Anxiety Disorders Have a New Addition, and It’s Fed by the Internet

Searching for information on health issues has many aspects, both beneficial and problematic, and one of them is creating more concerns than satisfaction.

Anxiety disorders are common, and there are at least 20 discrete anxiety disorders listed in the DSM-5 published by the American Psychiatric Association. However, even though there are separate disorders, anxiety is usually included as a factor in other disorders, such as depression.

The popularity of the internet, with its vast trove of information, often aided by algorithms such as ChatGPT, has become the next information-heavy wave when searching for medical information. Does anyone remember when people in the healthcare profession scoffed at “Dr. Google” when patients indicated they had found relevant information regarding their symptoms? The ease of symptom-searching for those with a more-than-usual interest in their medical health has led to the designation of yet another anxiety-related disorder.

Cyberchondria is when someone searches for health information online over and over again, which causes them to feel more anxious and distressed about their health. It is a multifaceted construct known as a "transdiagnostic compulsive behavioral syndrome" that is associated with three elements: obsessive-compulsive symptoms, problematic internet use, and anxiety-related factors.

There is not a single agreed-upon definition of cyberchondria, but most of them focus on online health research that is linked to higher levels of distress or anxiety. The two main theories of cyberchondria are based on reassurance-seeking and certain metacognitive beliefs. Any significant health outbreak, such as the COVID-19 pandemic, may fuel the disorder, which has implications for public health in terms of impaired functioning and changes in healthcare utilization.

It is also important to think about how much the condition might be like a behavioral addiction as a form of problematic internet use. Cyberchondria may have become more common during the COVID-19 pandemic, with people who are more likely to have health-related anxiety being more likely to experience it. Some data supports the idea that cyberchondria might be a behavioral addiction, but there are still many things we do not fully understand.

A study surveying patients at health clinics found reasons for concern regarding health anxiety. Out of the 43,205 people who went to the clinics, 28,991 (67.1%) were evaluated, and of those left over after patients who were not qualified were taken out, 5,747 (19.8%) had significant health anxiety. The researchers concluded that abnormal health anxiety, which is prevalent and a major concern among those who visit medical clinics, is something that should receive more attention.

If we look simply at hypochondriasis without adding cyberchondria, the concern for health and life mounts. A study in Sweden looked at 4,129 people who had been diagnosed with hypochondriasis and 41,290 demographically similar people who did not have hypochondriasis. The people who did have hypochondriasis had a higher chance of dying from both natural and unnatural causes, especially suicide.

One major issue is that those with the disorder may avoid medical attention altogether, and the results may be dire. A Norwegian longitudinal cohort study of 7,052 people found that after 12 years, people who said they had symptoms of health anxiety were 73% more likely to develop ischemic heart disease than people who said they did not have any symptoms of health anxiety. Was it anxiety that brought it on or the avoidance of medical evaluation that led to its development?

In a different study, people who felt more health anxiety after looking for medical information on the Internet reported more PIU (problematic Internet use) than people whose health anxiety did not change after searching for medical information or went down after searching.

Lifetime rates of health anxiety are 6% in the general population and as high as 20% in hospital outpatients. This causes more medical visits that are unnecessary, which costs the health system more money. Rates for healthcare may be rising because more people are browsing the internet excessively (cyberchondria) and requesting more assessments.

What can be done to help these individuals in terms of healthcare treatments? Some people find that antidepressants help with health anxiety, but they do not like taking them. On the other hand, cognitive behavior therapy, stress management, mindfulness training, and acceptance and commitment therapy have all been shown to be helpful in the short and long term. These therapies can be given one-on-one, in groups, or over the Internet.

The bottom line is that we may have a new addiction to put into any forthcoming DSM, or it may be placed in the area where it is of concern and needs more investigation. But, in the meantime, individuals who find they are avoiding medical evaluations and ceaselessly searching the internet for help should consider mental health treatment for their anxiety.