This picture, captured at Beijing’s military bootcamp-style Internet Addiction Treatment Center (IATC) by award-winning photographer Fernando Moleres, depicts a heavily disorientated and socially stunted 13-year-old Lu Jun Song, an internet addict having his routine cerebral dysfunction EEG check upon arrival.

The center is among the hundreds of inpatient units found in China, Korea and Taiwan. Coupled with prevention and internet addiction screening programs in schools, it’s an approach to tackling a life, family, community and society-damaging addiction that is only just beginning to be seriously addressed by government initiatives in other countries.

With Facebook-addicted moms forgetting to feed or pick up their kids from school, online gambling addicts plunging their family into debt, predominantly male internet porn addicts losing their jobs and wives, as well as addicted online gamers that lose their minds and even their lives to virtual worlds, we are not short of news stories reporting the shocking consequences of internet addiction.

Internet addiction in all its guises is essentially a continually growing worldwide pandemic, with studies across multiple countries es­timating the prevalence of such addictions to be between 0.7% and 11% of the population, rivaling – and in some cases exceeding – alcohol and drug addiction statistics.

Hints at the causes of this extremity lie in the rapidly developing neurological understanding of internet addiction. Both neural activity and connectivity, as well as losses and gains in grey and white matter – and even gene expression – in regions all over the brain reflect those found in substance abuse addicts. This includes violated homeostatis in the amygdala-striatal system and associated altered reward sensitivity linked to cravings and impulsive internet use, as well as grey matter loss and altered activity in predominantly prefrontal regions linked to loss of control and inhibition of internet use.

In contrast, a recent fMRI study that used a go/no-go par­adigm to examine people with low-to-medium levels of Facebook addiction symptoms, largely involved changes to the amygdala-striatal system only and not cognitive control regions. This hints that there may be a neurological turning point on the road to addiction, where excessive alterations in executive functioning impedes inhibition of internet use behaviors, pushing excessive internet dependence towards full-blown life-destroying internet addiction.

Enter psychologist Dr. Young, who was the first to ever research internet addiction. She wrote the first book, Caught in the Net, to identify internet addiction as a new disorder, was the keynote speaker at the first international congress on internet addiction last year, a recent TED speaker (see video below), and founded the Center for Internet Addiction in the US.

Who is most at risk of progressing from dependence to addiction?

Dr. Young and her colleagues put together one of the first statistical models that outlined the primary risk factors. These include poor coping style and high relief expectations that mediate internet addiction through other predisposing factors like depression and social anxiety, feeling socially isolated and unsupported, low self-efficacy and shyness.

Learning skills to cope well with difficult or painful situations and having no expectancies that the Internet can be used to increase positive or reduce negative mood, should in theory cut risk factors off at the root, and thus reduce the risk of developing internet addiction.

How should we treat internet addiction?

When it comes to treatment and recovery, Dr. Young reminds us that:

This isn’t like treating and using an abstinence model like you would drugs or alcohol, it’s really more about a food addiction, it’s looking at moderated, controlled and positive use of this technology… not villainizing technology, but really trying to say how is this promoted in our own daily lives.

At Dr. Young’s US Center for Internet Addiction, they encourage “digital diets” and “digital nutrition”, which do exactly what they say on the tin. With digital dieting, the length of time you use internet technology is reduced, while with digital nutrition it’s about controlling what you click on. As Dr Young puts it, “it’s the difference between eating a bag of potato chips or fruit and veg.”

How can we protect ourselves from internet addiction?

Thankfully, she has outlined three simple strategies to better manage internet technology in our everyday lives and protect ourselves from the harmful effects of excessive internet device use:

1. Check your checking. Reduce the amount of times you check your phone or computer for messages and updates. Instead of checking Facebook/email/news 30 times a day, perhaps twice is more than enough.
2. Set time limits. Do not let hours of internet use go by unregulated, set a time limit to prevent a quick check online ending in an all-night internet binge.
3. Disconnect to reconnect. Have 100% device-free time in your daily and weekly life. In her TEDx talk, Dr Young challenges us all to a 48-hour digital detox.

While Dr. Young has presented the only uniquely designed treatment model for internet addiction, cognitive behavioral therapy–internet addiction (CBT-IA), applying CBT with harm reduction therapy (HRT), internet addiction has yet to be classified as a behavioral addiction.

With a lack of government initiatives and inpatient treatment centers in many countries, it is up to us as individuals to step up and use the double-edged sword that is the Internet with respectfully measured control.

References

What You Need to Know About Internet Addiction by Dr. Kimberly Young @ TEDxBuffalo

Brand M, Young KS, & Laier C (2014). Prefrontal control and internet addiction: a theoretical model and review of neuropsychological and neuroimaging findings. Frontiers in human neuroscience, 8 PMID: 24904393

Turel O, He Q, Xue G, Xiao L, & Bechara A (2014). Examination of neural systems sub-serving facebook “addiction”. Psychological reports, 115 (3), 675-95 PMID: 25489985

Young KS (2013). Treatment outcomes using CBT-IA with Internet-addicted patients. Journal of behavioral addictions, 2 (4), 209-15 PMID: 25215202

Brand M, Laier C, & Young KS (2014). Internet addiction: coping styles, expectancies, and treatment implications. Frontiers in psychology, 5 PMID: 25426088

Image via Fernando Moleres