How Dr Google stokes anxieties of the ‘worried well’

Self-diagnoses after web searches are often wrong, writes Claire Keeton

ARE you prone to cyberchondria? Then beware Dr Google. Many South African soccer fans coming home from Brazil last month were convinced they had picked up sexually transmitted diseases (STDs).

Clinical sexologist Professor Elna McIntosh said: “I have seen about 10 guys back from the World Cup who have got vague symptoms like a sore throat — and guilt. They Google whatever they can and think they have got everything when they don’t. I have seen hundreds of people who misdiagnose STDs. There are about 6 000 skin diseases and only 26 STDs.”

Increasingly, the “worried well” are searching the web for medical information — but this can further stoke anxieties.

British doctor Andy Davies recalls the young woman sitting opposite him who was convinced she knew what was wrong with her — and she had the Google research to prove it. Showing the doctor her blue-tinged hands, she said she had looked up her symptoms and diagnosed herself with cyanosis, a potentially dangerous condition related to oxygen levels in the blood.

But Dr Davies had another theory. Having noted what she was wearing, he asked if her jeans were new, and taking a tissue, calmly wiped the denim dye off her hands.

“She’d had her hands in her pockets and the dye had rubbed off on them,” says Dr Davies. “She did laugh but said when she put ‘blue hands’ into the search engine, it was cyanosis that came up.”

Without professional training to analyse symptoms properly, the worried will run the risk of wrong diagnoses, from trivial to life-threatening. “The internet is a doubleedged sword,” said Cape Town family practitioner Dr Marmol Stoltz.

“Overall, it is positive to empower patients to manage illnesses, but they can be completely wrong with diagnoses. The lay person doesn’t have the insights from years of training and clinical experience to interpret symptoms.”

Dr Norman Mabasa, chairman of the SA Medical Association, said patients relying on the internet for medical advice are exposed to

Don’t panic straight away when you identify one or two symptoms

worst-case scenarios.

“Patients are tempted to multiply the symptoms they read about a thousand times and believe they are suffering from these diseases,” Mabasa said.

“They get fixed on an idea and may try to steer a doctor towards that by restricting information.”

Johannesburg GP and travel doctor Dr Jonathan Klotnick said: “I see patients coming to consultations with a pre-formed diagnosis. They fear the worst and come to us for reassurance. They keep doctors on their toes, which is good.”

Mabasa said it could be dangerous for patients to self-diagnose and self-medicate without consulting a doctor. “Sometimes the symptoms people experience and read about are secondary to the underlying cause — they may overlook conditions which are contagious or even fatal.”

Personalities inevitably influence people’s reactions to the medical realm on cyberspace. Those who feel stressed by health messages from Dr Oz on television or stories of malpractice are more likely to be susceptible to scare stories.

For a reality check, assess how many doctors’ visits in the past year were for genuine medical problems or triggered by trawling the internet.

Meryl Costa from the SA Depression and Anxiety Group (Sadag) said people should be careful with sites on the internet, which also has a host of support groups and helpful links. “You need to make sure you use the website of a reputable organisation or institution. Sadag has awealth of information . . . if you are feeling depressed or anxious,” she said.

“The internet should never replace the expert help of a doctor, psychologist or psychiatrist but should aid as a tool to help navigate where to go and how you can get further expert help.”

Unlike clinical assessments, online questionnaires can lead nearly anyone to suspect they have symptoms of conditions like attention deficit hyperactivity (ADHD).

Clinical psychologist Colinda Linde said there are two problems with reading about mental health conditions.

Firstly, terms like ADHD and OCD (obsessive compulsive disorder) are commonly bandied about even though the “clinical conditions are very specific and affect functioning more significantly than an occasional double checking or inattentive moment”.

Secondly, all of us have different combinations of resilience and healthy parts along with anxiety, depression, delusional thoughts and so on in a package and the latter become a disorder only when one is so dominant that it has a negative and enduring effect on functioning.

“Dr Google is only as accurate as those who input the information. Don’t panic straight away when you identify one or two symptoms.

“As the old-school GPs say, only when symptoms go on for more than two days, or become suddenly severe, it’s time to consult your doctor,” she advised. —