Dear Lifehacker,

Is it possible for someone to actually be addicted to the Internet? I mean, we all love our phones, and maybe I check mine whenever it buzzes, but is that the same as being addicted to alcohol or drugs? I've heard of people being so addicted to video games that they forgot to eat or feed their kid. How much of it is real psychology and how much is technophobic hype?


Sincerely,

Glued to My Gadgets

Dear Glued,

You hear a lot about people "addicted" to the Internet, whether it's the Internet as a whole, or articles telling you how to stop being "addicted to Facebook" or "addicted to your phone." Sometimes they actually do mean real addiction, but more often, those articles use "addiction" in the colloquial, where it's just inconvenient to be without access to the Internet—not a real illness.


Even so, is it possible to be actually addicted to the Internet? We sat down with Roger Gil, friend of Lifehacker and trained marriage and family therapist, to get to the bottom of the question.

Understand What Addiction Really Is (and What It's Not)

You probably already understand the difference between "real" addiction, like an addiction to alcohol, drugs, or gambling, and a "conversational" addiction, like being "addicted" to chocolate or your favorite TV show. Even so, to understand whether Internet "addiction" falls into one (or both) of those categories, we need to understand how addiction is quantified. Luckily, there is a very specific definition. According to the American Society of Addiction Medicine:

Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors. Addiction is characterized by inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response. Like other chronic diseases, addiction often involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.


Simply, addiction is a psychological or physical dependence on a substance or behavior to the point where it interferes with normal life, and pursuit of it becomes a person's primary focus. Roger explained that people struggling with addiction have difficulty refraining from the substance or behavior, and often makes poor choices—even if they know there are negative consequences—in order to get to it. They also usually experience serious physical or mental stress when deprived.

This is a simplified take on a complex topic, but you get the point. For example, it's one thing to not be able to imagine going a day without Facebook, but it's another to actually plan activities around using Facebook, to avoid any activities that may require you not, get seriously stressed out when you can't, or to find yourself unable to stop checking Facebook even though it's inappropriate in that situation.


What the Experts Say About "Internet Addiction"


The American Psychiatric Association’s tome of record, the Diagnostic and Statistical Manual of Mental Disorder V (DSM-V), does not list "internet addiction" at all. Some have called for its inclusion as a named disorder, but others note that "internet addiction" seems like an umbrella term that erroneously targets a medium as the cause of behaviors that need treatment. In reality, the behaviors may be explained by other conditions, like ADHD, depression, or OCD, and the medium is just a pathway. For example, someone addicted to online gambling is still addicted to gambling. The fact that the Internet is their method of choice for gambling changes the treatment approach, but not the diagnosis.

For now, the DSM-V lists "Internet gaming disorder" as an area worth additional study and research. Some of that is due to high profile cases around the globe of people injured or killed involving video games.


However, Roger explained, this doesn't mean that video games are addictive, or that even the Internet is addictive. It just means that video games may be an outlet for other compulsions or psychological conditions, or the people in the cases above were mentally ill in other ways that can already be addressed. He explained:

People that display things that might look like “internet addiction” often display symptoms that are characteristic of other mental health conditions. For example, someone with ADHD may be able to be online for hours on end, however their symptomology is more consistent with ADHD. As you mentioned, the Internet content is diverse. To label people with a preoccupation for cybersex with the same label as someone who is preoccupied with chat rooms would not seem to do either of their conditions justice. “Internet addiction” doesn’t describe whatever the person is fixated on. I’ve spoken with several colleagues who specialize in addiction and substance abuse disorders who are against codifying “internet addiction” as it’s own diagnosis. Those individuals were in favor of using the term “Internet” as a modifier for other conditions. For example, some with a gambling addiction whose primary means of gambling occurs online may have the term “Internet” or “internet type” tacked onto their diagnosis for codification purposes.


Similarly, Roger said that it's important to remember that addictions aren't compulsions. Compulsions are irrational, repetitive behaviors (e.g., repetitive hand washing, or someone who needs to tap the door three times before locking it.) Compulsions often look strange to laypeople, but they're a different issue. The person with the compulsion may have difficulty refraining, but they normally don't become a person's primary driver or focus in life. This feature at GigaOM explains in more detail.

However, in countries like China and South Korea, some organizations aren't taking the same approach. Controversial "training camps" have popped up all over many southeast asian countries to address "internet addiction" or "gaming addiction." However, there are more than a few horror stories about those camps, largely due to deaths, poor treatment, and a lack of professional standards, (and, as we pointed out, the mischaracterization of "internet addiction" as something that needs a different, harsher hand than other, already treatable mental health issues.)


Bottom Line: Addiction Is Real, but the Internet Is Likely a Symptom, Not a Cause


At the end of the day, the room is still divided over "internet addiction," but not over whether it's real. The question is whether the Internet presents substantially new and different challenges for identifying, diagnosing, and treating addictions and other disorders we already treat. Roger elaborated:

The jury is still out on Internet-related “disorders/addictions” so it’s too early for specific labels. For now, mental health professionals will likely diagnose with other mental health conditions and treat for those while trying to attempt to address any problematic Internet use.


Most psychiatrists agree that someone addicted to shopping in brick-and-mortar stores has fundamentally the same condition as someone addicted to shopping online, although the condition may manifest differently. Similar treatments work, and while addressing the online aspect of one patient requires different tricks than addressing the physical aspect of the other, they're the same disorder.

Of course, this is a hotly debated topic. In a few years, we may sing a completely different tune. That's the beauty of science and research: As new information comes to light, we're free to adjust and adapt to the best available information at the time. For now, though, there's no need to worry that you're "addicted to the Internet," or you need to "break your Facebook addiction." If you're worried about how much time you spend online or think it's unhealthy (or know someone in that boat,) there are plenty of things to do about it. Even so, odds are it's a symptom of a root cause that needs to be addressed—something that may manifest in other ways even without the Internet, Facebook, or video games at play, and something worth talking to a professional about.


Sincerely,

Lifehacker

Roger S. Gil, MAMFT is a trained marriage and family therapist who has treated individuals and families struggling with relational and mental health issues. You can follow him on Twitter at @rogergil79 . He offered his expertise for this post, and we thank him.


Title image made using Tachyglossus (Shutterstock) and Nemo . Additional photos by Melanie Tata , Michael Mandiberg , and Marcos Mesa Sam Wordley (Shutterstock).

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