People are actively using internet to seek information related to health conditions and this pattern of behavior has become prevalent in recent years. It is estimated that more than 100 million (10 crore) individuals who regularly use internet search for health information online. This has become more widespread due to use of several devices like desktop, smartphones, tablets, and laptops. People can look for such information for free and various expert sources provide valid information which is not difficult to understand. In UK alone, the number health information seekers has increased from 18% in 2007 to 51% in 2016 which is high in comparison to many other uses like e-commerce or blogging. It is not withstanding to say that internet has become the most popular way to search for such information relating to health and this number if ever increasing, expected to rise in coming years in developed as well as developing world.
There are obviously many benefits associated with searching such information. People are getting educated about causes and treatments of many diseases, including detailed descriptions of symptoms and nature if illnesses. One can read an article or watch a video to know such information. Despite its benefits, for people who are anxious and distressed about their health, or the health of family members, this online behavior is leading to more incidences of self-diagnosis. Health about anxiety is enhancing the habit of obtaining reassurance through repeated searching. In fact, out of their anxiety, people who are overly conscious of their health are looking for such information more than others and large number of such searches are primarily by such health-anxious individuals. Also, the time spent by such individuals is also significantly higher than those with no or less health anxiety. It is also possible to believe that by seeking health related information for any of the reasons may lead to more health anxiety. This is possibly regulated by the repeated attempts to bring clarity over the limited information. Therefore, more searches increase anxiety even more. It is also observed that such rises in health searches depend from person to person, and several other factors like personality may contribute to increase in overall health anxiety.
Scientists have come up with a word to define such excessive or repeated online searches about health related information, that is called cyberchondria. Cyberchondria is also accompanied by heightened health anxiety and psychological distress. Any online health-information seeking is not cyberchondria, however, the major difference lies between reasons for such searches and their consequences. That implies, cyberchondria is serious in ways that it leads to greater increases in health related anxiety with more subsequent searches. It becomes a never ending pattern leading to severe levels in anxiety. Cyberchondria is not just knowing or learning about a health condition, but it becomes a way to relieve anxiety through some more information. The motive being satisfaction with some concrete information which may confirm some diagnosis or give a sure alternative to it. That doesn’t mean one should worry about searching health information online, but if the amount of time spent becomes excessive and there is increased neglect of daily productive activities, then there are higher chances of developing a maladaptive pattern of cyberchondria. There is also more anxiety experienced after the searching is over. So the behavior becomes counter-productive, such that, instead of relieving from anxiety and worries, it actually escalates anxiety.
Cyberchondria is not a disorder. It is an abnormal behavioral pattern. The uncertainties about health increase even more due to such repeated searches online. This causes increases in fears and worries relating to future outcomes of the disease. There is significant impairment in daily functioning such that the individual begins to neglect activities of daily living and several important tasks. Due to such consequences of this obsessive behavior, cyberchondria needs greater attention and clarity. If left unacknowledged, it may lead to insomnia, reduced appetite, over medication, self-diagnosis, several repeated visits to doctors, regular wishes to get medical tests done, worries over the possibility of some major disease left undiagnosed, need for reassurance that nothing fatal is going to happen and depressed mood. Cyberchondria generally occurs during a psychological disorder like hypochondria, generalized anxiety disorder or panic disorder. In order to seek reassurance relating to health concerns, cyberchondria develops gradually over a period of time with inability to control the behaviors of online search.
In order to understand the impact of cyberchondria on an individual and its seriousness, a recent study by Brittany Mathes from Florida State University and her colleagues published in the journal Psychiatry Research threw light on the disability associated with this condition. This was a first study of its kind and aimed to look at the public health concerns associated with this condition. The researchers wanted to see the extent to which health anxiety and cyberchondria are deferentially associated with public health concerns like quality of life, functional impairment, and service utilization. They recruited 462 individuals from Mechanical Turk website in age range of 18 to 77 years. Participants completed several questionnaires like Cyberchondria Severity Scale, Short Health Anxiety Inventory, Sheehan Disability Scale, Physical and Mental Health-care Utilization scale, WHO Quality of Life assessment scale. They found high associations of cyberchondria with functional impairment. This association is stronger than the effect of health anxiety over impairment. That implies, the level of impairment in daily life caused by cyberchondria is higher than that caused by any levels of health anxiety alone. Reassurance seeking was highly related with physical health-care utilization, which implies, that individuals seek consultations and opinions from physical health doctors more because they want to be sure of their illnesses and symptoms.
The surprising finding was that mental health care utilization was less associated with cyberchondria than that of physical one. This implies, that although, health anxiety is psychological in nature, but people look for more physical explanations by visiting physicians rather than visiting psychiatrists or psychologists to know about the actual mental causes. Due to this lack of insight into the nature of symptoms, they delay the appropriate treatment and deny the role of mental causes and factors in the elevation of their anxiety. Health anxiety is purely psychological in nature, but due to excessive attention paid towards physical explanations through repeated online searches, individuals who are making heavy use of internet for such searches do not reach to a proper conclusion regarding the nature of their mental condition. This also indicates that such searches are determined highly by what and how much the person knows the value and role of certain factors which they consider worthy rather than the actual ones. They believe in only those pieces of information which they think is right, despite the fact that internet is informing them of the different possibilities. For example, pain in chest may be explained as physical or psychological over the internet. But individuals with high levels of health anxiety and cyberchondria would only believe in physical causes and would assume that their condition has nothing to do with their mind, and would therefore, consult only physicians or cardiologists. More so, even the advice and suggestion of physicians through face to face consultations would be neglected, in case they indicate the possibility of a psychological disorder. Such a neglect due to denial and poor insight would only delay the correct treatment, rather than giving any relief. This would eventually lead to impairment in daily life and an increase in maladaptive pattern of cyberchondria.
There is large ambiguity linked to online health information. Several sources suggest similar and different explanations about the same condition which increases confusions and reduce clarity. The conclusions are not drawn and the individual looking for such information becomes ever more perplexed about the nature of condition. A lot of information is misleading and inaccurate too, or rather incomplete. It is not possible to explain everything about the disease in clear terms in small spaces of articles and blogs because queries may not be specific. The experts behind such information may also vary in their areas of expertise. A simple information about diabetes would vary from doctor to doctor depending on their speciality. A general physician may not reveal too technical details, however, a specialist dealing with endocrine related diseases would indicate certain terms and explanations that may seem very scary. Or vice versa. Online health information may sometimes look authentic due to some trusted websites there, like WebMD or Mayo Clinic, but interpretation of such information is left totally upon the individual seeking it, because the specific details relating to the seeker may be missed in general coverage over the web. A face to face consultation with the doctor in the clinical room is more appropriate because the information would be highly specific and based on some analysis of the condition and reports.
An anxious person seeks reassurance due to uncertainties related to worry and repeated thinking. Worrying is an anticipated thought pattern related to future upcoming dangers associated with any outcome specific to worry concern. In a health anxious individual, worries revolve around health concerns which may be imagined or real. Any discrepancy in health related information is potent to trigger the cycle of worry in the individual. If this worry goes unchecked, it may cause more anxiety and more worrying thoughts. Worries motivate an individual to look for resolution of anxiety by seeking relevant information which is expected to bring relief. In health anxious individuals, worries over health make an individual indulge in online information searches with an expectation of helping and calming. On the contrary, such a person gets involved in abnormal patterns of seeking reassurance due to no achievement of certainty due to those searches. Every new piece of information brings some minor relief of reaching to some conclusion, but new discrepancies in that novel information triggers more anxiety and a cycle of uncertainties. This all leads to increasing levels of psychological distress and discomfort. The person may need professional help to heal the underlying causes of anxiety and worrying.
The research in this area is in its infancy, and researchers are coming up with new ways to understand this condition, with a possibility to even think of it as a separate disorder. In future, it is quite probable that with every routine assessment of physical condition, an underlying health anxiety and cyberchondria tendency would also be assessed. This would be necessary to provide complete health-care to the individuals because hidden cyberchondria may effect general health-care seeking behaviors of the individuals by increasing illness anxiety. As more individuals would seek online help for information, cases of cyberchondria are expected to increase manifold in near future. It is also possible that cyberchondria may give rise to other mental health conditions like obsessive-compulsive disorder, health anxiety, panic attacks, and depression. Hence, cyberchondria is more serious than is generally believed at present.
