It took me a while to realize that my former social anxiety has morphed into a new form: what I call health anxiety.

It’s hard to explain how debilitating it is. I’m constantly hyperaware of my body. I’m plagued by small, strange sensations: twinges of pain, muscles twitching, chest tightness. I can’t brush these things off. I feel everything that happens in my body, and every single thing triggers a spiral of fear and panic. For those who know what panic attacks are like, you’re well aware of how dangerous this spiral can be. If I’m already terrified that I might have covid, a panic attack can cause shortness of breath, chest tightness, difficulty breathing, a rapid heartbeat, and increased body temperature — all of which are very real symptoms of anxiety, but also of the exact thing I’m most afraid I might have. When there is a real danger present, one that could potentially kill me (as it has countless people), it’s near-impossible to break out of the cycle of panic, symptoms, and more panic. The fear of a symptom causes me to manifest that symptom. I experience the exact thing I’m afraid of. The health anxiety wins.

The thing is, I have good reason to be scared of these things. The reassurances that work for some people don’t always work for me. When I feel a sharp pain in my ribs, I wonder if it’s my years of binding finally catching up to me and destroying my ribs. When my doctors say I have nothing to be worried about, I feel like I can’t completely trust them because they’ve been wrong in the past, and there is so little research on unique health concerns for trans people that it’s entirely possible that she wouldn’t know what’s wrong. It doesn’t help that I do have a significant number of random body issues with no apparent cause: chronic joint pain, random lumps and bumps, joints that click when I move. Some things I’m used to. Others are a constant source of worry. Yeah, that new lump in an unusual place probably isn’t cancer, but I can’t know for sure. I’m genetically predisposed to some kinds of cancer, I used to sometimes smoke cigarettes, I don’t always wear sunscreen, I got an x-ray at the dentist last week…the list of potential reasons I might have cancer stretches on forever.

It makes me avoid things. I’m scared to exercise because getting out of breath can trigger a panic attack. I have to be careful about how I lay in bed so I don’t put too much pressure on my ribs. Sometimes I avoid breathing in certain ways because it makes my ribs click or my chest feel tight. Whenever I’m with friends, my time is interrupted by random body sensations that pull me out of the interaction and into my own mental hamster wheel where my brain races in circles without ever escaping. It’s like an intrusive thought, constantly reminding me that I can’t feel safe in my own body. Combined with my actual disturbing, threatening intrusive thoughts, I am hyperaware of the possibility of death at every moment.

But I’m trying to learn how to heal from this. I want to live my life without the constant plague of fear. I want to be able to trust my body, to not panic every time I have a natural random body sensation (because human bodies are naturally noisy and strange). I’m learning to view health anxiety as a strategic game against a very clever opponent. My opponent’s rules are that I must constantly scan my body for symptoms. I must always take every small thing seriously in case I might die. I must always check to be certain that something isn’t dangerous. I don’t have to play by those rules, though. I’m finding ways to respond rather than react. To redirect my attention, resist the desire to spiral into fear, and continue living my life free from that game. Human existence isn’t about being 100 percent certain and comfortable at all times. It’s about living. That’s what I’m trying to do.