Hypochondria in 2020

Hypochondria is a persistent anxiety in relation to physical ailments. Most commonly, it’s the idea that symptoms are either imagined entirely or blown out of proportion to fulfill a catastrophic fantasy.

I am a hypochondriac, though admittedly a functional one. It weighs on me, on a daily basis but does not debilitate me most of the time. My anxiety has manifested as hypochondria most readily since my large body transformation several years back.

As I became more sexually active, at some point I tested positive for gonorrhea for the first time. I didn’t really need to get tested, the symptoms were obvious. Despite having dealt with the obvious symptoms in my first go ‘round, it wasn’t until my third time catching gonorrhea that I began to appreciate it wholly. My throat had swollen up overnight and I woke up barely able to breathe. Treatment was much more acute and severe.

I now knew the extreme (sort of), and I proceeded with a seed of fear. Instinctively, whenever I fooled around after that, I would probe the lymph nodes around my throat incessantly, and I would be much more sensitive to how my genitals felt. It came to a point several times where I was convinced I was symptomatic and proceeded to get tested. I’ve tested negative almost every time. Worse yet, at least half of the time I’ve tested positive I have been wholly asymptomatic.

I do this to myself at least ten times a day. I think people might assume I’m into soft strangulation, but really I’m just obsessed with mah nodes.

It’s been genuinely disheartening and trying. I want to feel like I can trust my body, and explore my life. But I have evidence, and therefore reason, to believe that my body is capable and willing to tell fictional stories AND that my body is sometimes incapable of telling the whole truth.

Unfortunately, that’s a rather large part of it altogether. Biologically, the human body is fairly rudimentary and has a limited vocabulary to describe itself. That’s fundamentally one of the reasons we employ general physicians; they serve as interpreters for our body’s terrible language.

It’s a language of inflammation, bile, fatigue, etc. And despite being rather small, it’s trying it’s best to describe an incredibly large set of possibilities.

Bright side — we’ve come a long way since we were certain the body ran on four “humors.” I know my jokes make people gag sometimes, but that takes it a bit far.

There’s a reason WebMD so frequently tells you you’re dying. Well — there are a few reasons.

You are dying, it’s called living.

But also, inflammation, sore throat, head ache, fatigue, nausea, diarrhea? They’re literally all just ways your body is attempting to right itself.

Hypochondria is when I recognize these symptoms and begin to conflate them as specifically indicative of worst case scenarios. Flatly, this has become a monumental obstacle in the last several months. The increasing awareness of this pandemic, in concert with the evolving understanding of the virus and it’s fluctuating list of symptoms has been a siren I can soften to a low roar at best.

Mollifying my panic requires a lot of small interventions. If anything I wanted to write them down for personal reference, though perhaps they can be useful for you as well, dear reader.

Fever

You temperature will go up immediately after eating. As your body begins to digest the food, the chemical bonds broken release heat in a process called thermogenesis. You may experience what feels like a slight fever, and if you’re outdoors, it may feel chillier as your internal temperate climbs higher in comparison to the ambient air temperature. Similarly, drinking will increase your body temperature, as will physical exertion. Temperature regulation is a process, and your skin will flush and sweat to attempt to return back to a normal body temperature.

Am I hot in here or is that an everywhere thing?

Your hands are not accurate sensors of your own body temperature. Not only do they operate on the same system and therefore most frequently will be unable to feel a difference, it’s most likely that your hands will give a false positive for fever. This is because your hands (along with your feet and ears and other extremities) are highly vascular and therefore require a lot of bloodflow to maintain at the internal core temperature. It’s more efficient for your body to allow your extremities less blood flow, but this also means that they end up being a bit colder quite frequently. This problem is worse for people who have low body-fat for very thin skin, since both populations will struggle to keep in their body heat due to a lack of insulation.

Scratchy Throat

Coffee is a mild diuretic meaning you’ll need to pee more and you may become more thirsty as a result. A slightly dry throat can be expected.

It’s spring/summer. Flowers are in bloom and the air is changing both barometrically and compositionally. Your throat and nose act together as a breathing canal will respond to these changes in an attempt to mitigate them and maintain healthy function. It’s possible you’re producing phlegm because of increased particulates in the air or because the air is dryer. Mild inflammation and coughing are also symptoms against allergies.

Trouble Breathing

There is a lot happening right now, including your hypochondria. Panic attacks precipitate additional symptoms like a tightness in your chest, shallow breathing, and as a result some light-headedness. It’s crucial here to attempt deep breathing as a sanity check at the very least. Your ability to breathe in deeply, hold it in, and exhale in a slow and controlled fashion serves as a decent litmus test. Specifically, one of the primary concerns with this coronavirus is that it detracts from our ability to extract oxygen from the air. Not having oxygen is a physically very painful process that your body actively fights. Beginning to recognize the difference between panicked breathing and difficult breathing helps both you and the response teams (given the prevalence of people phoning in who are only exhibiting anxiety-induced breathing problems).

Listen to your heart. No really, your heart is an indicator of your panic and exertion. Does your heart rate make sense, or is there cause for alarm?

Right now, shortness of breath is a key symptom for this corona-virus (in conjunction with other symptoms). You are generally used to at least a bit more physical activity in your day-to-day. It’s somewhat reasonable that your physical ability has reduced a bit and that your lung capacity is not at it’s peak. Try taking deep breaths, and establish whether or not that’s possible before allowing panic to take over.

Fatigue

You are not being stimulated in the same way to which you have acclimated over your life. You’re used to certain levels of wanted or unwanted social interactions, physical activity, and mental stress. All of these factors are in huge flux right now and the shift itself is separately taxing on your mind and body.

Moreover, panic attacks cause a tightness in your chest and often involve an overstimulation of your vasovagal nerve. That connects your stomach to your brain, and when it’s overacting you’re going to burp and yawn more. You know from your experience with depression that yawning can psychosomatically trigger feelings of sleepiness because it is an expected behavior of physical and mental exhaustion. Try taking deep breaths, and trust your internal clock. Sleep when it makes most sense for you — at night and immediately after eating if you want a nap.

Vertigo

You do a lot more sitting these days. Standing up quickly changes the blood distribution rapidly and can lead to mild or severe dizziness in the short term. This is not a stroke; strokes are predicated by a host of other very noticeable symptoms that you can notice. Be most mindful of slurred speech, sudden severe head aches, and a slackening of one side of your body.

That’s the bulk of it. It’s an unprecedented time of ambiguity and discomfort. The body language of symptoms is necessarily imperfect; it quickly becomes apparent that it’s not enough to trust your body. Mindfulness becomes a necessary component of your survival.

Symptoms are just symptoms. Unpack them and analyze them. Consider alternatives.

Persistent symptoms are more problematic, but introduce a new idea to consider.

The virus is (and in fact most ailments) are not infinitely deadly AND our healthcare system if woefully finite. An unfortunate circumstance of these factors is that even for persistent symptoms, you will need to trust your body a little bit. Watch yourself but recognize that sometimes the only course of action is vigilant inaction in the short term. Our hospitals and doctors don’t have the capacity to indulge your hypochondria or frankly even your low-grade symptoms. Your body has an immune system for a reason, and will do some or even all of the work.

Be vigilant — like Batman.

Again — sometimes the only course of action is vigilant inaction.

In a similar vein, you can engage your hypochondria mindfully, but take precaution to avoid indulging it. I don’t own a thermometer right now, and I’m not certain I can healthily own one. I worry that I would check my temperature incessantly, letting loose another real concern.

Your brain is crazy powerful — the phrase “mind over matter” doesn’t come from nothing. It’s even possible for your body to manifest or amplify symptoms with no actual stimulus; it’s called a psychosomatic response and it’s largely stress-induced. Psychosomatic responses are exactly the situation to avoid here, because it allows what is likely a necessary anxiety to conflate with physiology. The result is a dangerous spiral that lends toward overburdening healthcare providers, and in some case genuinely causing damage to your body. That’s the most insane part; you can believe these symptoms so hard that even if they’re made up, they begin to wreak actual havoc on your body.

I hate this meat-suit.

Symptoms are just symptoms. They’re imperfect.

Breathe. Think. Watch.

Go carefully. Be safe and sane.

Sincerely Not Sick (probably),

August