Using the search bar to match symptoms with diseases can cause high levels of anxiety and fear, and spur on scary self-diagnoses.
We’ve all been there – some of just yesterday or even this morning. You’ve got, perhaps, a bit of a headache, maybe a bad back this week, or your stomach’s been especially difficult recently. You start googling your symptoms, and the next thing you know, you’re pretty certain you’ve got diabetes. Or maybe cancer. Or is it COVID-19? And from there, your anxiety spirals.
Searching symptoms and possible illnesses online is pretty common, especially when information about disease is literally at our fingertips. But for some, frequently turning to the search bar can cause high levels of anxiety and fear, and spur on scary self-diagnoses.
While many of us treat the googling of symptoms as a joke, research suggests the compulsion is linked to other underlying problems. The urge to find something wrong, to keep clicking until we have diagnosed ourselves with something truly terrible, has been linked to mood disorders. But there are ways to get past the unhealthy habit.
Is cyberchondria a thing?
Most of us have heard of hypochondria, or excessive and persistent health anxiety. Cyberchondria — also known as compuchondria — involves excessive worrying about health caused by internet searches for medical information, though there isn’t an official definition. In their study, Cyberchondria: Studies of the Escalation of Medical Concerns in Web Search, Microsoft’s chief scientific officer Eric Horvitz and researcher Ryen W. White defined it as “the unfounded escalation of concerns about common symptomatology, based on the review of search results and literature on the web.”
A systematic review, published in a 2020 issue of the journal Comprehensive Psychiatry, points to the compulsive nature of cyberchondria, suggesting that all that searching “may serve the purpose of seeking reassurance, whilst leading to a worsening of anxiety or distress and further negative consequences.”
The anxiety of self-diagnosis
If you’re googling health information for your own sake, you are definitely not alone. A 2010 study of 12,000 people across 12 countries showed that nearly half used Google for self-diagnosis.
And if it feels like even looking up a trivial symptom can lead instantly to information about a terminal disease, it’s not you, it’s the internet. Horvitz and White’s study looked at roughly 40-million web pages processed for medical queries and a survey of 515 individuals’ health-related search experiences. It found “surprisingly high rates of linkage of rare diseases, such as brain tumours, to common symptoms, such as headache.” About 90 per cent reported their searches escalating from finding an answer to a specific question to researching serious illnesses.
Even if you’ve just made a trip to the doctor’s office, seeking out info online is quite common. According to a report in the Royal College of Surgeons in Ireland Student Medical Journal, the highest scores on self-reported measures of anxiety were recorded in people awaiting the results of medical tests or diagnoses. One survey found that 35 per cent of participants have not only sourced their health information online, but what they found influenced their medical decisions.
The big bad world wide web
Part of the issue is that there’s so much health information out there, and a lot of it is unverified. But even trusted sources can spur panic. WebMD is frequently held up as a common source for those looking to self-diagnose. And yes, it even has its own page on cyberchondria.
Dr. Mark Berber, assistant professor of psychiatry at Queen’s University and the University of Toronto, and psychiatrist at Markham Stouffville Hospital, explains. “Even when they do go on to an incredibly reputable site, maybe it’s a leading institution with a five-star rating, sometimes they misinterpret the advice or symptoms given or exaggerate the meaning of the symptoms and then attribute them inappropriately to their own condition.”
It doesn’t help that many of us are now working from home and spending more time online than ever — cyberchondria may very well be on the rise.
“Stress is the physical and psychological reaction to an activating event that a person considers challenging,” explains Berber. “Let’s say a doctor has told you that you have cancer, even if it’s curable, it’s a huge threat and a huge challenge. And if you have threats and challenges, you’re going to have a stress reaction, which is usually anxiety due to the fear of the future, or depression if you start to think only negative, dark thoughts, and increasingly so as you have side effects. It’s a reaction to interpreting news in the worst way possible.”
And during a pandemic, he says, people are especially vulnerable to their fears; talk of illness is pretty much inescapable, and that only ramps up fears.
We can categorize this thought process under unhealthy self-talk, which involves destructively viewing things in a negative and unreasonable way. When a cyberchondriac visits a website and recognizes their symptoms, their mind immediately goes into negative self-talk mode, which in turn causes feelings of anxiety and depression. Those living with anxiety or have a family history of anxiety disorders, are more vulnerable to these triggers.
The 2020 systematic review of cyberchondria found a self-reported association with obsessive-compulsive disorder. It’s easy to see why the two conditions may be connected: cyberchondria is often “repetitive, compulsive and time-consuming, similar to the compulsions of obsessive-compulsive disorder.” And since it also seems to be associated with seeking reassurance, cyberchondria has a lot in common with anxiety disorders such as generalized anxiety disorder or panic disorder.
Stopping the spiral
But this doesn’t mean you need to lock up your laptop or avoid the internet if all of that medical information is making you anxious and miserable.
In his book, Psychotherapy: A Cognitive Approach, Berber looks at self-talk to track how people end up feeling so anxious and distressed. It often follows a pattern that’s been dubbed “BAD MOODS”: Black and white thinking, “Awfulizing,” Discounting the positives, Maximizing the negatives, Overgeneralization, Overestimating likelihood of negative outcome, Demanding, and Self-blame event.
Black and white thinking is the tendency to look at things in extremes — they are either good or bad, while ‘awfulizing’ is the labeling of things as awful or terrible and every event is considered a catastrophe.
“Let’s say a woman discovers a lump in her breast and she decides, ‘This is a catastrophe,’ even though it could very likely be benign,” he says. (In fact, 60 to 80 per cent of breast lumps are benign.)
“And then they discount the positive, and decide they might not get the treatment they need, they’re not going to survive,” he says. “And from there, it goes on, and it becomes, ‘I’m a loser, my life is terrible.’ It’s like a tsunami of negative thoughts, triggered by a little something that they found online,” resulting in an overestimation of the likelihood of a negative outcome.
“The person will look at the symptom and say, ‘Oh, that’s what’s going to happen to me,” he says. “‘I’m going to be one of those people with the worst prognosis. I’m going to be the one who only lasts one month, I’m not going to be the one who lasts for 10 years.’”
The last two types of negative self-talk include demanding — the use of phrases such as, ‘I must not fail’ — and self-blame, the process of unfairly blaming oneself for something bad that has happened.
While the negative downward spiral of thoughts can feel overwhelming, the best plan of attack and recovery is sitting down and assessing the negative self-talk, seeing it for what it is, where it’s coming from (hint: yourself) and tracking the escalation of your anxiety. Cognitive behavioural therapy, too, can be effective when it comes to tackling anxiety and depression.
“This phenomenon is as old as ancient times,” says Berber. “There’s this line, from John Milton’s Paradise Lost: ‘The mind is its own place, and in itself can make a heaven of hell, a hell of heaven.’ It all depends on how you look at things, and there’s no denying that the way we interpret facts affects the way we feel.”
source healthing.ca