Are You Obsessed with Your Health?
Hassett, who studied catastrophizing in fibromyalgia and RA patients, found that most people who catastrophize don't even know they do it, but the tendency is like a canary in a coal mine - a sign of a more significant problem. The study found that when people catastrophized, they perceived their pain as greater and reported increased depression -- as many as 44 percent of the fibromyalgia group and 20 percent in the RA group said they experienced moderate to severe depression. Another study at the University of Michigan led by Dr. Clauw found that people with fibromyalgia may be more susceptible to catastrophizing than people with other forms of arthritis. One Arthritis Today reader with fibromyalgia writes, "Twenty-six was not supposed to look like this. The good news is fibromyalgia isn't progressive or fatal. The rest is bad news: no cure, no real treatment, no respect from the medical establishment and no hope." Says Dr. Clauw, "Some people with fibromyalagia have difficulty understanding that it is a chronic condition and that they are going to have to adjust to it and live with it and do things on their own to make it better."
Sometimes, overfocusing on your health can even develop into a psychiatric disorder called hypochondriasis. This fear that every new symptom is more serious than the one before and that any new problem is the result of an existing -- or even imagined -- condition can create mental and physical stress. "Hypochondriasis involves the belief that one has a serious disease despite medical reassurance to the contrary," says Hassett. "People with arthritis, on the other hand, clearly have a medically diagnosed and treated condition, but even when a real condition is present, dwelling on the worst possible outcome can be a form of hypochondriasis." In general, one in 20 patients have hypochondria, which can result in increased anxiety and raised blood pressure. Signs that overfocusing has become a mental health concern are preoccupation with minor physical complaints, seeking repeated physical exams and tests, extensively researching a condition, feeling that doctors and specialists don't understand the problem, and seeking constant reassurance from friends and family about physical symptoms.
Overfocusing doesn't directly affect your arthritis, but it can create physical reactions that negatively impact your overall health. The fight-or-flight response is meant to help your body ward off immediate danger and acute sickness. In long-term chronic conditions, creating a constant state of emergency in the body can cause headaches, sleep loss, stress, increased pain and depression. (See "Almost a Great Time for Pain".) Stress can also exacerbate arthritis pain -- an Arizona State University study found that women with RA and osteoarthritis (OA) reported greater levels of pain and distress when they reported increased stress. By ruminating or catastrophizing, a person can increase the normal amount of stress on the body.
Overfocusing can spur a troublesome cycle of stress and anxiety -- which can result from the body's protective fight-or-flight response, too much ruminating or catastrophizing, or the emotional toll of living with a chronic condition. All of this stress and anxiety can increase blood pressure and raise levels of the stress hormone coritsol; increase cytokines such as TNF and interleukins and cause more pain; and lead to sleep deprivation and depression, which has been linked to heart disease, Alzheimer's disease and cancer, among other illnesses. When you get caught up in these negative cycles, their effects can make it difficult to break out.
