The number of people with chronic conditions is soaring. Are we less healthy than we used to be – or overdiagnosing illness?

Are ordinary life experiences, bodily imperfections and normal differences being unnecessarily pathologised? One doctor argues just that

School was a difficult time for Anna. It still haunts her. She recalls being a sociable child, good at making friends. But she also remembers becoming hyperfixated on one friend, then another and another in succession. She tended to be impulsive and, wanting to please others, easily led. One distressing incident in particular has never left her. On the first day after moving to a new school, she was relieved to be taken under the wing of two girls. At lunchtime, in fits of giggles, the girls egged each other on to do naughty things. Anna spat orange juice at the boys. She did it with relish, only to reproach herself later. She feels the episode coloured her whole school experience.

As a child and an adult, Anna felt sanctioned, judged and misunderstood. She considers herself a chameleon who adapts to new environments and survives by being funny, but all too often regrets things she has said. Her self-esteem is low. Anna is a nurse and, although she loves her job and is good at it, she still often feels inadequate. “People don’t think I’m as clever as I feel. I can’t get the words out quickly enough,” she says.