When Hannah* was told that her blood tests had come back normal, it did nothing to reassure her. She was convinced the abdominal pains she’d been experiencing were down to something sinister, and nothing the real doctors said was going to make a difference – at least, not while she kept checking in with Dr Google.
“When you type ‘abdominal pains and bloating’ into Google, it comes up with all sorts of things. Of course, some of them are common, minor conditions, but I wasn’t interested in reading about those. I only wanted to know about the cancers,” admits the 29-year-old marketing executive. “I’d spend hours trawling through websites, searching for information that backed up my theory; you can always find it if you look hard enough and I was obsessed.”
Hannah, who is a UK expat living in Dubai, was in the grips of what has been dubbed ‘cyberchondria’. As the word suggests, it’s basically a form of hypochondria whereby people become convinced that they have the serious health problems they are reading about on the web – often linking vague symptoms to life-threatening conditions.
Exactly just how many people are affected is unknown, but the experts believe it’s a growing problem internationally.
Most of us have used the internet to look up health-related information at some point, and a recent UK study by Medical Accident Group found that one in five people trust the web more than their doctor, with 42 per cent admitting they look up their symptoms online before deciding whether to go to a doctor.
A major US study in 2010 found 80 per cent of internet users look up health information, making it the third-most popular search topic.
Of course, not everybody who googles their symptoms will have cyberchondria, and in fact the internet – and particularly social media – now plays an important role in health-awareness campaigns. Plus, for those researching rare conditions, or seeking support via online groups, where they can connect with people going through a similar experience, it can be invaluable. But as the internet is so vast, information isn’t always reliable or accurate.
“There are a multitude of benefits to the internet. We all google questions and within seconds have access to a great depth of information at our fingertips,” says Dr Yaseen Aslam, consultant psychiatrist at The Lighthouse Arabia, Dubai (www.lighthousearabia.com). “However, this information often needs filtering and analysing with a fine lens.”
It only takes a couple of clicks to stumble across a dodgy website. Even those that look scientific and trustworthy might have information that’s completely misleading.
“I see patients every day who use the internet to diagnose themselves,” says Dr Mazin Rasool Aljabiri, a consultant of internal medicine at Mediclinic Dubai Mall (www.mediclinic.ae). “We have the curiosity in all of us, however, self-diagnosing using the web leads to sleepless nights with patients worrying about diseases they’ve learned about.”
Ironically, relying too heavily on Dr Google can sometimes be an added health risk.
“More often, online searches can go skewed, and for some people, googling symptoms can become a form of anxiety, which has a negative impact,” adds Dr Aljabiri. He also warns that if there is something wrong with you, googling may delay a proper diagnosis and treatment. And no website, no matter how sophisticated, can assess a patient the way a doctor can in the flesh. “A doctor will direct questions towards the patient’s age, sex, and other relating factors,” he explains. “The patient’s history is paramount in directing us towards our diagnosis and investigations.
“The web cannot personalise health consultations. Nothing can replace your doctor in correctly diagnosing your illness and providing you with the right treatment.”
So how do you know if you fall into the cyberchondria bracket?
“Individuals become preoccupied with the belief that they may be suffering from a serious medical condition,” says Dr Aslam. “Sometimes this may be confined to a certain bodily system, such as the cardiovascular or neurological system, or at other times the fear is more generalised.”
Dr Aslam says once you’re in this mindset, it becomes easy to interpret even mild and normal symptoms, such as common aches and pains, muscle twitches and headaches, as signs of something nastier. “For people with severe health anxiety, the fear is very real and causes significant distress,” he says. “People will often remain convinced that they do indeed have a serious medical condition, irrespective of the results of tests or what doctors tell them post internet search.”
This was certainly the case for Hannah. Despite the fact that she was given a diagnosis of irritable bowel syndrome (IBS) – a common condition which, while symptoms can sometimes be distressing, is benign and not medically serious – she couldn’t shift her obsession. She was so convinced that she actually had a tumour that even when a scan revealed nothing she struggled to believe the results were accurate.
“After the scan, I eventually had to accept that I didn’t have a tumour,” she recalls. “But rather than feeling relief, I found myself going back to Google and looking for alternative serious illnesses that could fit my symptoms. I even started researching liver disease and kidney failure. It was like I didn’t want to be told I was fine and healthy.”
It’s only when looking back that Hannah realises she was hooked on her Dr Google sessions – something UK-based addiction therapist Frankie Sikes is seeing more frequently in his clients and says isn’t so different from other forms of addictions.
“Any kind of addiction follows a similar pattern,” he explains. “First there’s a cycle of calm where you’re seeking certain behaviour – this could be going online and seeking out information. It’s usually a very focused activity; the rest of the world disappears. It’s a type of ‘using’ – going to chat rooms, reading articles – and these serve as a buzz-reward, leading to an increase in brain dopamine levels.
“Then there’s a drop afterwards, where the dopamine leaves the system and the mood falls. This type of behaviour [cyberchondria] may be triggered when you’re stressed, or feeling tested.”
Sikes notes that people who develop addictive behaviours often share similar personality traits, and often there’s a history of underlying anxiety too. “They have a similar baseline emotional state that is higher than usual, and they’re more anxious,” he says. “In trying to address that, they turn to the addictive behaviour.”
Dr Aslam points out that the causes can be complex, and all forms of hypochondria can be difficult to detect and diagnose, with a plethora of factors that may be relevant, such as a recent death in the family, or heightened stress levels. “Or you may have certain personality traits, which make you more vulnerable to developing this condition,” he says.
“It can occur at any time in one’s life, but more commonly arises in early adulthood. If the condition becomes overwhelming, and interferes with one’s social and occupational functioning, it is important to undertake a comprehensive assessment and evaluation from an expert psychiatrist or psychologist.”
Treatments – often in the form of cognitive behavioural therapy – can be very effective, he adds.
According to Sikes, mindfulness can be crucial too, particularly for curbing compulsive behaviour patterns in the long term, and to prevent falling back on them during stressful times. In fact, he runs a mindfulness walking retreat in Spain (www.walkinginspirit.co.uk), which welcomes people from all over the world.
“Short-term therapy may help but in the long term, it requires the person to take control and be aware of themselves and their patterns,” he says. “Often with addiction, there’s a degree of unconsciousness to the behaviour. It can feel almost automatic, so this is why mindfulness helps.”
This means identifying your triggers – whether it’s tension within a relationship, money worries, pressure at work, or physical factors such as not getting enough sleep.
“When that is in place, it gives people time to intervene with [and prevent] the behaviour before it happens,” Sikes says.
After three years of being obsessed with Dr Google and worrying about her health, something finally clicked within Hannah. “Once it dawned on me that my googling habits were the real problem, and not that I had a serious illness, I started to see things differently,” she says. “I realised I needed to address actual problems in my life that were making me anxious and stressed. I’d felt under pressure and unhappy at work for a long time, and I’d lost touch with activities that I enjoyed and that kept me grounded.
“It was difficult to resist browsing the web at first, and sometimes I couldn’t even be in the same room as my laptop because the urge was so strong.” But after about six months Hannah had conquered it without any outside help.
“Funnily enough, my IBS symptoms have eased now – probably because I’m not so stressed. And now if I notice something concerning, I make an appointment with my doctor and just talk it through.”