By Cohen Marill

May 30, 2019


Katie Golden began a symptom diary when she was first diagnosed with chronic migraines eight years ago. She recorded her pain score, what she ate, where she went, the weather and barometric pressure—anything that would unlock the possible triggers of her recurring headaches and help ease the pain. But here’s the problem with meticulous tracking of symptoms: It can make you feel worse. Fifteen percent of adults in the US use an app regularly or occasionally to track symptoms of a disease. About as many use a sleep-tracking app to figure out whether they get enough shut-eye. Thinking (or worrying!) about symptoms, including insomnia, will make them more likely to occur. That is the nocebo effect, the dark sibling of the placebo effect—the mind-over-matter tendency for people to feel better if they take a sugar pill that they believe is an effective medication.“The body’s response can be triggered by negative expectations,” says Luana Colloca, a University of Maryland neuroscientist and physician who studies placebo and nocebo effects. “It’s a mechanism of self-defense. From an evolutionary point of view, we’ve developed mechanisms to prevent dangerous situations.” For Golden, a 38-year-old patient advocate who began with an Excel spreadsheet and later used specialized apps, tracking initially helped her provide better information to her doctor. But she became focused on every possible factor that could make her headache worse. “I’ve seen people become very obsessed with it. I was at one point,” she says. “What did I do at lunch? What did I do at dinner? It can be all-consuming.” The symptom tracker doesn’t just reveal your highs and lows. It produces a state of anxiety—and possibly more pain….SNIP

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