It’s been a difficult week for those with illness anxiety disorder — the group formerly known as hypochondriacs. Primed to react with a jolt of unpleasant adrenalin to any health-related headline, the already troubled sufferers were this week brought the worst news imaginable as The Guardian sounded “the link between hypochondria and early death”. A Swedish study has found that, apparently, “people with what is now called illness anxiety disorder may die earlier than others”. As one commentator acutely put it: “It’s not enough just to have worries — now you have to worry about your worries.”
Pity the poor Guardian-reader; now faced, alongside all his other heavy psychological burdens, with the prospect of health anxiety spiralling in an uncontrollable loop, recursively feeding off his last set of worries about worries about worries until he keels over from sheer mental exhaustion. And the rest of the newspapers’ health pages this week won’t have helped much. Even as an early test for Alzheimer’s was being greeted with much fanfare, it was also emphasised that the latest drugs are still relatively powerless to reduce the disease’s terrible ravages once diagnosed: bad news for anyone who tends to panic when they lose their reading glasses or forget a word. And there were also unpleasant tidings for fans of ZOE, the wildly popular private programme designed to improve digestive health. One Times report this week suggested that ZOE’s focus on gut health is distracting people from more pressing problems like high blood pressure and cholesterol. Ironically, it also suggested that engagement with the programme is likely to increase health anxiety — bad news indeed for nervous ZOE users who subscribe to both the Times and Guardian.
As it happens, someone in my house has been a ZOE user for the past few weeks, so I’ve had an inside view of the process, as it were. And I can certainly see how it might encourage neurosis. For two weeks, you stick a needle in your arm and temporarily turn yourself into a cyborg, able to check your blood sugar at any point in the day by waving your smartphone somewhere near your armpit. Meanwhile, in a move perhaps secretly designed to revive the fortunes of the Royal Mail now that we’ve all stopped writing letters to one another, you are also instructed to send your faecal matter off in the post. Back comes a chart arraying your personal gut bacteria types, each cosily personified by use of a familiar first name. “Jesse”, “Bethan”, “Polly”, “Somesh” and “Priya” are good bacteria, while among the bad bacteria, there seems a strangely high preponderance of Scandinavian and Eastern European names, including “Sven”, “Slawek” and “Lars”. The goal is to decolonise your gut, quite literally. It’s not hard to imagine that perfectionist types, already susceptible to taking purity metaphors too far in their personal lives, will become obsessed.
I speak of all this relatively empathically, as a former member of the hypochondriac community. Though free from it now, at earlier times in my life health anxiety has been a torment, made no less unbearable by the knowledge that I was very probably imagining things. My first perceived encounter with the grim reaper was at university, when — sitting trembling in a doctor’s surgery I’d hastily found in the yellow pages — I stammered out my tragic tale to a bored looking medic. About two months earlier, I reported, I’d found a worrying lump on one side of my neck. Later, about two days before the present appointment, I’d discovered another symmetrical lump on the other side. The doctor reached forward and prodded the lumps. “These?” he asked. I nodded solemnly. A diagnosis was issued: “They are bones holding up your skull.” The relief was intense, as was my embarrassed resolution never to get into such a ridiculous state again. But both were ultimately short-lived.
It’s easy to laugh at hypochondriacs — I do, at my past self — and, if you are one, it’s easy to blame yourself, too. For me, shame was a crucial component of the distress, which lent to an agonising stand-off where I couldn’t bring myself to see a doctor to put an end to the worrying, at least momentarily, for fear of medical disapproval or even ridicule that would come with reassurance. And, actually, the real story is how widespread and debilitating health anxiety is these days, though sufferers are often too ashamed to talk about it; and how newspapers and even the medical profession itself contribute to feeding the beast to bank the clicks.
On one hand, there is the ludicrous boom-or-bust pattern of health reporting. First comes the hope: pouncing with great fanfare on some new piece of research or technology, emphasising its promise to improve some dreaded physical outcome (Ozempic, anyone?). Then, sooner or later, the more sceptical debunkers arrive, suggesting that the original breakthrough was not all it was cracked up to be. Most of us lack the expertise to assess either claim, optimistic or pessimistic, and so are at the mercy of whatever our individual psyches would have us believe. But the more (dis)information that circulates about the relation of behavioural choices to health, or about the range of diagnostic tests or prophylactics newly available, the more everyday decisions can seem freighted with potentially devastating consequences, and the heavier the guilty responsibility if you get things “wrong”.
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SubscribeI’ll die when I die, most doctors are quacks, most things tend to get better if you just leave them alone, don’t eat too much and don’t drink too much, exercise in moderation does wonders, try to get out in the fresh air more often, don’t pick at it, and the purpose of news stories is to sell newspapers, even news stories about health–if it bleeds, it leads. Take what they’re selling with a huge grain of salt.
Shouldn’t you have said “a moderate grain of salt?” [grin]
RWH should have specified Tibetan pink rock salt.
Hear, hear. I’ve been to three different ophthalmologists since October. Each time I got completely different diagnoses for the same “condition”. Treatment was all over the map.
As a character in the sitcom “Scrubs” noted astutely: a surgeon will always recommend surgery; a diagnostician will recommend pills.
apparently our bodies are replete with cancer scar tissue; cancers that were never diagnosed or treated.
Many more men die with prostate cancer than from it, which is why many doctors don’t want us to get tested. Like Covid.
“Get tested”. That sounds a simple concept. But no medical test is 100% accurate. They can throw up large numbers of “false positives”, people who then demand further tests and medical attention.
So some mass screening is justified, others not.
Too many false positives
“Apparently”. Lol!! What utter nonsense.
How about being grateful that you haven’t been hit with something more serious? Around half of the population will get cancer at some point in their lives, so it is sensible to be alert to the early signs rather than waiting until it’s stage 4 and there’s nothing you can do. A fit friend of mine thought that she was a bit constipated but didn’t want to make a fuss as it was during the pandemic. When it got too painful she finally went to the GP and it turned out that she had advanced colon cancer, had a very difficult surgery and was left with a colostomy bag. So that certainly didn’t
And don’t forget to ‘ eat a peck of dirt before you die’ to bolster your immune system.
Eat a peck of dirt… and get toxoplasmosis 🙂
exactly!
I agree with much of this, but I don’t that “most doctors are quacks”. So, I presume that you’ll accept no treatment for, say, cancer?
I think Churchill said (paraphrased) that the advantage of procrastination is that half of your problems solve themselves while you put off working on them. The same applies to worrying about your health. Then again, you can have that nagging dull stomach pain you ignore until the day you are diagnosed with end stage pancreatic cancer.
A charming thought.
Made slightly more palatable by the fact that almost all pancreatic cancer presents with weight loss and painless jaundice. That dull stomach pain you’re feeling is far more likely to be gastric cancer, equally grim.
Or it might simply be a boring old ulcer, brought on by worries that you might have pancreatic cancer.
A friend of mine suffered from persistent back pain, and on one visit the specialist thought to consider that it might be pancreatic cancer, which it turned out to be. He was given two weeks to live but lasted only a few days. At least finally he was released from the suffering that led him to apply to Dignitas years ago, but they said extreme pain wasn’t enough. He had to have a diagnosis from two doctors that he would definitely die within 6 months.
The author has somehow contrived to write nine long, and nicely composed, paragraphs about hypochondria without once mentioning the all-out assault launched by the UK and other governments on their populations barely four years. She even discusses the moralising and guilting nature of so-called public health campaigns! Am I alone in thinking this quite extraordinary?
Act like you’ve got it, one three people who have it don’t know they have it, going outside costs lives, protect yourselves and your loved ones and stay indoors, don’t go to work or socialise to “stop the spread”, keep 2m apart just in case someone sneezes, use hand sanitizer every time you enter a shop, wear a useless surgical mask even if you’re healthy just in case, don’t kill grandma, test daily, stay at home for days on end if you are pinged …
Lest we forget.
Perhaps she didn’t want to get sidetracked from the psychology of hypochondria.
The psychology of hypochondria was pounded into people by the government, making people into hypochondriacs and making hypochondriacs’ condition worse. That’s the point.
did you miss this bit
Or are you just on a hobbyhorse that there wasn’t really a Covid epidemic and nobody really died from it that wasn’t about to die anyway? I have two friends around the age of 50 who died from it, thank you.
I read that to be referring to posters encouraging people to check for signs of cancer, not covid?
In any case, I’m sorry for the loss of your friends. There was obviously some kind of seasonal virus. There is a similar such thing each year and this one seems to have been particularly bad one. Such viruses always do, sadly, take the lives of people who hadn’t perhaps realised quite how susceptible they were to such things.
But, regardless of how bad it was relative to the norm, the panicked, overwrought response – amongst public officials and the general public – to it did not help or save anyone. It made things much, much worse and it has left a trail of economic, social, and psychological wreckage in its wake – including paranoid hypochondria and a disproportionate sense of responsibility for others’ wellbeing, which is impossible to discharge and so renders those burdened with it with feelings of guilt and inadequacy.
It seems likely that it was a bio engineered virus.
Right. She analysed it from an individual perspective rather than a societal perspective. Western society can now be characterised by narcissism an hypochondria.
The Alzheimer example is a funny one. ALL ailments experienced over age 50 are not “illnesses”, they are the process of ageing.
We need to return to a time when the Death Certificate stated Cause of Death: OLD AGE.
People wanting to live forever, that’s narcissism.
Our medical training and public healthcare systems were never supposed to focus on chronic ailments, but on fixables.
We have lost that important outlook.
Alzheimer’s IS an illness, it isn’t just the ageing process. We can see the structural changes (actual losses) in the brain. Most elderly people don’t fortunately have it.
Yes, yes, yes. But surely we can talk about more than one subject?! Hypochondria and health obsession was not caused by covid or the overreaction to that disease.
And critically for the politics – unfortunately in my view – most of the population approved of even tougher and longer lasting measures.
I think it was a big costly mistake. But I think we wouldn’t – couldn’t afford to – repeat it. It will be quietly ditched, even probably in China, where the lockdowns were immensely costly to their economy.
But of course no-one will be held to account – the establishment were all too committed.
I find getting old to be a great panacea for worrying about one’s health. The closer I get to my past due date the less I care about staving off death.
If only that had been the prevailing attitude four years ago
It most probably was – among older people. But nobody asked.
Hence the concept of QALY “Quality-adjusted life year”You’ll find that doctors would much rather treat young people so that the treatment gives better value, but we’re danged if we don’t get sicker as our bodies atrophy. And we are so good at keeping people alive nowadays that we can go on to develop ever more novel and sinister illnesses. When the NHS was set up, if you got cancer, you wrote your will. Now we go to extraordinary lengths to keep people alive, even when they clearly are ready to go.
You are sadly in the minority. Everyone is now so self important and view their life extension as important to the world. Most are delusional. And the Medical Industrial Complex is guilty of creating that mindset.
Everybody rather than your oh so wise self, obviously Trisha!
I’m have conversations with lots of people – and most have thought deeply about these modern conundra.
I presume you refuse all medical treatment on principle? Let nature take its course?
I do enjoy KS’s articles as they are always entertainingly written. I have noticed though that when she introduces a character who could be of either gender, if they are neutral or good then the ensuing pronouns are “she” and “her” but if they are a bit thick or bad – in this case a Guardian reader then it he / his is used: “Pity the poor Guardian-reader; now faced, alongside all his other heavy psychological burdens,”
Nothing to do with KS personally, I also noted that her friend’s gut bacteria had female names for the ‘good’ sort and male names for the ‘bad’ sort.
It is one of the things I like about her writing. A lot of feminists feel they have to include gratuitous barbs against men, which detract from their point – Julie Bindel is one of the worst for this. KS gently and subtly mocks us in a witty and entertaining way.
Not sure why mentioning this attracts a down vote but hey ho.
I defend Julie Bindel! She is against rapists and sexual harassers, not men in general. Unfortunately 90+% of sexual crime is statistically committed by men.
She’s probably carefully avoiding calling people they/them, or even worse zie/zem (if you know your trans theory).
At least Zoe attempts to permit sensible, self-motivated people to build insights into their diet and metabolism. Time till tell whether this approach will succeed commercially and scientifically. If one is already an anxious hypochondriac, then using Zoe won’t make things any worse than an alternative like guzzling more and more meds from the GP. As for the comment in the article – “ZOE’s focus on gut health is distracting people from more pressing problems like high blood pressure and cholesterol” – what a load of tosh.
Zoe is snake oil in modern drag designed to appeal to the bourgeois health anxious as these things often are. The pivot from nutritionism to covid symptom tracker and back to nutritionism was opportunism writ large. There’s an interesting Freddie Sayers discussion about Zoe on Unherd.
how very uninformed. You clearly don’t know much about the subject, apart from reading an article by Freddie Sayers. I wonder if he is similarly ill-informed?
There is in fact no robust scientific evidence that the Zoe approach is valid, or that there are such things as “good” or “bad” gut flora.
Why is the latter point “a load of tosh”? Zoe is becoming yet another middle class fad diet costing hundreds of pounds, often taken by people (I’ve asked some) who have absolutely nothing wrong with them or indeed any symptoms.
It has zilch relevance in my view to the very real diet, exercise and lifestyle issues affecting so many British people.
Chap goes to the doctor. He was in his mid-sixties. An aunt he never knew just died and left him, as her only living relative, fifty million dollars. He told his doctor he had had a very hard life, never any money, and suddenly he had this fortune, and wanted to be able to extend his life, live longer, so he could enjoy his newfound wealth. How could he live longer? The physician thought for a moment, then said: “Here’s what you do: Start eating a very bland diet, no meat, uncooked vegetables only. No sugar, no salt. Cold cereal with skim milk, no sugar, or hot cereal, one cup only, for breakfast. No tea, no coffee. No alcohol of any kind. Get rid of your television. Get some books, nothing too exciting. Maybe just home improvement books. Stay home and read them in a dim light with the shades drawn to avoid direct sunlight. And no girlfriends, above all, no ladies.” The man listened and said, “If I do all of that, will I live longer?” “No”, the doctor answered, “but it will feel longer.”
ah, the old “wine, women and song will shorten your life” joke
Every cigarette you smoke takes 9 days from your life expectancy, which God then gives to Keith Richards.
Laughter is the best medicine and Dr Stock’s article is a good laugh. Thank you.The vision of waving a smartphone somewhere in the region of your armpit is hilarious and led me to wondering near what other regions one might wave it to check bodily odours or emissions.
you attach a blood sugar sensor to your arm: the smartphone is reading the sensor. Nothing to do with your armpit. And very much easier than what most diabetics have to do, which is to stick a pin in your finger, draw some blood, and put that on a sensor. You don’t want to do that more than a couple of times a day.
Most body odours and emissions can be sensed by your nose (or those of your acquaintances). It’s why a lot of people keep a dog, so they can have someone to blame.
Health reporting in the MSM is no worse than its reporting other topics; all are utterly appalling, half -assed mishmashes of specialist press releases the authors don’t begin to understand, incoherently cobbled together and published under sensationalist headlines. When the typical MSM health, science, technology, defence etc reporter has a degree in EngLit or history, and the current role is just the latest ‘beat’, what else can you expect? Amazingly, they give each other awards. Not for the quality of reporting, of course. But for selling copy.
You clearly don’t read many scholarly articles if you think there is no point in someone outside the profession trying to explain them to the untrained. My consultant friend often sends me links to articles about ME/CFS, and even now a great deal of it makes little sense, even though I’ve been studying the condition for decades.
Fortunately, hypochondria is the only thing I’ve never had.
shouldn’t you be worried that you don’t have it?
Doctor to patient: There’s good news and bad news. The good news is that you’re definitely not a hypochondriac.
You’re right. I need to get that checked. Let me Google the symptoms.
Other than a daily walk, it would seem that for most people one’s off colour moments can be satisfied with over the counter drugs. Since Covid my interaction with the Medical profession has been extremely limited and I find myself in a much more satisfactory place,
so you advise self-medication with pharmaceuticals? Dangerous.
‘…feeding the beast to bank the clicks.’
Never, ever stop writing. Just reading that sentence has increased my lifespan by several months.
Thank you!
I can agree with that. I have suffered with ME/CFS for decades, and the medical profession is useless. There is no pill or surgery, so I must need psychotherapy. The most recent downturn was after getting the Covid vaccines, where I went from being able to walk 30 miles in a day (after building up to that over several years) to being unable to walk more than a mile a day without ending up bedridden. But to dare to criticise the GP? The bare faced cheek.
I think doctors tend to overmedicate you where I am (well-intentioned of coz as they really believe in their pharmaceuticals) These medications probably cause other serious damage to the body and this is not even referring to recent side effects of numerous popular ‘solutions’. What comes to mind is also people taking Ozempic? For weight loss so easily when it has been stated that if you ever get off that drug, weight gain bounces back even more frequently. X
I caused consternation in my family by deciding to refuse all breast scans after reading research showing that overall no lives are saved by this diagnostic procedure.
How can this be? Since some lives are saved by early diagnosis there must be some lives that are lost due to it in order to balance out. These are caused by false negatives and false positives. False negatives cause people to ignore symptoms and not get them checked out, thinking that they must be okay due to the test result. False positives cause people to have surgery on lumps that would have gone away by themselves without surgery, since all surgery carries a danger, however slight, of death, these two issues balance the lives saved. To say nothing of the anxiety of waiting for results and so on.
I chose to forgo a very uncomfortable procedure for myself, others must make their own decisions of course.
There’s a book called “Dance With Chance” which covers this topic really well. And supports your approach.
Ditto. I was coerced by my doc into having two “baseline” checks, they are THE most uncomfortable medical exam for women, worse than the cervix for me. I won’t be having more. The Medical Industrial Complex are deluded by their poking and prodding abilities, but they serve little purpose.
Natural human longevity is around 55, or some years after menstruation ends. All ailments trending after that age are not “illness”, they are simply death. As a society, we are so narcissistic, that we must extend death, it’s really silly. If one naturally lives on to a ripe old age, fine, they were little genetic miracles, but we should get rid of the idea that all humans must be allowed to get old.
I have been having regular mammograms since I turned 50. My mother was diagnosed with breast cancer at 44. She had a mastectomy and has just celebrated her 91st birthday. My sister was diagnosed with breast cancer at 50. She had a lumpectomy and radiation. I was diagnosed with breast cancer, found through a mammogram at 64, I had a lumpectomy and radiation.
My husband’s sister-in-law decided that her healthy diet meant she didn’t need to do any checks for breast cancer. She died at age 58 from breast cancer that had spread to her brain. When it was diagnosed it was stage 4 and treatment was still possible. If she had been having regular mammograms from age 50 like I did, she would most probably still be alive. And mammograms are not that painful. I had one the other day. The alternative is way more painful.
I had my first mammogram 7 weeks ago. I was apprehensive because of all the negative comments I’ve read over the years and had put it off over and over again. I mentioned this to the radiographer who sighed deeply and said they’d had to institute a one way system so that those who’d just had theirs didn’t scare off the women in the waiting room.
It was totally painless, not even uncomfortable – why do women spread these scare stories? So much for the sisterhood!
When did we decide that journalists were the fount of all knowledge? Because today too many journalists seem to believe they are, even when all evidence is to the contrary.
Same with the mega rich. They seem to imagine that with each million they make they become wiser and better fitted to tell people how to live their lives.
I suspect much of this happens in society when we treat people as Gods, rather than believing in the actual God.
“When men choose not to believe in God, they do not thereafter believe in nothing, they then become capable of believing in anything.” G K Chesterton
I don’t believe in Gods or Journalists or the Medical Industrial Complex. The Need to Believe is a faulty one.
Good God man! Where is this actual one?
And when it comes to worrying about worrying about mental health, then all the above… but more so and with bells on.
Interesting article. Health anxiety comes in many forms and can be very debilitating for some people. While the article talks about de-medicalising health anxiety and calls on practitioners to cease fuelling patients’ concerns via media publications, it is essential that those who do suffer can access the support they need — avoiding reading newspapers or watching videos will not suffice for many. Health anxiety has existed long before modern media and medicine. As Immanuel Kant wrote in 1798: “The disease of the hypochondriac consists in this: that certain bodily sensations do not so much indicate a really existing disease in the body as rather merely excite apprehensions of its existence”.
At least in the US most diseases are lifestyle diseases: overeating, bad nutrition, overeating, smoking, lack of exercise, etc. So most medical interventions are mere overkill.
My ex-wife’s great-aunt was a notorious hypochondriac, virtually her only conversation subjects being the multiple ailments she had self-diagnosed and how very unwell she was. She outlived her two sisters by more than a decade. Hypochondria, at least, gives you an interest, which is always a good thing.