Handling hypochondria without SSRIs

[vsp]

Long story short: I am a hypochondriac, particularly when it comes to chest pain. I have accepted that as being part of me for two decades, and freely admit it. Dealing with it is generally manageable, but it's been a bastard over the last six or seven months, and knowing that it's there doesn't necessarily make it easy to resolve.

My father had a series of heart attacks in 1996 that should've killed him; the hospital nurses were told to keep him comfortable because he'd be dead in the morning. (Thankfully, he survived, and he leads a very productive life today.) HIS father died of a heart attack in the early 1980s. HIS father died of a heart attack right around when I was born in 1970. That contributes significantly to my paranoia about all things chest-pain related.

Of course, I'm not a thirty-year smoker like my father was. His father had cancer (something I didn't know about until twenty years after he died), and also had an extreme aversion to taking his blood pressure medication (and took none at all on the weekend that he died, which went a long way towards the attack that killed him). HIS father was old and basically on his deathbed already in the hospital when his attack claimed him.

I'm only 34, do not smoke, drink or do drugs at all (yes, I'm boring), and am far from a classic cardiac-risk case. My cholesterol was borderline high (around 200) when last checked a few years ago, but is not at the medication stage, and I have cut out tons of nasty stuff from my diet over the last decade or so. I'm much more cognizant about fat, cholesterol and sodium than I used to be (cooking for and dining out with a heart patient tends to cause that). I could stand to lose another 10-15 pounds (I'm 5'11", 175), but I'm far from tubby and have lost about 10-15 from my heaviest point. I need to exercise more, but apart from that I'm generally healthy; I've never had a serious illness, never stayed in a hospital, and have never even broken a bone.

That said... if something's hurting and I know why, I can almost always cope with it. If I'm sick, I deal. If I can logically associate chest pain with my acid reflux, I'm used to it and can treat it accordingly. If I'm tired and not getting enough sleep, I'm prone to headaches and all-over pain, often in my left shoulder or arm. They've been happening for 20 years, I'm used to them, I know they're not a sign of bubonic plague and thus I can adapt to them.

If something's hurting and I _don't_ know why, The Fear can sometimes take over. Knowing that discomfort in my chest isn't heart-related doesn't always do the job when it keeps on hurting. Flareups are usually years apart, but they can be spectacular; I've been in the ER twice for anxiety-related incidents, and walked into my primary doctor's once and said "I'm having a panic attack." I was correct in that, but recognizing it for what it was didn't mean I could turn it off like a light switch. Even a twinge or two at a bad time can trigger a bad adrenaline rush and that familiar tight-chest feeling.

At any rate, I've been having problems with it recently; I had a flareup in November-December that I beat without medication, and over the last couple of weeks it's been creeping up again. It ruined my day at the beach yesterday, as I was sitting on a bench on Rehoboth Avenue half-hyperventilating and wondering why my pulse rate wouldn't go down. It's exhausting to deal with when it's active.

Complicating things is the fact that I _really_ don't want to go on medication for this, as I'm highly suspicious of most of the major SSRIs that are remedies for anxiety and depressive disorders. My secondary doctor wanted me to try Paxil CR in December, and I shot that down after reading about the immense problems many people have when they miss doses or try to stop taking it, even with doctor-monitored tapering schemes. My primary wanted me to try Effexor XR recently, and one look at _its_ withdrawal-horror stories made me shoot THAT notion down. He mentioned Zoloft as an alternative, which I did take briefly years ago after the "I'm having a panic attack" incident, but only for a month or two, and I stopped taking it (with my doc's approval) due to the side effects (zombie-like emotions, dampened sex drive).

The pills do not cure the disorder themselves, nor should they be expected to; they simply help relieve some of the symptoms when they work properly. SSRIs without accompanying therapy to work out the root causes of the anxiety are a time bomb waiting to happen, IMHO. Likewise, it won't do for me to be anxious _about_ an anti-anxiety medication; if I'm convinced that taking it (or stopping taking it) will cause an anxiety relapse, well, that's sort of a self-fulfilling prophecy right there.

I pulled myself out of the funk in December mostly through forcing myself to confront the irrationality. I'm trying to do that again, but I'm open to suggestions as to some good ways to take it on non-chemically and/or distract myself.

(Professional therapy is an option, though I tried some CBT around December-January the last time this was a problem. The doc basically kicked me out after four visits, saying that I seemed to have a handle on the problem and that I wasn't bad enough off for full-fledged CBT. I'd also need to see how my health insurance plan covers such things.

My home life with my wife is great, I have no major worries looming over my head (no cash crisis, no impending doom, invaders from Neptune are still at least a light-year away), and I'm not seeing any major stressors apart from health anxiety messing with my mind right now.)

Thoughts? Meditation has been suggested, but I'm not sure where to even begin looking into that.