-Teresa Jacobson, DBH, LPCC-S, NCC
January 8, 2023
Who among us hasn't turned to searching the internet when curious about a medical symptoms we've experienced? When the internet leads us down a rabbit hole of symptomatology, the unfortunate result is usually an uptick in anxiety. Some research indicates the anxiety-intensifying effects of internet health searches, also known as cyberchondria, is actually becoming a public health concern.
Individuals who experience increased worry when reading online medical information are at higher risk for developing "cyberchondria, a phenomenon in which repeated Internet searches regarding medical information result in excessive concerns about physical health" (Mathes, Nora, Allan, Albanese & Schmidt, 2018).
Cycle of Reinforcement
The use of the internet as a primary source for health information can first lead to a decrease in anxiety, encouraging continued reassurance seeking, which is not helpful. Eventually this leads to the increased cycle of information-seeking behaviors.
If a person spends so much time worrying about illness or getting ill that it seems to take over one's life, that could be an indication of health anxiety.
Health anxiety is a general term for mild-severe cases of illness worries. "Although hypochondriasis itself as a diagnosis was removed from DSM-5, health anxiety now forms a central feature of both Illness Anxiety Disorder and Somatic Symptom Disorder" (Doherty-Torstrick, Walton & Fallon, 2016).
"Health anxiety reflects the – often unfounded – distress or anxiety that a person feels regarding his or her personal health and, because of the misinterpretation of bodily sensations, extremely health anxious people often believe that they have a serious illness or medical condition" (Poel, Baumgartner, Hartmann, & Tanis, 2016). Health anxiety can lead to much distress and impairment. Severe health anxiety can co-exist with depressive disorders and other anxiety disorders like panic disorder, generalized anxiety disorder, or obsessive compulsive disorder.
Health anxious individuals tend to feel even more frightened and anxious after reading health information found online. There are two reasons for this. "First, if health anxious people go online to find reassuring information, they may become overwhelmed by the amount or complexity of the information that they find online" (Poel, Baumgartner, Hartmann, & Tanis, 2016). The second reason refers to the "selective perception of external stimuli. Health anxious people are known to selectively attend to information that confirms their worries about being ill, and they ignore information that counters their existing belief of being ill: this is referred to as the illness-related attentional bias." This further fuels the consuming worries about health.
Symptom-checking Beware
A 2008-2012 study of 731 individuals with health anxiety confirmed detrimental impact of internet symptom checking. "Internet-using individuals with higher levels of illness anxiety also reported fearing more diseases and having greater functional impairment, but paradoxically these individuals also reported being less likely to have a medically confirmed unstable physical illness" (Doherty-Torstrick, Walton, & Fallon, 2016). "Correspondingly, longer duration internet use was related to increased functional impairment and a recall of increased anxiety both during and after on-line symptom checking." Those who tend to turn to the internet are trying to reduce anxiety and worry, but are left often with much distress and fear of worsening illness.
Engaging in frequent checking behaviors leads to an increase in awareness of and preoccupation with symptoms and bodily sensations, which perpetuates health-related fears. This exacerbates health anxiety, which is why seeking health information online can have a detrimental impact.
Common symptoms of health anxiety include:
constant worry about one's health
frequently checking one's body for signs of illness
always asking for reassurance of not being ill
worrying doctors or medical tests have missed something
obsessively looking at health information on the internet or in the media
avoiding anything to do with serious illness, like medical programs
avoiding engaging with physical activities
prior experience with medical trauma or loved one's death
The detrimental impact health anxiety has on an individual can be very challenging, in and out of the physician offices.
For self-help, you may try keeping a log of how often you check your body, ask for reassurance, or look at health information and reduce how often you do those things gradually. You may want to challenge your thoughts by writing your worries in the first column, and more balanced and accurate thoughts in the second. Keeping busy with other activities may help, like going for a walk or calling a friend. Pushing yourself to get back to normal activities can help. Self-compassion and taking time to relax are also very helpful strategies.
Please reach out to your primary care provider or a mental health professional if your worries about your health are preventing you from living the life you want to live, especially if the self-help is not working. There are some medications that can be helpful when health anxiety is impairing. Counseling interventions are also very effective.
The first-line treatment for health anxiety is Cognitive Behavioral Therapy (CBT). CBT helps people learn to utilize healthier ways of thinking and acting in response to health anxiety. Treatment can involve education about the body, the brain, disease and illnesses and the impact behavior of checking, avoidance, and reassurance-seeking fuels anxiety.
Acceptance and Commitment Therapy (ACT) is another evidence-based approach used to decrease health anxiety. ACT emphasizes acceptance as a way to deal with negative thoughts, emotions, circumstances, or symptoms. It also encourages increased commitment to healthy, helpful activities that align with your values or goals.
Treatment can be augmented by recent and promising therapeutic interventions which include Somatic work, Mindfulness, Safety Appraisal and Positive Affect Induction, all which may benefit an individual becoming more comfortable with bodily sensations while reducing the impact fear has on the body. At the same time, this treatment enhances positive emotions and sensations, and can make a lasting imprint on someones way, and comfort in life.
It might be wise to think twice about taking the symptom checker quizzes, or researching possibilities of symptoms. It is too easy to fall down that rabbit hole and into a pit of despair. Just remember if you do, a nearby counselor is reaching out their hand.
Teresa Jacobson is a Doctor of Behavioral Health and Licensed Professional Clinical Counselor Supervisor who is counseling Ohio and Kentucky adults of all ages and life experiences via secure Telehealth/Video visits. A strength-based, person-centered multi-cultural counselor, with an existential philosophy, Teresa can be reached by emailing teresa@steppingtowardserenity.org, calling (513) 206-3026, or visiting https://www.steppingtowardserenity.org
References
Doherty-Torstrick, E.R., Walton, K.E., and Fallon, B.A. (2016). Cyberchondria: Parsing health anxiety from
online behavior. Psychosomatics, 57(4):390-400. DOI:10.1016/j.psym.2016.02.002
Mathes, B. M., Nora, A.M., Allan, N.P., Albanese, B.J., and Schmidt, N.B. (2018). Cyberchondria: Overlap
with health anxiety and unique relations with impairment, quality of life, and service utilization.
Psychiatry Research, f261:204-211. Retrieved from https://doi.org/10.1016/j.psychres.2018.01.002
Poel, F.T., Baumgartner, S.E., Hartmann, T., and Tanis, M. (2016). The curious case of cyberchondria: A
longitudinal study on the reciprocal relationship between health anxiety and online health
information seeking. Journal of Anxiety Disorders, 43:32-40. Retrieved from
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