I’ve always been hyper-aware of my health anxiety and its ability to turn me into an irrational thinker. It started when I was a preteen. I would get sporadic abdominal pains that felt like razors were slicing open my nerve endings one by one. On countless hospital visits, nurses would ask me to tell them, on a scale of one to 10, how much it hurt. Ten seemed like an answer reserved for the dying, and though I often felt like I was, I knew better. So I’d answer, “Nine.” Still, doctors dismissed my concerns, and tests did not reveal anything wrong with me. I was scared to leave the house in case the pain flared up, and when it did, I’d hunch myself into a ball, waiting for hours until the feeling went away.
Eventually, I decided that if doctors couldn’t figure out what was wrong with me, I had to do it myself. I found a girl in an online medical forum for patients with undiagnosed conditions who described pain similar to mine. One poster in the forum suggested that her pain could be an umbilical hernia — a small hole in the abdominal lining that becomes irritated when a person’s intestines try to push through it. An emergency room doctor — probably the 12th I’d seen — finally confirmed that this was my issue as well, and a few weeks later, I had minor surgery.
While the abdominal pains went away after the operation, my anxiety did not. Almost 10 years later, consulting with Google for health advice is still part of my daily routine. On good days, I can debunk my medical worries in a matter of minutes. On bad days, I spend hours scrolling through web forums and medical encyclopedias, and typing my concerns into an online symptom checker. Feelings of panic and relief take turns as the internet spits out a long list of possible diseases and medical abnormalities, ranging from the common migraine to the rarest form of cancer. I realized things had gone too far this past summer when I spent the entire day before a 12-hour flight looking for instances of appendicitis onset on airplanes.
Around the same time, in September 2017, researchers in the U.K. found that those with health anxiety — a number estimated to be around one in five — were costing the National Health Service £420 million each year. In the U.S., it’s estimated that 80 percent of internet users search for health-related information online — a problematic trend, seeing as nearly half of those searches bring up extreme (and highly improbable) possible causes. While people with illness anxiety may or may not have an underlying condition, the fear can cause actual physical symptoms — such as increased heart rate, chest pain, and nausea — which drive frantic Googlers farther into the inconclusive depths of the internet.
As a proposed solution, a study led by Imperial College London professor emeritus Peter Tyrer suggested that cognitive behavioral therapy (CBT) be offered in all hospitals to hypochondriac patients as a way to curb costs and alleviate worry. The therapy is slowly gaining attention as the most effective treatment for health anxiety. “Until now, we had no evidence that health anxiety in medical settings could be successfully treated,” Tyrer told Medical News Today after completion of his study. “Our results indicate that [CBT for health anxiety] is relatively cheap, can be delivered by general nurses with minimal training, and could be easily rolled out in hospital settings.”
Christine Purdon, a psychology professor at the University of Waterloo in Ontario, Canada, who specializes in anxiety disorders and CBT, explains that anxiety thrives off of a perceived threat — and health anxiety is no different. “That’s the first thing we do when we sense a threat: We start looking for information to assess and evaluate how big the threat is, how imminent, and what we need to do about it,” she tells Yahoo Lifestyle. With health anxiety, this often takes the form of obsessive research as some sort of quest for reassurance.
This natural train of thought can be attributed to our brain anatomy. “There’s essentially an information superhighway. To respond adaptively to threat, we rely on past experience, so as soon as we become anxious, other instances that seem relevant are very accessible,” says Purdon. That’s why instead of considering facts (Google searches for “sore throat” result in “cancer” for one in three queries, while the actual risk of developing throat cancer is 0.3 percent), we might draw a comparison to a cousin or friend who got diagnosed with a terminal illness.
“What people are trying to do is manage their anxiety, not manage illness,” says Purdon. “This is where CBT becomes relevant; it helps people recognize their thoughts as hypotheses as opposed to facts.”
While anxiety presents conclusions as fact, with CBT a person can learn to take a mental step back by replacing worries with more rational thoughts. Purdon compares it to a movie camera, with which people can zoom out and see the whole scene — what’s actually happening in the present as opposed to what a person fears is going to happen in the future.
While Purdon recognizes the benefits of making CBT more accessible, she says there are things people can do at home to try to manage their fears. “When I work with people, I ask them to recognize that there’s a 100 percent chance these behaviors interfere with their life in a highly significant way, and it’s all to stave off a vague, very low probability,” she says. “Someone with illness anxiety might drive to a doctor without thinking about it, but the probability of feared illness is far lower than getting into an accident on the way. We do ‘risky things’ every day. Even if you decide to stay home in a bubble, the ceiling could collapse on you, or you could choke on your toothpaste.” She suggests trying “behavior experiments” to help assess how you really feel after chasing — or not chasing — information down an online rabbit hole.
As for me, she encouraged me not to go on the internet or seek medical help for 10 days after our conversation. “Just see how much better life is when you don’t do that,” she said.
Later that day, I suspected that I was getting a urinary tract infection. I sat down at my computer to open up the symptom checker, drumming my fingers on the keyboard while staring at the blue “Continue” button. Instead of proceeding, I took a deep breath, closed my laptop, and went for a walk. One day passed, then two, then a week. I was fine. Everything felt normal.
I still get urges to Google my symptoms when something in my body feels wrong, but then I remind myself that whatever my searching skills can dig up won’t change anything. When I tell myself that searching did help me diagnose the hernia, I force myself to remember that that was a one-time thing — a situation that I need not replicate. Instead, I get on with my day, I try to reason with myself, and I remember what Purdon told me: “Let go of this idea that bad stuff can happen, and remember that you’re allowed to get on with your life. All of life involves some risk, and that’s OK.”
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