Cyberchondria: Signs, Symptoms, & Treatments

What Is Cyberchondria?

Cyberchondria involves a preoccupation with having an illness and persistent concerns about one’s health that they then search about endlessly online. Medical exams by health professionals and diagnostic tests do not provide adequate assurance of good health. It is not uncommon to have an underlying mental health problem, such as generalized anxiety disorder or depression.

The disorder is similar to what used to be called Hypochondria. Hypochondriasis is no longer a diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Instead, approximately 75% of people previously diagnosed with hypochondriasis are considered to have somatic symptom disorder. The remaining 25% have high health anxiety in the absence of somatic symptoms and are classified as having illness anxiety disorder.¹

Cyberchondria Symptoms

People with cyberchondria exhibit five characteristic traits:⁶

1. A compulsive, unwanted searching for information
2. Distress caused by the searching behavior, including worry and panic
3. Excessive time used to search online
4. Seeking reassurance from a qualified person or source
5. Mistrust of medical professionals whose advice could be obtained in person

When there are significant physical symptoms, cyberchondria would not be the correct diagnosis. In the case of significant symptoms without a known medical cause, the diagnosis would likely be somatic symptom disorder.⁷

Is the Internet a Common Trigger for Health Anxiety?

The internet has overall increased our access to health information. For those with health anxiety, more information sometimes causes feelings of overwhelm. Increasing availability of information on the internet may exacerbate health anxiety and related anxiety disorders.² Research around cyberchondria even shows a link between development of internet addiction and health anxiety.²

Especially for younger users who may not yet have the education to vet the sources of their information, health-related internet searches can cause distress.² Distress may be compounded when users continue to search for and view negative health-related stimuli.³ Because search engines are designed to show information most viewed by users, compulsive health searches can promote the circulation of negative health-related stimuli and misinformation.

There Are Many Valid Reasons to Worry About Your Health

Concern about your health is normal and overall does not cause or exacerbate mental health issues. Concern about your health can be a positive and helpful trait for preventing and managing illnesses, but those with health anxiety have increased frequency and intensity of health-related concerns which are outside the norm. There are reasons why instances of health anxiety may present, especially in the modern age and with the ease of accessibility to information.  

• More information (and misinformation) about health: With the rise of the internet, there is more access to a variety of information about health. It is important to seek information from relevant and qualified sources, as certain resources have motivations other than providing you with accurate information.⁴
• Negativity bias: Some research indicates that individuals with health anxiety have a  greater attentional bias toward health-related threatening stimuli.³ Search engines are designed to show most-viewed information, and sometimes that information trends toward the negative. Users with health anxiety are more likely to continue to view negative information as they are searching for validation of their symptoms.
• A continuously stressful world: With stressful events continuing to happen, it is easy to get caught up in paying attention to only negative stimuli. Research shows that disease-related media coverage can prompt health anxiety symptoms, such as the recent Covid-19 pandemic and the increase in health-related searches.⁵

Signs You’re a Cyberchondriac

A key feature of cyberchondria is that the person worries about having a serious illness in spite of having minimal or no symptoms.

Typical signs that you might be experiencing cyberchondria include:⁸

• Your actual symptoms are minor or even absent
• You spend several hours per day searching online for information about minor health related symptoms that you’re experiencing
• You are fearful of having at least one serious illness, and possibly several
• Searching online causes you more fear and anxiety instead of relief
• You experience an increase in heart rate, sweating, or other anxiety-related symptoms when searching
• You jump to the worst conclusions about your health condition
• You may have a minor harmless health condition which has been diagnosed, such as a benign cyst, but you worry excessively about the condition
• You assume that what you find online is accurate and truthful

Causes & Triggers for Cyberchondria

There are various causes and triggers for cyberchondria, ranging from single traumatic events to chronic unmanaged stress. It is estimated that, in the US, up to 9% of the population has had some degree of anxiety related to physical symptoms. As many as 20% have anxiety about their health, regardless of symptoms.⁹

Common causes and triggers of cyberchondria include:⁷

• Being prone to worrying in general—roughly 71% of those with cyberchondria also have generalized anxiety disorder⁹
• Past trauma or tragedy, whether chronic or acute
• Chronic unmanaged stress
• Having a close relative (parent, sibling) with cyberchondria or illness anxiety disorder
• Heightened awareness of bodily sensations
• Personal or family history of serious illness
• Negative experience with a medical professional which led to lack of trust or confidence in physicians
• Any major life stressor
• History of having a serious illness, even if recovered from that illness
• Needing more attention from family or friends

Common Co-Occurring Disorders

The treatment of cyberchondria is complicated by the fact that about two-thirds of people with this type of disorder are likely to have at least one other psychological disorder.⁷

Common coexisting disorders that occur alongside cyberchondria include:

• Somatic symptom disorder
• Obsessive compulsive disorder (OCD)
• Generalized anxiety disorder (GAD)
• Post-traumatic stress disorder (PTSD)
• Psychosis
• Certain personality disorders (especially borderline and histrionic)

How Can Cyberchondria Affect Mental Health?

Undiagnosed or untreated cyberchondria can produce detrimental mental health effects. When health anxiety is not controlled and develops into cyberchondria, it can come with a variety of negative mental health consequences.

Potential long-term outcomes of untreated cyberchondria can include:¹⁰

• Increased depression symptoms
• Decreased quality of life
• Worsening anxiety symptoms
• Worsening of obsessive-compulsive symptoms
• Using unproven strategies found on the internet that could worsen physical symptoms
• Higher risk of developing an internet addiction

How to Deal With a Cyberchondria Attack

Coping with cyberchondria requires some self-compassion and a willingness to respond in a new way to health anxiety. Professional help is available for those with persistent or frequent symptoms or excessive anxiety. In addition to considering professional help, there are a number of coping skills that are helpful in getting through an episode of cyberchondria.

Here are six coping strategies that work well for those with cyberchondria:

1. Avoid Self-Shaming

Many individuals with cyberchondria feel embarrassed or ashamed about their tendency to believe that they have a serious illness. This embarrassment can worsen the anxiety and even exacerbate the physical, stress-related symptoms.

2. Be Compassionate to Yourself

Your health-related fears come from anxiety that may be deep-seated and long-term. Such fears can be difficult to understand, but they are valid feelings that you should acknowledge with compassion.

3. Practice Relaxation Skills

Effective relaxation skills for anxiety can be self-taught. These include deep breathing exercises, guided imagery, and progressive muscle relaxation.

4. Challenge Your Thoughts About Being Ill

Journaling can be incredibly helpful when trying to untangle a web of difficult feelings. Write down your concern and then write down the evidence against this concern.

5. Talk to Your Physician

Talk to your doctor about your concerns and the anxiety you experience. Get a medical opinion if your concerns persist rather than jump to conclusions about the worst case scenarios.

6. See the Bigger Picture

Realize that there is a lot of misleading information online. Some of it is actually presented in a way to grab your attention and increase your fear.

When & How to Get Professional Help for Cyberchondria

Cyberchondria can be diagnosed and treated by various healthcare professionals, including psychologists, psychiatrists, and social workers. The person should start with their primary care physician in order to rule out underlying physical causes. There may be a referral to a medical specialist if the physician notes any significant symptoms.

It is possible to have cyberchondria as well as a legitimate medical condition. This could occur when the person’s anxiety about the medical condition is out of proportion to the seriousness of the illness. After addressing any presenting symptoms, the primary care physician will likely refer the person to a mental health specialist. That provider will make recommendations about the form of therapy that will be helpful.

Therapy Options for Cyberchondria & Underlying Conditions

Research has been done to determine the effectiveness of psychotherapy for the symptom identified as “health anxiety,” which is a very treatable condition.

The following are some types of therapy which have been identified as effective treatments for health anxiety:

Mindfulness Based Cognitive Therapy (MBCT)

Mindfulness based cognitive therapy (MBCT) has been demonstrated to be a useful model for patients with health anxiety. Patients who participated in MBCT in addition to “usual services” showed significantly lower health anxiety than those who received only the usual services. This improvement was apparent immediately after treatment and also at a one year follow-up assessment.¹²

Rational Emotive Behavior Therapy

Rational emotive behavior therapy has been shown to be helpful in learning to respond appropriately to harmless or ambiguous signals from one’s body. Clients learn distraction techniques to help them refocus on thoughts unrelated to their health anxiety or symptoms. They also learn relaxation techniques to manage the anxiety and its physical manifestations.¹³

Medication

Anxiety medications like selective serotonin reuptake inhibitors (SSRIs) have been helpful in managing the obsessive thoughts involved in cyberchondria and illness anxiety disorder. The basis for this treatment is the similarity between cyberchondria/illness anxiety disorder and OCD. The same medications which are helpful in treating OCD may be helpful in reducing the obsessive and compulsive aspects of cyberchondria.¹⁴

How to Help a Loved One With Cyberchondria

When a loved one suffers from cyberchondria, it may be helpful to provide information which reduces their embarrassment about their health anxiety. Many people with cyberchondria feel shame or embarrassment which only worsens their level of anxiety. You might also help to encourage them to get help from a mental health provider, and offer your assistance in doing that.

Here are some tips to help a loved one with anxiety and cyberchondria:

• Encourage them to speak to their primary care physician about their symptoms
• Encourage them to get help from a mental health professional for their anxiety
• Offer them assistance in finding a qualified therapist to work with them
• Offer to remind them of appointments with the therapist
• Acknowledge that searching for some medical information online is a normal behavior
• Acknowledge that excessive online searching makes anxiety worse and can be managed with help