A woman sits at her desk supposedly working, but she’s actually furtively checking her Facebook page and other social media over and over. A college student cuts classes and gets by on little sleep to compulsively play online games. A young couple’s relationship is threatened because one spouse is neglecting a real life marriage to indulge in a virtual fling and nightly visits to online porn sites.
Researchers, psychologists, and psychiatrists are debating whether these people are simply drawn to the Internet for hours on end like millions of others or their behavior signals an addiction as serious as a drug or alcohol problem.
Although internet "addiction is being widely studied, it isn’t officially recognized by the US medical and insurance communities as a mental disorder. That’s because internet addiction is not included in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM), the standard classification of mental ills. Internet gaming disorder is, however, being considered for possible inclusion in the next edition of the DSM.
But the lack of an official diagnostic code doesn’t mean that psychiatrists and psychologists aren’t seeing and treating people who appear to have a behavioral problem with the Internet that produces some symptoms similar to substance addiction. Jerald J. Block, MD, a psychiatrist at Oregon Health and Science University and an advocate for internet addiction being recognized as a true addiction and mental disorder, cites physical problems that can accompany the problem. In his practice, he’s reported patients who suffered from nausea, tremor, sweating, shakiness, fatigue, anger, and irritability after a computer “binge.”
Psychiatrist Marc Potenza, MD, director of Yale’s Program for Research on Impulsivity and Impulse Control Disorders, has treated patients whose internet use causes them to engage in clearly non-healthy and even potentially dangerous activities, such as foregoing important social activities and using the Internet to set up sexual encounters with strangers.
Ryan Van Cleave’s internet problem was so severe he considered suicide. Before facing up to his addiction, he sat in front of a computer playing online games for 80 hours a week while his life spiraled out of control. He lost his job as a university professor and shut out friends and family. “I got so far into it, I couldn't realize how I got there," Van Cleave told CNN.
In extreme cases, deaths have been attributed to Internet addiction. In one nightmarish example, a South Korean couple let their 3-month-old baby starve to death while they remained at an Internet café, unable or unwilling to stop playing an online game about a virtual child. In England, a 20 year old suddenly died from a blood clot that doctors surmised was caused by the young man sitting in one position during multiple 12-hour Internet games.
Internet addiction is a global phenomenon that can adversely affect both health and interpersonal relationships, according to researchers from the University of Hong Kong who analyzed data from almost 90,000 people in 31 countries. The study found the overall rate of internet addiction is 6 percent, with the highest incidence, almost 11 percent, in the Middle East.
China and South Korea, countries where high numbers of people are diagnosed, have Internet addiction treatment facilities for youngsters and adults. Some are camp-like with barbed wire fences and strict, boot camp-type atmospheres.
In the U.S., the first hospital-based in-patient Internet addiction treatment center opened in 2013 at Bradford Regional Medical Center in Pennsylvania. The voluntary, 10-day program treats up to four people at a time who have been diagnosed with serious Internet addiction — and who can afford the program’s $14,000 out-of-pocket fee. Without official psychiatric recognition as a mental health disorder, internet addiction treatment isn't covered by medical insurance.
Psychologist Kimberly Young, founder of the program, noted it isn’t the hours spent online but the consequences that define a severe internet addiction problem. "Like any other addiction, we look at whether it has jeopardized their career, whether they lie about their usage or whether it interferes with relationships," she said.
After evaluation, patients in the Bradford program are put into “digital detox” and kept from all Internet and phone use for at least 72 hours. Next come therapy sessions and educational seminars to help patients break their compulsive Internet behaviors.
People with internet addiction, unlike those cutting cigarettes or alcohol out of their lives, can’t give up the source of their addiction — the Internet — entirely in a world that relies on that technology daily. So the goal of treating Internet addicts is to enable them to use the Internet in a healthy way, Young explained.
If you or someone you know is having social or personal problems because of over-the-top Internet use, where can you find help? If you can’t cut back on Internet usage on your own, consider talking to a psychologist or psychiatrist who has experience treating the problem. Working with a 12-step program may be useful for some, according to psychiatrist Ronald Pies, MD, a professor at SUNY Upstate Medical University and a clinical professor at Tufts University School of Medicine.
“Many individuals thought to have an Internet addiction also have a variety of concomitant or contributing psychiatric problems or disorders, such as schizophrenia, major depressive disorder or obsessive-compulsive disorder. It seems likely that, in many cases, such well-recognized conditions may better explain the person’s abnormal Internet use than a new and discrete diagnosis called ‘Internet addiction,’“ Pies said.
“However, this view may change as we investigate familial disposition, genetic patterns, biological underpinnings and response to treatment among those diagnosed with Internet addiction. In short, we have much to learn about this diagnosis, and the proverbial jury is still out.”
April 20, 2015
Christopher Nystuen, MD, MBA