Can’t see a general practitioner? Blame the state-sponsored hypochondria

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Throughout the pandemic, we have counseled each other to “stay safe”. Much has been written about the wisdom, or otherwise, of such advice (what, after all, is “security”?), But little has been said about the impact of such messages on people who are already anxious or having difficulty leaving their homes.

In my work as a general practitioner, I have always had patients with whom I speak largely on the phone because of this agoraphobia. Millions of people suffer from these kinds of mental health issues, with anxiety rates rising dramatically over the past decade, especially among young people.

A significant number of my older patients who previously led active lives – going to stores or attending community social groups – have come home, socializing less, having food delivered, and exercising less. These daily activities may not feature prominently in government analyzes of the impact of Covid interventions; but viewed collectively – as millions of little deeds done day in and day out – are fundamental to a healthy society.

Studies have shown that confinements have been detrimental to the health of older people with long-term neurodegenerative diseases, with frailty becoming more severe during periods of confinement. Simply put, the measures taken to protect these groups from the virus have made them perversely more vulnerable to the effects of Covid. Some of my patients have diligently protected themselves, only to suffer unexpected strokes or heart attacks. I can’t help but wonder if they had stayed more active, if they could have done better.

Colleagues who regularly deal with obsessive-compulsive disorder tell me that the past two years have been extremely difficult. How do you advise someone not to obsessively wash their hands to avoid germs or disease when the government has told us all to do so? The pandemic neurosis appears to have become state sponsored.

Many parents now call our office at the first sign of a cough in their children, and many fear that a fever could herald a potentially fatal illness. Frequent lateral flow testing, especially in children, means that even those without symptoms can be declared infected and asked to self-isolate. The disease has become a mythical beast, which could strike any of us at any time. The continued negative messages seem to make the public increasingly worried about their health: a significant degree of hypochondria should come as no surprise.

We have yet to see the wider repercussions of encouraging frequent isolation after minor viral symptoms. Young people now think it’s okay to miss school for 10 days every time they cough. Previous generations may never have lacked so much education in all of their childhood. How will these policies influence disease rates and group participation in the long run?

I remain deeply skeptical of the use of fear as a behavioral tool – for example, those horrific TV commercials of teenagers inadvertently infecting their grandparents. These messages, which at times bordered on propaganda, seemed to worry my most cautious patients, while further alienating those who were already suspicious of the government. In a society where anxiety is a huge burden on health services – an estimated two in five GP visits are for mental health – can it be wise to deliberately inflict more worry?

Higher levels of social connectivity – our social connections and activities – have long been recognized to improve physical and mental health, including life expectancy. Policies that reduce our social ties and promote fear will eventually make people sicker.

Young people are now more anxious than ever. Older patients have become more fragile. The rates of mental health referrals to the NHS have skyrocketed. Our unhealthy obsession with Covid and reduced social ties have fostered anxieties and health behaviors that make people sick. Are we becoming a nation of hypochondriacs who can no longer cope with normal life?

Dr Katie Musgrave is a general practitioner in Plymouth

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