Persistent cough causes social anxiety

Dear Eric: I am in my 70s, and for the last couple of decades I have had occasional coughing fits that are triggered by talking too long and/or too loudly. When these fits happen, I literally can’t talk or stop coughing for several minutes. I’ve been to several doctors but have not been able to get a clear diagnosis or effective treatment.

My closest family and friends understand the problem, but it’s still embarrassing, especially when it happens with people I don’t know well or in a public setting.

When I am talking to others, should I warn them at the beginning of the conversation that I might start coughing and have to interrupt the conversation, either by hanging up the phone or walking away until the fit ends? If so, how should I explain it? I don’t want to give them my medical history, and I don’t want them to think that I’m sick or contagious.

— Curious Cough

Dear Curious: Everybody’s body does strange things from time to time. I’m sorry that your body is doing something that’s causing you social anxiety. I understand how having a prolonged cough can invite questions, comments or other unwelcome reactions, especially in a world still dealing with the impact of the Covid-19 pandemic. There’s nothing wrong with having a cough; it’s just a matter of figuring out how best to care for yourself and your community.

For your peace of mind, try telling people “Just so you know, I have a condition that causes me to cough sometimes. It’s not contagious or cause for concern, but I don’t want you to think I’m rude if I have to leave abruptly. Thanks for understanding!”

You don’t have to do this. But you may find it reduces your anxiety and sensitivity about the issue.

If and when you tell people about your cough, think of it not as an apology for having a body, but rather as information that will help them make the conversation a more welcoming, less tense experience for you.

Dear Eric: A young neighbor couple confided in me that their young daughters told them that an out-of-town uncle visiting recently had exposed himself to them. These parents are beyond stunned, are unsure how to proceed, and asked me for my perspective. They are concerned they are perhaps required to inform some child protective services entity and/or police. However, this is a much-loved uncle. They also don’t want to destroy his career and family. He is married and is in a medical profession where he occasionally has children as clients.

They feel that taking any formal action could create major upheaval, however, some family members are urging them to report. They want to find a way to first protect their daughters and inform the uncle he will never be allowed to be alone around their kids again.

This is creating ongoing family strife. How should they address this situation?

— Concerned Neighbor

Dear Neighbor: Report it. I can’t emphasize enough how important it is to take action now to protect these children, and other children the uncle may come in contact with. Depending on where you live, it actually may be a legal requirement.

You can look up the specifics, and also get information on where to report in your state, on the Rape, Abuse & Incest National Network’s State Law Database. RAINN also has specific steps that will help parents as they go through this emotionally fraught process, some of which include telling the children that what happened was not their fault and that they are going to report it, as well as practicing self-care as the parents navigate the process.

This will begin an investigation. It is not a trial and it is not a verdict. Often, it’s easy for our thinking to snowball through potential consequences and overwhelm us. By telling the authorities what they know, these parents are fulfilling their duty to their children and entrusting trained professionals with the next steps.