Perfectionism and Overthinking Can Make MC Symptoms Worse

By Wayne Persky

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​Whether we realize it or not, many of us are perfectionists.

I certainly am. In fact, published research shows that perfectionism is often associated with microscopic colitis (MC). Perfectionism arises from a blend of genetic factors and environmental influences, including childhood experiences and inherent personality traits. This trait is often esteemed due to its association with high achievement and success, and many MC patients tend to be overachievers.​

Although perfectionism itself is not classified as a psychological disorder, it's closely linked to anxiety and other mental health conditions, such as obsessive-compulsive disorder (OCD). For example, approximately 12.5% of microscopic colitis patients have obsessive-compulsive disorder (OCD), compared to about 1.2% in the general population.

This somewhat common characteristic of MC patients is not well explored.

​The exact percentage of microscopic colitis patients who are perfectionists is not well-documented in scientific literature. However, anecdotal evidence and clinical observations suggest that a significant number of patients with microscopic colitis exhibit perfectionist traits, potentially due to the stress and anxiety associated with managing a chronic condition. Of course, this is a two-way street, and the trait of perfectionism may be associated with MC as an initial trigger for the disease, rather than as a result of the disease.

Perfectionists tend to overthink most issues.

Overthinking is characterized by excessive rumination and analysis, and it's closely associated with perfectionism. Perfectionists tend to set unattainably high standards for themselves and are often overly critical of their own performance. This constant self-scrutiny can lead to overthinking as they replay scenarios and outcomes in their minds, striving to find flaws and areas for improvement.

Many of us try to overthink every detail of our recovery journey.

As we attempt to understand MC, and develop our own personal recovery plan, many of us tend to overthink every little detail. The chronic nature of this disease, coupled with the need for constant vigilance, can encourage tendencies towards overthinking and perfectionism due to the following issues:

1. MC is a chronic and unpredictable condition. Patients may develop perfectionistic tendencies as a coping mechanism to gain some sense of control over their lives and health.
2. Chronic illnesses can lead to feelings of guilt and self-blame, especially if patients believe they could have prevented their condition through different lifestyle choices. This can foster a perfectionist attitude towards managing their health.
3. Living with a chronic condition can lead to heightened awareness of how one’s illness affects social and professional life. Patients may strive to appear “normal” and undisturbed by their condition, driving perfectionist behaviors.

Perfectionism and overthinking can make MC symptoms worse by:

• Increasing stress levels — stress is a known trigger for MC flare-ups, as it affects gut motility and the immune system, leading to inflammation.
• Focusing on flaws and failures (so that symptom improvements resulting from treatments tend to be overlooked, or underappreciated), leading to increased anxiety and depression, which can worsen gastrointestinal symptoms.
• In an effort to manage their symptoms perfectly, or speed up recovery, some MC patients choose to use various commercial products that are claimed to aid in intestinal healing. Often, the use of such supplemental products is counterproductive, and they either provide no benefits, or in many cases, actually slow down or prevent recovery.

The medical community acknowledges this problem.

A recent Medical Xpress article titled How can I stop overthinking everything?, addresses a common problem for chronic disease patients, including microscopic colitis (MC) patients (Ross, 2024, March 5).1

Recognizing and addressing emotions such as worry, anger, or sadness can help manage stress levels. MC patients can benefit from discussing their feelings with a therapist or support group.
Developing plans for dealing with potential issues can reduce anxiety. For MC patients, this might involve preparing for flare-ups by having medication and dietary plans in place.
Accepting that not all outcomes can be controlled and focusing on managing reactions can reduce stress. MC patients should focus on what they can control, such as diet, medication adherence, and stress management techniques.​

Reference:

1. Ross, K. (2024, March 5). "How can I stop overthinking everything?" A clinical psychologist offers solutions. Medical Xpress, Retrieved from https://medicalxpress.com/news/2024-03-overthinking-clinical-psychologist-solutions.html