Health anxiety, me and the NHS

This hospital is now a museum. Else I’d be running a mile.

Those of you who have been keeping track probably know that 2 years ago I self-referred myself for therapy to deal with a moderate case of anxiety that began around 2006 and has stayed with me since, although I can handle it much better with the techniques I learnt.

Without the therapy I would not have a clue what was actually wrong with me and what the triggers of anxiety were. It turns out I have a phobia (in the medical sense of the word) of not being in control. I’m a medically diagnosed control freak!

I wouldn’t swap my not-being-in-control-phobia1 for anything — it makes me who I am. My skills as a manager and software architect derive in part from it. My obsession with maps, public transport and strange details that other people miss. My tendency to try to keep groups together and be the one who organises stuff. These are all things that people like about me and maybe I wouldn’t be quite so interesting without my mental “illness”.

But at other times it’s fucking annoying. And perhaps none more so than with health anxiety. When hypochondriacs (as we used to be known) are pictured in fiction we’re always obsessively checking in with the doctor and asking inane questions about things that are clearly not illnesses. Maybe there are health anxiety sufferers like that, but I know my own experience is exactly the opposite of this. I stay the hell away from doctors.

Here’s how health anxiety manifests for me:

1. If I get ill, I try my damned hardest to pretend I’m not. For something like a cold or a headache I can usually genuinely convince myself I’m not ill and just get on with my life. (Pretty cool, if it didn’t come with all the other stuff.)
2. I only go to the doctor if something is wrong with me that I can’t “manage” (for some definition of this word) by myself.
3. If I do go to the doctor, I tend to say things like “it’s probably nothing, but”.
4. If I read about the symptoms of diseases that can’t be cured (even really common, harmless ones like herpes) I freak out. I mean properly freak out. The idea of something that can’t be cured is exactly the kind of thing that triggers my phobia.
5. I used to really try to avoid drugs completely. Now I’ll take a couple of ones I trust, like cetirizine and paracetamol, but it takes a long time to convince me and I still actively avoid them. I’ve never exceeded the recommended dosage of anything ever. (OK, except caffeine and alcohol – I guess I have some sort of doublethink where they’re concerned.)
6. I actively avoid preventative & non-essential medicine unless I force myself. This includes going to the dentist (I once avoided it for 10 years in a row), giving blood (for my sins I have never done it) and sexual health screening (I force myself to go twice a year but it’s a struggle to do this).

I believe that the NHS is failing those of us who have health anxiety.

If I go to the doctor, the doctor doesn’t know how much of an effort I have put in just to get myself through the door.2 Most of the time, I will tell the doctor it’s nothing and so I just get back “it’s probably nothing”. This puts me back in my place of ignoring the illness again.

What I really want is for them to examine me. They know I have a mental illness: it says so on their screen. So they shouldn’t trust me when I tell them I’m OK. I’m there for their professional opinion. I’m not a doctor, they are.

For all my life I think I’ve suffered from some form of IBS. I think it might be getting worse. But at periods of “every few years” I’ve gone into the surgery and tried to explain and just been left with an “it’s probably nothing” or they take a test and ask me to call for the results (do I ever call for the results? Of course not.) This leaves me on my own for another few years until it gets bad enough that I go back.

On Mental Health Awareness Day earlier this month, several political parties suggested that they’d improve the way mental health is handled in the NHS. I hope this happens. But if it does, they need to realize that mental health has a knock-on effect for all other aspects of health too. It isn’t just psychiatric teams that need extra money and training.

Anyway. I guess I’m putting this out there because it’s a good way for me to feel in control. And if I’m in control, I can do anything. So I’m going to go to the doctor. And I’m going to give blood. I just have these other more important things to do first…

1. Someone needs to come up with a proper Greek word for this – how about anelenchophobia? [↩]
2. When I finally — after many years — admitted I needed therapy I was just given a phone number and told to call it. You can guess how long it took me to call them. [↩]