“In daily life, people encounter bodily sensations that they cannot with 100% certainty determine are benign, and individuals with elevated levels of AS and IU experience increased anxiety in response to these normal sensations when others would not,” said Norr. This could compel the individual to repeatedly seek reassurance that they are okay through online searching. “However, as online medical information often does not provide a definite answer, these individuals may continue to experience increased anxiety, and in turn, continue their online searches, leading to the development of cyberchondria.”
Another possible factor may be the temporary relief provided by the checking behavior when health anxiety is triggered. “You check, you feel better, you start feeling anxious again, you check some more, you feel better,” and on and on, said Singh. His and Brown’s study found that some health-anxious individuals did experience a sense of relief after searching, but those with higher levels of health anxiety reported more tension post-search.
Among these more anxious individuals, there was a correlation between health anxiety and measures of internet addiction, such as being unable to decrease usage and experiencing negative effects on work and social life as a result of it. “If future research finds that addiction to the internet for health-related purposes does exist, then perhaps one day we may be able to treat it similar to how we currently treat other addictions, like alcohol and gambling,” said Singh.
In the meantime, there are steps clinicians can take to help patients reduce health anxiety. They “should generally be aware of whether their clients present with elevated levels of anxiety sensitivity or intolerance of uncertainty, as targeting those risk factors has been shown to both prevent the development of future anxiety symptoms as well as reduce current ones,” according to Norr.
Several studies have found that cognitive-behavioral therapy (CBT) is effective in treating health anxiety, and the internet can be the very tool to deliver it. A 2011 randomized controlled trial demonstrated that internet-based CBT also led to improvement among 40 people with hypochondriasis.4 The approach “was based on a CBT model for health anxiety, emphasizing the role of avoidance and safety behaviors, internal focus and interpretations of bodily sensations as signs of serious illness.” It included mindfulness training to teach participants to observe bodily sensations without engaging in reassurance-seeking behaviors.