BERLIN: This pain can't simply be a bout of side stitches! And what does the strange tingling in your fingers mean? Just a few clicks away on the internet await possible explanations for your symptoms, some of which can be very alarming. So now you're really worried.
This is a case of what's come to be known as cyberchondria. It's not a formal diagnosis, but an unfounded fear of, or heightened attention to, serious physical illnesses based on perusal of internet content, explains Dr Heiko Graf, director of the Department of Psychiatry and Psychotherapeutic Medicine at Karlsruhe Municipal Hospital in Germany.
It can lead to depression or, at worst, illness anxiety disorder (hypochondriasis or hypochondria), he says, which is indeed a formal, recognised mental health diagnosis.
"Health anxiety has increased over the last 30 years," says Graf, "mainly among people under 35," a group that uses the internet more often than older people do. And it's developing at an earlier age, "when you're more impressionable."
People with elevated general anxiety or who have trouble dealing with uncertainties are also more susceptible to health anxiety, he adds, and says studies have shown that it increases in 30% to 50% of those who do illness searches online.
In a survey by the German market and opinion research institute forsa commissioned by health insurer KKH, 91% of the respondents said they had researched illnesses/symptoms – either their own or someone else's – on the web at least once.
About a third said they had spared themselves doctor visits this way, and 13% said they had made a self-diagnosis at least once. Among 16- to 34-year-olds it was 20%.
"There's nothing wrong with googling illnesses and symptoms," says KKH psychologist Isabelle Wenck. "In most cases, you even improve your health literacy, provided the information is reputable and up to date."
But people with a mental illness, in particular, risk getting caught in a vicious cycle, she warns, "especially those who already have a concrete fear of serious or incurable diseases." The danger is namely cyberchondria, "a compulsive addiction to internet diagnoses that's also known as Dr Google syndrome."
The online searches often act as an accelerant of sorts for already existing fears, she says. Affected persons scour the internet for many hours a day in search of explanations for what ails them, overdramatise their symptoms, draw false conclusions and, at worst, make drastic self-diagnoses.
"The problem," agrees Graf, "isn't looking up individual illnesses on the internet, but that doing so can result in illness anxiety disorder."
The boundary is fluid: "At some point illness searches become compulsive. Affected persons generally come under psychological stress, then are often asked by others about their unfounded fears."
Doctors notice, for example, that their patient has already consulted many other doctors and continually doubts normal findings. Friends and family members may notice the person's unusual behaviour as well.
There's basically no reason not to consult the internet on health matters, Graf says. But when making diagnoses, doctors also take probabilities into account, he points out, such as how common a certain illness is at a certain age.
"You frequently don't have this context when you research symptoms on the internet, however," he remarks. "So when researching headaches, you arrive at brain tumours in three clicks, although a tension headache or migraine is much more likely."
What's more, he says, at least 40% of the health content on the web is unverified or even false. This is particularly true with regard to cancer, according to a systematic evaluation of dozens of studies.
Artificial intelligence applications such as ChatGPT are problematic too, in Graf's view, because they can draw on – unfiltered – web content with unfounded information.
"The quality of information on the web varies widely," seconds Wenck, who says only specialists can expertly interpret the large number of search results and properly contextualise them.
So what can cyberchondriacs do to ease their mind? Graf says psychotherapy can help, and that 25 sessions of cognitive behavioural therapy – on an outpatient basis too – can bring significant improvement. Medications are seldom prescribed as treatment.
"What's important first of all," he says, "is not to enter into a discussion with the patient that they don't have a physical illness, but rather to recommend strategies on how they can respond to their fears." – dpa
