Busy living

hypochondria & the risks of horizon thinking

nyc friends come see my stand up hour 6/28 at West Side Comedy Club! Okay enjoy the essay!

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I’m a hypochondriac. It started young, and I know the source. I came of age in the late 2000s, and I think we can all agree: Toxic Shock Syndrome ended up being much less of a thing than Seventeen Magazine led us to believe. And while I never lost any friends to it – as I’d originally anticipated – I did lose my sense of health. My sense that all was well within me.

Like most chronic conditions, my hypochondria comes and goes. This year, it came. In part, I was sick. Breastfeeding gave me a sodium deficiency that landed me in the ER. I got Covid, then pneumonia, which stuck around for months. I got mastitis from trying to wean, I got everything my daughter brought home from daycare, I sprained my ankle. The constancy was worse than the severity.

But my anxiety is never about the sprained ankle or the virus. It’s about whether or not those things are just the first hints of my imminent death. Does the minor injury belie a problem with my bone density, which belies early menopause and the onset of ovarian cancer? Am I even using the word “belie” correctly? I don’t know! And if not, is it because something’s wrong with my brain? Do I need an MRI? What’s happening in my body, and why has no one told me?

Hypochondria seems unreasonable, but is it? Or is it unreasonable that we are expected to live – sans vacations – inside these bodies of ours, without the full story? Is it unreasonable to carry on, as if all is well, when a tumor could be lurking in literally any of my organs? What if it’s been there for years? I didn’t know I was pregnant until I was five weeks along. On the one hand, that means I discovered it very early (early enough to get an abortion in Florida, if you can believe it). On the other, it means that for more than a month, I had no knowledge that I was sharing my body with a foreign invader. Am I the crazy one?

And so, I get tested for things. I’m blessed with good insurance, but it’s still not cheap. The results show nothing, or they show something unconnected to my condition. Some incidental finding that may never cause me any physical harm, that I wouldn’t have known about, if not for the test. But I do know about it, because of the test. And now, one more thing to worry about.

I feel guilty, of course. Hypochondria feels like a luxury disorder. To be a person so free of problems that I go digging for them. But I’m not pulling illnesses out of thin air. The panic starts with something physical. Why does it feel like I’m wearing a headband, even when I’m not? Compound that with our modern curse of too much information. I try every AI chatbot in turn, experimenting to find which will diagnose me with the most gruesome condition. Tension headache, no, a hormonal imbalance, no, glioblastoma. Not because I’m avoiding the doctor (I think my doctors would prefer if I avoided them a bit more( but because I need more than a doctor could give me. My hypochondria is insatiable.

I remind myself of something I once heard from – of all people – a doctor: just because a problem is physical doesn’t mean it’s medical. The physical sensation is there, but that doesn’t mean I need medicine. I remind myself that all these tests aren’t serving me, that I should be out living my life. But therein lies the problem. Once I finally accept that I’m not dying, I have to focus on the much harder task at hand: living.

I’ve heard the term “horizon thinking,” in which we put our goals off until some vague future horizon. I’ll start dating when I lose weight, I’ll start writing my book when work calms down, I’ll start planning that trip when the economy is better. And sometimes, those horizons make sense. Sometimes, the horizon represents an honest point at which it does become feasible to pursue our goals.

But sometimes, the horizon offers us an excuse to disengage. To tell ourselves that this isn’t the “real” us, so it’s okay that we’re not happy. To procrastinate “real life,” as if there is such a thing. To avoid looking inward. Because who would possibly want that? What if I look inward, and there’s nothing there? What if I finally admit I’m at the horizon and that it’s time to start being “happy,” but I can’t make that happen? What then?

That’s what the medical tests offer me: a stall. That, and an emotional ride. I’m sober. The results give me the dopamine hit once proffered only by booze. They are an incredible high – all the anxiety and build-up, only for the sweet relief. Only for a doctor to tell me I’m fine, I’m not dying. I’m alive. Which, if you think about it, might be one of the scarier diagnoses we can get.