Long-term conditions, children and bad nights

When you have a diagnosed condition. People living with a long-term illness have real reasons to look things up, and real symptoms to interpret. The one look still works. Your trusted source may be your clinic's own material, a specialist nurse's phone line, or the charity for your condition. Ask your team the safety-net question in a general form. Which changes should I ring you about, and which can wait for my next review? Their answer is the instruction you follow.

When you're searching for someone else. Parents search their children's symptoms, and adult children search their parents'. It frightens them the way searching their own symptoms would, and they feel more responsible. The rule is the same, and it's firmer for young children. The NHS says to call 111 if you need advice for a child under five. A parent's sense that a child isn't right counts as information, and it should go to a person who can assess the child. Reading forums doesn't do that.

When you're pregnant. New sensations arrive weekly in pregnancy and the stakes feel doubled. You also have something most people don't, which is a midwife and a maternity unit with a phone number, whose job includes answering exactly these questions. Use that number. I'd keep off pregnancy forums late at night.

When the news is full of a disease. During an outbreak, or after a celebrity's diagnosis, many people's searching rises. The same points apply. Pick one official source, read what it says to do, and don't follow the rolling coverage.

When someone you live with has this habit. You'll have been asked, many times, whether it looks all right. Telling them not to be silly doesn't help, and neither does answering the question for the fortieth time. What helps is to ask what the page said to do, and whether they've done it. If the answer is to see someone, offer to sit with them while they book. If they've been frightened for weeks, show them the NHS page on health anxiety and let them read the list themselves.

When you slip. You'll have a bad night. Something will scare you, and an hour later you'll be on a forum with your heart pounding. It doesn't undo the weeks before it, and it doesn't prove the approach has failed. Close the browser and put a mark on the card. In the morning, do the one look properly, in daylight, and write down the instruction. Then work out what led to the slip. It's usually tiredness, stress, or a phone that had found its way back to the bedside.

When a search did once find something. Some readers will say that they searched, went to the doctor because of it, and it turned out to matter. I believe you, and I'm glad you went. What helped was that you went. One look at the NHS page would have sent you just as surely, days sooner and with less fear.

When it's more than a habit. Go back to the NHS's list. It includes constantly worrying about your health, frequently checking your body, always asking for reassurance, worrying that doctors or tests have missed something, and obsessively looking at health information. It also includes avoiding anything to do with serious illness, and acting as if you were ill. If several of those fit and they're affecting your life, the NHS advice is to see a GP. You can also refer yourself directly to an NHS talking therapies service without going through a GP. The usual treatment is cognitive behavioural therapy, often called CBT, and sometimes medicine for anxiety.

There's decent evidence that it helps. In a trial led by Peter Tyrer, 444 hospital outpatients with high health anxiety were given either five to ten sessions of CBT adapted for health anxiety or the clinics' standard care. A year later the therapy group had improved more, and about twice as many of them had reached normal levels of health anxiety. The proportions were small in both groups, at 14 per cent against 7, so this wasn't a cure for most. It did make a real difference, and the difference lasted two years. A smaller trial reported by Jill Newby and Eoin McElroy looked at searching in particular. People with severe health anxiety who did an online CBT course reduced their compulsive, distressing searching much more than a comparison group did.

Needing that kind of help says nothing bad about you. The NHS describes health anxiety as related to obsessive compulsive disorder, and explaining it to yourself doesn't make it stop.

When the fear is of dying, or you feel hopeless. If the worry about your health has tipped into despair, or you have thoughts of harming yourself, ask for an urgent GP appointment or call 111. Treat that as an emergency for a person to deal with, and don't search it.