Calling all hypochondriacs: Check your pulse

Health. It’s one of those things we all need to worry about. If we didn’t, we wouldn’t do things like exercise, watch our weight, or eat foods like broccoli and alfalfa sprouts. By worrying just enough about health, or anything for that matter, we are generally safer.

Like many things in life, anxiety is neither good nor bad. It depends on the amount of it. Too little health worry and we don’t do things like eat well, exercise, and avoid cigarettes. Too much of it though and we can ruin the lives we are trying to protect.

Anxiety is unpleasant for a reason. It is like the mechanism of pain. It pushes us to do things until it goes away. This normally makes us safer and ensures maximum survival. Unfortunately, when that maximum is not 100%, we have to deal with the fact that something bad can happen despite our best efforts.

A big problem occurs when we focus too much on our health. When worried, we tend to check. Checking is usually good because it reassures us. Unfortunately, despite this reassurance, there is no guarantee we have nothing. After all, health ultimately fails all of us. This means we must also learn to live with the fact of not knowing for sure. By resorting to the health check, we never learn to let go and trust that we are as healthy as can be (or at least insofar as we can control).

When we worry too much, we tend to become hyper-vigilant. By focussing too much on our bodies, we will start to notice minor fluctuations in how our body works (mild pains, flutters, spasms, variable heart rates, headaches, etc). These are completely normal and happen to the healthiest people. But when we are focussing on them, they tend to trigger anxiety. This anxiety can not only make us feel worse, it can also create more symptoms (such as an increase in heart rate), which in turn will feed the anxiety.

In today’s Metro column, I tell the story of a man who tried too hard to reassure himself and how this exaggerated effort created the panic attacks that were plaguing him.

Check your pulse
(Source: Prenez votre pouls. Journal Métro, January 28, 2014)
SVP, voir plus bas pour la version Française

I once worked with a man who had a terrible fear of having a heart attack. He was so scared he constantly checked his pulse to see if everything was normal.

There are only two possibilities when it comes to checking your pulse. The first is that it is elevated and the second that it is normal. Let’s look at these two possibilities in detail.

Elevated pulse
Let’s suppose the gentleman tests his pulse and finds it is elevated. Then what? He will think there is a problem with his heart and this will trigger panic. The panic will make his heart rate increase which in turn will worsen the panic. Basically the result of this possibility is a guaranteed panic attack. What about possibility two?

Normal pulse
Here’s where it gets interesting. When we are nervous we tend to check to see if everything is normal. That’s what this man does when he worries. If his pulse is in the normal range he breathes a big sigh of relief. Perfect. Except it is only a matter of time before he gets the thought again. What about now?

Each time he checks, and it is normal, he feels good. It is like scratching an itch. Each time he gets a worrisome thought he will have an urge to check again. But no matter how healthy he is his heart rate will fluctuate like everyone else’s. Eventually he will find it is higher than expected. Oh my God. Now it isn’t normal! This will surely trigger a panic.

In other words, by checking his pulse this man is guaranteed to experience either an immediate panic or an eventual panic. In his efforts to reassure himself he will only cause more suffering.

It is important to feel worry because it protects us. When we worry about a problem, our search for reassurance helps us find solutions. As a result we are typically better off. Better off, that is, if there is a solution to be found. When there isn’t then we’re in trouble. When we check we feel good but it increases our need to check again. There is no point in overdoing it. When there are no guarantees of health, any reassurance we feel will be fleeting.

Health is one of those things we can’t absolutely control. No matter what, we have to get used to the idea that we may die soon, even if there are no warning signs. The only security we really have is to do the right things – eat well, exercise, follow medical advice. We must also accept that, while improving our odds, it is still no guarantee of a long and healthy life. But at least it’s a guarantee of a less worried life.

______________________________________________________________

Voici la version Française:

Prenez votre pouls

J’ai déjà travaillé avec un homme qui avait une peur bleue de subir une crise cardiaque. Il prenait constamment son pouls pour vérifier si tout était normal.

Il n’y a que deux possibilités lorsqu’on prend son pouls. La première est qu’il soit rapide, et la deuxième est qu’il soit normal. Examinons ces deux possibilités plus en détail.

Un pouls rapide
Supposons que l’homme prenne son pouls et le trouve rapide. Il pensera qu’il éprouve des problèmes cardiaques et cela déclenchera la panique chez lui. La panique fera accélérer son rythme cardiaque, ce qui augmentera sa panique. Donc, cette possibilité mènera inévitablement à une crise de panique. Qu’en est-il de la deuxième possibilité?

Un pouls normal
C’est ici que cela devient intéressant. Lorsque nous sommes nerveux, nous avons tendance à vérifier si tout est normal. C’est ce que fait cet homme lorsqu’il est inquiet. Si son pouls est normal, il pousse un grand soupir de soulagement. Parfait. Mais ce n’est qu’une question de temps avant qu’il ne pense : Est-il encore normal, maintenant?

Chaque fois qu’il se tâte le pouls et que celui-ci est normal, il se sent bien. C’est comme se gratter lorsque ça démange. Chaque fois qu’il est assailli par une inquiétude, il ressent le besoin de vérifier de nouveau. Même s’il est en parfaite en santé, son rythme cardiaque fluctuera, comme pour tout le monde. Il finira par enregistrer un rythme plus rapide que prévu. Oh mon Dieu. Il n’est plus normal! Et cela entraînera sûrement une crise de panique.

Autrement dit, en prenant son pouls, cet homme est assuré de paniquer sur-le-champ, sinon un peu plus tard. Ses efforts pour se rassurer lui-même ne feront que causer davantage de souffrances.

Il est important de ressentir de l’inquiétude, car c’est ce qui nous protège. Lorsque nous sommes préoccupés par un problème, notre besoin d’être rassurés nous aide à trouver des solutions. Par conséquent, nous nous en portons mieux. S’il y a une solution à trouver. Parce que quand il n’y en a pas, nous sommes dans de beaux draps : le fait de vérifier nous fait sentir bien, mais cela augmente notre besoin de vérifier de nouveau. Ça ne sert à rien d’exagérer. À chaque fois, nous ne serons rassurés que temporairement.

La santé est une chose sur laquelle nous n’avons pas le contrôle absolu. Nous devons nous faire à l’idée que nous pourrions mourir prochainement, même en l’absence de signes avant-coureurs. Tout ce que nous pouvons faire, c’est prendre soin de nous : bien manger, faire de l’exercice, suivre les conseils de notre médecin. Nous devons aussi accepter le fait que, tout en augmentant nos chances, cela ne garantit pas de profiter d’une vie longue et en santé. Par contre, vous vivrez avec moins d’inquiétudes.

Tagged as health anxiety, hypochondriasis.

Posted in Anxiety.

Posted on 28 Jan 2014