		Thomas S. May, M.A. Medical Writer
Home Portfolio Contact		Internet Addiction: Myth or Reality? By Thomas S. May, Medical Writer The top five signs of Internet addiction, according to a joke that has been circulating on the Net lately are: #5) You respond to your e-mail while listening to voice mail while eating lunch at your desk. #4) You check your e-mail and it says "no new messages." So you check it again. #3) You list your computer as your closest living relative in case of emergency. #2) You get in a cab and tell the driver to take you to www.301parkavenue.nyc.com. #1) You name your children AOL, Eudora, and Dotcom. Can surfing the Net really drive you crazy? Those of us who spend a lot of time sitting in front of a computer browsing the Web or talking to strangers in chat rooms know that the Internet can be quite "addictive." But can it really be so dangerous that you develop serious mental health problems requiring medication or some other forms of treatment? Some experts believe it is quite possible to become pathologically addicted to the Net and develop "Internet Addiction Disorder." Others are more skeptical, however. Problems galore Dr. Kimberly Young is a clinical psychologist at the University of Pittsburg at Bradford, and she is considered by many as "the world's foremost Cyberpsychologist." She believes that Internet addiction is a very real and serious condition, which can lead to numerous problems, including social isolation, sleep deprivation, depression, and marital discord. Internet addiction can also cause work-related problems such as reduced productivity and absenteeism, Dr. Young suggests. Workers affected by this condition may spend a lot of time on the Internet talking to others in chat rooms, for example, or looking at pornographic sites during working hours. "There have been a number of lawsuits for wrongful termination, because of this," she says. "Workers who have been fired have launched wrongful dismissal suits, based on the Americans with Disabilities Act, arguing that Internet addiction is a 'protective mental disorder', and you can't fire somebody for that. They [the employers] need to offer rehabilitation." Surprising results A recent study conducted by Dr. Nathan Shapira, a University of Florida psychiatrist, appears to confirm that pathological Internet use can have very significant and deleterious effects on a person's life. "This was the first study to do a face-to-face, systematic, psychiatric evaluation of individuals with problematic Internet use, and some of the findings were quite surprising," Dr. Shapira has told CBS HealthWatch. "The group of people we looked at couldn't control their Internet use. They would sit down for an hour and be on for several hours or all night long, and it was causing problems in their life: social, occupational, and financial difficulties. People would often be doing many things like downloading, chatting, and playing a game simultaneously. For example, I had one individual who was a successful businessman, but he was having problems in his social life. He would be on three different computers all at once in his home—and watching a movie at the same time," Dr. Shapira said. One of the most surprising findings of the study, according to Dr. Shapira, was that all of the subjects had other, long-term psychiatric illnesses besides problematic or pathological Internet use. The study also found that when some of these people received treatment for the associated or underlying disorder, they seemed to gain control of their Internet use as well. Cause or effect? Based on the above study, one may wonder whether the Internet itself can cause mental illness, or perhaps can only serve as a trigger or catalyst for other psychiatric conditions. Dr. Shapira seems to think that the latter might, in fact, be the case. "Many of these people have had long-term psychiatric illness, which apparently interacted negatively with the Internet. So one could characterize the Internet like a 'psychiatric stress test'," he said. Another question that is often asked regarding excessive or pathological Internet use is whether it can be called an 'addiction'. Dr. Shapira admits he does not like to use the term addiction when referring to problematic Internet use. "Under the current diagnostic codes for psychiatry, for a condition to be classified as an addiction, there has to be an ingested substance like alcohol, for instance. There is a category of disorders called 'impulse control disorders', and we believe that problematic Internet use belongs in this category," he says. Whether problematic Internet use is called an 'addiction' or an 'impulse control disorder' is no trivial matter, Dr. Shapira argues. "I think it's important to differentiate, because there has been a lot of research on impulse control disorders, and they commonly have associated psychiatric disorders, like mood disorders such as depression or bipolar disorder. We know that if you treat the associated mood disorder, you can often help the impulse control disorder as well," he adds. Nevertheless, Dr. Shapira agrees that, regardless of what we call it, problematic Internet use is a very serious—and growing—problem. "My sense is that this will get worse," he says. "I base that on the fact that everyone I've evaluated so far liked the speed and liked to do more than one thing online. I think as the prevalence and the size and the speed of the Internet expands, this problem is actually going to get worse." *Sidebar:* Are you hooked? In her book *Caught in the Net: How to Recognize the Signs of Internet Addiction and A Winning Strategy for Recovery*, Dr. Kimberly Young lists eight questions that can help people find out whether or not they are addicted to the Internet: 1. Do you feel preoccupied with the Internet (think about previous on-line activity or anticipate next on-line session)? 2. Do you feel the need to use the Internet with increasing amounts of time in order to achieve satisfaction? 3. Have you repeatedly made unsuccessful efforts to control, cut back, or stop Internet use? 4. Do you feel restless, moody, depressed, or irritable when attempting to cut down or stop Internet use? 5. Do you stay on-line longer than originally intended? 6. Have you jeopardized or risked the loss of significant relationship, job, educational or career opportunity because of the Internet? 7. Have you lied to family members, therapist, or others to conceal the extent of involvement with the Internet? 8. Do you uses the Internet as a way of escaping from problems or of relieving a dysphoric mood (e.g., feelings of helplessness, guilt, anxiety, depression)? Patients are considered "addicted" when answering 'yes' to five or more of the above questions.

Thomas S. May, M.A.

Medical Writer

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Internet Addiction: Myth or Reality?

By Thomas S. May, Medical Writer

The top five signs of Internet addiction, according to a joke that has been circulating on the Net lately are:

#5) You respond to your e-mail while listening to voice mail while eating lunch at your desk.

#4) You check your e-mail and it says "no new messages." So you check it again.

#3) You list your computer as your closest living relative in case of emergency.

#2) You get in a cab and tell the driver to take you to www.301parkavenue.nyc.com.

#1) You name your children AOL, Eudora, and Dotcom.

Can surfing the Net really drive you crazy?

Those of us who spend a lot of time sitting in front of a computer browsing the Web or talking to strangers in chat rooms know that the Internet can be quite "addictive." But can it really be so dangerous that you develop serious mental health problems requiring medication or some other forms of treatment?

Some experts believe it is quite possible to become pathologically addicted to the Net and develop "Internet Addiction Disorder." Others are more skeptical, however.

Problems galore

Dr. Kimberly Young is a clinical psychologist at the University of Pittsburg at Bradford, and she is considered by many as "the world's foremost Cyberpsychologist." She believes that Internet addiction is a very real and serious condition, which can lead to numerous problems, including social isolation, sleep deprivation, depression, and marital discord.

Internet addiction can also cause work-related problems such as reduced productivity and absenteeism, Dr. Young suggests. Workers affected by this condition may spend a lot of time on the Internet talking to others in chat rooms, for example, or looking at pornographic sites during working hours. "There have been a number of lawsuits for wrongful termination, because of this," she says. "Workers who have been fired have launched wrongful dismissal suits, based on the Americans with Disabilities Act, arguing that Internet addiction is a 'protective mental disorder', and you can't fire somebody for that. They [the employers] need to offer rehabilitation."

Surprising results

A recent study conducted by Dr. Nathan Shapira, a University of Florida psychiatrist, appears to confirm that pathological Internet use can have very significant and deleterious effects on a person's life. "This was the first study to do a face-to-face, systematic, psychiatric evaluation of individuals with problematic Internet use, and some of the findings were quite surprising," Dr. Shapira has told CBS HealthWatch.

"The group of people we looked at couldn't control their Internet use. They would sit down for an hour and be on for several hours or all night long, and it was causing problems in their life: social, occupational, and financial difficulties. People would often be doing many things like downloading, chatting, and playing a game simultaneously. For example, I had one individual who was a successful businessman, but he was having problems in his social life. He would be on three different computers all at once in his home—and watching a movie at the same time," Dr. Shapira said.

One of the most surprising findings of the study, according to Dr. Shapira, was that all of the subjects had other, long-term psychiatric illnesses besides problematic or pathological Internet use. The study also found that when some of these people received treatment for the associated or underlying disorder, they seemed to gain control of their Internet use as well.

Cause or effect?

Based on the above study, one may wonder whether the Internet itself can cause mental illness, or perhaps can only serve as a trigger or catalyst for other psychiatric conditions. Dr. Shapira seems to think that the latter might, in fact, be the case. "Many of these people have had long-term psychiatric illness, which apparently interacted negatively with the Internet. So one could characterize the Internet like a 'psychiatric stress test'," he said.

Another question that is often asked regarding excessive or pathological Internet use is whether it can be called an 'addiction'. Dr. Shapira admits he does not like to use the term addiction when referring to problematic Internet use. "Under the current diagnostic codes for psychiatry, for a condition to be classified as an addiction, there has to be an ingested substance like alcohol, for instance. There is a category of disorders called 'impulse control disorders', and we believe that problematic Internet use belongs in this category," he says.

Whether problematic Internet use is called an 'addiction' or an 'impulse control disorder' is no trivial matter, Dr. Shapira argues. "I think it's important to differentiate, because there has been a lot of research on impulse control disorders, and they commonly have associated psychiatric disorders, like mood disorders such as depression or bipolar disorder. We know that if you treat the associated mood disorder, you can often help the impulse control disorder as well," he adds.

Nevertheless, Dr. Shapira agrees that, regardless of what we call it, problematic Internet use is a very serious—and growing—problem. "My sense is that this will get worse," he says. "I base that on the fact that everyone I've evaluated so far liked the speed and liked to do more than one thing online. I think as the prevalence and the size and the speed of the Internet expands, this problem is actually going to get worse."

Sidebar:

Are you hooked?

In her book Caught in the Net: How to Recognize the Signs of Internet Addiction and A Winning Strategy for Recovery, Dr. Kimberly Young lists eight questions that can help people find out whether or not they are addicted to the Internet:

1. Do you feel preoccupied with the Internet (think about previous on-line activity or anticipate next on-line session)?

2. Do you feel the need to use the Internet with increasing amounts of time in order to achieve satisfaction?

3. Have you repeatedly made unsuccessful efforts to control, cut back, or stop Internet use?

4. Do you feel restless, moody, depressed, or irritable when attempting to cut down or stop Internet use?

5. Do you stay on-line longer than originally intended?

6. Have you jeopardized or risked the loss of significant relationship, job, educational or career opportunity because of the Internet?

7. Have you lied to family members, therapist, or others to conceal the extent of involvement with the Internet?

8. Do you uses the Internet as a way of escaping from problems or of relieving a dysphoric mood (e.g., feelings of helplessness, guilt, anxiety, depression)?

Patients are considered "addicted" when answering 'yes' to five or more of the above questions.