Internet Addiction Explained
Few inventions have changed the world as thoroughly – and as rapidly – as the internet. For some people, unfortunately, the internet has become an all-consuming obsession, wreaking havoc upon their personal lives and permanently damaging their future prospects.
Internet addiction disorder (IAD) is a condition characterised by excessive use of the internet to an extent that has detrimental consequences for a person’s daily life.
Because internet use is a relatively recent phenomenon compared with most other activities known to be habit-forming, and because its potential to result in addiction has only been recognised even more recently (effectively, within the last two decades) research into the condition is still very much in its infancy. Furthermore, there are a great many different activities which can comprise “internet use”, some of which may themselves potentially be associated with distinct disorders and addictions (for example, online gambling, pornography and shopping), while the internet has quickly established itself as such an integral aspect of daily life, both professional and domestic, that it can be hard to identify if and when a person’s internet use has become problematic even if it takes up many hours of each day (a timeframe which for most other activities would be immediately recognisable as being symptomatic of a serious problem).
As a result, there is no firm consensus amongst medical and psychiatric professionals regarding the extent to which internet addiction should be recognised as a condition in its own right, let alone the establishment of an agreed diagnostic framework.
Neither the current (fifth: DSM-5) edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association (probably the leading diagnostic publication worldwide focusing exclusively on mental health) nor the International Classification of Diseases (ICD – a classification manual produced by the World Health Organisation which is much broader in scope than the DSM, covering as it does all aspects of health) recognise internet addiction as its own disorder, though the DSM-5 contains a note stating that internet gaming disorder, seen by many as one type or subcategory of IAD, could potentially be considered as a disorder in its own right should further research support such a classification.
Therefore, what constitutes internet addiction disorder may vary from one diagnosing physician to the next, and many different social, cultural and personal factors may impact upon the nature of such a diagnosis. However, one silver lining for addicts desperate for help is that many facilities and organisations treating addiction in the UK in particular are finding success through a combination of a broad-brush approach treating behavioural addiction generally and highly tailored, bespoke treatment plans based on a very close analysis of an individual addict’s specific situation and requirements; in many cases a formal diagnosis of internet addiction disorder has not been a prerequisite for successful treatment.
Why people become addicted to the Internet
Types of Internet Addiction
The number and variety of activities which can now be carried out over the internet are staggering (especially considering that the World Wide Web is still less than 40 years old). Pretty much anything in the sphere of human activity which does not require actual physical contact with people or objects can be done online (and with advances in robotics and artificial intelligence increasing in pace by the day, even that physical barrier may soon be broken for many activities); moreover, the mobile/smartphone revolution has seen the great majority of individuals in the developed world (and a growing proportion of those in the rest of the world) carrying powerful computers with them at all times, with the internet only a swipe of the screen away. As a result, almost every activity traditionally viewed as habit-forming can be engaged in – or at least facilitated – over the internet, at will.
In 1995, American psychiatrist Dr Kimberly Young founded the Center for Internet Addiction Recovery, having become aware of the extent to which internet use was already coming to dominate certain individuals’ lives, at significant cost to marriages and other important relationships. In a paper published in 1999, Young highlighted five behavioural subtypes under the umbrella term of “internet addiction”:
- cybersex addiction (the compulsive use of internet pornography and/or engagement in cybersex)
- cyber relationship addiction (the obsessive pursuit of and participation in online relationships)
- net compulsions (compulsive online gambling, shopping, trading etc)
- information overload (compulsive and/or obsessive surfing the web or database searches)
- computer game addiction (playing videogames – distinct from gambling – over the internet
The categories proposed by Young are not the only potential subtypes of IAD which might be recognised. The emergence of the likes of Facebook, Twitter and Instagram have had a revolutionary impact upon people’s behaviour both on and off-line, and many psychologists now propose social media addiction as a stand-alone disorder.
Virtual worlds such as Second Life – distinct from video games in that they typically do not propose any final objective but rather provide an environment within which alternative existences and personal development may be enjoyed – are often the focus of obsessive and/or compulsive behaviours. Video streaming sites – especially YouTube – have created a whole new ecosystem of celebrities and fans, and some aspects of those platforms may be seen to drive various addictive behaviours.
These impulse control problems – including those cited by Young – may have their own diagnostic frameworks and symptoms, and may need to be approached somewhat differently from each other in terms of treatment. The extent to which the fact that they have the internet in common makes them subtypes of internet addiction disorder rather than conditions in their own right will vary from one diagnosing authority to the next, as will the degree to which that classification has any significance in terms of the way treatment is provided.
Stages of Internet Addiction
Various different stages of progress have been proposed for internet addiction disorder – as indeed they have for both behavioural addictions and substance abuse disorders generally – but, again, these can differ significantly from one doctor/expert to another. As few as three, and as many as 10, distinct stages of addiction have been identified.
It is important to remember that every case of addiction is unique, just as each individual is unique, and one person’s progress through the condition may look very different from another’s. Any proposed stage scheme or timeline should be considered as a rough guide only; just because your own experiences, or those of someone close to you suffering from internet addiction, do not match perfectly with any given scheme does not mean that you (or they) are not addicted to the internet.
A basic stage scheme for the progress of IAD may look as follows:
- Initial exposure: in the developed world today, most people’s first encounter with the internet takes place at a very young age (indeed, only time will tell how such lifelong immersion in the connected world will affect the development of human psychology). However, exposure to specific habit-forming activities may happen at any age (becoming more likely as young people gain independence from the parents as they grow up). That initial exposure may not feel especially significant at the time, though it is likely at least to pique interest and create the desire to repeat the experience.
- Increased familiarisation: an individual may begin to engage in the activity in question on a regular basis, becoming familiar with relevant platforms, terminology and any subculture surrounding it. If financial outlay is required, they may begin to make initial investments.
- Growing obsession: the activity comes to take a greater and greater significance within the individual’s life, starting to impact upon their schedule in terms of commitments and obligations missed, and relationships neglected, in order that they may continue to engage in the activity. They will become increasingly preoccupied with the activity, possibly finding concentration on other matters difficult, and might begin to display furtive and/or deceitful behaviour to conceal the amount of time – and possibly money – they are spending online. If they find themselves forced to spend time away from the activity they may become irritable and agitated and begin to suffer mood swings. Sleeping and eating patterns may also begin to be affected, resulting in fatigue and slight cognitive impairment.
- Addiction: engaging in the activity in question is now the individual’s overwhelming or even sole priority. Important relationships may be broken as a result of the individual’s thorough neglect of them and/or their deceit; professional or academic performance may suffer to the point at which the individual loses their job or place. Their physical health may suffer considerably as a result of chronic sleep deprivation, unhealthy eating, and a lack of fitness, while a range of co-occurring mental health conditions may manifest including depression, anxiety and other addictions. If the activity in question requires financial input, they may now suffer extreme financial hardship as a result compulsive spending. They may also experience destructive isolation, loneliness and dysphoria, from which they seek to escape by spending ever greater periods online in a vicious circle which has the potential to result in complete physical and mental collapse.
Risk Factors of Internet Addiction
Interpersonal difficulties including low self-confidence, poor communication skills and introversion are seen as prominent risk factors for the development of internet addiction, as people suffering from them may find internet-based relationships much easier to handle much less likely to end in emotionally devastating rejection. People who lack solid social connections and support typically gravitate towards virtual communities and relationships.
A history of addiction or other mental health disorders is a strong indication of the susceptibility to internet addiction; the most common co-occurring disorders associated with internet addiction disorder are major depressive disorder, attention deficit disorder (ADD) and attention deficit hyperactivity disorder (ADHD).
Low levels of parental education, high frequency of using social networking and gaming sites and a low age at which an individual first used the Internet are all also considered significant risk factors for internet addiction disorder.
Signs & Symptoms of Internet Addiction
As with any addiction, someone suffering from internet addiction disorder is likely to strive to conceal their condition from those around them making some signs and symptoms difficult to observe. It is also important to bear in mind that due to the aforementioned lack of consensus regarding internet addiction’s diagnostic status, there is no unanimity over what do and do not constitute symptoms of addiction.
Someone suffering from internet addiction disorder is likely to suffer from some or all of the following psychological symptoms: depression; anxiety; feelings of profound guilt and remorse; agitation and irritability; and feelings of euphoria when engaged in internet-based activity.
Addicts typically neglect even their most treasured relationships; internet addicts in particular may seem to be entirely apathetic about their relationships preferring to spend their time online rather than with their partners. They may find intimacy more and more difficult, preferring the virtual world. Strain placed on relationships by addiction may drive the addicts further and further into isolation and further away from resolving relationship difficulties.
Although few physical symptoms are likely to manifest in the short term, over the long term internet addiction may be identified by the manifestation of any of the following: weight gain or loss; insomnia and generally disturbed sleep patterns; headaches; backache; blurred vision; and carpal tunnel syndrome. Serious – even potentially fatal – health disorders can result from regular very prolonged sessions of activity online; various cases have been reported of users collapsing and dying from seizures, stroke and other conditions after engaging in unbroken internet use for days on end.
As noted above, deceitful and furtive behaviour may indicate that someone is struggling with an addiction which they wish to conceal from others. Other behavioural symptoms may include an inability to make appointments or deadlines; frequent disappearances; constantly checking and/or using one’s phone; disengagement from social circles and family; absenteeism; an inability to concentrate; financial difficulties manifesting in regular requests to borrow money; and a disregard for personal hygiene and appearance.
Internet Addiction and Mental Health
Mental health disorders are known to both contribute to the development of addiction and result from addiction itself. As noted above, depression and attention deficit disorders (ADD and ADHD) are the two most common co-morbidities associated with internet addiction, though a wide range of other disorders can also play a role, including anxiety disorder, substance abuse disorders, learning disabilities, agoraphobia, bipolar disorder and many others.
On the other hand, internet addiction disorder is considered to be a likely driver of disorders again including (but not limited to) depression, anxiety disorder and substance abuse disorders. Some of the consequences of internet addiction disorder may themselves contribute to the development of subsequent mental health disorders; for example, sleep deprivation can cause a range of problems including, potentially, psychosis.
Long-Term Impacts of Internet Addiction
Clearly, some of the mental health consequences of internet addiction disorder listed above can have long-term if not permanent ramifications for the affected individual: each year a growing number of people kill themselves as a result of depression associated with internet addiction disorder, while psychosis can lead to acts of extreme violence and/or self-harm which can themselves have obvious permanent consequences. Most of the physical symptoms of internet addiction listed above are long-term consequences,
and some may be difficult or impossible to treat successfully: for instance, chronic back pain can be extremely debilitating and the prognosis is often relatively disheartening. As also noted above, protracted periods of unbroken internet usage can result in a variety of potentially fatal disorders including seizures and stroke.
Internet addiction can have devastating financial consequences if the activity or activities engaged in require financial outlay (especially related to gambling and shopping); moreover the impact of addiction upon an individual’s professional life can be very severe resulting in job loss and impaired chances of future employment which can in turn have a catastrophic impact upon their finances.
Previously treasured relationships such as marriages can be destroyed by internet addiction (with obvious further consequences for the addict’s mental health) while an addict’s relationships with other family members and close friends can be similarly irreparably damaged.
Internet Addiction in Kids
Children in the Western world now spend on average over 40 hours per week in front of screens, and many experts have voiced significant concerns over the susceptibility of children and young people to Internet addiction disorder. Dr Kimberly Young has highlighted the following signs that should prompt action on the part of parents concerned about their children’s internet use:
- Loses track of time while online
- Sacrifices needed hours of sleep to spend time online
- Becomes agitated or angry when online time is interrupted
- Checks email or online messages several times a day
- Becomes irritable if not allowed access to the internet
- Spends time online in place of homework or chores
- Prefers to spend time online rather than with friends or family
- Disobeys time limits that have been set for internet usage
- Lies about amount of time spent online or “sneaks” online when no one is around
- Forms new relationships with people he or she has met online
- Seems preoccupied with getting back online when away from the computer
- Loses interest in activities that were enjoyable before he or she had online access
- Becomes irritable, moody or depressed when not online
Parents are advised to set robust boundaries around and limits on internet usage where possible; to encourage activities which do not require a computer or smart phone including regular outdoor activities where possible; and to speak honestly, openly and with love, but also firmly, to any children who may be exhibiting signs of problematic internet usage.
Treatment for Internet Addiction
Treatment for internet addiction typically there is that given to individuals suffering from other behavioural addictions; psychotherapy lies at the heart of treatment, and may be provided during a stay in residential rehabilitation (rehab), along with various other elements designed to improve an addict’s general health and their outlook upon life. Because, as discussed above, there is no single globally recognised diagnostic basis for identifying internet addiction, approaches to treating it do vary from one doctor or treatment facility to the next.
How Internet Addiction is Diagnosed
The aforementioned lack of consensus around how to diagnose and categorise internet addiction means that various different diagnostic frameworks have been drawn up which may be used by individual doctors and addiction specialists. Dr Kimberly Young has drawn up an eight-point checklist, the Young Diagnostic Questionnaire (YDQ), according to which anyone fulfilling any five of the following eight criteria will be diagnosed as having an internet addiction:
- Preoccupation with the internet
- A need for increased time spent online to achieve the same amount of satisfaction
- Repeated efforts to curtail internet use
- Irritability, depression, or mood lability when internet use is limited
- Staying online longer than anticipated
- Putting a job or relationship in jeopardy to use the internet
- Lying to others about how much time is spent online
- Using the internet as a means of regulating mood
Some doctors use Young’s extension to the YDQ, the Internet Addiction Test (IAT) comprising 20 questions with each answer placed on a five-point scale. Scores range from 20-100, with anyone scoring over 70 classed as a problematic internet user.
Other screening instruments which may be used in a diagnosis include the Internet-Related Addictive Behaviour Inventory (IRABI), the Chinese Internet Addiction Inventory (CIAI), the Compulsive Internet Use Scale (CIUS) and the Problematic Internet Use Scale (PIUS).
As noted, treatment may vary from one facility to the next, and will typically be tailored to each individual’s specific requirements; different therapies may be deployed, and timetables for treatment may be very different from one case the next.
Individual, group, or family therapy
Therapy can be provided in different settings: individual (one-on-one with the therapist); group (several different patients working together in a session with one therapist); and family (the patient being treated in the company of their loved ones – who may also benefit from therapy).
Behaviour modification describes behaviour change procedures applied in therapy, using both positive reinforcements to encourage positive behaviour and negative reinforcement, including punishment, to discourage negative behaviour and thoughts.
Cognitive Behavioural Therapy (CBT)
Cognitive behavioural therapy is a therapy model (technically a “psycho-social intervention“) focused on uncovering and addressing negative and unhelpful thought patterns and behaviours through dialogue with a therapist. CBT was originally designed to treat depression but has since been recognised to be extremely useful in the treatment of addiction, partly because of the way patients are encouraged to develop coping mechanisms which can be used to prevent relapse.
Dialectical Behavioural Therapy (DBT)
Dialectical behavioural therapy, a modified form of cognitive behavioural therapy (CBT), is an evidence-based psychotherapy model used to change damaging patterns of behaviour including substance abuse and behavioural addictions (including internet addiction disorder). It combines standard CBT techniques with concepts such as mindfulness and acceptance, some of which are derived from meditative practices found in Buddhism.
Equine therapy – or equine-assisted therapy (EAT) – uses activities involving horses to promote benefits for mental health; patients can engage in riding, grooming, and feeding horses whilst discussing their feelings and behaviours, in a manner which helps them in social, emotional, cognitive or behavioural ways.
Art therapy uses creative expression as a therapeutic technique. Patients can benefit psychologically from engaging in the creative process, while the therapist can interpret the patient’s self-expression in art and discuss the significance of what is produced.
Recreation therapy is a systematic process using leisure activities as a means of addressing the patient’s needs and promoting psychological and physical health and recovery. Such activities may include creative arts, sport, learning activities, games and many others.
Reality therapy is based on the perspective that the patient is suffering from the unsuccessful attainment of their basic needs, and focuses on the patient’s present state (rather than past actions), encouraging them to discover their true desires and to develop behaviour aimed at realising them.
Prevention for Internet Addiction
With many addictions – both behavioural and substance-related – abstinence is a core component of prevention. However, the internet has become such an integral part of human life that abstaining from its use is practically impossible for many people. As a result, prevention needs to be focused upon limiting an individual’s use of the internet as much as possible – for example,
Any activities which have been proving especially problematic – gambling, pornography et cetera – need to be avoided where possible. An individual may benefit
from having a basic phone which does not allow access to the internet, and if sharing a house with others, from informing housemates (including family) of their condition and keeping any internet-connected devices in communal areas.
Want to know if you are addicted to the internet? Answer these seven questions:
- Do you experience distress and agitation if you are unable to get online at will?
- Has your internet use led to arguments with loved ones?
- Do you find yourself accessing the internet as a way of dealing with negative moods?
- Has your use of the internet caused you to spend more than you can afford online?
- Has your internet use had a negative impact on work?
- Do you regularly get less sleep than you should as a result of your internet use?
- Do you lie to others about the amount of time you spend online?
If you’ve answered yes to three or more of those questions, you may be suffering from internet addiction disorder: contact your GP and/or an addiction specialist as soon as possible.
Internet Addiction Facts/Statistics
- Just under 10% of people admit that they have tried to hide the scale of their internet use from friends and family, and/or from their bosses.
- Every three months, the internet grows by 25% in size.
- Only 39% of people say that they could stop using the internet at will.
- Around three-quarters of children aged 13 to 17 could be considered addicted to the internet.
- Women are more likely than men to describe themselves as having an internet addiction.
Ready To Get Help?
As with every addiction, only those who are able to acknowledge their condition will benefit from treatment; however, if you are prepared to own up to an internet addiction, there are now many facilities across the UK treating addicts and getting them back living happy and healthy lives. You could soon be one of them.
Get help today
If you can acknowledge your internet addiction and reach out for help, don’t let another day go by in which you struggle under the burden of this condition. Contact your GP and an addiction specialist immediately to discuss treatment options which may be available to you.
Take control of your life – get started on the road to recovery.
Addiction can make you feel like you’ve lost control of your life – but with help, you can take back that control and resume a life of happiness and success. Speak with your GP and an addiction specialist, and take the first steps on the path back to a happy and healthy life.
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