You could be sick ... but probably not

Do you automatically assume that a headache is a brain tumor? Do you worry that a minor cut could lead to flesh-eating bacteria ravaging a limb and requiring massive surgical intervention?

Do you see those ads for a battery of scans of various bodily systems and think, gee, what's the harm in that?

You may be suffering from a raging case of worried wellness.

"Worried well" is the term for people who spend too much time visiting the doctor and obsessing about their health even though there's nothing physically wrong with them.

Who can blame them? Doctors issue ever-evolving and often confusing advice on when, and if, screenings for various illnesses - most recently prostate cancer - are necessary. Even the annual physical exam is under fire because it often leads to tests that are useless or even harmful because they can prompt unnecessary follow-up procedures.

Yet public health officials extol more screenings and tests as a way to avoid illness.

Result: Untold billions of dollars are wasted every year by Americans for unnecessary scans, biopsies and tests. Not to mention all that anxiety waiting for the doctor's call with your test results.

Why are so many Americans well but worried? Because they're "encouraged to think like hypochondriacs" says Catherine Belling, a Northwestern University medical school professor who wrote a just-released book, "A Condition of Doubt: The Meanings of Hypochondria."

Belling blames "a public health culture of early detection and disease awareness that encourages us to think that we may well be sick even if we feel completely fine and have no symptoms."

Then, too, we don't automatically trust doctors as we once did. People are encouraged to take responsibility, not just follow a doctor's instructions blindly. There's increased awareness of medical errors and doctors' fallibility. "So when the doctor says you're fine, rather than saying 'thank you' and accepting it, many people wonder, should I get a second opinion?" Belling told us. "Or, 'When I Googled my symptoms, the Internet diagnosed me with something so what's the doctor missing?'"

What's the cure? This gets tricky.

You may think that, say, the thump of your heart when you're climbing steps is a sign of big impending trouble. So you get an EKG that shows there's nothing wrong.

Two things happen: You read the fine print on these tests and realize that they are sometimes wrong. There are false negatives, meaning that you still could have this dread problem without knowing it.

Or you barely enjoy the relief before you start focusing on another body part that doesn't seem to work quite as well as it did yesterday.

There are quite a few body parts to fret about.

That fretting is often fueled by a Web search, which provides an endless and horrifying array of real and possible and just barely possible afflictions you could have, based on just about any symptom you can name. Just Google a symptom, no matter how minor. You'll see what we mean.

Or check out a graphic from a 2009 Wall Street Journal story titled "What Your Body is Telling You," which listed a catalog of warning signs for a variety of illnesses.

Those signs ranged from "feeling hot all over (overactive thyroid, menopause, reaction to medication or caffeine or anhidrosis, the inability to sweat, which raises the risk of heat stroke)" to "feeling cold all over (underactive thyroid or other hormone disorders, iron deficiency, or in rare cases, a warning sign of leukemia.)"

Sure, but you might just turn up the heat or turn down the air conditioning before you bolt to the emergency room.

If there were a warning label for provoking hypochondriacal panic among healthy Americans, this story would have earned it.

We'd advise readers to consider Belling's paradoxical advice for overcoming such fears: You have to fool yourself a little to be mentally healthy. That is, you must accept the fact that yes, you are going to die ... sometime. Then just ignore it. "We need to delude ourselves about the risks that something is going to go wrong. We need to tell ourselves everything is going to be fine."

Repeat after us: Everything is going to be fine. Now stop worrying and enjoy the rest of summer.

(c)2012 Chicago Tribune
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