PACEMAKER - TUESDAY, SEPTEMBER 23, 2014


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Living with Anxiety and Hypochondria: A Patient’s Perspective


By Anonymous It is quite hard to trace the exact origins of a generalised anxiety dis- order (GAD). When I was first diag- nosed with GAD in 2011, at the age of 22, I began to reflect on my gen- eral disposition and realised that I have always had inclinations towards anxiety. Of course, everyone has mo- ments of feeling deeply anxious, but this is usually brought on by stress- ful circumstances. However, the type of anxiety that I experienced was not provoked by circumstance but was more like an underlying nervous ten- sion, causing situations that would ordinarily be stress-free to feel un- manageable. But as the proverb goes hindsight is 20-20 vision. It was not until I started suffering from panic attacks that I realised that something wasn’t right. The immediate cause of the worry


that led to these panic attacks was a feeling of numbness and weakness in my right arm. This marked a turning point: my anxiety beginning to ex- press itself as hypochondria. Rather


than going to the doc-


tor when I first began to experience these symptoms, I waited, and as the ‘symptoms’ grew more pronounced, so did the mental slideshow of all the possible awful and debilitating condi- tions that could be responsible. Once it had mushroomed into a full-blown neurosis, I did just about the worst thing one can do: I self-diagnosed on the Internet. The term ‘cyberchondria’ was


coined to explain the burgeoning phe- nomenon of a modern hypochondria


exacerbated by the vast amounts of information found on the Internet. The problem with this information is that it does not come qualified with critical insight. If it did, the GP, first port of call to diagnose your ail- ments, would be out of a job. One of the things that I find most interest- ing about anxiety is the power of the mind to manifest symptoms. Abet- ted by horror stories on the Internet, a few odd physical symptoms and a sense dislocation between my mind and body, I convinced myself that I was suffering from multiple sclero- sis and then brought the associated symptoms into being: an asymmetri- cal numbness down my right side, stiffness in my hands, shooting pains in my eye, tightness in my muscles, to name a few. When I finally went to my doctor,


he quickly diagnosed me with anxi- ety. I had an initial treatment course of cognitive


behavioural therapy


(CBT). However, I had been living abroad at the time and when I left the UK, for some reason, my anxiety died down and I did not complete the CBT treatment. Unfortunately anxiety, like most chronic health problems, can and does return. When my anxiety came back in 2013 the pattern was identical. The same set of imagined symptoms be- gan again, and despite having had a full neurological exam in 2011 and being assured nothing was wrong, I was still convinced I was ill. I could not sleep and lost weeks of


time lying in bed, unable to motivate myself to do anything. The only thing


Physician Associates


By Cressie Moxey CONTINUED FROM COVER - Physi- cian associates have been part of the NHS workforce for the past decade and are able to provide an interme- diate level of care: take a patient’s history, order tests and carry out ex- aminations, make simple diagnoses and decide upon treatments. Howev- er, physician associates cannot pre- scribe drugs or order X-rays without the signature of a doctor. Currently, around 200 physician


associates are employed within the NHS, in comparison to over 80,000 within the United States healthcare system. Plans for the NHS recruitment


drive of physician associates include a doubling of training places to 225 across UK schemes. These schemes are usually open to


science graduates who will go on to receive two years of intensive train- ing instead of the seven completed by doctors; many will have already


I really had time for was constant worry, convinced I was slowly dying from some obscure, unidentified ill- ness.


The doctor who saw me most reg-


ularly suggested that I start a course of anti-anxiety medicine in conjunc- tion with more CBT. Like most peo- ple, I was frightened by the prospect of medication. Unsure of the side ef- fects and afraid of the how I would cope with them, I refused drugs. The problem, as I later discovered, was that the sense of disconnection that anxiety causes means that often CBT does not work and I found myself un- able to engage with the therapist. It was only after three months of ping- ponging back and forth between doc- tor and therapist in a near constant state of panic, unable to pull myself out of the hole into which I was stead- ily sinking, that I decided that I need- ed to be medicated. From there things improved very


quickly. I went to see a psychiatrist who diagnosed me with anxiety spe- cifically caused by OCD and pre- scribed a 5 month course of an anti- anxiety/ anti-depression medication called citalopram. The psychiatrist told me that the longer the course the better, as the medicine will actu- ally change the chemical structure of the brain. Since that point, I have been able to move on with my life. It may sound trivial when looking back, but it is hard to put into words how damaging GAD was to my life. I now know I will have the tools to cope in future, and hope other people in the same situation will get help too.


been trained as nurses, paramedics or physiotherapists and will receive two years training in addition to that. Plans to introduce a new genera- tion of physician associates are with views to relieve a strained NHS and help take workload pressures off doc- tors.


Health secretary Jeremy Hunt has backeds the idea, saying that “grow- ing the workforce further with a new class of medic” will provide “busy doctors (with) more time to care for patients”. However, concerns have been raised that the cheaper to recruit jun-


By Olivia Holtermann Entwistle Prevalence: Anxiety disorders are more com-


mon than any other class of psychi- atric illness, including GAD, OCD, panic attacks and phobias. Te NHS estimates that 1 in 25


people in the UK suffer from GAD at some point in their lives. In other words, at some point in your career, you will undoubtedly encounter it or suffer from it yourself. GAD is most prevalent in those aged 35 to 55 and is more common in women. Causes: A variety of factors are known to


contribute to the development of anx- iety disorders, including: neurotrans- mitter imbalances, genetic predispo- sition, a history of trauma, drug or alcohol abuse, over-activity of brain areas involved in emotions and be- haviour, and suffering from a chronic health condition. Some physical illnesses may also


directly cause anxiety, such as, hyper- thyroidism, heart failure, asthma and COPD. Diagnosis: Tis is done by asking several


questions, such as: “Have 3 of the fol- lowing symptoms been present for 6 months or more: restlessness, fatigue, poor concentration, irritability, mus- cle tension and disturbed sleep?” “Have they experienced excessive


worry about activities or events?” and “Is the anxiety present on most days?” “Have symptoms interfered with


everyday life?” and “Does the patient have difficulty controlling the worry?” Treatment: Antidepressants, psychotherapies eg. Cognitive Behavioural Terapy.


ior posts will be used to replace the more expensive doctors to make up staff numbers on wards. Dr Mark Porter, chair of the Brit- ish Medical Association, said: “only doctors can provide certain types of care so the government needs to en- sure that standards won’t be affected by these changes and the quality of patient care will be protected”. With suggestions that physician


assistants could adopt many of the roles currently undertaken by junior doctors, Porter also warned that the roles must not damage the training of junior doctors.


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