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From hemorrhoids to depression: taboos can stop us from seeking help on health problems. We show how inhibitions can prolong suffering – and how talking openly about "embarrassing" issues can make a difference.
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00:06What was the big topic at the last party you went to?
00:10Travel plans?
00:11A job interview?
00:12Or that movie everyone's talking about?
00:15Now imagine bringing up bowel problems or hemorrhoids.
00:19Or something more serious.
00:21Depression or anxiety.
00:23Or being rejected after a date.
00:25For many people, that's the kind of thing they'd rather not discuss.
00:28But why?
00:30Let's meet people who are speaking openly about subjects many of us keep to ourselves.
00:36I've never understood why this is such a taboo subject.
00:41Breaking taboos on In Good Shape.
00:57Surely going out to a bar is the most obvious way of finding a potential date.
01:01But it's not that simple, say these male students in Stockholm.
01:06Society still generally expects us guys to make the first move.
01:11With dating apps too, we're under this massive pressure to pile up the likes.
01:16But sometimes that doesn't work, which can make you feel insecure.
01:25Sweden's National Association for Sexual Education has compiled a special guide to help young men navigate the dating world.
01:34It provides advice on how to write to somebody and ask them out, and on good topics to discuss on
01:39a date.
01:40Plus tips for dealing with nerves.
01:44Basically a step-by-step guide on everything from which photos and personal details to put in your dating app
01:50profile, to making a good impression at that first meeting.
01:55I can relate to a lot of other things here, like sometimes having no idea what to do on a
02:00date.
02:03If you tend to get nervous from the off, it suggests preparing questions and topics in advance, which is definitely
02:11good advice.
02:14Follow-up questions are attractive.
02:16Don't sound like you're at a job interview, but do show interest in the other person.
02:20Who are they and what kind of things are they into?
02:24Some of the advice, like showering before a date, might sound obvious.
02:28But judging by some women's experience, they're tips worth giving.
02:34The one guy I dated was so nervous he couldn't stop shaking.
02:37And when he tried to sit down next to me, he spilled his glass of wine all over me, which
02:42left him really embarrassed for a moment.
02:46The biggest lesson from the guide is for young men to become more confident,
02:50because dating failure is something many still find hard to talk about.
02:54It's not something my friends and I really chat about.
02:58It's more like just, nope, I'm sad about it, and that's it, pretty much.
03:03A lot of young men fear they're the only ones it happens to.
03:06Women tend to have a better support network, which helps them to see that it can be a challenge for
03:10anyone.
03:12And there's another important message for young men.
03:15Don't try to mask your insecurities behind cheesy pickup lines, a point that many women likely agree with.
03:22These tips are like a hug for guys.
03:25They say it's okay to be nervous.
03:27It's not telling them the usual, you need to act big and tough.
03:32A dating guy that says failure is nothing to be afraid of,
03:36and that a little preparation can go a long way.
03:43Is the feeling of shame something we're born with?
03:47Even small children can experience it.
03:51Many psychologists believe we learn shame early when we're scolded or corrected.
03:56And blushing may actually help us.
03:59Studies suggest it can spark empathy and understanding in others.
04:04For some people, illness itself is a source of shame.
04:08They may even avoid seeing a doctor, especially when it comes to sexuality, bladder or bowel problems.
04:15We meet three people who are pushing back against that stigma.
04:20First up, Anna and her experience with hemorrhoids.
04:27Not the kind of interview that everyone would feel comfortable about doing,
04:32because hemorrhoids are not exactly a popular topic.
04:36But Anna Hillebrandt has agreed to share her story.
04:41I've never understood why this is such a taboo subject.
04:46I've known so many people over the years who suddenly say,
04:50yeah, I have problems with them too.
04:54In her case, as with a lot of women, those problems began during pregnancy.
04:59Hormonal changes and increasing pressure inside the abdomen are major contributing factors.
05:06At some point, I became constipated, which is common enough during pregnancy, and didn't really bother me.
05:12I even welcomed it, as I often get diarrhoea, so I didn't do anything about it.
05:17But then the pain in my butt started.
05:19I'd never even heard of hemorrhoids before.
05:24The midwife tried to push them back in.
05:26But definitely by the time you give birth, there's no point doing that.
05:31Because you have to push so hard during labour.
05:33And then, they were absolutely out.
05:37Anna was overjoyed to welcome her son to the world.
05:41But the enlarged hemorrhoids kept on making life difficult for her.
05:49First, there's the pain.
05:51Then there's the blood on the toilet paper after you wipe, and the constant itching.
05:57And because the hemorrhoids were protruding, there was always some stool getting caught.
06:02Always.
06:05So I'd wipe again with moist toilet paper.
06:08I was constantly applying creams and ointments, because I just wanted the itching to stop.
06:17But at some point, it didn't help anymore.
06:21After suffering for 12 months, Anna Hinebrand went to see a proctologist to have two larger hemorrhoids treated.
06:28But after an initial improvement, the symptoms returned.
06:33Eventually, I could literally feel there was something sticking out while wiping.
06:37It felt as if I wasn't done.
06:39Or there'd be this strong urge to go to the toilet.
06:42And it hurt.
06:45It stopped getting better.
06:47I was still in pain.
06:49I waited for maybe a year before going to see the doctor, who said I had third or fourth degree
06:55hemorrhoids,
06:55and that surgery was the only real option.
07:00Hemorrhoids are classified into four grades, according to severity, explains proctologist Momoko Nagata.
07:09Grade 1 is slightly enlarged hemorrhoids, which can cause a feeling of pressure or itching, or discharge.
07:16With grade 2, they bulge out more, but are not yet externally visible.
07:21They generally involve itching and discharge, and sometimes bleeding as well.
07:27Grade 3 hemorrhoids are externally visible, but they can be pushed back inside with the finger.
07:34With grade 4, they protrude all the time and cannot be pushed back in.
07:38They can cause pain, and the anus no longer closes properly, so you never have clean underwear.
07:44Anahe Hillebrandt was afraid of the surgery, and initially delayed the procedure.
07:51You reach the point where it's just all too much, and you need things to change.
07:57You want an end to the pain and the endless ointments.
08:03And eventually, she did go ahead with the surgery.
08:07After the hemorrhoids were removed, the wound was left to heal naturally, instead of being stitched.
08:14For an entire week, I could only lie down.
08:19The anal area is one of the most sensitive regions of the body, with an incredibly complex network of nerves.
08:26Without that sensitivity, we wouldn't be able to tell if we're passing liquid or gas, and that's why the area
08:32could be so painful.
08:34Anahe Hillebrandt does still have minor issues from time to time.
08:38But right now, she's symptom-free, and is hoping things will stay that way.
08:46It's a nuisance, something you don't want to have bothering you every day.
08:50Waking up in the morning, wondering if it's gotten better, but it's still bad.
08:55And the same when you go to bed.
08:57And eventually, you just get sick and tired of it.
09:00It's an issue that not many people wish to speak openly about.
09:04Anahe Hillebrandt's advice to other sufferers is,
09:07don't wait too long to see a doctor.
09:09Sooner rather than later.
09:20For years, Henning Douyin was plagued by cramps and pain caused by chronic bowel inflammation.
09:27Today, he's helping other people to understand how the digestive system works,
09:31while himself having learned to enjoy his food again.
09:36The big thing for me is actually looking forward to it, too,
09:40which I hadn't been able to do for a long time.
09:42Once you start getting anxious about food,
09:44that fear can take over and is likely to have a negative impact on you.
09:48For a lot of people, it starts with a bad feeling in your gut.
09:52For a time, he was reluctant to talk about his digestive problems,
09:56as are most people affected.
09:58He's since learned a lot about the body's inner workings,
10:01which is why this pizza-in-a-pan he's preparing is of the gut-friendly variety.
10:09Anti-inflammatory options can also provide you with a lot of energy.
10:13We have some of them here.
10:15But there are loads of others, above all vegetables,
10:18high-in-fiber foods, as seen in the Mediterranean diet.
10:23Food influencers are all over the Internet,
10:25but the taboo issue of gut health has only recently become a popular topic on social media.
10:29It's a bit strange, but Jule and I make us trotz anti-entzündlicher and darm-freundlicher Ernährung
10:35the delicious food eating at all.
10:36A really good stool-in-a-pan, it looks like this.
10:40Or at the vegetarian, it looks like a little bit heller.
10:43You will not believe it, but since I'm being anti-entzünded and darm-freundlich ernähre,
10:47I make my all the best food for all the best food.
10:49Jemand mit Reizdarm, Unverträglichkeiten oder einer chronisch-entzündlichen Darmerkrankung
10:53braucht ganz andere Lebensmittel als jemand ganz ohne Beschwerden.
10:58Henning Dooyen had always loved his food, but after puberty often felt unwell.
11:03Then there was the pressure over having to work for his family's company.
11:08He suffered increasingly frequent panic attacks, as well as stomach and bowel problems.
11:15I was getting stronger and stronger signals from my body.
11:18It was saying, time to wake up, Henning, and I just wasn't listening.
11:23The young civil engineer quit his job as a construction manager and focused more on his health.
11:28He trained as a nutrition coach and now passes on his insights in courses
11:33and on speaker tours in his home region.
11:36And there's no shortage of people eager to listen and talk openly about digestion-related issues.
11:45This is a hosepipe, which I'm going to unroll.
11:50And what is it representing?
11:54The gut, right.
11:57More colour means better for your health.
12:00These foods have lots of antioxidants, which reduce inflammation.
12:04And the gut needs movement, otherwise you might get constipation.
12:11I've definitely learned something, especially the going for a walk after eating.
12:17We exercise a lot and eat healthy food, but also unhealthy food, which I'll now try to cut out.
12:26It was really interesting to see someone with an autoimmune disease finding a solution via their diet
12:31instead of resorting to doctors and medication.
12:37Henning Dooyen now has his chronic inflammatory bowel disease under control
12:41and has learned to live with the condition, even turning it into a new career,
12:47helping others to help themselves.
12:56It's not something people like talking about, which is why I want to see this taboo challenged,
13:03so people don't feel ashamed of it.
13:08Bladder problems are a constant issue for Eva Miller.
13:11Her pet dog gives her company an emotional support.
13:15She has spent years battling severe infections caused by an overstretched or distended bladder,
13:21despite only being 45 years old.
13:26It's already accumulated so much damage from the stretching that they can't repair it now.
13:34It's like the bladder of a 70-year-old man.
13:39Her bladder can now hold one liter of urine, more than twice the capacity of a healthy one.
13:45And it's becoming less responsive when full.
13:49To avoid repeated infections, Eva Miller has to catheterize herself several times a day
13:54to empty the bladder, a time-consuming routine.
14:02I have to do everything under ultra-sterile conditions.
14:06I have to sterilize my hands, prepare and disinfect swabs,
14:10clean myself down there and disinfect that area too.
14:18Then I insert the catheter and wait until it's done.
14:26Not a satisfactory setup, but perhaps a bladder pacemaker will help.
14:31Urologist Inge Pirtas explains the procedure.
14:36In the initial operation, an electrode is placed inside the pelvis
14:40and connected to an external temporary stimulator via a cable.
14:47If the test phase proves successful,
14:49a permanent pacemaker is implanted in a second operation.
14:56Our hope is that stimulating the bladder nerves
14:58will trigger the bladder into contracting again.
15:01In patients like Frau Miller,
15:03the aim is to reduce their chronic urinary retention,
15:06to reduce the residual urine that stays in the bladder.
15:11Eva Miller's bladder infections have now become an almost chronic condition.
15:15Regular catheterization is crucial,
15:17as without it, she would be at risk of serious complications.
15:21Otherwise, urine can back up into the upper urinary tract,
15:25the ureters and the kidneys' urine collection system,
15:28so the body poisons itself.
15:30A bladder pacemaker could spare Eva Miller
15:33the ordeal of regular catheterization,
15:35but years of overstretching have left her bladder severely worn out.
15:39The treatment has a success rate of only 50 to 60 percent.
15:43It's a chance I want to take, even if it were only 10 percent.
15:48Ten years from now, I don't want to be regretting not having it done.
15:54With the patient under general anesthetic,
15:56the first procedure begins.
15:58The electrode is inserted next to the sacrum,
16:01towards the back of her pelvis,
16:03from where electrical impulses will travel along nerve pathways to the brain
16:07and signal when the bladder needs to be emptied.
16:12The operation lasts just half an hour.
16:15The doctors use X-ray guidance to ensure maximum precision,
16:18while a technician adjusts the external pacemaker's settings.
16:26She does a bit of fine-tuning of the electric current during the operation, too.
16:33So, when I test how much signal is arriving from the sacral nerve.
16:41The operation is almost over.
16:43Now comes the make-or-break phase.
16:46Over the next four weeks,
16:47Eva Miller will have to see whether the pacemaker does its job,
16:50and her bladder responds to the stimulation.
16:53The electrode is right where it should be.
16:57I have seen stronger responses before,
17:00but we shouldn't read too much into that.
17:02It might well still be sufficient for the patient.
17:09A few weeks later,
17:11Eva Miller has another appointment at the hospital.
17:15The test period has been something of a rollercoaster ride.
17:19She's had a series of infections
17:21and, unfortunately,
17:22has seen no improvement from the pacemaker.
17:27I've failed the test phase.
17:30But I'm not disappointed.
17:32It was worth a go.
17:34Of course,
17:35it would have been great
17:35if everything had worked properly
17:37and I didn't have to catheterize myself so often.
17:42Her bladder failed to respond to the signals,
17:45which for the patient
17:45means continuing to use catheters
17:47practically every time she goes to the toilet.
17:50If she does do it regularly,
17:54it will significantly reduce the frequency of infections.
17:59My estimate would be around five times a day.
18:03The bladder pacemaker may not have been a success for Eva Miller,
18:07but for her,
18:08it was a chance worth taking.
18:13Many people with mental health conditions
18:15find it hard to talk about what they're going through.
18:17In societies focused on success and performance,
18:21vulnerability is often seen as a weakness.
18:24For someone living with depression,
18:26even everyday tasks can feel overwhelming.
18:29Many fear being judged, misunderstood,
18:31or facing consequences at work.
18:34Opening up isn't easy.
18:36But for some,
18:37it can be an important step toward recovery.
18:42My children have always meant the world to me.
18:47And so suddenly,
18:48not being there for them,
18:50I'd say that was the worst part for me.
18:58I had a lovely husband,
19:02lovely children,
19:03and a lovely old apartment.
19:05I had a job,
19:06and we had enough money to lead a nice life.
19:09Basically,
19:10I had it all.
19:12I had no inkling
19:14that this kind of thing was about to happen.
19:18I did notice that I was running on empty,
19:21the constant worrying,
19:23not being able to sleep,
19:24my heart racing.
19:27But I pushed all of that aside
19:29and ignored it.
19:33I was in this deep black hole.
19:36I was incapable of taking care of anything.
19:38and was basically unable to function.
19:41I basically lived in our bedroom
19:42and didn't know how I was supposed to get up in the morning.
19:45My brain was full of all these crazy and confusing thoughts,
19:48and I felt like I was on a different planet.
19:56I would never have made it without psychiatric treatment.
20:00I was so ill that I absolutely needed to be in a clinic.
20:03First, I needed the protected environment
20:06that psychiatric care provides,
20:07where you're completely removed from everything,
20:10all the stress and the responsibilities.
20:15This was a severe case.
20:18I think the patient herself was completely surprised
20:20at ending up in that kind of state.
20:24Unable to function,
20:25and where all the methods she'd previously used
20:28to pull herself together and get back on track
20:30simply didn't work anymore.
20:40I eventually understood that depression
20:42is telling you to take a closer look at things.
20:45You've inflicted so much harm on yourself
20:48with your perfectionism
20:49and always being eager to please
20:51and be nice to everyone
20:52and to do everything right,
20:54while never asserting yourself.
21:04Then I started writing everything down,
21:06like in a diary,
21:07to help me process what was happening.
21:15I also started drawing and making collages,
21:19and I realized how beneficial it was.
21:27Some friends saw what I'd been writing and drawing
21:29and said,
21:30that's brilliant, Kerstin.
21:32Reading this stuff,
21:33you feel like you understand
21:34what someone with depression is going through.
21:37You really should turn this into a book.
21:43I want to remove the stigma from this issue.
21:47Are people ashamed of having cancer?
21:50No.
21:51So I don't understand
21:52why that is the case with depression.
21:55I hope my story not only removes the shame,
21:58but also gives people encouragement.
22:00I want them to think,
22:01she went through all of this
22:03and managed to recover,
22:04so I can do that too.
22:20Laughter is something most of us see as a good thing.
22:23But people with gelatophobia live with an intense fear
22:27of being laughed at.
22:29It can leave them feeling isolated and insecure.
22:33And being mocked can be deeply painful,
22:36as many children who are picked last in sports class
22:38know all too well.
22:42For some,
22:43that fear doesn't go away.
22:45It can stay with them for life.
22:50For his entire life,
22:51doing this was unimaginable for Spinev Spatovic.
23:01It was a fear of the water,
23:03which meant I couldn't go swimming.
23:05I was in awe of the water.
23:07I was in awe of the water.
23:14And I'll count to ten.
23:20At the age of 60,
23:22Spinev decided to take the plunge
23:23and sign up for a swimming class
23:25for adult beginners.
23:28He'd always been embarrassed
23:29and ashamed of being unable to swim.
23:32But here,
23:33he's not alone.
23:38I have huge respect
23:39for people who come to us at that age.
23:41People are self-conscious about others
23:43seeing that they can't swim.
23:45It takes a massive effort on their part,
23:47so it's a real achievement.
23:52Lee Ungoyen is a veteran swimming instructor.
23:55He gives 16 beginners classes alone every week,
23:58with pupils ranging in age from 18 to 74.
24:03Many of them have traumatic water-related memories
24:05from childhood,
24:06but not Spinev.
24:08I'm from Sopot, near Gdansk, in Poland,
24:13so right by the beach.
24:17But learning to swim in the sea is really tough,
24:21so I managed to avoid it somehow.
24:25Although, of course, there were times,
24:28like on holiday,
24:28when I did want to jump into the water.
24:32But I couldn't.
24:36Learning to swim gets harder as you get older.
24:39Some need a full 18 lessons.
24:41This 61-year-old is already seeing progress
24:44after just five.
24:48Definitely.
24:49And our instructor is always there
24:51to support us in the water,
24:53which gives you confidence.
24:56It would probably be different
24:58just on your own in the pool.
25:00Here, you know he's watching out for you.
25:04So I do feel safe.
25:10This time, jump in and turn around once.
25:14And that's it.
25:17Getting comfortable in the water
25:19is a crucial first step.
25:20The next lesson will be about the leg kick.
25:23After 45 minutes in the pool,
25:25they're all physically and mentally exhausted,
25:28but are already getting ambitious.
25:34A long way to go,
25:36but first I want to learn breaststroke.
25:38And my real goal is doing the front crawl.
25:42A goal that Spinev, Spetovic
25:46and the rest of the class
25:47have taken a big step closer to achieving.
25:51They'll get there.
25:53No problem.
25:57And hopefully you'll have no problem
25:59joining us again soon.
26:00See you then.
26:07Switch.
26:07Switch.
26:08Switch.
26:09Switch.
26:10Switch.
26:10Switch.
26:10You
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