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Hypochondriac, HIV +, and living in hell

Oct 17, 2012

Since I was a child I was afraid of HIV and acted weird. In my mind I knew I had HIV and worried constantly about it. This stopped when I actually got my HIV+ diagnosis at the age of 14. I was dying, my CD4 was only 20, but I went on meds and got better and my mental health got better too. I was not constantly worrying and lived a normal life until six months ago.

I don't know what triggered it but since then my life is hell. I am worried I have several diseases (oral and esophageal candidiasis, KS, canker sores, fungal sinus diseases ,retinitis, and many others), but in principle I am afraid of fungal diseases. I search the internet non-stop, losing entire days looking at pictures and symptoms. I watch my mouth literally every hour with mirrors and flashlights and analyze every red or white spot. Sometimes I'm afraid I am getting a fever and have to check it. I had a few canker sores that really hurt and now I have white spot on my lip that doesn't hurt and looks like candida and it really drives me over the edge.

The fact is that since this started several doctors checked my mouth: one ENT, my infectious diseases doctor twice and yesterday another infectious diseases doctor . They said I only have some post nasal drip that irritates my throat but I am convinced they didn't look close enough to see my problem.

My doctor tells my fungal infections should not worry me my labs are so good. This week I got my new results with a CD4 of 915. Because my test came back this good I'm afraid they are not mine and the nurse made a mistake. I cannot call this life anymore, it's like my brain is telling me to stop stressing and look at the facts, but I can't and keep on worrying. I drive my family nuts and I'm ashamed to go to the doctors to constantly check me out. There is no HIV psychologist in my town and I don't know if I should visit a psychiatrist for this. The fact is I don't want to swallow any more meds because my liver is not doing too well (also chronic hep B).

What do you suggest for my case? Can I get out of this on my own? I'm a 25 year old female.

Thank you.

Response from Dr. Fawcett

Thank you for writing. I am glad that your counts are so good - that is a testimony to your ability to take care of yourself physically and adhere to your medication regimen. At times, most people feel worried about various symptoms which can result in mild anxiety. Sometimes, as in your case, these worries get out of hand. They are not rational and, unfortunately, it is nearly impossible to think one's way out of them. Whenever a worry is resolved, another "what if" pops up to take its place.

I would agree that you are experiencing hypochondriasis, a preoccupation with bodily symptoms and concerns about illness. While hypochondriacs have obsessive fears about their health and often "ritually" check themselves for symptoms, it is different than Obsessive Compulsive Disorder, in which someone is concerned less about physical health but rather other themes such as contamination, sexuality, etc.

As you know firsthand, these fears can be quite disabling. I strongly recommend that you get a mental health consultation to determine the best course of action to get you relief. You don't need a psychologist specializing in HIV but rather a practitioner who can do a general assessment. In many cases there are behavioral interventions that are very effective, so you may not need a medication. That will be a decision that you can make with your healthcare providers.

Good luck! -David

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