What the searching costs

You may think of the habit as costing the odd bad night. Add it up more carefully. Most of this chapter is my own reckoning, and I'll say where a study comes in.

Sleep. The search happens late, in bed, on a screen, and ends in fear. It would be hard to design a worse hour before sleep. Then the tiredness produces symptoms of its own the next day.

Fear that outlasts the search. White and Horvitz found that the anxiety from an escalated search persisted after the session ended and broke into people's activities on later occasions. You'll know this from the Wednesday after. The forum post comes back to you in a meeting and again at your child's football match, and your stomach turns each time.

More symptoms. Chapter 8 described the loop. Worry and poor sleep produce sensations, checking makes them worse, and each new sensation starts another search.

A bent relationship with your doctor. It can bend in either direction. Some people book repeated appointments for reassurance that doesn't hold. Others, as chapter 7 said, are too frightened to go, or have talked themselves out of going. Neither gets the benefit of a calm consultation in which the doctor hears a plain account of the symptom.

The people around you. A partner gets asked whether the mole looks bigger, or whether the leg seems weaker, or whether they think it's serious. They say no, it helps for an hour, and the question comes again. The NHS lists always asking people for reassurance among the signs of health anxiety. Over months a partner will tire of answering, or will answer without looking, and you'll notice when they do.

Money. Some people pay for private scans, tests and supplements bought at one in the morning. They don't settle anything. A clear result reassures you about as long as a reassuring page does, and the supplements you bought on a forum's advice do nothing for a twitch that coffee caused.

Attention. Hours of each week go into reading about diseases you don't have. The habit also takes up part of your attention during the day. While you work and talk you're also monitoring your body for the next thing.

Trust in your own body. I think this is the largest cost. Someone without the habit who notices a twitch thinks "that's odd" and forgets it. You can't do that any more. Every sensation has become a question, and the only tool you have for answering it is the one that makes things worse. You've ended up afraid of a body that, on the evidence so far, has been working well.

It's worth putting a number on some of this. Go back to the history you looked at in chapter 1, add up the hours for the month, and multiply by twelve. Write the figure down. It's the time you spent last year reading about illnesses.

Against that, count what the searches have found. Over the past year, how many of them turned up a real illness that needed treating? If any did, you'd have got there sooner and more calmly by ringing the surgery on the first day.