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July 08, 2020

Comments

KC

That is *fascinating.* And yes, this is... not giving me less adrenaline here.

But yeah. I've heard about something that is perhaps like that with some people who have experienced The Disaster They Always Feared - some anxious people are cured, and some have their anxiety severely exacerbated, by things like Death Of Child or House Burned Down.

And some people do just absolutely go full-chill when it is disaster time - emotions have left the building. I wonder what's going on in bodies in that state in terms of neurochemicals, and how long that state can persist?

And I wonder whether, maybe, those having lower panic attack levels during the pandemic will also have fewer panic attacks post-pandemic - that would be cool!

TheQueen

KC -well, they do say that hypochondriacs are cured by getting a diagnosis is of what is really wrong with them (they sense something is wrong, so they attended more closely to their health than expected) so maybe this crisis will resolve panic attacks.

KC

I... think that if someone labeled a hypochondriac then ends up with an actual medical diagnosis which indicates that their hunches were, in fact, correct, and they were, in fact, ill, then they were *probably* not actually a hypochondriac? And yes, if behavior is solution-seeking rather than for its own sake, then they will stop when they have a solution! (with some possible slush due to habits, etc., probably?).

(I mean: one doctor suggested to me, fortunately well after I had both a diagnosis and some experience of what it takes to manage this, that instead of being actually sick, I was a hypochondriac, because I pay "too much attention" to things like blood pressure. You know, blood pressure, where when it drops, I black out, but do get a couple of symptoms before I black out completely? Apparently I should just "let it go" and ignore symptoms [and faint, frequently, in an uncontrolled manner, like I did before a different medical professional told me to Pay Attention You Idiot If Things Go Grey Sit Down Fast] and then I'd be all better... which I suppose I would be, if I hit my head hard enough after fainting?)

If someone just wants the validation that Something Is Wrong With Them, though, then maybe they could still be hypochondriacs? I mean, if instead of saying "oh, yes, you have [issue] and we will try to ameliorate that" you said "oh, yes, you have Unicorn Fake Disease! How fascinating and rare! But fortunately not fatal!" and they were fine with that, then I am not sure. Even then, sometimes, if you have symptoms as a reasonably-mentally-healthy person, you might just want to know whether you actually should be worried about these symptoms or not - whether this is the sort of thing where, if you take it into the ER, they say you're an overreacting idiot to bring this sort of thing into the ER, *or* whether if you *don't* take it into the ER, the doctors tell you you were an idiot to not bring this sort of thing into the ER immediately, what were you thinking, you could have died? Sometimes you just want to know, for a given weirdness, if the right choice is to wait it out, or the right choice is to seek medical treatment!

(that said, I thought hypochondriacs kept thinking they had things they don't have? And have phantom symptoms to match the Illness Du Jour? Or is that something else?)

TheQueen

KC - I have never before hit page two of the comments. It would seem there’s a double arrow at the bottom of the comments area if you max out a page.
There is something to be said for ignoring your body, at times. It seems to help me with my MS. But if you know something’s wrong, why would getting data be bad? I suppose because it prompts more questions to the doctor?

KC

Sorry to make your blog work harder and have extra comment pages!

Oh, absolutely! If you know what's going on and ignoring things is the best way to go, then ignore! (I also have symptoms I do my best to ignore. It's just that there are *also* these symptoms that are indicative - either that I need to hit the floor, or drink more water, or potentially change a medication dosage - and ignoring those results in Big Problems and I prefer to avoid as many Big Problems as I can.)

I think some doctors just view levels of patient engagement beyond X as "pathological" whether or not those levels of engagement are being actively functional in this instance. We had one doctor who reacted really poorly to the fact that we had a spreadsheet we plop medication data and dates-of-hospitalization data and similar "we don't want to have to remember this stuff" information into, because he viewed that as "obsessing" about the illness. But then he asked various questions (and expected us to know the answers!) and... yeah. So, I could either put "start date of medication Y" and "end date of medication Y" in a spreadsheet and forget about it, *or* I can actively remember it (for years - he was asking about events in *prior years*) and have it take up real estate in my brain continually.

Which sounds more obsessive? Apparently, to this doctor, dumping things into the spreadsheet and forgetting them.

(I mean, we've also had doctors who were *all about* notes and spreadsheets, because normally they're dealing with patient memories and "uhhh, maybe? that sounds sort of familiar?" and who *knows* how accurate or not things are, and they love that it's fast-lookup and accurate and all just right there. Doctors: they are a mixed bag, and some of them can adjust appropriately to 'complex medical situation' and some can't.)

TheQueen

KC - it’s fight or flight. Fight = spreadsheets, flight = ignore. Who are these doctors dictating which defense mechanism you should use?

KC

Well, there's also freeze, in addition to fight/flight. I'm not 100% sure what that would look like in this case.

But yes. Determining whether a threat is something to fight or something to run away from is a *good plan* in general. I do think some doctors have the common sense to sort out what a good patient approach is, but some really do just go for the "one size fits all" thing and assume the approach to all conditions should be the same, from the patient point of view, and I feel very sorry for the diabetics under their care, if they *also* get the "the best thing to do is to try to completely forget you're sick..." schtick.

TheQueen

KC - well I imagine the doctor is looking for the response that gives the fewest questions and make for the most compliant patient. So, no spreadsheets, no questions. Too much fight bring s questions, too much flight is non-compliance.

KC

That seems plausible, for some doctors. Fortunately, there are others who *do* welcome reasonable questions!

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