The new hypochondriac

Most anxious people have pretty well been like that most of their lives. Their anxiety may get better or worse but, for the most part, they always consider themselves anxious people.

But in a small number of cases, a debilitating anxiety disorder seems to come out of the blue. These people seem to have functioned very well for most of their lives until a relatively minor event throws them into a state where they are overwhelmed with fears and obsessions. In the column I published last week, I tell the story of two fictional people. Joe represents just this type of person, one I see from time to time in my practice.

This type of later in life and sudden onset anxiety is actually not that difficult to understand. The reason it occurs has to do with how we think and how we perceive risks. I explain it below so I won’t repeat myself but this can occur to anyone who thinks in absolute terms and does not put risk into perspective. A car accident, a near miss plane crash, or a health scare, to name a few examples, can interact with the black and white thinking style and mess with the person’s previously calm mind.

New challenges
(Source:  Nouveaux Défis. Journal Métro, November 15, 2011) (Voir plus bas pour version Française)

Mike and Joe are both relatively well-adjusted and normal men as they approach middle age. They both wake up one day with strange pains in their chests and end up in emergency. Fortunately, nothing seems to be wrong with either of them. Some sort of muscle spasm caused the sensation. Their hearts are strong.

Mike quickly gets back to his normal life and forgets the incident. The chest pain turned out to be nothing more than a blip on the radar. Joe, on the other hand, is a changed man. He struggles with existential questions of life and death. He obsesses over his health and spends hours every day panicking and crying. How can the same incident have such radically different effects on two seemingly normal men?

Probable or possible
It turns out that Mike and Joe think very differently and did not see death the same way before the incident. Mike was able to think in greys all his life and always understood he could die any time. He also knew that, although possible, this was not very probable in the short term. This made him able to get through the incident and chalk it up to, “Whew, I guess it wasn’t my time yet!” Life goes on.

Joe, on the other hand, is a black and white thinker. In his mind, death was one of those things he knew could happen, sort of, but it was too remote to feel real. In his case, the incident shook his reality. The fact death can happen any time is now something very possible. That it is not very probable at this stage in his life is totally irrelevant. His mind can’t think in degrees. His black and white world is no longer white.

Blissfully naïve
Some people are able to see their lives and their worlds in very probabilistic terms. They know bad things can happen but most of the time don’t. They can put risk and dangers into perspective and live with them. Then there are people who are more absolute in their way of seeing things. Something is either dangerous or not. Accepting relative risk is not in their mindsets. They go through life blissfully naïve until an event occurs that forces them to the other extreme. They are suddenly thrown into a world where bad things become real and appear imminent.

Such is the nature of new challenges. Since they are uniquely different from ones we have faced in the past, they can sometimes reveal character traits we didn’t know existed beforehand.

Voici la version Française:

Nouveaux défis

Michel et Jean, deux hommes d’âge moyen, sont relativement équilibrés et normaux. Un matin, tous deux s’éveillent avec d’étranges douleurs à la poitrine et ils aboutissent à l’urgence. Heureusement, il s’agissait d’une fausse alarme, pour l’un comme pour l’autre. Un spasme musculaire aurait causé cette sensation. Leur cœur est solide.

Michel retourne rapidement à sa vie normale, et oublie l’incident. Cette douleur n’était qu’un écho sur l’écran radar. Jean, par contre, a changé. Il est aux prises avec des questions existentielles sur la vie et la mort. Obsédé par sa santé, il passe des heures, chaque jour, à paniquer et à pleurer. Comment un même incident peut-il avoir des effets aussi radicalement opposés chez deux hommes apparemment normaux?

Probable ou possible
Il se trouve que Michel et Jean n’ont pas la même mentalité et ils n’envisageaient pas la mort du même œil avant l’incident. Toute sa vie, Michel a été capable d’établir des nuances, et il a toujours pensé qu’il pouvait mourir n’importe quand. Il savait aussi que, bien que ce soit possible, c’était peu probable à court terme. Cela l’a aidé à passer à travers l’incident, qu’il résume par : «  Mon heure n’était pas arrivée! » Et la vie continue.

Mais pour Jean, tout est blanc ou noir. Dans son esprit, la mort était une chose qui pouvait se produire, mais cette idée était trop éloignée pour être réelle. L’incident l’a ébranlé. Que la mort puisse survenir à tout moment est maintenant possible. Le fait que ce ne soit pas très probable à ce stade de sa vie est hors de propos. Son esprit ne fait pas de nuances. Son monde blanc et noir n’est plus blanc.

Une naïveté béate
Certaines personnes sont capables de considérer leur vie et leur monde d’un œil probabiliste. Elles savent que les malheurs arrivent, mais que, la plupart du temps, ils ne se produisent pas. Elles peuvent mettre risques et dangers en perspective et s’en accommoder. Et puis, il y a les gens qui pensent d’une façon plus absolue. Une chose est dangereuse ou elle ne l’est pas. Accepter un risque relatif n’est pas dans leur mentalité. Ils traversent la vie dans une naïveté béate, jusqu’à la survenue d’un événement qui les pousse à l’autre extrême. Ils sont soudainement plongés dans un monde où les malheurs deviennent réels et semblent imminents.

Telle est la nature des nouveaux défis. Comme ils diffèrent totalement de ceux auxquels nous avons dû faire face dans le passé, ils peuvent nous révéler des traits de caractère dont nous ignorions même l’existence.

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Posted in Anxiety.

Posted on 23 Nov 2011

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2 comments to The new hypochondriac

  1. Heidi
    On Nov 24th 2011 at 18:23

    Wow…this is me …the world is black or white…dont take risks very often …how do I change after a lifetime of living this way….

  2. Jean-Marc
    On Jan 4th 2012 at 19:28

    C’est exactement ce qui m’est arrivé. Right on Dr. Z !