Are you hooked on Dr Google?

We all rely on the in­ter­net as a vi­tal source of in­for­ma­tion, but is it fu­elling a wave of health anx­i­ety? Abi Jack­son in­ves­ti­gates ris­ing lev­els of cy­ber­chon­dria

Friday - - Health -

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 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

‘On­line searches can go skewed, and for some, Googling symp­toms can be­come a form of anx­i­ety’

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 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, (Top to bot­tom) Frankie Sikes, Dr Mazin Ra­sool Al­jabiri and Dr Yaseen As­lam

It soon be­comes easy to in­ter­pret even mild and nor­mal symp­toms as signs of some­thing nas­tier

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. walk­ing in­spirit. 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.”

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