_01 9:06

Like a hyper discipline of yeah, well, if I perfect everything I eat and do and things like that, then uh my fear won't come true. Yes, I can somehow control this process. Yeah, and they can be very defensive about that sometimes. It's like, no, no, this is this is healthy, and yeah, you're right, that is healthy, but also I'd argue feeding health anxiety and OCD is not healthy, and we're allowed to have flexibility. And anxiety disorders hate flexibility, they want rigid instructions, and then uh one of my my favorites who we've decided that this uh other case study, this final character, is gonna appear in all of our books that we write together. It's Buck the Threat Monitor. Tell us about Buck the Threat Monitor.

SPEAKER_02 9:50

Oh, Buck. Buck is my favorite one, just because his name is Buck, so we gotta include him. But like yeah, the threat monitor. I I think I was kind of the threat monitor. I was always hypersensitive to any change or feeling or difference in my body, or even just a thought that I might have something going on in my body, and it was just a constant hyper-vigilance of what is happening in my body, what is happening in my body, what is happening in my body. Uh it it's really you're preoccupied all the time with that. No fun.

SPEAKER_01 10:20

Yeah, yeah. Yeah, and well, there's some of the case studies we wrote about, we wrote loads of uh about it throughout it, but we'll talk a bit more about it later. But let's move on to the community and have some health anxiety related questions and things, and um, and some did it anyways as well. Um, we had what did we have?

SPEAKER_02 10:38

Um I have one that I can read. Um this person did not give us the opportunity, the uh permission to share his name, but we will mention it anyway. So every now and then I experienced health anxiety as a young adult, which always passed with time. Well, five years ago I had a fainting episode, which shook me up a bit. Many months of stressful medical tests later, I was told that I had a common faint and not to worry about it. But I did in fact worry about it. I became hype, I appreciate that line, right? I became, yeah, don't worry about it. Everybody with an anxiety disorder should just chill out, don't worry about it, right? So this person says, I became hyperaware of what can cause a faint hot showers, dehydration, blood pressure changes, and even fear itself. I developed unhelpful protective behaviors, body scanning, bracing my head muscles when stressed, worst case scenario, thinking and avoidance. I lost the unquestioned trust in my body, which makes almost everything a do-it-anyway. Earlier this year, I noticed that I was avoiding driving unless I absolutely had to. I work from home, so I can get away with that. I also learned that my wife was going to have our second child. I became determined to become more comfortable driving because I would need to take my wife to the hospital appointments and I would need to take my daughter to school every day, which is about a one-hour round trip. Ooh, that's remote. I discovered your podcast around this time, and for the past nine months or so, I made a conscious effort to get in my car and do it anyway. Drive every day for an extended period of time to teach myself that I am safe, even if my mind isn't 100% convinced. The physical sensations and mental dialogue can be very intimidating in some moments, yet they did not once prevent me from arriving safely at my destination. Other times I would actually look forward to getting in my car, uh to getting clear my mind. The intensity that comes with having a newborn in the house has also tested my health anxiety, but I'm happy to report that I was successfully able to drive the new mom, infant, and toddler to where they needed to go, often on a little sleep and high stress. And while I remain a work in progress, I am grateful for resources like you guys. Uh, you know, thank you, and any tips would be welcome.

SPEAKER_01 12:43

Oh, get in. I love that. I love that as well, particularly proving when we're talking about the optimizer before. Actually, I can do this not optimized. You know, I haven't got had much sleep. I'm stressed, and I can still do it. Really well done.

SPEAKER_02 12:55

Yeah, yeah. With little sleep and no stress, but I can still do it. It's okay. I won't go to that.

SPEAKER_01 13:00

Yeah, well, that's a really good one. I've got one for you, Drew. This is from Josh. What a great name. You must be handsome and successful and charismatic and and modest. You must have certificates for humility on your wall. Hello. I just wanted to share. I did it anyways, and yes, you can use my name. Cheers, Josh. What a guy. While working today, I was driving and felt an adrenaline rush come on. Good reframe. This all stemmed over constant fear of checking my heart rate. After checking it a couple of times and seeing it was higher than normal, I thought it to myself, all the things you guys say on this podcast, and that this is just an adrenaline rush. After this, I felt my body relax as I continue to do what I was doing. This felt like a major accomplishment for me, as the prior times this has happened, it would send me into a spiral that would take days to come out of. Your podcast has been super helpful in my anxiety journey, and I love to listen to it for the laughs as well as the content. Oh, someone finds us funny, Drew. That's really nice. Uh, looking forward to the health anxiety book, I thank you guys for doing what you do. Well, that's great because today Yeah, as it turns out.

SPEAKER_02 14:13

We we have a health anxiety book on the market, but that that gets a little bit of a thank you, thank you for sharing. Appreciate it for sure.

SPEAKER_01 14:22

Uh well done, Josh. I love that. You didn't compulse. I know, which is so we talk a lot about people with health anxiety, they believe that compulsions are keeping them safe, you know, because they're addicted to short-term relief. Oh, this compulsion, one more checking, look in my fitness watch, the damn fitness. One of the the main logos throughout this book is the fitness watch.

SPEAKER_02 14:42

Yeah, isn't it, Drew? Yeah, the Apple Watch, the Fitbit, uh, your Garmin watch, whatever you got.

SPEAKER_01 14:47

Yeah, I just need to monitor. In fact, a lot of them now is these mood rings.

SPEAKER_02 14:51

People have these mood rings, not mood rings, the aura ring, the fitness rings, yeah, exactly.

SPEAKER_01 14:56

Yeah, yeah, yeah. And they just monitor constantly monitor, monitor like metrics so intense. Now, my friend is a footballer, and she she's a professional footballer, she's very good. She has one because it monitors, you know, the metrics you need to be at a top-level athlete. Yeah, I don't need to monitor my via tools and things when I'm lying on my ass eating pizza, watching Netflix. I do not need to keep an eye on that.

SPEAKER_02 15:23

I have a little uh app. It's interesting. See, now I can find it interesting, which is I think a commentary on health anxiety. Back in the day, I would have never been able to see this data, but on my Apple Watch right now is there's a little app that basically measures your stress level. What is it doing? It's checking my heart rate variability. That's all it's really doing. It might look resting heart rate. Right now it says that my stress level is 16, which is pretty low, which is right, because I like and like this is fun, right? I like doing the podcast. But someday, sometimes I will glance down at like, oh, my stress level is 85 out of 100. Like for somebody with health anxiety, that can become an absolute obsession, though, because oh, HRV indicates my stress level, which indicates my health. Like, oh, I can't be too stressed because the card is always gonna kill me, and blah blah blah blah blah. And then you just constantly check all day long and try to keep that number really low, and that's not okay. Can't do that.

SPEAKER_01 16:12

No, and also not all stress is bad. Right. No, I'd love to um measure my HRV levels whilst listening to the Anxiety Guys podcast. I'd love to be interested in the stats there. 100% correct. Uh, I've got something else. Um, hi Drew and Josh. My name is Jeanette, and you can use my name. I just wanted to share a did it anyway, doing it anyway with you guys. I've been suffering from panic disorder, GAD, and health anxiety for well over five years now, to the point where I left my job and couldn't leave the house because of all the weird and wonderful physical symptoms panic and anxiety bring. Anyway, after listening to your podcast and all the great advice that you guys give, I feel like that this past year especially, I've I've really turned a corner. I've gone back to work in a job that I love. And also, me and my partner have started IVF treatment, which for me, having health anxiety and being a bit of a control freak has really tested my anxiety, having to go through all the medical tests and all the uncertainty it brings. And even though at times I've noticed my anxiety trying to take over, I've let the uncertainty be there and give myself a pat on the back and given myself the credit every time Craig the Critic has been in my ear trying to put me down.

SPEAKER_02 17:28

Oh, come on.

SPEAKER_01 17:33

How good is that? That is awesome.

SPEAKER_02 17:35

That's so good. You know what? Even in health anxiety, we talk about this stuff all the time on the podcast. That is a move away from the fear that health anxiety creates and toward values. I'm I'm Oh, yeah, he loves he loves his values. I'm a big fan of values. Like uh we're doing IVF treatment for a reason. We want a family. This is something that's important to me at a core level, so I will move toward that, even though the fear tells me to move away from that. Well done. Yeah, yeah.

SPEAKER_01 17:58

It's so good. That was really nice. I had a massive smile on my face after reading that.

SPEAKER_02 18:01

Yeah, love it.

SPEAKER_01 18:02

Um let's talk for seconds. Really well done.

SPEAKER_02 18:06

Yeah, for sure. I have a question for you, Mr. Therapist in the room. What if Yeah? And so I think this is kind of uh I I want to bring it up because I think in a lot of times people, uh, just about everybody with panic disorder, or many people with panic disorder and agoraphobia, will often say, Well, I have health anxiety. Which they might. But I uh there's a subtle difference, I think, and I want to hash it out a little bit. What do you think the difference is between the health the health fixation in something like panic disorder and the health fixation in health anxiety? Now somebody can have both at the same time, it's true. But what do you think the difference is?

SPEAKER_01 18:42

There's for some people, the catastrophic thought in panic disorder is that something urgent is going to immediately kill me. So panic disorder is often what if my heart explodes, what if this gets so much that I break because the intensity of the panic and the anxiety is the thing that's going to kill them. Health anxiety is more of I there's a fear that I am already decaying and declining, and I must keep an eye on that because that's going to happen in the future. It's almost like you've been tricked into thinking you're preventing something bad happening, you know, where it's a little less urgent in the sense of when the catastrophe is, but the compulsions and the obsession and the fixation still the same. Uh panic disorder often, I mean, there's lots of similarities, you know. I there the I are I do believe that all um anxiety disorders are obsessive-compulsive, um, but the reasoning is different, I think, sometimes, you know, and and of course they can overlap. So when you've got that, you know, I've got health anxiety, uh, cardiophobia, which we write about in the book. Did you know we wrote a book? We've not announced it. And what we're gonna do is you might be afraid of your heart, but then you are also afraid of panic, and then what is panic doing to my heart? So there's loads of overlap and things like that. Um, but yeah, in general, I my approach is the same. We look at compulsions, safety behaviors, and avoidances, and we build big ourselves up to address them and stop them.

SPEAKER_02 20:19

Yeah, I think great answer. Um, I would agree a hundred percent. I think it, you know, somebody has that health where the panic or even just anxiety is represent is uh interpreted as an immediate health threat, your avoidance and compulsions are tend to be to try to avoid the anxiety or the panic itself, because that's what brings about the scary body thing or or health crisis. Whereas in health anxiety, not so much. It doesn't, you don't have to be anxious to fear the the health outcome. So it's a little bit different. I mean, there's overlap, but people often get confused by that. Well, well, I have health anxiety too, but really it's well, I I I fear that when I get very anxious, that means I'm having a stroke, which is a little bit different. But in the end, you're right, the approach is gonna be the same, just that the time frame might be a slightly different, right?

SPEAKER_01 21:02

So did you ever have the one where like honestly, and sometimes I still get the intrusive thoughts now, like I smell like burnt toast or a weird smell, and I'm like, and I immediately just go, and I don't even think this is a health anxiety. I think a lot of people are just I'm like, Yeah, and I immediately just grab like my face and be like Yes, I have that. Yeah, yeah. I even get it now, yeah. And I'm just like 100%. Yeah, it's probably unlikely, but who the hell is making toast in this field?

SPEAKER_02 21:32

That can happen, it really can. And I have ideal that is really making me laugh. Remember because I have the same thing. Sometimes it's a weird smell, and like, uh, is there some sort of bleed happening in my brain right now that's making me smell because why? Because when we deal with people, it's interesting. Let's talk about like, you know, we talk about this in the book for sure the disordered guide to health anxiety. When you overcome health anxiety, a lot of people feel like, oh, well, that means that I'm going to overcoming health anxiety means I will attain a sense of. Peace and certainty about my health. But that's not really it, right? So and there's no delete button in our nervous system and in our brains and in our pathways. We know that. We can only make new pathways. That's why Josh and I will smell odd smells and and have the thought, like, hmm, clearly I'm having a stroke. Now the recovery from that uh moment for us is probably pretty quick. Like, uh, what is I can what is a silly? I get it. But the the issue when you overcome health anxiety is recognizing that, like, oh yeah, I did get triggered into a health scare, but I know what this is, and I know the instructions to compulse and and fix it and be sore about this, but I don't have to do that. I can go back to my life and whatever it is you happen to be doing at the time and let that pass, and then it's not a lingering concern that lasts for two weeks or or two months, right? So the burnt toast.

SPEAKER_01 22:48

Yeah, yeah, and yeah, I forget about it like a lot in the day. It's the difference, that's that's not disordered anxiety, right? It's just a human thing.

SPEAKER_02 22:54

Yep, yeah.

SPEAKER_01 22:55

You know, in fact, I remember at the time it happened, I was with my friend, I was like, Can you smell toast? And then my friend looked back at me and he was like, Yeah, I was worried I was having a stroke. I was like, I was worried I was having a stroke. And then I said, What if we're both simultaneously having strokes?

SPEAKER_02 23:09

Well, yeah, so this is so interesting because in health anxiety, and I've talked about this a lot. Like, I I I I don't think I invented this, but I used to use the term health math or risk math, right? Life math. So is it possible in that moment that you and your friend are simultaneously both having a stroke? It is possible.

SPEAKER_01 23:27

It's possible.

SPEAKER_02 23:28

It is possible, you know, the probability is not zero, but and if it's not zero, health anxiety would be like, I cannot take that kind of chance. So like you'd both be in like dual ambulances heading to the AE, right? Because like, I can't take that kind of chance. Well, the what are the odds that both of you are having a stroke? Not zero. And if it's not zero, health anxiety says, do something. We need zero.

SPEAKER_01 23:50

Yeah. Well, one of my favorite chapters in the book that we that we wrote together is that it's not the health, that's right, it's the anxiety. Yeah, and you know this as well. I've got a friend who's gone through cancer twice, you know, it isn't obsessive and compulse. And I and I sit there sometimes. I'm like, wow, I mean, I I might do, you know, if I was in your situation, because he's not got a firing off threat response going off. Overcoming health anxiety is turning off the misfiring, hyper-vigilant, overactive. Yeah. Wait, wait, where is it?

unknown 24:24

Amygdala.

SPEAKER_02 24:25

I can do better than that.

SPEAKER_01 24:27

Amygdala.

SPEAKER_02 24:28

There you go.

SPEAKER_01 24:28

Exactly. I like that. And um that's what it's like. Because the aim is to not eradicate all symptoms so you feel fine because you have learned nothing. The aim is to turn off the misfiring whoosh, you're about to get eaten by a lion response when you feel a twinge in your leg or your chest starts to hurt. The having a chest starting to hurt is fine, you know. Um, and it's well, it's not fine, obviously, you know what I mean, but like it's we you overcome health anxiety when you react to it like non-anxious you would do, or slightly anxious you would do, right? Not 100% I've got a bazooka pointed at my eyeballs kind of reaction.

SPEAKER_02 25:11

Yeah, right. And I think it it's the length of the impact, right? So anybody who just randomly is walking down the street and experiences pain in their chest might get a little bit triggered, like anybody, health anxiety or otherwise, which is fine. And then the person with health anxiety doesn't that never dissipates. I mean, it does, but they don't let it naturally dissipate, and they instantly will say, that is so important that I cannot treat it like my friend would treat it. I must treat it with more urgency, I must be more thorough, I must not forget it, I must keep this problem alive and make sure that I'm sure about it. Whereas, you know, it can still happen to you, and maybe you'll have that momentary, like, ooh, jolt of fear, because any human would, but how quickly can you get back into the like, wait, how do I want to treat this? What's the right way to do this? That's it. So you're right, it has nothing to do with the health, it has everything to do with the anxiety. And a lot of people listening be like, of course it has to do with health. No, it actually doesn't. This is an overvaluation problem. You are overvaluing thoughts and emotions and ideas and experiences and memories and data and misapplying them. Health just happens to be the topic. Same mechanism at play in GAD, OCD of various themes, other same thing, just that it's latch onto health for you. That's it.

SPEAKER_01 26:23

Yeah. And that's why health anxiety and OCD are often uh go hand in hand. Yeah. You know, it's the obsession. And because OCD with any theme, anyone with OCD listening to this will relate to the fact that their theme is important because that's right, you know, and then they always say the same thing. I'd switch my theme with someone who's a hand washer, I'd switch my theme with someone, yeah, because you can't empathize because your threat response doesn't bazooka when you have that thought. Yeah, the same applies with health anxiety, you know. Someone you because it's your health, it taps into your values and justifications to this is your health, or you're a mother or father, you need to look after yourself because what else's gonna happen there and whatever. Anything to get your attention to feed the obsession, and it's usually through attention-based compulsions, which we do talk about in depth in the book that we wrote that is available now. What is the name of that book? It's called The Disordered Guide to Health Anxiety by Disordered Press. Yes, it is. So, yeah, yeah, yeah. We we're not we're doing a disordered press series and things. Um, can you play the sad trumpet? I could. Wonderful, that's announced a question. Hey Drew and Josh, how can I manage my anxiety when I am awaiting medical test results? Well, there's a great person here that's done it himself. My health anxiety has been pretty bad recently, and it's even harder when I'm having real symptoms that the doctor wants me to get thoroughly checked. How can I stop catastrophizing and function this week until I find out if it's good or bad news? Thanks. Excellent question.

SPEAKER_02 28:10

Oh, okay. You want me to answer that one? Um, here's the way I would approach that. Like the first thing we always want to do is validate and recognize you are in fact worried about that, and anybody would. So a lot of people will say, I have to find a way to calm down and not care about that. How do I not care about that? How do I not catastrophize? No, no, you will. You are worried, you are anxious, you are afraid. So start there. What am I experiencing in this very moment? I am afraid, I'm having a lot of thoughts about my health. Okay, cool. Now what should I do? Because as much as I think, see, this is why it's not about the health, it's about the anxiety. The compulsive response would be I have to keep thinking about that. The right thing to do is to simulate outcomes and tell myself stories and go and see, you know, on Google or ChatGPT or look in forums for this particular problem, or just keep talking about it again and again and again. But really, that is pointless. So remember, I see this as an overvaluation of thinking and thoughts. There is no useful outcome at all, only a negative outcome. So I have to take the risk of moving my attention to something else like lunch or texting my friend or playing, you know, the game that I'm in or whatever it is, while I can acknowledge that I'm worried about my health.

SPEAKER_01 29:31

That's a really good answer. In fact, that we've had so many questions like this. There's another one here. I've um I've really struggled in the past few weeks as I'm experiencing very real symptoms that doctors are concerned about. Yeah. Um, how can I manage my health anxiety during this time as my panic feels justified? But also I'm absolutely spiraling and haven't been able to function. Yeah. The referral waiting time is agonizing to me, but I want answers urgently now. And guess what I'm really asking is how can I manage the symptoms and compulsions of health anxiety during a genuine healthcare? That's the answer there. Also, plenty of tips as well that we do in each case study in the book. But in general, there's so many of these questions. You're not alone in that. Yeah. But we we kind of focus on the anxiety side of things, the firing response, the adrenaline in the cortisol that's keeping us, you know, that's torturing us, really. Yep.

SPEAKER_02 30:23

I think, you know, the emotions are justified. The fear, the uncertainty, the feeling of vulnerability, the concern, like all of those things are going to be elevated in that context, and they are justified. The emotions are justified. The response in the form of desperately trying to find certainty or answer the question that cannot be answered right now, that's not justified. So the concern about your health is 100% justified. How what you do with that concern is not justified. Constant worry and active rumination that you are choosing to engage in or follow the instruction to do, or or whatever other compulsion you engage in, that is not justified. It does not save you, help you, or protect you at all. So that's a hard sell, but it's true. If there's something you can be doing, great, then do it. Certainly do it. But if there's nothing you could be doing, and those compulsions are not actually doing anything except trying to calm you down in the moment, still I I I like looking at health anxiety through a mechanistic lens, but also like people with health anxiety will all every single one will admit actually, I've been a worrier in my life.

SPEAKER_01 31:33

I've worried about other things I've worried growing up. Yeah. And this is a question of things getting the credit. So as you've grown up and you've worried about things and they've turned out okay, what you've actually inadvertently taught the brain is that the worrying has got some of the credit for those for that uh outcome not becoming a disaster. And that's great. And you can get away with that throughout your life, but then when there's something that you know that happens that where it requires you to wait, be patient, lean into uncertainty, that worrying mechanism that we've done throughout our lives, that we've confirmed, well, thank you, worrying. You know, you've kept me safe in the past. You apply that now, you've got the perfect kindling for health anxiety because your brain's going, well, this is something that has got some of the credit for bad things not happening in the past. So I'm gonna use that now. And that's I can definitely relate to that myself as well.

SPEAKER_02 32:27

Yeah, yeah, I'm with you. Uh you're an overvaluation of cognition as a problem solving or protective mechanism, or sometimes there are behavioral compulsions, like you know, the Googling and the constant checking of symptoms and learning as much as I possibly can about that, that's protective. Well, I mean, you have a right to know about your health, certainly, but like you only you will know when it is tipped into I've done enough of this and I want to step away from my keyboard, but I feel like I can't. It's too dangerous to stop researching. That's when you know that you're in health anxiety territory. So yeah, yeah. Like I need something to protect me. You have a right to want something to protect you. Let's validate that. But does this actually protect me? No, it actually doesn't.

SPEAKER_01 33:07

So yeah, we've written down what we know about health anxiety, yeah, all in a lovely book for you. It's not a big book, you know, it's just a nice pocket-sized book that you can refer to. Yeah, and everything you need to know is in there with the health anxiety. Loads of examples, questions, pitfalls. We share our own experience, and um, we're really excited to be able to kind of share it with you. You can, it's available on Amazon and you can purchase it there. And yeah, we'd love to see you um, you know, send any pictures with it or let us know your thoughts and things like that. Yeah, um, because we're excited, also a bit nervous as well. I'm a bit nervous, but I think people really like it. I'm very proud of it. Um, and yeah, just let us know if you want to um, you know, your thoughts and feedback on it.

SPEAKER_02 33:55

Yeah, it's so interesting. I'm nervous about it. Me too. It's uh I mean I haven't published a book in a few years, and it's when you texted me this morning and like, hey, look, I uploaded to KDP, I was a little nervous, a little propped up, like, oh, cool.

SPEAKER_01 34:08

Um Yeah, it's gonna be great. I'm really looking for we've also mixed up the Anglicanized and Americanized words as well, so that's quite fun.

SPEAKER_02 34:16

I've done a fair amount of bitching and moaning in the book about the British spellings of several words, so you'll appreciate that.

SPEAKER_01 34:22

I would look at the correct spellings of words, yeah, yeah.

SPEAKER_02 34:25

Yeah, I want to I want to bring up one more thing that we did write in the book because when we talk about this stuff, and we've done another health anxiety episode, or people might read the book and think like, oh, well, you know, easier said than done because health is so important, and I have kids, and I can't take that kind of chance, and blah, blah, blah. We wrote a chapter in the book on courage because in every anxiety disorder, there are moments when you must choose to be courageous when you turn your back on the compulsion, right? That the Oh, yeah. Yeah. Like that is real. You are scared, and it feels super reckless, especially people with health anxiety will say this feels reckless, irresponsible, and dangerous.

SPEAKER_01 35:03

I can relate to that.

SPEAKER_02 35:04

Yeah. Yeah. I have had it all, especially I hear from parents all the time. I have a family. I can't take this kind of risk. I understand. So that means if you turn your back on that health-based compulsion, you know, that you that you keep engaging in that's kind of ruining your life, but you think it's saving you, that's a brave moment. You there's no way to turn off this fear or make that feel less reckless. Only repeated experiences will teach your brain that you know, it's it was never reckless. It's okay. But it's okay. We got to acknowledge that. We wrote a whole chapter in the book about the role of courage in overcoming health anxiety because it's in there.

SPEAKER_01 35:41

Oh, yeah. Wish it wasn't, but it's in there. Very happy. Honestly, I'll if if I had this book when back in the midst of mine, that would have been like bloody hell. Would have been much better. These two arrogant pieces of no, no, no. That'd be like, wow, that's that that's my brain.

SPEAKER_02 35:54

Yeah, 100%. I hear you. So anyway, yeah. Um I'll put a link to the book in the description of this podcast too.

SPEAKER_01 36:00

So if you're on YouTube, yeah, and we'll put it on disordered.fm website as well. So if you if you're not sure where to find it, you can put it there. But yeah, go find it. That's cool. Anyway, we'll be back next Friday. If you've got any did it anyways and things, send it in to disordered.fm voice notes and emails and things. And we tried to get through them. We really appreciate your support for this podcast as always. And uh we'll look forward to catching you next Friday. Go and enjoy the book. Let us know what you think.

SPEAKER_02 36:27

Thanks for hanging out. We'll see you next week.