Overwhelming fear that I’m going to die

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Been the same for most of my life. I’m in my thirties. I spend most of the day worried I’m going to die. It’s a constant horrible feeling, I look for signs that I might be unwell and obsess over it.

I’ve had therapy, I’ve had hundreds of tests, I’ve spoken to dozens of doctors and nothing gets rid of the fear. It’s there constantly.

I go to the doctor and the doctor tells me I’m fine and I come home and google to check if the doctor is right.

I can never , ever, get reassurance. Or if I do, it lasts an hour at best.

At its worst I won’t leave the house. It’s at its worst just now. I have been for a walk TWICE since June.

I want to be able to do normal things, but trying to I am almost paralysed by fear and it’s just bloody easier not to try.

I started a new voluntary role two weeks ago, working weekends only, and I’m desperately trying to find excuses not to go tomorrow now because I’m scared I will feel anxious or unwell while I’m there.

I don’t know what to do anymore. I’m scared I’m slowly killing myself anyway.

I have health anxiety, I now take Venlafaxine. It really helps

Yup - there's the issue. The only thing I would add is that a short course of remedial hypnosis would be very helpful in resetting the maladjusted thought patterns which are distressing you so much.

Obviously I don’t know your exact symptoms but it sounds like you may have OCD with obsessive thoughts about dying. The recommended treatments/therapies for OCD are a bit different to anxiety especially around reassurance seeking. In fact your post seems to be a form of reassurance seeking which doesn’t help in the long term.

I read a book about chronic back ache, back in the 1990s, by a Dr Sarno. His idea was that severe health issues can be caused by the brain locking onto some life altering health complaint to distract you from something more upsetting.
So perhaps you are caring for a disabled family member and it is sapping the life out of you, you suddenly develop a mysterious severe back pain which means that 'sadly' you can no longer do the caring. So you are let off but without the guilt.
I didn't explain this well but could there be something in your life eg failing marriage, v sad relationship with a parent, something bad from your past that you are being distracted from by the fear so you avoid facing and dealing with it.

OCD has been mentioned yes. Which would make sense as it’s a repetitive thought, always at the back of my mind, that I need to ‘check’ things and get reassurance to neutralise it. It’s hell. I need to leave the house tonight to do voluntary shift and I’ve spent all day counting the hours down.

This sounds horribly paralysing.and exhausting. I think as well as medication you definitely need to explore talking therapies /CBT.

I live with a serious illness that means even a mild cold could kill me (and I have to take immune suppressants so get a lot of colds), and honestly I rarely give it any thought.

But I realise what you are dealing with is something you have to learn to control, and it must be horrible when those thoughts overwhelm you

Managed my voluntary shift last night OK in the end, but then my friend today said she’d like to go out for lunch and just paralysing terror at the thought . It involves going into a shopping centre, walking around, eating dinner, being in a busy place. I want to go, I haven’t been out for dinner for ages, friend knows I’m not good at going out and says going out will help me, but I’m terrified.

You know, logically and rationally, that there is no danger in going out, have dinner, etc. But there's a part (or parts) of your subconscious mind which absolutely believes that this is either horribly dangerous in some way or that you will be unable to cope; that's why it's firing up the feelings of fear to persuade you to avoid the situation.

Think of your subconscious as a frightened child who is convinced there is a terrifying monster under the bed. The mother (the conscious part of your mind) can either decide to run screaming into the street or to check under the bed to assuage the child's and then let it know there's nothing to worry about.

Have a look at this video on anxiety, it will help you better understand anxiety - what it is, why we need it and how you can work with it rather than fighting it;