Internet addiction disorder is one of the fastest growing and most controversial topics in psychological research today. Internet addiction disorder research has been identified as a public health risk in many countries including China and Korea but in the United States, we are just starting to recognize the disorder. 

The prevalence rate for internet addiction disorder in modern research varies between .3% to 38% of the population. This can be attributed to the fact that there is no one standard agreed upon diagnostic criteria or questionnaire to assess the disorder that all practitioners use. If your child is playing video games online or is using the internet, whether that is watching YouTube videos or social media or playing games to the point where they are ignoring homework, making friends, or missing out on social opportunities then you can certainly consider this to be a primary or secondary behavioral health issue.

Internet Addiction Disorder: Is it Real?

Sometimes, parents or grandparents have a hard time understanding how internet addiction disorder can be real. Most of us grew up with very simple video games such as Pac-Man or Pong. For those of us that have never experienced modern video games, we just don’t see how video game or internet addiction disorder can be real.

Overall, the gaming industry produces revenues of over $100 billion dollars. Psychologists and statisticians are employed to make games as habit-forming as possible. Remember, these companies are loyal to their shareholders, not to the minds of the young people to which they are trying to sell their products. As a result, much thought and research has gone into making games of today as addicting as possible. Constant measurable growth and variable reward schedules make games as addicting as gambling or many substances more commonly associated with addiction.

Internet addiction disorder can start like any other habit.  A teen comes home from school, goes online, and finds a chatroom where they are accepted.  Maybe they had a hard day at school and were bullied, or maybe they got into an argument with their teacher.  The internet gives the child a level playing field.  Bullies can be blocked instantly.  Therefore, the child can interact with others, but they have not learned any real-world skill of how to deal with a bully.

Internet Addiction Disorder: How Does it Start?

There are multiple different models or series of internet addiction disorder. There is the ACE model, which suggests that internet addiction disorder comes from Anonymity, Convenience, and Escape. There is a “Phase Model” of pathological internet use where social, cultural and biological factors are taken into consideration. There is also the Cognitive Behavioral Model of problematic internet use.

Generally, parents report that the problem began slowly, and the child began using the internet more and more until the habits took over and snowballed out of control.  Parents describe their child as “only feeling successful online” which did not happen overnight.  As a child learn how to become good at video games, they miss out on social practice and it becomes harder to break the behavioral pattern.  At this point, internet use becomes a true addiction.

With all addictive behavior, it takes more and more to reproduce the pleasurable effect that the individual initially felt.  This is where teens can get caught in a self-perpetuating loop of feeling bad at school, going online at home, and only feeling successful online at home.  It takes up more of their time and further opportunities for socialization are lost.  Additionally, when a teen in caught in this loop they begin to become more detached and feel like “mom and dad just don’t understand.”  To the person with internet addiction disorder, being online is that only thing that makes them feel good and likely the only social support they have, so they just don’t see that harm it is causing.

Brain Processes Behind Internet Addiction Disorder

We do know that there is a mechanical process in the brain that represents internet addiction disorder, no matter what we call it. Dopamine can be released along with other neurochemicals. It is known that addictions like internet addiction disorder activate a combination of sites in the brain associated with pleasure.

We also see a tolerance effect with these associated pleasure receptors increasing the need for more game time to produce the same stimulation for the reward center in the brain. Internet addiction disorder may also lead to dopamine release specifically in the reward structures of the brain involved with other addictions such as the nucleus accumbens.

Many clinicians believe there are a variety of mental disorders that co-occur with internet addiction disorder. ADHD and depression along with anxiety and interpersonal sensitivity as a result of the spectrum base disorders can be comorbid or be exacerbated through internet addiction disorder.

Internet Addiction Disorder Treatment: Unplugging and Detox

The goal of treatment with internet addiction disorder is not total abstinence. Because we are living in a technology-driven world, individuals must learn how to manage their internet use and to both identify and reduce harm associated with their internet use. Developing insight and awareness is the first step in this process.

Most treatment facilities for internet addiction disorder are going to involve an initial detox period. During this initial detox period, a patient will experience withdrawal symptoms from their internet addiction. Withdrawal signs from internet addiction disorder include cravings, anger, frustration, and physical acting out.

The good news is that the initial withdrawal symptoms generally subside after 1 or 2 weeks although cravings may continue for weeks if not months.

Internet Addiction Disorder Treatment: Building Insight

After the initial withdrawal period, patients must begin the insight building phase of treatment. Depending on the style of the therapist or the clinical approach of the facility, factors that led to the patient’s overuse or misuse of the internet will be explored.

The patient will learn that their internet addiction disorder played some kind of role in regulating their emotions. For example, a patient might discover that they developed their internet addiction disorder because of an underlying fear of social rejection. This social anxiety needs to be treated concurrently with the internet addiction disorder. Otherwise, the patient might find another escape that is just as harmful as the internet addiction disorder such as drugs or alcohol.

Helping the patient reconnect with others and create a peer group is often the next step in internet addiction disorder treatment. It is not uncommon for internet addiction disorder treatment facilities to have groups where social skills are taught.  Additionally, the focus can be on teaching very basic skills such as how to have a conversation or introduce yourself to others.

Additionally, the facility should offer a wide range of other activities that the patient might participate in so that they can find a productive hobby or other way to connect with friends.  Often, individuals with internet addiction disorder will create a reality where, “All of my friends are online, and if I stop this behavior, I’ll lose all of my friends.”  In some respects this is true.  However, the patient lacks the understanding that if they unplug they can find different ways to connect to others and to be just as successful offline as they are online making friends.

Internet Addiction Disorder Treatment: Next Steps

The first step in treating internet addiction disorder is to sit down and have a conversation with the person you are concerned about. Most of the time, the individual with the addiction will try to minimize the negative effects of their behavior and will minimize the harm it’s causing in their life. Additionally, individuals with internet addiction disorder often do not see the future consequences of continued use.

The harm from unaddressed internet addiction disorder can be both physiological and psychological. We know that excessive internet use can lead to physical symptoms such as obesity and psychological symptoms including depression, anxiety, and frustration about not being able to connect in the real world.

If you know someone that is affected by internet addiction disorder it is recommended to intervene as soon as possible. Like many health conditions, early intervention is the key. There have been extreme cases where individuals blur the lines between reality and living in an online fantasy world.  This becomes increasingly problematic to treat psychotic symptoms go beyond just teaching basic social skills or replacement activities to connect with others.

Sometimes though, it is quite clear that the person with internet addiction disorder is quite talented at computers and they will most likely end up being a programmer, web designer, or some other type of computer operator for a living. This is all fine, but increases the need for recognition of the harm that can be caused by sitting for excessive amounts of time and detaching from a social network.  If your teen plans to work with computers and you believe they are headed towards an internet addiction, it is recommended you intervene now so that they will be armed with skills, strategies, and insight related to reducing the harm associated with internet addiction disorder.