Health anxiety

[YourHeartyUser]

my brother has extreme health anxiety - I’ve supported him emotionally over the past 10 years, throughout his various operations, tests, scans etc. He lives in USA - I’m in UK. He seems to be able to persuade Dr’s of his ailments - it seems easier to do over there with their health system. Fear im making him worse through enabling. Im worried if I’m harder on him he might get worse and maybe do something to himself. So I’ve plodded on. However, it’s now affecting my life since I worry about him so much. And I know in the long run I’m just fuelling his anxiety. It’s a toxic relationship I know. I’m unsure how to move forward. I’ve not seen him in person for 13 years.

if I don’t respond to texts immediately - he responds ‘where are you, where are you’. On the phone crying hysterically.

You are not responsible for your brother's mental health. The problem with anxiety is that a person can talk about it everyday without improving if they don't physically do something about it. Overcoming phobias and health anxiety, social anxiety etc requires effort but it is your brother who needs to put that effort in.

Don’t want to be responsible for him taking his own life

I have health anxiety, it's awful.

But he needs to learn that coming to you for reassurance is keeping the illness alive. Also, not sure why you're his go to person for the reassurance as you're so far away.

I imagine the doctors in the US are happy to see him for any concerns as he'll be paying for the privilege.

Is he getting any treatment for it? A good SSRI will enormously help him.

You're not responsible. He's responsible for getting treatment for his own illness.

Won’t take SSRI - but uses 6 valiums a day

But you won't be. I know this is really hard for you because he's your brother but he needs professional help, cbt, counselling. How often do you speak to him?

WhatsApp daily

If he's on valium that's probably making him worse!

valium and codeine

Does he not have any friends over there to help him?

He is a drug addict. Simple as that. And the US system is keeping him hooked.
He has capacity to make decisions about his life. This may include capacity to decide to end his life. You can not prevent it or count yourself responsible for it.

No friends.

I’m so drained of it. Invested so much emotion.

You can attend Zoom meetings for Nar-Anon, as a family member of a drug addict OP.

Is he getting therapy for his anxiety? I'd insist on it. If he has the time and money to pursue all of these doctors, he can spend that on therapy.

I'd also decide what boundaries you will be following from now on, explain them to him kindly, and then stick to them. E.g. "brother, me responding instantly to texts is creating an unhealthy pattern for both of us. I'm going to check and respond to texts once a day from now on."

The problem with reassuring a person with debilitating anxiety is that you enable them, by (inadvertently) trapping them in a reassurance loop.

Of course US doctors are handing meds to your brother like sweeties: they profit from that treatment model. As a result, your brother now has a fairly serious substance abuse issue.

The best way you could support your brother is by helping him access good therapy, but the issue there is that the person has to want to get better first.

In the short term, to help protect your mental health, I second the approach suggested by @ManchesterGirl2.

OP how do you know your brother has health anxiety? Does he have a diagnosis? Just because my advice would be different. If he definitely has health anxiety (basically validating your concerns about enabling making his anxiety worse). However, could it be that he has physical symptoms but investigations haven’t yet found the cause? It might come across as loads of tests etc. but could be a valid approach in that scenario. That doesn’t necessarily mean that you don’t need to have some boundaries around the amount of support you’re able to give.

what is your support network like?