Articles. Some silly, some serious. Originally published in The Founder, the independent student newspaper of Royal Holloway, University of London.

Monday, February 14, 2011

Hypochondria: a health condition in its own right


 No one gets through life without a health scare. Everyone knows what it is to rush to the doctor in a panic, or to scour self-diagnosis websites with baited breath and sweaty palms. After a trip to the doctor, however, and perhaps a test or two, the majority of us go back to everyday life and forget all about it. But some do not. Some cannot. Some remain so convinced that their symptoms are the sign of a terminal disease that no amount of reassurance can convince them otherwise; others are so scared of what their doctor might say that they are unable to make an appointment in the first place. Hypochondria, now known as health anxiety or illness phobia, is frequently dismissed as needless fretting, a trivial concern of the neurotic and the self-absorbed. But in reality it is a genuine, disabling psychological condition, and it can have a devastating effect on a sufferer's ability to lead a happy and fulfilling life.

When I was sixteen, I spent the best part of a year convinced I was dying of multiple sclerosis. It began when I watched 'Hilary and Jackie', the biopic of the legendary cellist Jacqueline du Pré, whose career was cut short by MS when she was in her twenties and who died of the disease at the age of 42, fourteen years after it was diagnosed. By the end of the film, du Pré, played by Emily Watson, is confined to her bed, unable to control a single muscle in her body and dependent on carers to feed, wash and dress her.

It was perhaps not a wise film choice for someone with a chronic fear of disease. But I didn't think of that. I just thought it was a good film, so I watched it again, and again, and as I watched it, something happened in my brain. In the weeks that followed, I began to wonder if I wasn't exhibiting some of the same symptoms du Pré had experienced in the early stages of her illness. The tired feeling I sometimes had in my legs, especially when I climbed stairs – did it mean something was wrong with me? My hands trembled sometimes, too – should I be worried? The tingling sensation I occasionally felt in my back made me uneasy, as did the muscle palpitations that seemed to be occurring with increasing frequency. My concern rapidly turned into fear. Before long I was convinced that something terrible was happening to my body.

Panicking, I googled 'multiple sclerosis'. Reading the lists of symptoms brought me out in a cold sweat; those I had not already noticed I began looking for obsessively. After reading that uncontrollable head or tongue movements were always cause for serious concern, I found myself in front of the mirror, examining my tongue for signs of abnormal movement. I scrutinised my hands and panicked over the slightest tremor. I held my arms and legs in strenuous, unnatural positions and told myself that any resulting pain or muscle fatigue was evidence of something sinister. I even watched my shadow for twitches and shakes. It comes as no surprise to me now to learn that health anxiety is often classified within the Obsessive Compulsive spectrum of anxiety disorders.

According to Terri Torevell of the charity Anxiety UK, some sufferers of health anxiety will go to their doctor 'countless times'. Negative test results and verbal reassurance from medical professionals do nothing to quell their fears. Others, like me, are the opposite – they avoid doctors because they are too afraid to face up to the diagnosis they believe to be inevitable.

I didn't just avoid telling my doctor – I avoided telling anyone at all. For months, I kept my fears to myself. I longed for the reassurance doctors had offered me in the past, but I didn't for a moment believe I would get it. There was so obviously something wrong with me, I thought, that anyone I told would have no option but share my concern. Whenever I considered going to my GP I imagined her recommending, with a grim expression, that I go to hospital for further tests, and I simply couldn't bring myself to make the appointment. However miserable they were making me, I preferred to live with my fears than risk having them validated.

Had it occurred to me at any point that I might be suffering from an anxiety disorder rather than an actual physical condition, I would undoubtedly have been able to move on much quicker than I did. Seeking help might have opened my eyes to the fact that being 'healthy' doesn't necessarily mean being entirely pain- or sensation-free, and crucially, to the possibility that my constant state of fear might not just have been the result, but the cause of the symptoms I was experiencing.

'Anxiety produces very real physical symptoms,' says Torevell. 'With people suffering from health anxiety, they misinterpret these normal physical reactions to anxiety, and believe them to be signs of their feared illness.

'One of the things we often say to people on the helpline, when they're calling in the throes of a panic attack, is that nobody has ever died from a panic attack,' she continues. 'The worst thing that can happen to them is already happening. And panic attacks and prolonged anxiety cannot go on forever. It has its ebbs and flows, it has peaks and troughs and it will ease eventually.'

Calling a helpline such as this might have saved me months of misery. Instead, I let my fear take over my life. It cast a shadow over everything I did. I couldn't bear to think about the future – about going to university, or starting a career, or travelling the world – because I didn't believe I would live that long. I was plagued by a constant, nagging worry, which regularly escalated into panic. Sometimes I was so scared I couldn't think straight. There was no respite, no situation in which I could feel at ease. I simply could not escape it.

Eventually, when I could stand it no longer, I told my mother everything. Just talking to someone made me felt better, although it by no means solved everything. But as the days and weeks went by, I found myself feeling more relaxed. I began considering the possibility that my symptoms were nothing more than my body telling me to do some exercise. The less I worried, the less I noticed them. Gradually, they disappeared altogether, taking my anxiety with them.

But my experience with health anxiety has left its mark. Even now, five years later, I avoid reading, watching or listening to anything that so much as mentions multiple sclerosis, and while I don't fear it like I did, I do fear the appearance of some new and unmistakable symptom. I fear the blind panic that will inevitably ensue. I fear the sinking feeling, the cold sweat, the rising heart rate. Most of all I fear the possibility that next time, my worries will be justified.

Health anxiety is not trivial, and nor is it comic. It can ruin people's lives. It ruined a good few months of mine, and I am fully aware that it might do so again. But next time, at least, I will know that I am not alone, and that help is out there, and that I do not have to suffer in silence.

Anxiety UK is the nation's leading anxiety disorders charity. Advice and support for sufferers of conditions including agoraphobia, post traumatic stress disorder and social phobia can be found at www.anxietyuk.org.uk, or by calling the helpline on 08444 775 774. Lines are open Monday to Friday between 9.30 and 5.30. All members of staff have personal experience with anxiety.

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