Health Anxiety + Your Appearance

[RadioGaGa]

I'm a long term sufferer of health anxiety. Although I'd say I've been in remission (after CBT, using this forum, no meds, practicing what I actually know about the human body etc), I won't use the word "cured" as I believe its always there potentially waiting to be triggered... A bit like asthmatics who go into remission - always chance of recurrence.

Nevertheless, I was wondering is anyone else with health anxiety concerned with their appearance? I was sitting watching Botched tonight and the thought entered my head.

For me personally, I always hated my side profile, and thought it was my nose. After consulting several plastic surgeons, I was told my chin was a bit "weak" e.g. recessed from a line dropped vertically from your lower lip. So they all suggested chin implant. I was meant to get it done last month, but found out the surgeon was going to use a "button" implant, rather than an extended implant, so a different surgeon is doing it next month (Long story)

So yeah - anyone else with anxiety suffer the same re appearance? A bit too tired to Google into it!

Thanks

(When I say "suffer the same" I don't mean "do you have a weak chin?", I mean "do you care more about your appearance than the average person?" :roflmao:

[KK77]

Don't you think that a big part of the problem is fearing what other people think of us and feeling judged? We want acceptance, and because society places so much importance on appearance, we think it's logical that the more we "fit" into society's mould and idea of "attractive", the more we will be accepted and "liked".

[RadioGaGa]

Very true - I think a lot of the problem comes from social networking sites e.g. Insta/FB etc. Where we see the "ideals" of appearance. We then compare ourselves to this and see what they have, that we don't.

But I was just really curious - is this perhaps amplified in those with health anxiety, decreased or the same as the average person. E.g. I'm more concerned about my health than a non-HA (or was?) but does this make me more prone to worrying about appearance? Maybe a bit of a dumb "connection" on my part but the thought did enter my mind

[KK77]

I think there is a link with anxiety and how it expresses itself. Maybe when the mind can't find anything physical to be worried about, it then moves on to other "cosmetic" concerns/areas?

Having said that, looks can easily become an obsession too. Then compulsions to do something about it. You know the drill... :whistles:

[MyNameIsTerry]

I think take a wider look at it. Part of this is about human beings, their insecurities and social pressure. Was the only difference between Victorians the fact they didn't have plastic surgeons the reason why their pressure was not quite the same when it comes to appearance? Or were they all secure in how they looked? I bet women were judged for their appearance back then and blokes got away with it easily since society was more patriarchal back then (although men would be scrutinised over masculinity).

But also take a wider look in anxiety-land too. Whilst I don't have HA elements I do have issues with my body. I do have OCD and within OCD there is Perfectionism.

So how about a HA link? First consideration = HA is NOT a medical label, it's a sufferers term. You could have HA as theme of OCD. OCD has that Perfectionism issue within it. OCD is seen to have close ties to Body Dysmorphic Disorder (BDD) in terms of co morbidity. Whilst we may not all have BDD, perhaps like so many things in the human condition we have lesser elements of it that don't add up to enough for a diagnosis just as many think they have OCD because they like order & cleanliness (like the many celebs who OCD a fashionable label, or did until they moved onto bipolar and now Autism).

And then there are other mental health conditions where there is obsessive focus on a part of the body that isn't right to them aside from BDD. But given the obsessive focussing of the HAer it wouldn't be much of a walk from checking the body for possible signs of those cancers to focussing on perceiving imperfections. It's more about why but if you add in underlying issues with self esteem and confidence you can see it happening.

Until they start engineering us in labs there will always be elements of this whether part of normal experience or enough to be a problem with our mental health. Just as there will always be social pressures. They may change but it's kind of just being part of being human. I expect one caveman mocked enough for the size & shape of his club :blush:

Much of this one is likely to be nurture. Pressure on us and our insecurities.

To be honest with you I'm wondering about this surgery you are contemplating. Do you really need this? What the surgeon is saying feels like his view of what gets you closer to the "ideal" like how the celebs chase a certain look. But do you need it to be happy?

I have mixed views on plastic surgery and I think there are a lot of doctors who see it as a way to get a new Merc rather than if the patient really needs it. There are certainly issues raised about BDD sufferers getting what they want from "tame" docs who don't seem to be stopping them to so they sort out their mental health. We think as doctors as highly ethical but anyone who does what they do to some of the celebs is not ethical in my book, some of them would have been in the circus freak shows of old.

And...I'm an asthmatic in remission now! I've always thought they make us sound like a brand of vacuum cleaner! :ohmy:

[RadioGaGa]

Lucky for you your asthma is in remission. Although mine is well controlled, I doubt I'll ever remit now ha.

Certainly I agree about the ethics of plastic surgeons. A friend had her nose 'done' and although objectively 'better' I couldn't help but notice it had a bit of a Michael Jackson-esque quality to it.

I *think* it will improve confidence. Although it may not, and then begins the worry of 'will this be a gateway to wanting more?'. Although I hope not.

At first I couldn't come over the fence - close friends had never noticed a problem with my chin, but then I asked my dentist (we have good rapport) and she said it was a bit 'weak'. Although nowhere near retrognathic, which would require invasive (not to mention, VERY expensive orthognatic surgery) so it was on this basis, and my feelings I decided to proceed - my dentist would have no financial gain from the implant, but would obviously be in a good position to see the 'need' for it.

Either way, nervous is an understatement. Although usually done under local, my surgeon wants general, which I've never had before. So that's a first too.

Certainly I feel in the UK we're not at the American level of commercialising plastic surgery.

I found one American plastic surgeon who advertised a chin implant as follows:

''Got a weak chin? Got 30 minutes? We can fix it. From weak chin to strong, defined chin in 30mins or less under local anaesthesia''

It trivialised it quite a bit imho - as if getting silicone in your chin is a small issue, not to mention costs etc.

But, alas, it'll probably come here in no time!

[MyNameIsTerry]

A Michael Jackson nose? Is that one that needs a CRB check if it passes a school? :winks:

It does all seem a PlasticSurgery4U over there. It's the weirdness of Hollywood which we don't have as much of. Some of them just look like another species now. :ohmy:

If it's what you want and it will improve your life then why not? I'm not against it, I just think it would be great if we never felt the need for it. It's your money and your life.

I did wonder what you meant by "couldn't come over the fence" for a minute. I found myself about to say if it's disabling you, sort it out :doh: But yes your dentist is more objective not having a financial stake in this.

General is fine. To be honest I would rather someone knock me out than do weird feeling to me but I understand how it raises those HA doubts. You are close to the numbers though being in a connected profession so you can hopefully self reassure over the millions of people who have them with no issues. Once you have it you will just drift. Your anxiety may not want to lose control in the same way it does this about going to sleep but you will get through it. And the nurses will be very used to this problem so perhaps even have a chat beforehand and they may give you some additional support on the day?

God knows when my asthma went into remission. I haven't had wheezing for many years. I was very surprised because I do have breathing issues but I think they are more about muscular tension and some back issues. I could not take Preventers for months with no change even when exercising. Never used a Reliever other than a mild asthma attack about 10 years ago which was when I was having a breakdown anyway so plenty of panic going on as well.

[RadioGaGa]

Ha! Yeah it certainly would. But, on a more serious note her nose has a bit of "I've been done" look at about it. The nice thing with the chin implant, although permanent (unlike "boob jobs", it doesn't have to be replaced, which I believe have to every 10 years") its also reversible - so if I get it in, and really don't like it, it comes out much easier than it went in.

I would definitely agree - its a shame we don't live in a society where these things aren't an issue. I consulted four surgeons regarding this (not many offer this procedure in the UK - it seems to have largely been replaced by "fillers", which are temporary and cost more over the long term, whereas in America this is a very common procedure). But only one of those surgeons (the surgeon I'm going with) actually got me to fill in a form beforehand. To me, this was a form which was obviously intended to assess your "mental well-being"... but perhaps to unsuspecting people, it wouldn't appear as such. But why this shocked me is (I read into this) up to 25% of people seeking plastic surgery have BDD.

So these patients will go in with a picture of a certain nose they want. The surgeon will say "OK" and then they get the surgery, get the nose they want. But then, their BDD makes them unhappy with the result, or want something else. And then they end up looking like people on Botched who go OTT. In some rare but tragic cases, some of these patients have subsequently attacked and killed their surgeon. Because, rather than being given the "OK" for a nose job, they should have been refused and referred for therapy.

It interests me because, only 1 of the 4 surgeons I saw performed any sort of mental "assessment" on me - and, coincedentally, the same figure of patients (potentially up to 25%) are not good candidates (psychologically) for surgery, surely this should be a requirement, rather than an option? But then again, who wants to loose 25% of their income?

Apparently, male patients seeking rhinoplasty are a major red flag for plastic surgeons. They even have an acronym for it SIMON: Single, Immature, Male, Overly expectant, Narcissistic. Men seeking nose jobs with these qualities should never undergo the procedure. But I'm sure many do. (For some reason, this only applies to nose jobs - with other procedures, men are no more likely to have an adverse outcome than women)

I mean, if you need cardiac surgery, and they find out you're not fit enough for it - you won't undergo it. And it's strict. It's odd the same principles aren't enforced with plastic surgery.

As far as the GA goes, my nervousness for it comes from the "what does it actually feel like?" and having never had it before. Statistically, I'm not worried at all about the drugs. More so the skill of the anaesthetist looking after me!!! (Haha).

But certainly, it's an interesting topic

[MyNameIsTerry]

I know what you mean about "the look". But like you say it won't the same in your case and if you have a reasonable, ethical surgeon then they won't be looking to fit a Hollywood off the peg chin into you and look towards your needs.

You could have it done, change your mind and correct it so you have some options here. If you went that way then it is going to be worth understanding why. Whether it is because it wasn't what you hoped, it needs to be augmented in some way to work for you or you come to a realisation that you don't need it. Then it comes down money, time and some pain.

It is very worrying about BDD. There have been press articles about it and little regulation is a problem. If you had that mental health condition that persuades you to lop off a limb you would stand out but with BDD they seem to be happy to take the money until someone tells them they need to sift people out to ensure their wellbeing. Not all but some are clearly just treating it as a route to wealth creation.

I guess it's difficult because what about people who want something like a boob job to boost their confidence & self esteem? That suggests a mental health issue but is it enough to be considered a problem?

I'm betting there is a female equivalent to SIMON too?

The easy way out of all this is to get lots of money. Tame doctors seems much easier to find for celebs. They seem to get their hands on drugs, and scheduling, that we can't access. Celebs are very misleading over this too, I remember Beverly Callard (a mental health ambassador, aren't they all these days? :winks:) getting annoyed she cold turkey-ed off a med for her mental health because the med was pulled...yet you will know better than us that takes time and they don't just do it and cold turkey everyone on it AND her private GP who was prescribing it never even contacted her to discuss options? BS. Oh and, it was one we humble NHS patients can't even get.

With the GA you will just drift away like you were absolutely knackered. I've had a couple of them for ops over the years and you start counting backwards and then you wake up post op getting a bowl of cornflakes shoved in your face and nurses obsessed with your bowel movements :biggrin: Like how a benzo can feel like it's radiating a wave of calm down your body from your head. One minute you are there, the next you are fast asleep...like if a party political broadcast comes on the TV and you aren't quick enough on the remote control :biggrin:

[RadioGaGa]

Interestingly, there doesn't seem to be a female equivalent of SIMON - well, not really. They have an acronym SYLVIA (Secure, Young, Listens, Verbal, Intelligent, Attractive) which is meant to hint that the patient is a "good" candidate. This, from my research, seems to be applied to women. But my first issue with it is the "S" - if someone wants to undergo invasive surgery for their nose, how can they be considered "secure"? Unless they mean "secure" in some other sense (financially or whatever)

My dermatologist (who I've seen privately following my "mole anxiety") is a classic example of how rich doctors can become through "filler" and other cosmetic-dermatology treatments. When I first booked the appointment with her, I recognised her clinic was based in a very wealthy part of my city.

It's the sort of housing area where, when you're standing on the street it has that "I'm probably far from any major city, but I'm actually in the city centre" feel about it

So the night I was walking up to see her, I was getting closer to the address (Range Rovers, stay at home mums, etc galore lined the streets) I began to think "she must be practicing from her own house!".

Not so - I turned the corner and saw the clinic. It was a large detached Victorian (former) home. A conservative estimate would be 6 bedrooms, as most houses in this area are. Solar panels lined the roof. The door was glass, and the clinic had marble flooring throughout. If you didn't know any better, you'd have thought it was Harley Street. I keep aquarium fish as a "hobby" and in a dividing wall was a custom built sal****er aquarium.

Sal****er fish alone cost an eye-watering amount. As this tank was custom built, allowing those in the waiting room to "see through" to the corridor, the coral, the fish inhabiting the tank, in my "guesstimate" (and this is a conservative figure) would have cost in the region of £6k to set up. Maintenance etc would not be cheap. I can't imagine my Dermatologist cleaning it out, nor any of the staff I saw (I mean this kindly, but the receptionist had that look about her that even the sight of fish poop would be enough to send her into a coronary, never mind cleaning it out!). So somebody is probably paid to come in and clean in.

Turned out my derma had set this clinic up, and plastic surgeons, other dermatologists and orthopedic surgeons would hold clinics there too. The entire house had been converted, and upstairs where the bedrooms would have been were now a spa/relaxtion area. Aroma therapy, that kind of stuff.

I later saw a house for sale on the same street, roughly of similar size for £1million.

It's a lucrative business to be in (I may sound like I'm envious, but honestly I'm not!). My derma does every cosmetic dermatology procedure you can imagine - importantly, dermal fillers. These can cost anywhere from £300-£700 per ml. The syringes wholesale cost can be as low as £40 per ml! So the mark up is substantial.

Lip fillers are the hot favourite among women. Most need several mls to augment the lips, and it would take an experienced injector about 5 minutes (if that) to do it. So 3 x £300 = £900 for 5 minutes work! Wow. Yes, it's not all "profit", but some people don't even clear £900 per month!

I do have great faith in my dermatologist, and I hope that post doesn't sound too critical of her - its merely my observations of how successful cosmetic dermatology can be.

The closest I've ever come to experiencing a GA was with midazolam when I had the episode of Alcohol induced Atrial Fibrillation. Obviously, Midazolam is only to sedate, but due to my tiredness, it almost had a GA effect on me. I went into AF at 02:00 and ended up "pulling an all nighter" in the ED. So by 15:00 the next day, when they were ready to DC Cardiovert me, the consultant gave me Fentanyl and Midazolam. The last thing I remember was looking at the ceiling light above the bed, and then before I knew it I was waking up. It was kind of "cute" of them because they'd "tucked" me into bed :roflmao: But the Consultant later said he'd never seen anyone fall asleep so quickly. I was that tired! Most people he says "jump" when they're given the shock (see YouTube videos!) but nope, not me apparently. Although I only slept for about 45 minutes after the injection, I have never​ woken up feeling so refreshed!

The forums have automatically blocked "salt water". Move the two words together, remove the "SAL and ER" and you'll see why :roflmao::roflmao::roflmao:

[glittery]

I have always suffered with body image issues. People find it weird or funny because according to them I am quite a looker (which I always doubt), and some would think I am seeking attention by fishing for compliments. But the truth is, I genuinely doubt the way I look.

Before HA, my biggest concern was my looks. I would often distort my looks in the mirror. For example: I have a very thin nose, but I would sometimes look at the mirror and think "my nose looks extra huge today." I would be upset about it for hours.

Imo, my body image issues or anxiety in general have a root cause. The root cause being I was bullied a lot at school, and did suffer from sexual abuse. I wasn't bullied for my looks, I was bullied because I was introverted or too shy, something that people always poked fun at.

I guess people making fun of me at a young age and making me feel miserable caused a lot of insecurities in me. The insecurities led me to think I am not good looking, I am a loser, maybe I dont deserve good things.

I try to fight these thoughts and tell myself that I am amazing and deserve good things happening to me.

[Fishmanpa]

I've been following this thread. Self esteem is something most people struggle with, anxiety or not. I do believe, and I see it in my daughter, that anxiety and other mental conditions can exasperate negative self image and esteem issues.

Positive thoughts

[MyNameIsTerry]

Watch out for those rude fish :roflmao:http://yoursmiles.org/tsmile/fish/t107012.gif (http://yoursmiles.org/t-fish.php):roflmao:

Can I have some of that cocktail you were on? I rarely seem to feel refreshed these days. It is like that though with a GA, one second you are there and the next you are waking up on a ward.

There's bound to be a female SIMON! Reality TV has supplied with enough narcissistic plonkers of both genders :yesyes:

Your derms office sounds quite palatial. When you are in the waiting room does someone come over and fan you will a big leaf? :biggrin:

[MyNameIsTerry]

I have always suffered with body image issues. People find it weird or funny because according to them I am quite a looker (which I always doubt), and some would think I am seeking attention by fishing for compliments. But the truth is, I genuinely doubt the way I look.

Before HA, my biggest concern was my looks. I would often distort my looks in the mirror. For example: I have a very thin nose, but I would sometimes look at the mirror and think "my nose looks extra huge today." I would be upset about it for hours.

Imo, my body image issues or anxiety in general have a root cause. The root cause being I was bullied a lot at school, and did suffer from sexual abuse. I wasn't bullied for my looks, I was bullied because I was introverted or too shy, something that people always poked fun at.

I guess people making fun of me at a young age and making me feel miserable caused a lot of insecurities in me. The insecurities led me to think I am not good looking, I am a loser, maybe I dont deserve good things.

I try to fight these thoughts and tell myself that I am amazing and deserve good things happening to me.

Sorry to hear what you experienced. Given this you have a very obvious reason why your self esteem could be low. I bet many of us have similar, if not as traumatic, reasons in our childhoods. I think back to mine and I was never very body confident when it came to sports and I think that lack of confidence is still there now. I was confident in my career and would deal with people of any level but not so with physical stuff. I have lots of scarring due to poor skin in childhood and I can remember what people said, or didn't say as a look is enough, but even though GF's haven't had an issue (and I would mention it first) I'm not someone who can take their shirt off. I'm a bit out of shape at the moment but even if I wasn't I'm still not sure...

So it can't be that confidence is general, we can be confident in some areas but not others and the nurture you mention explains that.

[glittery]

Sorry to hear what you experienced. Given this you have a very obvious reason why your self esteem could be low. I bet many of us have similar, if not as traumatic, reasons in our childhoods. I think back to mine and I was never very body confident when it came to sports and I think that lack of confidence is still there now. I was confident in my career and would deal with people of any level but not so with physical stuff. I have lots of scarring due to poor skin in childhood and I can remember what people said, or didn't say as a look is enough, but even though GF's haven't had an issue (and I would mention it first) I'm not someone who can take their shirt off. I'm a bit out of shape at the moment but even if I wasn't I'm still not sure...

So it can't be that confidence is general, we can be confident in some areas but not others and the nurture you mention explains that.

Everything I am posting today is getting deleted for some reason. Anyway, what I wrote in my earlier comment was that my HA has taught me that looks really don't matter. What matters is a healthy body, mind and soul, which we always take for granted.

Looks fade, and it truly isn't important unless we are in the modelling business.

And truly beauty lies in the eyes of the beholder. I find my boyfriend very handsome, but most people would probably think he is just average. That is what love does.

Thank you so much for your response <3