WSJ Interactive:
October 5, 1999
Page One Feature
On the Internet, Diseases Are Rampant,
Playing to Worries of Hypochondriacs
By ANN CARRNS
Staff Reporter of THE WALL STREET JOURNAL
Melissa Woycechowsky sat in her bedroom one night late last year, bathed
in the glow of her computer screen, crying softly as she surfed the Web for
confirmation of what she already knew was true.
She had noticed a tingling in her feet. There were various odd aches. "I was
sure I had multiple sclerosis," recalls Ms. Woycechowsky, a real-estate
agent near San Diego, Calif.
Ms. Woycechowsky isn't suffering from MS. What she did have was an acute
case of what might be called cyberchondria. "I saw a banner Web ad for a
multiple-sclerosis medicine," she says, "and I knew I had it."
The 'Worried Well'
The Internet is making it easier than ever to be a hypochondriac. The
anxious used to have to trudge to the library to research symptoms in tomes
like the Physicians' Desk Reference or the Merck Manual
(www.merck.com/pubs/mmanual1). Now, the explosion of medical information
on the Web -- there are an estimated 15,000 health-related Web sites -- has
provided a powerful new tool for wired worrywarts, including the "worried
well," on which they can pore over highly technical medical journals and
commiserate electronically from their homes.
The uniquely interactive properties of Internet chat rooms and bulletin
boards also amplify the impact of the anecdotal information shared there,
bolstering medical fact with first-person testimonials. "It's more powerful than
just reading about symptoms in a book," says Ms. Woycechowsky, 30 years
old. "You're talking to someone, hearing about their symptoms -- and you
think you have them, too."
Those testimonials and the sheer mass of unedited information -- while they
may be powerful -- can also be less reliable than more established sources
of medical information. "There's a conspiratorial tone suggesting that the
real facts are being kept from people, that your doctors won't tell you this,
but here's the real story," says Arthur Barsky, a Harvard University
psychiatrist.
Toxic Fears
One of Dr. Barsky's patients, for instance, became agitated by an Internet
reference to a toxic side effect of a medication she'd stopped taking
decades earlier. "People are becoming alarmed about things that aren't that
much of a threat," he says.
The Internet has obviously provided invaluable information to the truly ill.
And Carla Cantor, who wrote about her experience of overcoming
hypochondria in the book "Phantom Illness," (www.hmco.com2) scoffs at the
notion that the Web will ever surpass traditional media as the favored
implement of torment for health worriers. "A big poster on the subway saying
one in 500 women have lupus -- now, that's much more scary than what you
find in the Internet," she says.
Yet doctors say that potential hypochondriacs are drawn to the Internet.
They start out with a desperate need to reassure themselves that their
headache isn't caused by a brain tumor, but the more they research
symptoms, the more convinced they become that they are in dire trouble.
It is only if unsubstantiated fears begin to damage a person's social or work
life, or persist for longer than six months, though, that abnormal psychology
is suspected. The current thinking is that hypochondriasis, as it is formally
known, may be related to obsessive-compulsive disorder and can be treated
with psychotherapy and medication. Studies estimate that 4% to 10% of
people seeking primary medical care may have some degree of the
condition.
Brian Fallon, a New York psychiatrist who studies the phenomenon, says
that one of his patients became convinced she had "mad cow" disease; this,
despite the fact that the ailment hadn't been reported in the U.S. "She was
tortured by the Internet" searching for details, Dr. Fallon says. Apparently,
so are plenty of others. A recent inquiry using the AltaVista search engine
turned up nearly 9,000 Web pages that mention "mad-cow" disease, also
known as Creutzfeldt-Jakob disease.
And even those who insist the Internet's health offerings are generally
beneficial can slip into panic mode. Jackie Needleman, vice president of
allHealth.com (www.allhealth.com3), the health channel of iVillage.com,
scared herself briefly last week while reading articles on the Internet about
breast cancer, in preparation for a feature to boost awareness of the
condition. One day in the midst of her research, she felt a sharp pain in her
right breast and thought she detected a lump. "I convinced myself that I
knew the symptoms of breast cancer, and I knew this was it," she says.
"Anxiety was an understatement."
She calmed herself down within "minutes," she says, realizing that she had
just started a strenuous new exercise program and had probably pulled a
muscle. But just in case, she scheduled a visit to her doctor, who
pronounced her healthy.
Nicole Schwab, a 22-year-old college student in Phoenix, says she found out
late last year how the Web can fuel anxiety. She had what she now suspects
was a panic attack that made her heart beat rapidly, but she initially feared
food poisoning or a heart attack and started plugging symptoms into Internet
search engines.
"Because of the way the Internet works, you always get something back,"
she says. "So if it hurts to take a deep breath, or you have pain in the chest,
it could be lung cancer, or pleurisy, or anything. And as far as my
personality goes, I tend to worry about it. Before the Internet, I would have
said, 'Oh, it's just a pulled muscle.' But now you can kind of design your own
illness."
AIDS Web sites routinely attract visitors who fear they are infected with the
HIV virus even though they have tested negative. "We see it all the time,"
says Rick Sowadsky, an AIDS hotline coordinator in Nevada. "The Internet
feeds their fears because they can learn about symptoms they didn't have
access to before. They go from one Web site to another. It's a vicious
cycle."
Fueling Concerns
Mr. Sowadsky finally authored an article, titled "Are You a 'Worried Well'
Person?" His recommendation to such people: "Get off the Internet."
Not bad advice. Sites abound that seem to delight in fueling concern with
details of exotic infections or newly discovered terrors. "New Cause of
Sudden Death in Young People Found," blares a headline on
cbs.medscape.com (cbs.medscape.com4), a new consumer site. The story
describes bacteria, never before seen in humans, that can cause a fatal
heart inflammation.
"People love diseases," shrugs Alyssa Robinson, who operates the
"Wonderful World of Diseases" Web page (www.diseaseworld.com5). It
features a section dedicated to details of the Ebola virus, which causes
victims to bleed profusely. "There's sort of a gore to it that people find
fascinating," says Ms. Robinson.
Fellow Travelers
Creepy as that sounds, sites discussing neurological or autoimmune
diseases may be even more enticing to hypochondriacs, who often worry
about illnesses that have difficult-to-pinpoint symptoms. Ms. Woycechowsky,
who has her hypochondria under control, says she favored a neurological
health forum run by Harvard, and suspects other visitors were worriers, too.
"I just know they're lurking there," says Ms. Woycechowsky, "because there
are all these postings saying, 'I have this symptom, could I have multiple
sclerosis?' "
Even people who have diagnosed medical conditions can worry
unnecessarily about complications they learn about on the Web. Seth
Feltheimer, a New York general practitioner, ran into that problem with a
patient he diagnosed with sarcoidosis, a condition that can cause chronic
inflammation of the lungs that, under certain conditions, can be fatal. This
particular patient wasn't at risk for the condition's more severe effects, but
she became convinced otherwise after reading on the Internet about a
patient who ended up on a respirator.
"Based on her Internet readings, she thought she was dying," sighs Dr.
Feltheimer, who read to the patient from a medical text to persuade her that
she was unlikely to get worse.
Even doctors who welcome the Web's plethora of health information as a
valuable resource for educating patients say those prone to suggestion can
go overboard. "People become obsessed," says an exasperated Everest
Whited, a family practitioner in Pflugerville, Texas. "You can give yourself
gray hair worrying about every possible side effect."
URL for this Article:
interactive.wsj.com
Hyperlinks in this Article:
(1) merck.com
(2)
hmco.com
(3) allhealth.com
(4) cbs.medscape.com
(5) diseaseworld.com
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