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Guardian — Health anxiety can be all-consuming. Accepting uncertainty is an important step
- Thread starter SNT Gatchaman
- Start date
Oh, the irony. The labelling of many people with 'health anxiety' is surely partly the result of doctors feeling uncomfortable with a situation where they can't otherwise identify a cause of the patient's symptoms. Feeling that they must know everything and always get things right, 'health anxiety' provides a handy diagnosis to fill any gaps of knowledge.
Accepting uncertainty and coming to terms with our fallibility is a challenge for us all, but some people clearly have substantial trouble with that.
I wouldn't have a problem with the article if doctors and psychologists were capable of distinguishing genuine health anxiety, which I assume does exist for some people, and genuine physical illness that can currently only be diagnosed by the pattern of symptoms like ME/CFS.
While we are still in the situation where the likes of Wessely, Sharpe et al train clinicians to misdiagnose ME/CFS as health anxiety, we have a major problem.
The article does us a disservice by not spelling out that major problem and directing blame where it belongs. It wasn't Dr Google who led clinicians down the wrong path.
While we are still in the situation where the likes of Wessely, Sharpe et al train clinicians to misdiagnose ME/CFS as health anxiety, we have a major problem.
The article does us a disservice by not spelling out that major problem and directing blame where it belongs. It wasn't Dr Google who led clinicians down the wrong path.
Andy
Retired committee member
Two, among a number of, good comments from readers
"It is sadly common to see people who are suffering badly with Long Covid (and other chronic illnesses) being diagnosed with somatic symptom disorder. They are then dismissed by multiple health providers as this incorrect diagnosis follows them everywhere. This article touches far too lightly on the ruling out of physical illness - it is the experience of many that they are dismissed even before any useful investigations are done. You can dress up the language all you like, but the reality for many is that they are treated as 'hysterics'. There is still a very long way to go."
and
"The problem here is that people with anxiety, and specifically health anxiety, can actually have health issues. The problem is that once a doctor is aware of stress/anxiety of the patient, everything is now dismissed as stress or anxiety and go do some mindfulness. This means that serious illnesses/diseases are overlooked.
I personally had this struggle in 2014, where after spending a year being dissmissed by GP's but continuing to demand referrals to specialists etc , I was diagnosed with multiple chronic illnesses that had been simply put down as "stress and anxiety" by so many GP's and specialists. I had physical tests done to diagnose the issues, and now have an excellent neurologist and gastroenterologist. It was far too difficult to go through this process and it was soul destroying to be dismissed while suffering physically so much"
Both available from https://www.theguardian.com/comment...ing-uncertainty-is-an-important-step#comments
"It is sadly common to see people who are suffering badly with Long Covid (and other chronic illnesses) being diagnosed with somatic symptom disorder. They are then dismissed by multiple health providers as this incorrect diagnosis follows them everywhere. This article touches far too lightly on the ruling out of physical illness - it is the experience of many that they are dismissed even before any useful investigations are done. You can dress up the language all you like, but the reality for many is that they are treated as 'hysterics'. There is still a very long way to go."
and
"The problem here is that people with anxiety, and specifically health anxiety, can actually have health issues. The problem is that once a doctor is aware of stress/anxiety of the patient, everything is now dismissed as stress or anxiety and go do some mindfulness. This means that serious illnesses/diseases are overlooked.
I personally had this struggle in 2014, where after spending a year being dissmissed by GP's but continuing to demand referrals to specialists etc , I was diagnosed with multiple chronic illnesses that had been simply put down as "stress and anxiety" by so many GP's and specialists. I had physical tests done to diagnose the issues, and now have an excellent neurologist and gastroenterologist. It was far too difficult to go through this process and it was soul destroying to be dismissed while suffering physically so much"
Both available from https://www.theguardian.com/comment...ing-uncertainty-is-an-important-step#comments
And for the laypersons who point to those they and we know in real life are indeed a bit hypochondriac and using that to justify THIS: I bet my bottom dollar those who get all health anxiety with their friends are pros in appointments and it’s the people who are working their backsides off harder than the well people despite having whatever ailments that are getting labelled as ‘not worth hearing a word from’ before they’ve even opened their mouth to say what they have.
This is just a cover for misogyny - where people don’t want to listen to certain types and want to invalidate them by being obvious about it and letting them know. People need to be reminded this vile misogynistic, disability-hate narcissistic behaviour isn’t useful, wise, kind or ‘education’ to others no matter what those who are that way inclined want to label it as for the propaganda. And yes it’s incitement - this whole area is encouraging others to throw at others cynicism, invalidation, disability hate and misogynistic ‘don’t listen to their words they are pathetic wrong-thinking women who need lessons in how you think better that’s why you aren’t ill they are lazy layabouts’ stuff. How on Earth medicine let this nasty vile area in the door given the history in other bad things like eugenics and that this was already done years ago when there was less science and fewer diseases known so why us it they want to hark back to pretend that knowledge doesn’t exist for one segment so they you can return to the days of siloing them off to ‘the mad house’ rather than make scientific progress? Unless some were wanting to do this anyway and appreciate the manifesto whether it adds up or not to pretending it is 'an alternative theory' instead of what it actually is.
It’s all so strange that the worst propaganda and incitement business is ending up being grown under all this
and they need to stop being allowed to use the term ‘mental health’ as a cover for an old fart or vicious misogynistic woman to actually call another woman ‘hysterical woman like the old days ill women were sent to the asylums for not behaving right’ which is and was twenty years ago seen as s sanity/delusion issue if the name-caller and not the targeted one. It's quite the opposite of 'mental health' to encourage harming others in all ways possible (physical health, psychologically harmful, unkind, situationally destructive) - full stop. Just because you want to call the victim of your behaviour 'a nutter' doesn't make them 'a nutter' and phrasing it a more polite way doesn't make it any kinder, just snider.
And to lump such utter power and free-will removal 'just because you irrationally don't like them' under 'mental health' is the most insulting thing to real mental health illness that could be thought of really.
Psychosomatic is some misogynistic diss that 'they are making themselves ill with their attitude' being pretended to be 'something real as a concept' by pretending it is the same as those who genuinely might be worrying about something they have. Neither deserve no respect or compassion and yet this attitude does just that.
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I think its worse than when a doctor can't understand symptoms (because they are complex). The more messages around health anxiety are repeated the more doctors blame this - dismiss symptoms and don't try to diagnose properly. I suspect there is a reason that the UK is very poor with early cancer diagnosis and doctors are obsessed with 'health anxiety'.
I guess there are lots of reasons.
It's increasingly hard to see the same GP when making appointments - practices tend to be larger with a big roster of doctors and an even bigger number of patients. Without that continuity of care, it's easier for doctors to dehumanise their patients.
Also, at least here where I live, doctors are incentivised to minimise the care that patients receive - they get paid a capitation fee for each patient on their books. So, a GP practice ideally wants lots of patients on their books who hardly ever have an appointment. People who come in frequently reduce the profitability of the practice. So, a strategy where you either annoy a 'frequent flier' patient enough that they go off to another clinic, or you manage to convince them that they should not be coming in to the clinic so often is deeply attractive.
And then there's the facts that the GP's only have 15 minutes to achieve something and getting a referral to a specialist is increasingly difficult. A diagnosis of 'health anxiety' with a rehearsed explanatory speech about sensitisation helps the GP to feel that they have achieved something, especially if the patient seems to accept that diagnosis. The most likely alternative in an under-resourced health care system is to feel impotent.
It's increasingly hard to see the same GP when making appointments - practices tend to be larger with a big roster of doctors and an even bigger number of patients. Without that continuity of care, it's easier for doctors to dehumanise their patients.
Also, at least here where I live, doctors are incentivised to minimise the care that patients receive - they get paid a capitation fee for each patient on their books. So, a GP practice ideally wants lots of patients on their books who hardly ever have an appointment. People who come in frequently reduce the profitability of the practice. So, a strategy where you either annoy a 'frequent flier' patient enough that they go off to another clinic, or you manage to convince them that they should not be coming in to the clinic so often is deeply attractive.
And then there's the facts that the GP's only have 15 minutes to achieve something and getting a referral to a specialist is increasingly difficult. A diagnosis of 'health anxiety' with a rehearsed explanatory speech about sensitisation helps the GP to feel that they have achieved something, especially if the patient seems to accept that diagnosis. The most likely alternative in an under-resourced health care system is to feel impotent.
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Mostly by shifting responsibility to the patient, and the blame when it inevitably goes wrong.
It is just an excuse generating mechanism for the inevitable limits to doctors' knowledge, coupled with their cowardice in refusing to stand up against the endless cost cutting to the health service.
rvallee
Senior Member (Voting Rights)
About something that actually adds costs on the long term, and it's been happening for so long that we are now firmly reaping the consequences of this folly. On the short term it could be argued that it's just deferring the costs to the future, but that future is now and the losses compound as long as the underlying issues are not dealt with.
It's basically Arrested development level of economics. You steal a dollar from the registry, you throw away a banana. You are now out $2, the lost sale from the dipped banana plus the cost of the banana. And the stolen dollar, of course.
This is yet another way medicine and healthcare are political. There is supposed to be a long-term view that is detached from short-term political priorities. And yet this foolishness has been happening for decades, and in every country. It's actually hard to imagine a worse deal: you harm people, for zero gain, in the pursuit of 19th century ideology that has been proven not to work.
And of course many people, and most MDs, believe in this "power of anxiety" precisely because so many people with severe illnesses have been mislabeled. So of course it looks powerful, and it's a self-perpetuating failure when the outcomes are made worse, which leads to perception that those mechanisms are just super powerful.
RedFox
Senior Member (Voting Rights)
The discussion around health anxiety is not inclusive because it fails to discuss the experiences of people who have actual health problems. I have experienced two forms of anxiety around my health:
- Fear that I do not have a legitimate health problem.
- Fear that any sporadic symptoms is a manifestation of serious, systemic issues, or a worsening of my disease
Yes and this to me is why part of GPs actually treating (in the broadest sense) PWME should involve annual or biennial reviews.