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‘It’s OK to be a hypochondriac now’
it’s OK to be a hypochondriac now’
Lee Kynaston on suffering from health anxiety
As we start to head back to the office amid talk of a second Covid wave, ‘coronanxiety’ is on the rise and health anxiety has trebled.
Lee Kynaston, who has suffered from this crippling condition for most of his life, reports
Worried about getting ill right now? It seems that an increasing number of us are. In fact, with health stories dominating the news cycle and the Prime Minister warning that Covid-19 will be with us until at least next summer, it’s hard not to be in a heightened state of alert. Thanks to a UK death rate over 40,000 and an unprecedented societal shutdown, being concerned about your own and your family’s health has become the national mindset.
Little wonder then that mental-health charities have had to extend their helpline hours due to ‘coronanxiety’, higher-education institutions such as Glasgow Caledonian University are training staff to deal with Covid-induced anxiety among students, and FOGO – fear of going out – has become a bona fide thing. So bad have things become that polling by communications firm Kekst CNC shows that over three quarters of Brits now expect a second wave.
Being a little fearful about your health isn’t necessarily a bad thing, of course. It’s only when we overreact to potential threats that it becomes an issue. ‘Anxiety about illness only really becomes problematic when it significantly interferes with your health through intrusive worry, lack of sleep, or the need to take problematic precautions against illness,’ says Paul Bennett, professor of psychology at Swansea University.
When that happens it tips over into fullblown health anxiety – a mental-health condition thought to affect four million people in the UK, though researchers from Imperial College London estimate that at least one in five people attending hospital outpatient appointments suffer from it. It tends to affect women more than men, frequently peaks in middle age ( just when those niggling aches and pains appear), and is thought to cost the NHS around £420 million a year in outpatient treatment alone.
Unsurprisingly, the pandemic has fuelled a sudden increase in health anxiety cases, with a study conducted by the University of Bath suggesting the condition has leapt from affecting between four and six per cent of people in the UK to almost 15 per cent.
And don’t think it can’t affect you just because you’re ‘not the worrying kind’. ‘It’s true that most people who develop illness anxiety disorder do so on the background of an anxiety-prone personality, but there are undoubtedly instances of it arising de novo,’ warns David Baldwin, professor of psychiatry at the University of Southampton, who leads the Anxiety Disorders Research Network.
You don’t need to tell me what it’s like to live in fear of illness because for most of my adult life – and I’m a still-sprightly 53 – I’ve suffered from health anxiety.
Also known as hypochondria, this mental-health condition is characterised by an unhealthy preoccupation with having or getting serious illnesses. Sufferers convince themselves that minor aches and pains are major, life-threatening illnesses, catastrophising to the extent that they seek reassurance from medical professionals or the internet only to dismiss negative tests results.
If you suffer from health anxiety, backache is never just backache – it’s possibly bone cancer, and a blood test will never conclusively prove it’s not. There’s always the suspicion that the test might have missed something. Or that you received someone else’s results. Or that the rookie doctor doesn’t know how to interpret the results.
To the uninitiated this level of doubt and suspicion probably sounds ludicrous – laughable even – but it can be every bit as debilitating as depression, social phobia or OCD, with some sufferers left feeling suicidal as a result, like I once did.
Charles Darwin, Andy Warhol and, ironically, Florence Nightingale were all thought to have suffered from health anxiety. More recently, Loose Women presenter Stacey Solomon opened up about her battle with the condition. ‘At my worst, I was so fearful of death I’d think about it for six hours a day,’ she said, in a confession fellow sufferers will instantly identify with.
Researchers don’t know for sure what causes it, though certain personality traits seem to be factors (sufferers are often sensitive, cautious and have issues around control and uncertainty), as does a history of general anxiety, a family preoccupation with health and an experience of illness or death at an early age.
I can trace the origins of my anxiety back to childhood and the death of an aunt I was close to, who passed away from cancer aged just 19. Wanting to protect me, my family concealed much of her illness but as a sensitive seven-year-old with, like most children, a penchant for eavesdropping, I quickly filled in the gaps and my mind ran riot. Suffering a bad stomach ache a few months after her death, I became convinced that I too would die of cancer. My fear of illness was triggered again – and massively amplified – when years later, my dad also succumbed to the disease aged 52. Things only got really bad, though, when I hit my 40s.
In the past 13 years I’ve ‘suffered’ from pneumonia, deep vein thrombosis, rheumatoid arthritis, diabetes, cancer (of the bones, blood, lungs, throat, prostate, skin, oesophagus, bladder, pancreas and stomach), Parkinson’s,
HIV (twice), motor neurone disease, heart failure, tuberculosis, chronic obstructive pulmonary disease, peripheral neuropathy, ME (which later morphed into fibromyalgia and Lyme disease), gallstones, early-onset dementia, glaucoma, Morgellons disease (after reading that Joni Mitchell had it) and worms. Let’s not forget the worms.
‘For God’s sake, Lee, it’s all in your mind!’ my long-suffering partner would say to me when I complained I was feeling ill again. And, of course, it was. But that doesn’t make it any less real, as anyone with health anxiety will tell you. If you’re a sufferer you become so attuned to every minor ache and pain and amplify them through worry until they become – and feel – absolutely real.
Like Solomon I began to waste entire days obsessing. I’d buy home testing kits and look up my ‘symptoms’ online hundreds of times a day. So obsessed with self-examination did I become that I once felt the glands in my neck so frequently they actually popped up, like
‘It’s hard feeling like death is at your door every day
– it sucks the joy out of your life’
mushrooms, overnight. My relationships, work and social life deteriorated as I became tired, depressed and self-absorbed. I tried to blot out my worries with alcohol. At one point I displayed classic ‘avoidance behaviour’ and became agoraphobic too. At my lowest point I felt suicidal – and it was at this moment I decided to get help.
It was utterly exhausting – something Helen, a 48-year-old fellow sufferer who contacted me for support when I mentioned my health anxiety on social media, understands all too well. ‘I’ve suffered for many years but the death of my father to motor neurone disease and a sister who was diagnosed with colon cancer four years ago at age 45 were triggers for my anxiety and sent me into a tailspin,’ she says. ‘Since then it’s been a constant struggle. It’s hard feeling like death is at your door every day and it’s so tiring – it sucks the joy out of your life.’
A global pandemic, of course, is the daddy of anxiety triggers. Not only has its arrival created unprecedented global uncertainty but ambiguous and often contradictory Government advice has muddied the waters, triggering often disproportionate concern. And that’s bad news for everyone because we have a habit of confusing uncertainty with risk – something borne out by research by Kekst CNC, which shows that people significantly overestimate the fatality rate of Covid-19.
Compounding the problem is the fact that it’s almost impossible to ignore the threat. ‘With Covid, we’re faced with constant reminders of the issue, with news reports having the potential for triggering health anxious thoughts on each occasion,’ says Prof Bennett. What’s more, because the virus is unseen, and symptoms vary and take a while to appear, reassurance is difficult. ‘Unless you completely avoid venturing out into potential risky situations (which, if you are highly anxious about health, is probably anywhere), it’s difficult to reassure yourself that you are Covid-free,’ he says.
It’s a nightmare scenario – especially now lockdown is over, shops and businesses are opening up and there is talk of a second wave. It’s no wonder people who don’t suffer health anxiety are feeling anxious about their health. For many of us, including me, lockdown provided a safe space. Only when it ended did my anxiety levels begin to creep up – as they did with fellow sufferers like Helen. ‘When my family and I went into lockdown a funny thing happened,’ she told me. ‘I felt so protected that my health anxiety got a lot better. Society was starting to feel what I feel all the time. But as lockdown was lifted and my husband returned to work, I began drinking more and felt scared by every break in the safety net.’
It is clearly something businesses and employers will have to think carefully about, especially with a survey conducted by The Healthy Work Company showing that only 14 per cent of us are in a rush to get back to the office. ‘As we now look to the future, many people may feel anxious about reintegrating into office life,’ says workplace health and safety expert Heather Beach, whose company conducted the survey. ‘Managers are going to have to step up and show real emotional intelligence, talking to staff individually about their fears and what’s being done to allay them, because everyone’s anxiety levels are different. I don’t think blanket emails are going to cut it.’
For men, of course, these challenges are compounded by stiff-upper-lip stereotypes, outdated notions of masculinity and a reluctance to open up about mental-health issues. ‘From boyhood, men are told to be brave and with the pandemic have come new pressures,’ says psychotherapist Noel Mcdermott. ‘On top of that, men in general have fewer social and emotional support systems and the places where they could talk about their problems are closed.’
What saved this man was therapy. Three years ago I finally decided to seek help. Months of private ‘talking’ therapy – a 50th birthday present to myself – helped uncover the causes of my anxiety, while a targeted, eight-week course of cognitive behavioural therapy (CBT) via the NHS provided me with a toolkit of survival techniques I’ve been able to deploy to keep the worst of my anxiety at bay. CBT was especially useful because
it tackles, head on, the invasive thought patterns that fuel the anxiety, exposing them for what they are – irrational – and giving you the confidence to challenge them.
It was hard work and it hasn’t ‘cured’ me but it has enabled me to manage some of the more excessive aspects of my anxiety. So, apart from one day in March when I checked my temperature eight times (we’re all entitled to a relapse) things have been bearable.
My main worry now, though, is that the pandemic is teeing up a healthanxiety time bomb, the repercussions of which may only become apparent in years to come – a concern shared by mentalhealth experts such as Bennett. ‘Data from Covid is still only just coming in but there’s previous evidence from SARS that anxiety, depression and PTSD levels all rise significantly in both those affected by the condition and the general population, so expect to see significant and long-term problems in the future,’ he says.
Early figures certainly confirm that those surviving Covid-19 are at risk, with an Italian study revealing that 42 per cent of those hospitalised because of the virus suffered from anxiety, while 28 per cent had PTSD.
Even more concerning is research conducted by suicide-prevention charity CALM which revealed that people experiencing major anxiety for the first time during the pandemic were the least likely to speak about how they were feeling.
And if the condition is a drain on NHS resources now, what will it be like in years to come when the psychological impact of the pandemic really begins to manifest itself ?
Until quite recently, sufferers of health anxiety like me were ridiculed and dismissed as resource-draining malingerers. We were weak and neurotic. I’ve certainly been laughed at for my fears in the past.
Covid-19 has changed all that. Because of the pandemic, fear of illness is as ‘new normal’ as mask wearing and elbow bumping. Let’s face it, we’re all hypochondriacs now. But I’d hate that fear – a degree of which is necessary to keep us and our loved ones safe – to become the kind of fear that actively causes us harm.
Over the years, I’ve learnt a lot about anxiety and fear of illness – not least that with the right tools and a friendly ear it can be managed. I’ve certainly learnt a lot about life through thinking so much about death. And somewhere among those thousands of hours of unnecessary worry, there’s a lesson for us all: every minute you spend worrying about dying is one you could have spent thinking about living. As Helen says, a fear of death really does suck all the joy out of life. So, grab your hand gel and face mask and… live!
‘Unless you completely avoid venturing out it’s difficult to be reassured you are Covid-free’