How I'm Fighting My Health Anxiety as a Therapist

I thought I was going to die 37 times today.

Just hear me out.

I’ve been struggling with some pretty intense health anxiety the past few months. It shouldn’t surprise me; my pattern is usually that I hold it together through a period of stress or crisis, and then the anxiety hits after I’ve let my guard down. Throw a pandemic at someone with health anxiety and she might keep her shit together for a few months, but eventually she will fold. I go through these seasons every few years, and I’m lucky it’s been about five years since my last. This one isn’t as intense as my bout with postpartum depression (PPD) and postpartum anxiety (PPA), but it’s lingering. It’s relentless.

And I hate this about myself.

I have a master’s degree in mental health and consider myself an outspoken mental health advocate. So, when my mental health is in the crapper, it’s kind of embarrassing. I should know better, you know? I know all the tools and interventions. I’m on medication. I can pinpoint exactly which thoughts I have that are distorted, and I know the more I have those thoughts without challenging them, the more they wear a pathway in my brain. I know all of this the same way I know in order to lose weight, I need to burn more calories than I consume. It’s just actually doing it, right?

Yesterday, I was so drained and exhausted from fighting these thoughts and these physical symptoms, I knew something had to give. I lay in my bed with tears streaming down my face and thought, “This has got to stop.” So, what do I do? I know there’s not a switch that flips that makes me go from bad to good; it’s usually a gradual recovery. I know there are small things I can do, but God, I just don’t have the damn energy to do them.

But I can’t keep just existing. I can’t keep living this death.

What are my options?

Well, I don’t want to go up on my medication dosage, and I damn sure don’t want to switch meds. I hate taking meds to begin with (not just antidepressants, I hate all medication — it’s a health anxiety thing), so I have no intention of going through the adjustment process all over again.

I don’t want to go to therapy. I know I should, but I’m struggling with agoraphobia, and the idea of sitting in an enclosed space for an hour makes my skin crawl. I could look into online therapy, I suppose. But … maybe I should try my own advice first.

So, what would “Haley the Therapist” tell “Haley the Client?” I treated a lot of kids and teens with anxiety. I can put my knowledge to use here. What are some things I know about anxiety?

I know cognitive behavioral therapy works (CBT). I know health anxiety is a form of obsessive-compulsive disorder (OCD). I know the reason CBT works on anxiety disorders like OCD is it forces the individual to notice each thought, examine it and challenge it. I know our brains have neuroplasticity, which means they are constantly changing and reforming based on our thought patterns. So, we can change our patterns and the way our brains work at any point in our lives (thank God). And I know one of the best ways to do this is to adopt an affirmation or a mantra to use as a response to those obsessive negative thoughts. The more we respond to those irrational negative thoughts with a realistic or positive thought, the more our brains believe our responses. Our knee-jerk reaction eventually goes from irrational, anxious thought to rational, realistic thought. It’s a gradual change, but eventually those life-giving thoughts wear their own pathways in the brain. This literally changes our brain. But, it starts with noticing our distorted thoughts.

So, I examined my thoughts. I took note of the negative, panicked, anxious thoughts that went through my brain yesterday evening, and I came to this conclusion: I constantly believe I am an inch away from death. Even typing that makes me feel “crazy,” but my main recurring thoughts all point to impending death. They’re all death-thoughts.

I feel short of breath. Is it COVID-19?

My head hurts. Am I having an aneurism? A stroke?

I want to go for a walk, but what if I have a heart attack?

Am I about to pass out?

I feel so tired. Is something wrong with me? What if it’s cancer?

I want to try this new food, but what if I have some kind of allergic reaction and go into anaphylactic shock?

When was the last time I ate? I need to eat soon. I feel a little faint. Do I have diabetes?

And on and on and on and on and on. God, it’s so fucking exhausting.

After noticing all of my irrational, destructive death-thoughts, I thought about what mantra I would use to challenge them. I needed something directly contrary to these death-thoughts … a life-thought. I needed something that makes me feel healthy and whole. Or, at least something that sounds like I’m healthy and whole. If I say it enough, eventually I’ll feel it. Fake it til you make it and all that.

I have these affirmation cards I read from time to time, and there’s one I have taped to my mirror in my bathroom. The first sentence is:

I am healthy and vital and strong.

Bingo.

That’s exactly what I need. Because I don’t feel healthy and vital and strong. I feel unhealthy and lethargic and weak. Like, all the damn time. I’d give anything to feel healthy and vital and strong. That’s the dream right there.

After deciding on the mantra, I made a commitment to notice my anxious thoughts today, and to respond to those thoughts with that affirmation. And, because it’s important to quantify symptoms to track progress, I figured I’d track how many times I had a death-thought and responded with a life-thought.

So, I did. I noticed every, single time I felt an anxious sensation or had an anxious thought today, and I responded with, “I am healthy and vital and strong.” You know how many times this happened? 37 times. Thirty-seven times my mind went straight to death when I had the slightest sensation out of the ordinary — 37 death-thoughts. I’ve only been awake 14 hours. That’s over two and a half times an hour.

No wonder we with anxiety are so fucking exhausted. We are constantly on edge, constantly looking out for the next threat, constantly waiting for death to knock on our door. What a half-life.

I’ll do this again tomorrow. And the next day. And the next. Because, while I don’t believe mantras can cure anxiety, I do know if you change your thoughts, you change your life. I have to start somewhere.

I am healthy and vital and strong.

Maybe tomorrow will only be 36.

A version of this article originally appeared on Haley Hardin West.