Can’t see a GP? Blame state-sponsored hypochondria

Throughout the course of the pandemic, we have advised one another to ‘stay safe’. Much has been written about the wisdom, or not, of such advice (what, after all, is ‘safety’?), but little has been said about the impact of these messages on people who are already anxious, or struggling to leave their homes. 

In my work as a GP, I have always had patients who I largely speak to on the phone because of this agoraphobia. There are millions who suffer from these sorts of mental health problems, with rates of anxiety having increased enormously in the past decade, particularly amongst younger people.

A significant number of my older patients who previously led active lives — popping to the shops, or attending community social groups — have reverted to staying at home, socialising less, having food delivered, and taking less exercise. These daily activities may not register prominently in government analyses of the impact of Covid interventions; but viewed collectively — as millions of small acts undertaken day in and day out — are fundamental to a healthy society.  

Studies have shown that lockdowns have been detrimental to health in older adults with long term neurodegenerative conditions, with frailty becoming more severe during lockdown periods. Put simply, the measures taken to protect these groups from the virus have perversely made them more vulnerable to the effects of Covid. Some of my patients have shielded diligently, only to suffer unexpected strokes or heart attacks. I cannot help but wonder if they had remained more active, whether they might have fared better.

Colleagues who deal regularly with obsessive-compulsive disorder tell me the past two years have proven extremely challenging. How does one counsel somebody against obsessively washing their hands to avoid germs or disease, when the government have told us all to do so? Neurosis over the pandemic appears to have become state-sponsored.  

Many parents now call our surgery at the first sign of a cough in their children, with a good number worried that a fever might herald a life-threatening illness. The frequent lateral flow testing, especially of children, has meant even those with no symptoms may be declared infected and advised to isolate. Ill health has become a mythical beast, which could strike any one of us at any moment. The continual negative messages appear to be making the public increasingly anxious about their health: a significant degree of hypochondriasm should come as no surprise. 

We are yet to see the wider repercussions of encouraging frequent isolation after minor viral symptoms. Youngsters now believe it is entirely normal to take 10 days off school every time they have a cough. Previous generations may never have missed this much education in their entire childhoods. How will these policies influence sickness rates and group participation over the longer term?

I remain deeply sceptical about using fear as a behavioural tool — for example, those awful television adverts depicting teenagers inadvertently infecting their grandparents. These messages, which at times bordered on propaganda, seemed to create anxiety amongst my most cautious patients, whilst further alienating those already distrusting of the government. In a society where anxiety is an enormous burden upon the health service — two in five GP consultations have been estimated to involve mental health — can it be wise to deliberately inflict more worry?

Higher levels of social connectedness — our social ties and activities — have long been recognised to improve physical and mental health, including life expectancy. Policies which reduce our social connections and promote fear will ultimately make the population sicker. 

Young people are now more anxious than ever. Older patients have become frailer. Rates of mental health presentations to the NHS have sky-rocketed. Our unhealthy obsession with Covid, and reduced social ties, have promoted health anxieties and behaviours that make people unwell. Are we becoming a nation of hypochondriacs who can no longer cope with normal life?


Dr Katie Musgrave is a GP in Plymouth

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