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You’ve developed a tickle in your throat, or a pinkish rash suddenly shows up on your arm. Perhaps you’ve been feeling a bit down lately and have become preoccupied with thoughts that the people you love don’t really love you. Questions about our physical and mental health can crop up like this without any warning. In decades past, these questions would come and go, and if any symptoms seemed serious enough, we’d get a professional check-up. However, with the advent of online health advice sites, a diagnosis and its possible treatment are no further away than a few mouse clicks.
New research shows that we’re all turning to online advice sources, though some more than others. Carrying your anxieties about your health onto your Internet search behavior may be a symptom that you’ve got the increasingly common ailment you won’t find diagnosed there: Cyberchondria.
A few years ago, the diagnostic nomenclature in psychiatry officially removed the term “hypochondriasis,” replacing it with the less pejorative and perhaps more accurate “illness anxiety” or “health anxiety.” Whatever it’s called, the core of this type of anxious concern is a tendency to interpret normal variations in the body’s functions as reflecting symptoms of a serious disease. Cyberchondria, according to New York State Psychiatric Institute’s Emily Doherty-Torstrick and colleagues (2016), refers to “searching the web excessively for health care information” (p. 390). It’s an exaggeration of what about 90% of Americans do ordinarily, which is “online symptom checking.”
If you’re a regular web health-checker, you may have learned to appreciate what you gleaned from your online pursuits to be poor or unreliable advice. The ailments you’re told you have are statistically highly unlikely or based on users commenting to each other in unmonitored chat rooms. If you search for “why do I have a rash on my arm?,” for example, you may come across a DIY health site that links arm rash to death. If you’re a cyberchondriac, you’ll ignore the highly improbable outcome of your pink pores and start to believe that you really do have something serious. The more you search, the worse your imagined fate becomes. This is just one sign, as it turns out, that your problem is not your arm rash, but your tendency to become preoccupied with normal bodily signs.
Doherty-Torstrick and her colleagues tested the hypothesis that the constant checking that cyberchondriacs go through would increase, rather than decrease, their anxiety about their physical ailments. Suspecting that your arm rash is a sign of your impending demise, as you can imagine, would hardly be a reassuring outcome. A previous study indeed reported that the more Internet health searching people engage in, the higher their levels of illness anxiety. The more reassurance you seek, in other words, the less you will find. According to cognitive-behavioral models of illness anxiety, the New York team pointed out, seeking reassurance only serves to maintain your illness anxiety over time.
Using an empirically-based measure of illness anxiety, Doherty-Torstrick and her fellow researchers assessed the severity of symptoms among an Internet-based same of 720 volunteers averaging 33 years old, of whom 2/3 were female. Most were White, and most lived in the United States. Perhaps reflecting the self-selected nature of the sample, their scores were relatively high (average of 50 out of a total possible 70 points). The participants showed a variety of maladaptive behaviors related to their high illness anxiety, including not going to a medical professional out of fear for what they might learn.
It’s with the high illness anxiety of the sample in mind that we should approach the question of how much is too much when it comes to online symptom-checking. Yet, even among this perhaps biased sample, there were striking variations in Internet health-related behavior according to whether they scored high or low on the hypochondriasis measure. These comparisons show the 5 tell-tale signs that you're a cyberchondriac:
- You check online for symptom information from up to 1 to 3 hours per day. On average, people high in illness anxiety spent a little over 2 hours a day as a high point during the past month on their worst day. In contrast, people low in illness anxiety spent less than an hour, or 1 hour at the most on their very worst days.
- You fear having several different diseases: Those high in illness anxiety feared having nearly 5 diseases compared to their low illness anxiety counterparts, who feared having less than 2. How many diseases do you think you might have?
- On your worst day, you’ve checked 3 to 4 times a day: People high in illness anxiety not only spend more time, but also take more opportunities to search online for information on their symptoms. Those low in illness anxiety check perhaps once a day, if that, even when they're feeling the sickest.
- Looking online to get symptom information makes you feel more anxious: If those high in illness anxiety are trying to reassure themselves, their online probing is only making them worse. During and after their checking sessions, they report far higher anxiety than individuals scoring low on the illness anxiety scale.
- Your health is actually medically stable: Although people high in illness anxiety had higher self-reported disability, their health hasn’t undergone major changes. They were actually less likely to have an unstable medical illness than were those low in illness anxiety.
If these 5 qualities apply to you, The Doherty-Torstrick team propose that your best way to handle your anxiety is to stop checking. As the authors conclude, “checking online for reassurance by an individual with high levels of illness anxiety does more harm than good” (p. 397). On the other hand, if you’re low in illness anxiety, and only check online when you actually are experiencing symptoms, the chances are you’ll feel better.
You can make productive use of online searching when you wish to find out what your symptoms mean, but only if your general levels of illness anxiety are low to begin with. Doherty-Torstrick and her colleagues note that: “the vast resource of medical information on the Internet seems problematic for individuals with high illness anxiety—a hidden effective price for using a cost-effective informational source” (p. 398).
Maintaining your health is one of the primary ways to experience fulfillment in all spheres of your life, and avoiding the dangers of cyberchondria seems to be one of the best ways to achieve that fulfillment.
Follow me on Twitter @swhitbo for daily updates on psychology, health, and aging. Feel free to join my Facebook group, "Fulfillment at Any Age," to discuss today's blog, or to ask further questions about this posting.
Copyright Susan Krauss Whitbourne 2016
Reference
Doherty-Torstrick, E. R., Walton, K. E., & Fallon, B. A. (2016). Cyberchondria: Parsing health anxiety from online behavior. Psychosomatics: Journal of Consultation and Liaison Psychiatry, 57(4), 390-400. doi:10.1016/j.psym.2016.02.002
