Dr. Shraddha Banerjee

Is there anybody you know who uses internet excessively in a day, like for playing video games, visiting porn sites, for online shopping, using Facebook or visiting different chatting sites again and again? Is his or her excessive internet usage interfering with daily life, interpersonal relationships, work, school, etc.? If the answer is yes, then maybe he or she is suffering from internet addiction.

Internet addiction is a growing social issue which is being debated worldwide. Internet has become an inseparable part of our daily living. Problematic use of internet can lead us to various mental and physical problems. Surveys in the United States and Europe have indicated alarming prevalence rates between 1.5 and 8.2 percentage respectively.There are some criteria to classify and diagnose internet addiction disorder.

The following 5 criteria are required to diagnose internet addiction:

1. The individual remains preoccupied with the internet (thinks about previous online activity or anticipate next online session)

2. Needs to use internet with increased amounts of time in order to achieve satisfaction.

3. Has made unsuccessful efforts to control, cut back, or stop internet use.

4. Is restless, moody, depressed, or irritable when attempting to cut down or stop internet use.

5. Has stayed online longer than originally intended.

Additionally, at least one of the following must be present:

1. Risked the loss of a significant relationship, job, educational or career opportunity because of the internet.

2. Lying to conceal the extent of involvement with the internet.

3. Use internet as a way of escaping from problems or of relieving a dysphoric mood (like; feelings of helplessness, guilt, anxiety, depression)

There are different models available to explain the causal factor of internet addiction disorder. A comprehensive model of the development and maintenance of internet addiction by Winkler & Dorsing which takes into account socio-cultural factors, biological vulnerabilities like genetic factors, abnormalities in neurochemical processes, psychological predispositions and specific attributes of the internet to explain excessive engagement in internet activities.

Apart from the above discussed points, there are two significant psychological issues commonly seen in this group - a strong tendency to escape from the reality is there among internet addicts. These individuals find difficulty in facing the real world , may be due to certain conflict issues which evoke stress and anxiety in them. Involvement with technology and internet becomes a way out to get rid of the discomfort. Another psychological issue is the tendency to control the environment. Humans have a tendency to get a control over everything and it is a fact that we can't control other persons and situations. Internet addicts are involved in this compulsive behaviour may be because it is easy to get a control of technology and internet than the real world which is more threatening for them.

Impact of problematic usage of internet on social relationships has become alarming nowadays. The habit of surfing the internet continuously can be destructive indirectly. Even it has been seen that people drift away to the point that he/she cannot interact with people. Constant preoccupation with internet is damaging one’s social skills. People are losing touch with their life and their self-identity. Nowadays people don’t make efforts to establish face to face conversations, as many easy ways are available over internet, like chat messengers, email, etc. The constant effects of addiction to internet can lead an individual to such situations that involve various mental and behavioural problems like depression, anxiety, substance abuse, etc. The absence of social interaction also can lead to various physical effects on individual’s brain chemistry and the general physical health.

There have been lot of debates on which treatment modality is effective for the treatment of Internet Addiction Disorder. In many cases, multimodal treatments have been employed. It has been seen that there are lots of underlying psychological problems found in internet addicts, like anxiety, depression, etc. In such cases medications are also considered to be effective.

Apart from pharmacological interventions, different psychotherapeutic models are found to be very helpful in treating internet addiction like cognitive therapy, behaviour therapy, art therapy, family therapy, skill building training, etc. Studies have found cognitive behavioural therapy, in particular, is very effective and can bring better outcome among this group.

What is Addiction?

Addiction is a condition in which individual engages in using a substance or seeking a behaviour which leads to rewarding effects in the brain and it reinforce the individual to repeat the using or seeking behaviour again and again. Addiction develops gradually over a period of time and due to the repetition of same pleasure seeking pattern individual become physically and psychologically dependent on the substance or to any other object at the center of addiction.

People can get addicted to many substances like, alcohol, nicotine, drugs, solvents, etc. In case of these substances, physical and mental dependency both can occur. There are other objects and behaviours which also activate brain reward system in the same way and can make people dependent on them, like gambling, shopping, videogames, watching pornography, etc. But in case of these objects or behaviours, psychological dependency can be more prominent.

It has been seen that there are lots of other mental problems found among individuals suffering from any kind of addiction, like anxiety, depression, personality disorders, psychosis, etc. Individual who is addicted to a substance or an object or behaviour indulge into compulsive pattern of seeking the same inspite of their detrimental consequences. Consequences of addiction can be seen on person’s health, personal life, occupational life and social life. Addiction can lead to severe unmanageability in one’s life.

Especially when it comes to substances, like alcohol, nicotine or any kind of drugs, we must understand how the tolerance level of the brain develops? Tolerance develops when an individual no longer responds to a substance in the way he/she did at first. So, it takes a higher dose of the substance to achieve the same effect as when the individual first used it. This is why people with substance use disorders use more and more of a drug to get the “high” feeling that they seek.

A blog posted by an alcoholic:

“I always wished I could drink like other people. But I never could. I thought it was the third drink that got me into trouble. If I only had two, then I’d be fine. Thing is, once I put that first drink to my lips, I could no longer accurately predict what would happen next. I might go home, but I might not.

You’d think if I made it home, then my drinking was a success. Wrong! If I made it home after two drinks, there was an insatiable need raging within me and I was gonna take it out on you.  After all, you’re the reason why I had to come home. I would punish my family by being silent, or mean, or emotionally distant.

Looking back, it was never intentional. I didn’t purposely choose not to go home.  I didn’t leave the house with a suitcase containing a fresh set of clothes, a tooth brush and my cosmetics. Seriously, I was only going out for ‘a few.” 

If anybody can relate to this or can understand this, he or she can understand tolerance, powerlessness and unmanageability.

How to recover from addiction?

To be an addict can’t be anybody’s choice, but recovery can be one’s choice. The first key step to come out of your addiction is developing acceptance. For a person to admit their powerlessness in addiction to drugs or alcohol or to any other object at the center of addiction is a monumental first step to recovery. Powerlessness means the person do not have any control over his/her use of substance. Powerlessness may indicate weakness and helplessness; some may think it fosters a victim mentality. Acceptance starts developing when a person admit that he or she is powerless over the substance or object at the center of addiction and their life have become unmanageable because of that.

Addiction is a disease and recovery is not an easy process. Individuals who are already into the grip of addiction need to seek help. One cannot go through the journey of recovery alone. There is a myth that addiction is a habit and one can get out of it if he or she has the ‘Will Power’. It’s actually not true. To get out of the disease you need to develop ‘Skill Power’, like skills to understand your physical and psychological mechanisms when it comes to the substance or the object of addictions, skills to handle cravings, skills to be assertive enough to manage social cues, skills to deal with day to day life stressors, etc. And in this process of developing skills and maintaining your recovery you need help of professionals.

A complete treatment program has three important approaches. First one is psychopharmacological (medicine) approach, second is psychotherapeutic approach and the third one is the 12 step program of alcohol/narcotics anonymous. A combination of psychotherapies along with the basic essence of 12 step program can bring greater outcomes in individual suffering from addiction.