Four pages of health every Tuesday
If you think every twinge or pain is a sign of something serious, then you could have an overwhelming fear of illness, says LisaSalmon Summer’s here and your toes are on show. Make sure they look good and — more importantly — feel good. By
It’s normal to worry about your health from time to time, but when the worry persists with no justifiable cause for concern, and the fear of illness becomes so great it hinders your whole life, it’s possible you might have health anxiety.
The condition, also known as nosemaphobia or hypochondriasis, is one of the most common reasons people seek therapy through Anxiety UK. The charity believes cases of health anxiety have been exacerbated in the modern era by Dr Google, with the worried searching their symptoms online and often wrongly concluding that a minor symptom is really a sign of serious illness.
Nicky Lidbetter, chief executive of Anxiety UK (anxiety.org. uk), says: “Health anxiety can be a vicious circle and if you constantly check your body for signs of illness, such as a rash or bump, you’ll eventually find something, often following this up with a Dr Google appointment.
“Often it won’t be anything serious — it could be a natural body change, or you could be misinterpreting signs of anxiety such as increased heart rate and sweating, as signs of a more serious condition.
“This form of self-diagnosis is a key factor behind the rise of health anxiety.”
What is health anxiety?
A person with health anxiety has persistent concerns about a specific illness or disease, such as cancer, HIV or heart disease, fearing they are already unwell or worrying they’re eventually going to get a diagnosis they don’t want to hear.
“It can also be a constant fear or worry about a series of health conditions that causes health anxiety,” explains Lidbetter. “It’s very natural for us all to worry about any form of illness and that could rise or fall depending on other stress or anxiety. But if the anxiety or worry is wholly focused on a preoccupation with a serious illness, despite reassurance from your GP or other medical professionals, then it would be classed as health anxiety.”
What are the signs of health anxiety?
People with health anxiety are likely to be extremely aware of minor symptoms such as headaches, joint pain or sweating, and think they’re symptoms of a serious medical complaint.
This can lead to stress and spark a vicious cycle, as stress can cause symptoms including headaches, nausea and pain, leading to worries that further symptoms of the feared disease are developing.
Sufferers may become nerv- ous and obsessed with frequently checking possible symptoms. Some may need constant reassurance, complaining of their symptoms to friends and family, and visiting the doctor regularly, despite tests showing everything is normal.
Other sufferers may avoid visiting the doctor altogether, because they’re frightened of hearing bad news. They may also be reluctant to share their fears with loved ones, either because they’re afraid of having their fears confirmed, or because they believe they won’t be taken seriously.
“As with many forms of anxiety or phobias, the impact of health anxiety can range from it being a constant frustration that impacts on day-to-day quality of life, to being extremely debilitating,” says Lidbetter.
“For some, the anxiety becomes chronic, and they may spend many hours checking for symptoms, seeking reassurance from others, surfing the internet for information about different diseases, or repeatedly visiting the doctor.”
What causes health anxiety?
Knowing someone with a serious illness may be a trigger for health anxiety, but there are many other possible causes for the condition to develop, including a family history of a particular long-term or chronic illness such as cancer or heart disease.
Other triggers may include negative experiences in childhood, publicity campaigns around specific illnesses, or general anxiety leading to concerns about health.
Links to OCD
Health anxiety and obsessive compulsive disorder (OCD) can sometimes be linked, because health anxiety sufferers can rapidly go from fearing illness to becoming obsessed about illness, convincing themselves that every ache and pain is a sign of something sinister.
Anxiety UK says that when health anxiety has its roots in OCD, sufferers often change the illness they’re worried about. For example, many young people with health anxiety initially worry about HIV, but as they get older they begin to worry about cancer and heart disease instead. For this reason, it’s important that treatment doesn’t just focus on alleviating concerns about a specific disease, as the sufferer could then begin to worry about a completely different disease instead.
What’s the treatment?
Health anxiety is treatable, but recovery can take some time. Initially it might help to have a thorough check-up with a GP to help calm fears about specific illnesses. Talking therapy such as cognitive behavioural therapy (CBT), prescribed anti-depressant medication, or a combination of both is the most common form of treatment.
Local self-care and self-help support groups can help with finding ways to manage the condition, and Lidbetter notes that self-help books can be useful.
If you need extra advice, Anxiety UK can also provide help and information, as well as access to CBT support on 034 4477 5774
Keeping your feet in tip-toe condition is easy once you know how. Here’s everything you need to know and unfortunately, that means losing the high heels — at least for the most part.
BIN THE FLIP-FLOPS
Good footwear is the first principle of foot health, advises podiatrist Aoife Reilly, who says that when choosing shoes, stability is key. “The shoe shouldn’t be too easily bent,” and should provide good support around the arch of your foot. That means “there is a bit of an incline there that follows the natural contours of your foot”. At the front of the shoe, look for “a wide, deep toe box, so that there is no compression on the toes, and so that your heel is supported as well”.
It’s worth noting that flip-flops provide none of those features. Worse still, the movement required to walk without support causes a twisting motion of the heel which can cause dry skin and cracked heels. “Opt for similar characteristics in shoes both in summer and winter months,” she says.
High heels, sadly, aren’t much better and should be limited to occasional wear if possible. “The lower the heel the better,” says Aoife, who advises a well-fitting high heel that doesn’t compress the toes.
WALK, WALK, WALK
Modern sedentary lifestyles are taking their toll on our feet, according to podiatrists, who report seeing clients suffering stiff and tight muscles as a result. There are more than 100 mus- cles ligaments and tendons in the feet and keeping these strong will prevent problems later in life. Try to fit in a quick walk at lunch-time and in the evening as this helps loosen up muscles and gets the blood flowing to legs. People often complain of cold feet — and sometimes this is caused by a condition known as Raynauds — but experts say that more often your tootsies are cold just from sitting all day.
BE VIGILANT IF YOU HAVE DIABETES
People with both type 1 and type 2 diabetes are more vulnerable to foot problems such as heel cracks and ulcerations, which can have serious and far-reaching consequences.
Neuropathy, the loss of sensation in the extremities, is a common complication of diabetes. “If someone has a stone in their shoe or a pebble, because they have reduced sensation they might not notice that. Over time that damages the skin a cut can occur. That’s an open site for bacteria and infection,” says Aoife Reilly. “People with diabetes can have reduced healing. So you can imagine those symptoms can exacerbate quite quickly.”
She adds that prevention is better than cure.”
Regular screening with a podiatrist is recommended, but patients can play their part in daily prevention. “Check your feet, dry them well. Perhaps place a mirror around the floor area, pop your feet up and check that there are no cuts or damaged skin, or maybe family members can check as well.”
EAT YOUR WAY TO HEALTHY FEET
Diet has a major impact on our feet and is especially important for people who have, or are at increased risk of developing pre-existing conditions. That means keeping blood sugars well controlled for those who have diabetes.
Another common foot condition is gout, which is linked to excess consumption of alcohol, red meat and sugar. Uric acid crystals build up within the joint and leave the skin around the joint red, tender and swollen. The patient is unable to even touch the skin of the toe and jumps at the lightest touch.
WATCH YOUR WEIGHT
Our feet bear the load of our entire body weight so if we are carrying extra pounds our feet tend to flatten out as a result and this puts a greater strain on the muscles and tendons around our feet, particularly the posterior tibial tendon and the plantar fascia which are easily inflamed from excess loading.
If you are suffering from pain or tenderness around the leg or foot then this can be rectified with orthotics — a supportive device worn on the foot or in the shoe. Your podiatrist should also be able to provide you with an exercise plan that will help.