Doctored If You Do, Doctored If You Don’t: Where Phobia Meets Anxiety

TW: Medical (including needles)

Imagine waking up on a deserted isle completely alone. For the average person it would be a terrifying experience, but for you the real terror of the situation only compares with your two longstanding phobias: boats and planes. Imagine if the only way out of one awful situation was confronting another? What would you do?

The area where I can provide the most benefit to others is anxiety because I have both lived experience and clinical treatment. It’s a subject about which I can speak somewhat intelligently. To that end, my blog often features some discussion of my illness anxiety disorder but I have not provided much insight into my companion problem: medical phobia.

Now, people are familiar with phobias. It comes from the Greek, “scares the living piss out of me” and clinically refers to fears and/or anxieties well beyond what the situation requires. You know, if you find yourself face to face with a great white shark, it’s reasonable to have a fear response. If you are in your urban high rise and still afraid of sharks, then you have a phobia.

(138) A Charlie Brown Christmas – Clip – YouTube

Illness anxiety is a different beast. People hear the name and might think it relates to “white coat” anxiety – a sense of unease in medical settings. Illness anxiety is closer to what one used to call hypochondria; the frequent correlation in the DSM-V is somatic symptom disorder. A distinction between the two is, in amateur terms, that those with somatic symptom disorder have specific symptoms they view as more serious whereas with illness anxiety the symptoms may change or not even be present.

I, for example, tend to assess my internalities intensely. The slightest twinge or change in how something feels sends my mind into a spin. Heaven forbid it disrupt me enough that I feel compelled to use the Internet for clarity.

Between over-interpreting actual sensations (I won’t even call them symptoms here) and a general sense that something awful will eventually happen, I obsess about my health. I check my temperature even when well for trends and likewise assess my pulse. I worry often that I have not had the proper nutrition or hydration to support my activities, and exercise is intimidating because I worry about injury and whether my body can handle the stress.

The real pain is the phobia though. I cannot handle medical things – I mean, the people, sure, but not the settings, procedures, or tools. The more invasive a procedure, the worse the phobic response is. Let me back up. The more invasive a possible procedure, the worse the phobic response is.

See, it works with the illness anxiety. I have a symptom and assume something is wrong. Usually it starts minor and if I can wait it out, everything passes. If the sensation lingers then my mind starts to demand answers (obsessive thoughts begin). Not being a medical professional, my search into what it could be never goes well and I instead see a list of possible causes. Those causes tend to correlate with a list of examinations and curative procedures.

Possible exams and procedures may as well be scheduled exams and procedures in an anxious mind.

In particular, anything that involves penetration is a concern and, within that definition, anything that involves cutting. Palpating and visual examinations make me nervous to the point of sweating, but few things register on my fear scale like the idea of something other than food, drink, oxygen, or mild medication entering my body (even stronger medications scare me). This extends to non-medical settings (the idea of a paper cut, even typing it here, triggers me and I have to step away and de-escalate), but medical settings are prime for this sort of thing.

The two tend to feed one another. For every twinge of worry caused by the illness anxiety I start to imagine the tests necessary to determine if anything is even wrong. The phobic response causes me to avoid medical care in many circumstances, which tends to enhance the illness anxiety because I worry that I’m not catching the serious thing as early as I could. Not only is it more likely that I will have a serious issue at some point because I do not seek routine care, it’s also likely that it will be worse because I will not catch it as early as the average person.

Pursuing medical care excessively (which is indicative of the same mental health issue) would reveal my concerns are irrational, thus alleviating the illness anxiety, but would require subjecting myself to fear-inducing tests.

I have not even mentioned the social anxiety of making these poor medical professionals deal with my nonsense!

I despise my teeth and smile, which along with my fear of literally everything at the dentist (they use drills, metal hooks, and needles – all far too close to highly sensitive nerves) makes me a sweaty, apologetic mess. Routine cleanings are spent bracing for an unexpected sensitive spot or news that a root canal or extraction will soon follow.

Nurse practitioners and technicians become the good cops with whom I plead for understanding before the doctor arrives (I never expect doctors to have patience for my nonsense, and the unnerving work often falls to the staff anyway). It leaves me feeling even worse for dumping so much emotional work on the support staff – not to mention the fear that I become the subject of water cooler conversation the second I am gone. I suppose my charm is an attempt to switch those conversations from mockery to compassion, at least in my own mind.

Having both illness anxiety and a severe medical phobia truly is life between a rock and a hard place.

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