Last week I decided to officially stop buying newspapers. Not because I don’t like them, exactly – but because every time I open one up I seem to come face to face with my own mortality in the shape of yet another article on “new ways to get cancer!” or “diseases you didn’t even know you should be worrying about” or the like.
Every day brings another thing to worry about: a link between cancer and cream cheese, or some exotic new disease which sends me trotting off to the computer to look it up on the internet and find out if I have it. (I normally do. You’d be amazed how many diseases list “tiredness” and “inability to concentrate” as a symptom). Then there’s the rest. The headache which can’t possible be just a headache, and is obviously an aneuyurism waiting to happen. The pain in my leg which is clearly a deep vein thrombosis. That slightly queasy feeling which has nothing to do with that second bottle of wine I opened last night and everything to do with the stomach ulcer I just have to be brewing from all this angst.
The truth, of course, is that there’s absolutely nothing wrong with me. Nothing at all. According to my doctor (who I see so often now that I’m thinking of asking her if there’s some sort of loyalty scheme I could join; sort of like a club card for hypochondriacs), I’m in positively rude health. I don’t believe her though. You see, I’m a Worried Well. And I’m not alone.
Last week I decided to officially stop buying newspapers. Not because I don’t like them, exactly – but because every time I open one up I seem to come face to face with my own mortality in the shape of yet another article on “new ways to get cancer!” or “diseases you didn’t even know you should be worrying about” or the like.
Every day brings another thing to worry about: a link between cancer and cream cheese, or some exotic new disease which sends me trotting off to the computer to look it up on the internet and find out if I have it. (I normally do. You’d be amazed how many diseases list “tiredness” and “inability to concentrate” as a symptom).
Then there’s the rest. The headache which can’t possible be just a headache, and is obviously an aneuyurism waiting to happen. The pain in my leg which is clearly a deep vein thrombosis. That slightly queasy feeling which has nothing to do with that second bottle of wine I opened last night and everything to do with the stomach ulcer I just have to be brewing from all this angst.
The truth, of course, is that there’s absolutely nothing wrong with me. Nothing at all. According to my doctor (who I see so often now that I’m thinking of asking her if there’s some sort of loyalty scheme I could join; sort of like a club card for hypochondriacs), I’m in positively rude health. I don’t believe her though. You see, I’m a Worried Well. And I’m not alone.
Jill, 25, is a marketing executive from Edinburgh: “Two years ago, during the whole anthrax scare, I was always going to accident and emergency for nothing,” she says, cringing. “Flu symptoms, skin rash – I even went about black spots on my lips which turned out to be leftover lipstick.”
All Jill was suffering from was a classic case of the “what if’s.” Luckily it’s not too serious. Like me, though, Jill is a Worried Well. Every little “illness”, no matter how trivial, gets her thinking, “what if it’s serious?”
“These are patients who come to see us frequently and apparently inappropriately,” says Dr Allan Harris, a GP from York. “Our appointments software enables us to see how many consultations these patients have had, how many over-run, how often they don’t turn up, how often their appointments occur. Sometimes this amounts to hundreds of individual consultations.”
Jill is a doctor-shopper. Many of us worried wells are. You see, we know we’re probably not ill. I mean, what are the odds of getting cancer and a brain tumour all before breakfast? Oh, we know what we’re doing: we are, of course, experts in all things health-related. I’ve read so many medical encyclopaedia’s and websites that I could probably get a licence to practice medicine in some countries. Except, of course, for the small fact that I can’t tell the difference between a pimple on my chin and a malignant melanoma.
So we doctor-shop. Embarrassed by the ever-more frequent doctor’s visit (I’ve started taking my own magazines now, because I’ve read all the ones in the waiting room. Twice.) and maybe just a little bit put out that these doctors steadfastly refuse to find anything at all wrong with us, we give up and move on to the next one. We know we’re probably not ill, but no matter what we do, we just can’t believe it. We obsess about it – and we need the doctor to make it all go away.
It can, of course, go the other way. Sophie, 27, is a P.A. in London. “I never check my breasts,” she confesses. “It’s too scary; I’m terrified I’ll find a lump and the fear alone will kill me. I put off having a smear for years for the same reason – I finally had to have one last year when I started bleeding between periods. It turned out to be just a side effect of the pill, but if I wasn’t so terrified I’d have gone to see the doctor and put my mind at rest much sooner. I know I shouldn’t put these things off – I’m just terrified of finding out there’s something seriously wrong so I put off the ‘inevitable’ by not going to see the doctor.”
Sophie is a symptom-surfer: someone who types each and every “symptom” she notices into an Internet search engine, looking for an instant diagnosis. It’s a common trait in the Worried Well; GPs like Dr Harris are becoming more and more used to the sight of patients appearing in their office clutching printouts from the Internet, or the latest health-scare article from the paper.
“Patients frequently appear with clippings from newspapers which contain some very inadequate journalism,” says Dr Harris. “The Internet can be a useful resource for our patients but they need guidance as to which sites have reasonable content.”
And not all of them do. Dr Harris recommends well-established websites like NHS direct or Quackwatch.org, but while these may help you understand what your “symptoms” really are, they won’t put a stop to your worrying. So what’s a worried well to do?
Well, don’t fear the doc for one thing. “People obviously have different expectations, pain thresholds, and understanding of disease,” says Dr Harris, who believes that the GP should attempt to uncover the deeper reasons why someone ends up worried well. “Sometimes their behaviour can be challenging and wearing,” he admits, “but ultimately, with a good rapport, the visit can become therapeutic.”
And if the doctor’s still too much to face, well, there’s always your mum… “My mother’s heart must sink every time she hears my voice on the other end of the phone,” says Sophie. “I call her three to four times a day because talking to someone about my fears is the only thing that makes me feel better, although no matter how many times she tries to convince me, or I try to convince myself, that I’m not dying, it never works. I can’t see a doctor for fear of finding out there’s something really wrong with me. Throat cancer is a big fear. Brain tumour is another. And also heart disease and lung cancer.”
Sophie isn’t ill, but she may as well be – and, if she continues the way she’s going, she probably will be. Sophie’s is the more extreme form of the “what if’s” – the kind of anxiety that keeps you awake at night and makes you miserable when you’re awake. “Some days I worry so much about my health that I can’t concentrate at work,” she admits. “I just want this to stop.”
In the US, where even anxiety is bigger and better than over here, the answer comes in the form of clinics where patients can pay around $800 for a full body scan to tell them once and for all whether it really is all in their mind. For those looking for a slightly cheaper option, Sophie may be onto something with those chats to her mother…
The Health Anxiety Centre’s online discussion boards currently list almost 9,000 messages from members, all of whom obsess about health. Members use the boards to talk about their current fears, seek reassurance or take part in private interviews with the board administrators, who help them try to get to the root of their anxiety. “We can’t all be dying,” is the official slogan, but for the dedicated worried well, that’s just a matter of opinion.
Karen, (25) from Newcastle, became a worried well shortly after her brother was diagnosed with liver cancer. “Ever since then, if I have a pain anywhere I’ll always think it’s more serious than it really is,” she says. “My doctor said I was suffering from depression, but I don’t really want to take tablets for it: just knowing that a professional had spoken to me about it made me feel a little bit better.”
According to U.S. psychologist Dr Peggy Elam, Karen is suffering from a classic case of “hypochondriasis” – good ol’ hypochondria to you and me. “In some people, hypochondriasis is associated with past serious illness in the patient or family members, particularly in childhood,” she says. “Other people seem to have developed the preoccupation with illness after a psychosocial stressor, especially the death of someone close. It’s something for which psychotherapy will probably be more helpful than medication.”
For many worried wells, the talking cure – whether it’s to your mum, your best friend or the dog, is the only thing that works – something that mental health charity SANE know only too well. Since it was established in 1992, its national helpline, SANELINE (0845 767 8000), has taken hundreds of thousands of calls, helping people deal with anxiety in all its many forms. “”SANELINE cannot be a substitute for inner peace and happiness,” says the charity’s chief executive, Marjorie Wallace, “but it offers someone to talk to, and the confidence that our volunteers will understand.”
Worried wells take heart; and remember – we can’t all be dying…
