Dear Dr Nina: 'My daughter is suffering from anxiety and is convinced she has a yeast infection'
Our resident GP answers your medical queries.
Dear Dr Nina: My daughter is in her early 20s and she has become very anxious in the past year or so. She is doing a PhD away from home and I have a feeling that she is floundering, but she won't say. She is convinced that she has some sort of yeast infection in her vagina, even though her GP has told her that there is none. She does an over-the-counter treatment almost biweekly and even got a stronger medication from her GP, but to no avail. She complains of stinging and soreness, and I feel that she may be focusing all her anxiety on this one thing. Can you give me any advice? Do you think it could be a psychological issue or could there be something that her GP is missing?
Dr Nina replies: Anxiety can certainly cause the symptoms your daughter has. Somatic symptom disorder involves being distressed or having one's life disrupted by concerns involving physical symptoms when there is no obvious physical or medical cause found.
We all suffer low mood or anxiety from time to time, in the same way we all have days when we feel extra happy. If mood was put on a spectrum of 1-10, with 1 being profound depression and 10 being manic elation, most of us rotate between 4 and 6 throughout our lives. Low mood or anxiety becomes a concern when the symptoms hang around, being present daily for at least two weeks.
There are several main symptoms of depression. These are: feeling sad; lacking energy; poor concentration; disturbed sleep (feeling unusually tired or suffering from broken sleep); lack of interest in usual activities or withdrawing from friends, family and social occasions; feeling guilty or having low self-worth; physical aches or upset, or feeling that life isn't worth living.
Anxiety can make you feel on edge, unable to relax sleep or eat, along with physical symptoms such as nausea, palpitations and chest pain. Studies show that up to one third of GP consultations have a psychological basis. Depression can occur after a major life event such as bereavement, separation, work stress or relationship difficulties but what many people don't realise is that depression can also occur with no obvious cause.
Despite huge media campaigns as regards mental illness, there remains a stigma attached to it. People who are feeling unwell often end up feeling guilty, withdrawing from those close to them and feeling socially isolated. Physical symptoms, which are socially more acceptable, may predominate.
Reaching out for help is the first, most important, step on the road to recovery. Approaching a health professional will help guide you on the road to recovery. Those with somatic symptoms disorder may not realise the psychological basis for their condition. Their symptoms are genuine and real and they will often spend many hours and much money trying to get a diagnosis.
Counselling is one of the most important modes of treatment. Talking to a professional therapist will help explore mood, emotions and personality in a safe, controlled environment. Therapy will provide the tools needed to rebuild confidence, a sense of self-worth and mood. There are a number of excellent books that can be very helpful. Medication can be very effective when prescribed and used appropriately. The newer tablets have much fewer side-effects than the older ones and are usually very well tolerated. Leading a healthy lifestyle will also help. Nourishing body and mind with healthy, unprocessed foods, exercising regularly and allowing time for rest and relaxation are very important. Taking some time off work initially can be very beneficial.
The first step is talking to your daughter, exploring her anxieties and asking her to consider a psychological cause. Reassure her this is as treatable as any physical cause and that addressing it will hopefully be a first step on her road to health.
Health & Living