Don't Be a Cyberchondriac: Use the Internet to Self-Screen, Not Self-Diagnose

Internet health information can be a friend or an enemy.

Posted Jan 06, 2010

If you’ve never taken a psychology class, you may not be familiar with Psychology Student Syndrome, a common (and often frightening) “condition” whereby an intro to psych student begins to think s/he and others has the mental conditions they are learning about. 

A bad day?  Self-diagnosis - major depression.  PMS?  Oh, no!  Maybe it’s bipolar disorder. Medical students catch their own version although, of course, their “symptoms” tend to center around life-threatening physical illnesses.

Now, thanks to the internet, you don’t have to be a psych major or first year medical student to develop the internet version of hypochondria – cyberchondria.  With all that health advice just a click away, it’s all to easy to consult Dr Google when we're feeling under the weather – and all too easy to give ourselves a serious case of the heebie-jeebies.  This is especially true if we already have health anxieties.

Why Health Information on the Internet Can Lead Us Astray

While cyberchondria has been around for almost a decade, Microsoft scientists Eric Horvitz and Ryen White were the first to systemically investigate it.  After analyzing the internet behavior of a million surfers around the world and surveying more than 500 Microsoft employees, they found:

  • In contrast to the actual prevalence of life-threatening illnesses, the proportion of websites listing them as primary causes is significantly higher.   For example, while brain tumors occur in less than one if 50,000 people, 25% of the documents showing up in a web search for “headache” point to a brain tumor as a possible cause. 
  • About 75 percent of internet health information seekers fail to check either the date or the source of their health information. 
  • People frequently confuse search rankings with the actual likelihood that a serious disease exists.  For example, if a search for “muscle twitching” produces three results near the top of the page about ALS, then, it’s 'Oh my God, I've got a terminal disease."

The solution isn’t to stay clear of the internet; it’s a great resource.  However, it’s unfiltered.  This is especially true when it comes to mental illnesses, which often have overlapping symptoms and differ from normal emotions only by their frequency and severity.  So the next time you scour the internet when you’re feeling emotionally out-of-whack:

Self-screen – but don’t self-diagnose.  There are lots of mental health screening tools available on the internet.  These can be useful both as a starting place in evaluating troubling emotional symptoms and as an ongoing reality check in terms of how much progress is being made.  For instance, the instrument that has been reported to be most helpful in screening for bipolar disorder is the Mood Disorder Questionnaire, which is widely available for free on the Internet.  

Don’t forget, though:  screening tools cast a wide net.  By design, they over-recognize symptoms so that the person will be encouraged to follow up with a professional.  Take advantage of these free resources, print out your answers, and bring them with you to your clinician. 

Check your sources.  Not all health sites are created equally and it’s hard to know which one to trust.  Start with the Health on the Net Foundation (HON), which requires the 6,500 sites that have signed up to it to display information responsibly and inform readers about its purpose and source. It also runs Medhunt, a search engine that pools results from trusted sites. 

Consider the context.  It is normal for people who’ve just lost a loved one to suffer many of the symptoms of major depression; in this context, they’re the typical manifestations of grief.  Unfortunately, current Diagnostic and Statistical Manual (DSM - IV) criteria doesn’t recognize the intense normal sadness that can arise after the end of a love affair, marital separation, diagnosis of serious illness in oneself or a loved one, or the loss of a valued job.  A recent study, however, if DSM-IV guidelines for bereavement were extended to reactions triggered by other losses, about 25% of persons who are currently diagnosed with depressive disorders might, in fact, be experiencing an intense, but normal, grief reaction that will reside on its own within a couple of months..  

When it comes to using the internet to research health information, it’s important to find a balance between taking charge of your mental health and catastrophizing every normal emotion.  Be your own advocate - but not your own doctor.