Guest Blog: Experiencing and Managing Second Hand Health Anxiety as a Caretaker

By Lauren Bowden

 In 2015, the New York Times highlighted a study conducted by Arthur Aron that theorized you can make anyone fall in love with you by asking them increasingly probing questions. You probably remember the buzz. Just ask 36 questions in order and by the end of the list you’ll be drunk with love, and better yet, someone of your choosing, someone with flicky eyes and good bone structure will be mesmerized by your quirkiness and resilience. Friends sat down and tried to push past the platonic. Some of them no doubt succeeded. One of my coworkers described a painful car ride with prospective university students where she was trapped with a carload of gushing, crying strangers using the questions to shortcut their way to lifelong college friend status.

As much as also I want to fall in requited love with most everyone, what I remember most about this trend was a question that made me so keyed up with anxiety, so scrutinized with an unwelcome targeted flashlight, that I couldn’t bring myself to answer it aloud to anyone. Do you have a secret hunch of how you will die?

I did. I do.

The question was 7th on the list. By the test’s own logic, this was a softball. Most people who are relatively healthy do not know for sure they will die. This question prompted a guess. A reflection on lifestyle habits. So why did this feel like acknowledging a curse?

Looking back now, I recognize that I was set up for health anxiety. My capital T trauma was the sudden death of my father at age 43 to a heart attack when I was in 8th grade. This was compounded by our family lore. Particularly, stories of how my grandmother, my father’s mother, died of breast cancer in her early 40s after years of painful, devastating chemo in her 30s. My dad recalled how his funny, lively mother was thoroughly and routinely poisoned by her crude, now-abandoned medical treatments. Thin, nauseous, her veins would burn from the inside out. How she became old while she was still young. How her mind went quickly. How she became mean and hateful at the end. Worse yet, she died a few days before my parents’ wedding and their guests walked around in an uncomfortable fog.

In my mind, my grandparents died young. My father died young. My mother was sick and might die. And I was up to bat.

Additionally, growing up girl, especially growing up as a girl in the Bible Belt, meant that I had a complex relationship with my body, my sexuality, and my femininity. My mother and my maternal grandmother raised me to feel pride in my curves, my breasts, my thick hair, and the fun promise of casual, safe, consensual, sex. However, my classmates, teachers, and mentors were steeped in Christian purity culture, repressive gender roles, promise rings, the whole gamut.

Two separate teachers implored me to not take birth control because of dire health risks. Sex ed was a morbid slide show of genital warts. While getting measurements for the school play, a teacher clicked her tongue and asked me to wear a compression bra. Our dress code meant we were punished for cleavage and I was forced to wear a dirty oversized t-shirt as public penitence more than once. We were bribed to take abstinence pledges with donuts and rumors spread about people who failed Jesus by succumbing to masturbation. Thankfully, I was well-liked and not slut shamed out of existence like some less fortunate classmates, but I knew that my comfort talking about sex and bodies and queer identity raised hackles for many and labeled me less worthy, refined, and attractive for most.

I was also assaulted, twice, when I was 14, only a few months after my father’s death. Both times were with older men I wanted to impress, albeit from a distance. Both times made me feel that grief made me an easy and obvious target and as a result, I conflate grief with sexual shame to this day.

To me, it made a twisted kind of sense that I might one day be punished for valuing my body, for liking my breasts, for being openly sexual. Between the family history and the lingering internalized misogyny, I had a secret, quiet suspicion that I was cursed to die young and also learn some kind of existential lesson about my body as a temple in the process.

Then, in 2019, my mother was diagnosed with bilateral invasive lobular carcinoma, a kind of breast cancer that occurs in the lobes of the breasts. My mother felt the cancer intuitively and insisted on a biopsy despite normal scans and the dismissiveness of her doctors. She was right to worry. Not only did she have cancer, but it had spread to her lymph nodes.

When my mom told me about the cancer, I was both horrified and unsurprised. Since the death of my father in 2003, I’d spent 16 years tense and certain that I would lose someone else, likely her, suddenly and unexpectedly. I prayed nightly that I would wake up and everyone would still be alive and well. I
rehearsed phone calls with bad news and imagined the tidal wave of horror with a sick thrill. When Mom told me about the diagnosis, I felt terror and resolve -- I told you. I knew this would happen.

Still, she explained that they had caught it early. She would have surgery. She probably wouldn’t need to chemo or a mastectomy. In the end, she needed both. But at the time, this reassurance was a balm to get me through the news.

But then, there was something else. As an afterthought, my mom mentioned that she had opted for a genetic test to let us know if she had one of the genes that almost promise an early onset of breast cancer. She didn’t know when she would test and when she would know the results, but her doctor’s thought it was a good idea. She was young. The cancer was relatively rare, and it was on both sides.
Better to protect your daughters, they thought.

This was too much for me. The stress on top of stress overwhelmed me. The panic was blinding and embarrassing. I felt dizzy. My vision blurred. Anxiety overtook me, and I felt deeply, shamefully selfishly out of control. My mother had cancer. I had the fear of cancer. There was a chasm of difference. I felt myself spin out. My mother needed caretaking and love and presence of mind. There was no time for my bullshit.

Eventually, I would confess my fears to my wife, my therapist, my friends, and regrettably, to my mother. But initially, it churned inside me. Sick and taunting. The next 6 months were the worst of my life. By Thanksgiving, my mother had drains coming out of her armpits and a hospital bed moved into her room. By New Years, she was receiving chemo and crying as her hair fell in clumps that caught on her shirt. By the start of covid lockdown, her immune system was shot, her face was puffy, her eyelashes were gone, and there were no concrete plans to give us updated scans on if the treatment had worked.

Simultaneously, the country shut down, people with poor immune systems began dying suddenly, my workplace went remote, my best friend and I were on rocky terms, and my beloved dog was diagnosed, ironically, with a kind of fast-moving brain cancer. As my wife could not work remotely, I spent most days alone or with my pitiful dog. I was a bad daughter. A bad wife. A bad friend. A bad colleague. A bad human.

I have come to learn that this self-hatred is its own kind of stumbling block. Unhelpful, navel gazing, unproductive.

At the very least, I was not a well-functioning person. I researched manically. I read hundreds of clinical studies about prognosis, treatment, spread patterns, precancerous cells, overactive cell activity, cancer stages, recurrence. I read about BRCA genes and less common mutations in TP53 and CDH1 genes. I learned how these genes could cause stomach cancer or brain cancer. I joined Facebook groups to watch people receive genetic diagnoses and navigate prophylactic surgery. I researched public records and old newspapers to see if I could document a genetic pattern of cancer deaths. I bought an ultrasound scan and a DNA health screening kit but never used either. I watched YouTube cancer treatment journeys. I imagined myself without a stomach, without ovaries, with a hysterectomy, with weight gain, weight loss, with misshapen or missing breasts.

Due to stress or some other psychosomatic trigger, I soon began experiencing sharp chest pain. When I reported this to my doctor, my heart rate and low blood pressure prompted him to call for x-rays and an EKG to check for a pulmonary embolism.

There was no embolism. There was no gene. I’m sure to many this was obvious. What I was experiencing was an unchecked anxiety disorder.

Thankfully, I slowly got connected with good treatment. My wife helped me find a therapist I liked and then another that I liked even better. I started taking 10 mgs of Lexapro. I started drinking chamomile tea and reading to calm myself and get to sleep. My dog died peacefully at home and we adopted a puppy. My mom walked miles every day while receiving chemo. She was tired but treatment proved less traumatic than we’d feared. Her hair started to grow back. She started to laugh more. In March 2021, she had reconstructive surgery and got the covid vaccine. Fingers crossed, this is the last scheduled surgery and she may be cancer free.

Strangely, I feel more at peace now than I have in almost 20 years. Facing the worst of my fears and surviving, learning that I am now better prepared to take care of myself than I was as a teenager, getting medicated and getting connected to a good therapist have all paid dividends in all areas of my life.

I am strangely grateful for the onslaught of last year. I am better for it. I am a better caretaker, partner, and friend because of it.

I know there must be others who have had second hand health anxiety while taking care of someone with a scary diagnosis. We are never as unique or singularly shameful as we think we are. I see you and I know you are underwater with fear and embarrassment. Please know you are loved and understood. It’s okay. It’s normal. There is a way out and through of this you will come back to yourself and be better to those you love for it.

Here is what I wish I knew then and what I offer you now with peace:

1. Any kind of obsessive worry, no matter how well founded it may feel to you, is an indication that something is wrong or off about your mental health. You can and should get help. You do not and should not live like this.

2. The adage that you can only save someone if you save yourself is true. If I could go back, I would get myself to a psychiatrist immediately rather than spend months blaming myself for the selfishness of a fear I did not have the tools to control the fear.

3. Do not ever try to be a caretaker to anyone, especially someone you love desperately, without a good therapist in place for weekly check ins.

4. Spread out the need for support between your partner, friends, therapist, other family members etc so you do not overwhelm any one person or burden your loved one with the diagnosis.

5. If, like me, you compulsively confess your fear to your diagnosed loved one, that does not make you a bad person. People who are sick need you to avoid changing the terms of your relationship with them just because they are sick. They need to feel like they still know you and love you. Don’t harp on your own struggles, but don’t hide them altogether.

6. Taking care of someone who is sick involves a level of chronic stress, acknowledging this does not mean that you love that person any less.

7. Mental health is not a subset of bodily health. Mental health is health. If you are mentally unhealthy, that is a legitimate health need that you should not dismiss or fail to treat just because others have a different, serious and chronic diagnosis.

8. Shame blooms in secrecy and dies in the light. If you are out of control behind closed doors, telling someone, anyone, will help to stop the progression.

9. Antidepressants, when done right, have the power to make you feel like yourself on vacation. Just you plus the ocean and a cocktail. I’m serious. There is no reason to spend your whole life running from a more sea breeze version of yourself.

10. To answer question 7, gene mutation or not, statistical models say I have a 44% lifetime chance of a breast cancer diagnosis, so that’s my suspicion of how I’ll die, but it could just as easily die of something else. Why worry about it? What's the next question?

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