Dr Google and the virality of cyberchondria

“The abnormal practice of searching health information on the Internet to alleviate stress and anxiety but instead worsening the condition is called cyberchondria… It refers to the unfounded increase in concerns about general symptomatology, which is based on Internet search results… Cyberchondria has been inextricably linked to escalated health anxiety, stress, and depression and is also associated with obsessive-compulsive disorder… cyberchondria elevates distress consecutively causing high blood pressure, anxiety, and muscle spasm, which are generally triggered by an event like a sick person or the news of a death of someone close to them.”

— A 2021 paper released by the National Center for Biotechnology Information (NCBI)

A friend called late one night. Uncharacteristic of her. “I have something to tell 
you,” she began, her voicing sounding unusually shrill. Pause. “I think I may have a brain tumour.”

“What?! How do you know? Did you get a scan done? When?” I wanted to know.

“Well, I’ve been feeling really fatigued lately, and today I woke up with the most terrible headache. I did some online research… most sites I visited indicate brain tumour may be a likely cause.”

At this point, her husband snatched the phone from her hand and spoke to me. “She’s just being 
crazy… don’t believe a word of what she said, she’s been consulting Dr Google. We’re going to a real doctor tomorrow.”

The next day, she was diagnosed with anemia and put on a dose of iron supplements.

My friend’s case study reinforces the obvious. That there is a high chance a stubbed toe or a sudden stab of pain in the stomach (that just won’t go 
away) may throw up dire diagnoses if you are trawling on Google. Maybe you have skin cancer (for scenario no 1); or maybe you need a hysterectomy (for scenario no 2).

“One out of every two times you search for a health issue on Google, the worst will appear on top causing you unnecessary anxiety and stress for days,” says French beauty entrepreneur and wellness thought leader Myriam Keramane. “This then delays you from going to see an actual doctor and, sometimes, you won’t even go to the doctor to get a professional and medical diagnosis because you are so frightened by what you found on Google that you would rather stay in the dark, and never be 100 per cent sure.” Case in point: a Pew Research Center survey says only 50 per cent of women who Google reproductive health issues follow up with a doctor’s visit.

Professor of psychiatry Dr Vladan Starcevic, editor of Mental Health in the Digital Age: Grave Dangers, Great Promise, in a Sydney Morning Herald report — chillingly titled ‘Cyberchondria could kill you’ — pointed out, “We’ve narrowed down its [cyberchondria] use to refer to searching for information about health on the Internet, which then leads to anxiety. If, as a result of searching for health material, a person becomes more anxious, which in turn leads to more searching, then that could provisionally be termed cyberchondria.”

‘Cyberchondria’ was coined in 2008, when Ryen White, an information technologist at Microsoft Research, and his research partner Eric 
Horvitz “noted that more than one in 20 search engine queries concerned health information”. In another article in World Psychiatry, Starcevic argued cyberchondria is “one of a range of psychological functions that have been reconfigured by the digital revolution”.

Admittedly, it’s been a complex medical matrix, marked by admissions from older generation folks who say, “In our times, when I had a cold, I’d take a spoon of honey and go to sleep — and that was that” to a Google-empowered generation that reads up on Covid symptoms on 10 different sites every time an amped-up air-conditioning setting sends a few chills down the spine.

Where, and how, does one draw a line?

Your GP vs Dr Google

A JAMA Internal Medicine study that appeared a few years ago claimed that 64.2 per cent of those surveyed were using online sources to read up health matters; only 56.7 per cent were actually visiting a doctor. Another study indicates that 80 per cent of women Google health and wellness information; and that, as a ballpark, women consult a doctor three times a year, but spend at least an hour a week looking for medical info online. In other reports, it has been stated that “patients are beginning to question a doctor’s authority and expertise when their diagnosis or advice doesn’t match that of online information” (according to a piece by The Citizen).

And then, there are those anecdotal accounts where people say they no longer trust doctors because they are “driven by targets and insurance — they will make you go through a series of tests, for nothing”. There are often complaints of misdiagnoses, although, ironically, it usually takes another doctor to point out a misdiagnosis.

“Well, there are good doctors… and not-so-good ones,” says Dr Ruhil Badiani of Cornerstone Clinic. “Find a doctor who listens to your concerns, discusses your options and explains why they are performing tests or prescribing — or not prescribing — medications. Ask for recommendations from friends and family and if you are unhappy with the advice you are given, always look for a second opinion.”

Dr Ruhil often sees medical questions such as “What is this rash on my daughter’s face?” being posted in Facebook groups and it does make her feel a little better seeing responders say “Check with a doctor”. She points out that while we are very lucky to have so much information available to us at our fingertips, getting advice regarding medical conditions from the Internet can be dangerous — “if it is not from a reputable source”. “The pandemic has really opened everyone’s eyes to how bad information can cause a great deal of harm. My advice to patients who Google their symptoms or research their diagnosis is to always double-check with a medical practitioner they know and trust. Not all advice is bad on the Internet, and it can be very useful when deciding on your treatment options, but it must always be followed up, scrutinised and evidence shown to support the claims.”

Myriam, who’s opening her first hair salon in City Walk Dubai soon, gives an interesting perspective about haircare — a sector that is not even viewed by many as being something complexly medical — has to be driven by professional advice, and not Internet searches. “I created a full supplement range specially designed for those who suffer from hair loss and want to regrow their hair. Every time a customer ask me about it, I always suggest to those that have any health condition to first get the point of view from their doctor. Only the doctor who has the medical file of a patient can decide whether or not to take dietary supplements, even if it’s made of vitamins.”

Cause + Effect = The Prescription

Neha Pandey is a Dubai-based singer (she calls herself a ‘creative artist’), influencer and businesswoman, and, like most of us, she’s been through life’s peaks and troughs. There was a time when she turned to Google to figure out why she was feeling “a certain way”. “Soon enough, I was convinced I am depressed, that all the symptoms I was displaying were signs I have clinical depression.” Luckily for her, she chose not to go down the rabbit hole. “One day, I decided to get offline, and heal myself. I think I was feeling depressed because Google was adding fuel to the fire. When you search for negativity, it somehow finds you right back — and that’s exactly what was happening to me.”

In Neha’s case, a renewed thrust on music proved to be the biggest healer; it took her mind off the keyboard, and got her back in the groove.

It’s okay to check Google to get an idea of what a particular health issue might be, feels Myriam, but the best option is to go directly for a consultation with a specialist. “Whatever the issue is, be it health, hair or skin, nobody except a specialist will be able to help you accurately. Even if Google is an open library, it will never replace a personalised diagnosis.”

Meanwhile, consider this googly. If you Google something as simple as “Is heartburn dangerous?”, you might find that oesophageal cancer is one of its many causes, says Dr Ruhil. “This will, understandably, cause much concern — but, as a medical practitioner, I would take a very detailed history and examination and, in most cases, will tell you it is caused by lifestyle issues or even a bug called H.Pylori!”