‘Dr Google’ diagnosis can be a headache

Casually searching for possible causes and remedies for a minor ailment on the internet may not seem like much of a big deal to you, but for many, it’s an obsession.

Called cyberchondria, this disorder is evident in people who persistently search their health symptoms on the internet, often diagnosing themselves with fatal diseases or conditions, causing high levels of anxiety.

The condition is related to hypochondria – an abnormal, chronic anxiety about one’s health.

Although the condition first surfaced a number of years ago, the easy availability of technology has had a major influence on the number of cases, leading people to believe that even a minor headache could indicate a brain tumour.

For example, a Google search for a red itchy rash brought up 59 possible causes including contact dermatitis, Fifth disease, impetigo, shingles, German measles, atypical pneumonia and infectious mononucleosis. Armed with this information – however true or false – a person will then present themselves to a medical practitioner, provide their own diagnosis and request treatment.

The website Psychology Today says symptoms of cyberchondria include checking online for symptom information for up to three hours per day, fear of having several different diseases, feeling even more anxious while looking online for symptom information, yet looking up to four times a day, even while your health is medically stable.

East London-based Dr Cayley Koen said she had seen one such patient in her time in practice.

According to Koen, such patients tend to hop from one doctor to the next, with each doctor conducting both a physical examination as well as taking blood samples to a laboratory for testing. If the results come back clear, such a patient will not be satisfied and will seek another medical opinion.

“They will then move from doctor to doctor with the hope that one will give them the diagnosis they want to hear,” Koen said.

According to Dr Daya Appavoo, when a patient comes in reporting certain symptoms, doctors are bound to conduct a number of tests to exclude a number of different conditions. This is often followed by a specialist review if the patient continues to present symptoms after test results come back clear.

“It’s usually after this that the patient may be listed as having a condition which may not be physical.

“There are many cases of people who come in reporting that they are ill when the illness is nowhere in their bodies but only in their minds.

“In such cases, doctors tend to give a psychogenic diagnosis and refer the patient to either a psychiatrist or a psychologist for further treatment.”

In a research paper published by the Royal College of Surgeons in Ireland Student Medical Journal titled The Age of Cyberchondria, it is reported that internet users who search for health information online have a tendency to gravitate to search for more serious conditions.

Statistics provided by the research show that 80% of American internet users have searched for health-related information online, which amounts to an estimated 113million searchers 18 years and over. The research further states that two-thirds of health information seekers began their last online health inquiry on search engines such as Google or Yahoo with only 15% checking the source and date of the information.

“The web may be a major source of information for those who suffer from hypochondria and cyberchondria, allowing very detailed investigation of perceived symptoms and conditions,” the research reads.

“Users have a tendency to gravitate to search more serious conditions, for example, one may commence a search for headache type symptoms and subsequently escalate to reviewing material related to brain tumours.

“Search engines, chat rooms, diagnostic internet sites, applications and global health scares carried by media and television shows that demonstrate the intricacies of surgery all generate vast amounts of technology-supported medical information.

“However, patients searching online for reassurance become anxious. There is a relationship between health anxiety and hypochondria and medical searches online can lead to anxiety. This may lead to a relationship between anxiety, hypochondria and cyberchondria.”

However, a study in the Journal of Anxiety Disorders points out that despite the dangers, there are a number of benefits to using the internet to access medical information, including anonymity, cost-effectiveness and feeling better informed about your own or someone else’s medical experience.

Counselling psychologist Linda Truter says one of the benefits is that the information allows one to quickly identify certain minor illnesses, treatable with over-the-counter medication, which is particularly useful for those who cannot always afford to visit a doctor.

“People can also look up health tips such as how to control diabetes, which foods to eat to counter high blood pressure and healthy eating tips,” Truter said. “People who have already seen a doctor and received medication can even look up how to take their medication properly and join chat rooms so they can connect with people with the same conditions as themselves for support.

“The problem comes in when it’s done to the extreme, where people start diagnosing themselves without having being examined by a medical practitioner.

“This is called hypochondria, where people obsess over the smallest symptom and create an entire illness in their minds which often doesn’t even exist.

“This condition is then made worse by the easy availability of information on the internet,” she said.

Truter said treatment is behaviour therapy, where a therapist will attempt to change people’s thinking and perception of things.

She said: “The therapy is usually not easy because most people get this behaviour from their childhoods, where they are always stressing about general things and their health. There are even people who have a cough and they stress, or they experience a bit of blurry vision and they stress.

“In some cases this comes from over-protective parents who did that to them. Sometimes it’s a traumatic or stressful incident from the past.

“There are certain ways of dealing with these kinds of issues, such as asking the person to keep a diary and make daily entries of their symptoms and how they are feeling so we can try to see a pattern.

“These cases are not always easy to deal with but they are treatable.”

The study in the Journal of Anxiety Disorders called for more research on cyberchondria in an effort to better understand it.

“Given its associated distress and potential economic costs, it is important to better understand cyberchondria. To achieve this goal, it is of course necessary to develop valid assessment tools.

“To date, cyberchondria has primarily been assessed using single items, such as whether individuals experience greater health anxiety as a result of internet searches for medical information. Cyberchondria is best considered a multi-dimensional approach,” the study said. — zisandan@dispatch.co.za