Potentially Hypochondriac Sister

[keepitsimplesilly]

I am looking for some advice, and also just to vent.

I am pretty sure my sister is a hypochondriac. She has been diagnosed with a few psychiatric disorders, though other than OCD, she will not actually tell me her other diagnoses. I am an RN and the only person in her life that works in healthcare other than a couple of her friends.

She is 31 years old. We have no history of cardiac disease in our family. She has had a battery of tests done (EKGs, echos, CXR, stress test, labs) that have all come back normal, yet she is constantly convinced she is having an MI. We don't live in the same area, so she will text & call asking if ___ is a symptom of a heart attack. I am always fairly certain she is not having a heart attack, but I always get this moment of anxiety knowing that in young females, MI symptoms are all over the place and not textbook. She has been to various ERs, quite a few times, she probably averages about once every two months. Each time they conclude she is not having an MI. Lately she is convinced she is having syncopal episodes, but what she describes to me just sounds a lot like being tired and falling asleep against her will (which I think happens to a lot of people lol). I told her to go see her PCP but somehow she never seems to be able to make an appointment.

Has anyone else ever had a family member that's probably a hypochondriac calling you all the time because you're a nurse? And what did you do about it?

[brownbook]

Not as bad a hypochondriac as your sister. I just say uh huh, uhmm, (a lot), parrot back what they say, don't give any advice, therapeutic listening.

If she specifically asks what she should do, repeat like a broken record, call your doctor.

[kp2016]

Best answer would probably be to decide on a scripted narrative (finally a situation where the dreaded scripted narrative may actually be a good idea) something along the lines of "it's impossible for me to say what that might be over the phone, you need to see your primary care provider" and consistently give only that as your response.

The fact that she can't seem to make an appointment isn't your problem, it's hers. I hope your sister is ok, but this kind of sounds like attention seeking. If you remove the attention she may decide to seek it elsewhere.

[Rionoir, ADN, RN]

If she's primarily worrying about having an MI and has already had all the cardiac workups done, then my money is on an anxiety disorder. Feeling like you are having a heart attack is anxiety 101.

[ruby_jane, BSN, RN]

13 hours ago, kp2016 said:

Best answer would probably be to decide on a scripted narrative (finally a situation where the dreaded scripted narrative may actually be a good idea) something along the lines of "it's impossible for me to say what that might be over the phone, you need to see your primary care provider" and consistently give only that as your response.

The fact that she can't seem to make an appointment isn't your problem, it's hers. I hope your sister is ok, but this kind of sounds like attention seeking. If you remove the attention she may decide to seek it elsewhere.

Beautifully written. My favorite boss used to tell me I didn't have to attend every argument I was invited to. The same goes for curbside assessments....

[PeakRN]

I would avoid the topic 100%. I agree with the script suggestion, but often tell people something along the line of "it sounds like you think you are having a medical emergency, you should probably seek emergency treatment." You have to set strict boundaries with her, you are not her health care provider nor would it be apropriate to fill that role.

Unfortunately patients with psychiatric illness can be difficult to evaluate. She could be having variant angiospasm which may not be found on later exam. She could be having an arrhythmia that hasn't presented during prior evaluations. She could be having side effects of drugs, anxiety, a psychotic feature, attention seeking related to being borderline or some other personality disorder (which is my hunch based off your post, but again who knows), or some other cause.

[keepitsimplesilly]

On 11/17/2019 at 6:38 PM, brownbook said:

Not as bad a hypochondriac as your sister. I just say uh huh, uhmm, (a lot), parrot back what they say, don't give any advice, therapeutic listening.

If she specifically asks what she should do, repeat like a broken record, call your doctor.

Thanks for the suggestions. She typically calls at night (aka not business hours) when her only option would basically be the ER. I think because she has already been there numerous times and essentially just been sent home she is not happy with that option. I've tried talking to other family members and some of her friends about this and no one knows what to do. I am researching psychologists that specialize in working with hypochondriacs in her area and am hoping she will go if I refer her to someone.

[CommunityRNBSN, BSN, RN]

On 11/17/2019 at 6:19 PM, keepitsimplesilly said:

Poor girl. I am a really anxious person too, and have been a hypochondriac in the past.
My advice is: Engage with the anxiety, not with the details. So when she says, “Am I having an MI?” you say “Oh gosh, you sound so anxious. I’m sorry you’re panicking. Do you want to talk about this health anxiety?” She says “No no, I’m not nervous, but I might be having an MI.” “Yes, I remember last week when you were so anxious about this too. I’m so sorry you’re feeling this way. Anxiety can be really awful.” Repeat repeat repeat.

She has been thoroughly examined by a cardiologist, so there is NO reason to engage about cardiac issues. What she needs is behavioral health care. Hopefully she will be open to that after she realizes that her anxiety is out of control (and her heart is fine).

[egg122 NP, MSN, APRN]

On 11/18/2019 at 4:18 AM, kp2016 said:

Best answer would probably be to decide on a scripted narrative (finally a situation where the dreaded scripted narrative may actually be a good idea) something along the lines of "it's impossible for me to say what that might be over the phone, you need to see your primary care provider" and consistently give only that as your response.

The fact that she can't seem to make an appointment isn't your problem, it's hers. I hope your sister is ok, but this kind of sounds like attention seeking. If you remove the attention she may decide to seek it elsewhere.

This X 1000. Set boundaries. You will likely get push back in the beginning since people generally do not like it when people do set them, but in the end the extra attention may be escalating the behavior like kp2016 wrote.

[DeeAngel]

Stop discussing anything medical with her at all and tell her to see a doctor. Do it every. single. time. You’re just enabling her, she’s an adult and should go annoy someone else.

[Golden_RN, MSN]

As others have said, learn how to set boundaries. You can rest easy knowing that she has been worked up and tests are negative. A therapist can help immensely with setting boundaries if you need help.