Although behavioral addictions have become increasingly accepted as genuine conditions—just like drug or alcohol addictions—in recent years, Internet addiction is still struggling to find widespread acceptance. Does the lack of recognition of the condition in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (the DSM-V, commonly called the “bible” of mental health conditions) represent a fundamental difference between Internet addiction and things like compulsive gambling, or is it simply that more data is needed? Answering the question may seem simple, especially for those who’ve seen firsthand what Internet addiction can do, but it actually requires treading a lot of interesting ground and uncovering some facts that make Internet addiction more problematic for diagnosis and treatment than other addictions.
The Reality of Behavioral Addiction
The first hurdle for Internet addiction gaining acceptance is an issue that’s now resolved in the eyes of experts. Originally, people who specialize in treating addiction, like Yale University psychiatrist Marc Potenza, would deal only with substance addictions. However, it wasn’t long until he realized that many patients had issues that weren’t so clear-cut as repeated ingestion of substances. For example, some people suffered from an uncontrollable urge to pull their hair out, and others gambled themselves into massive amounts of debt but couldn’t stop. At the time, these were not considered to be addictions, but people like Potenza started to question this viewpoint.
The basic similarities are hard to dispute: both behavioral and substance addictions can be described as the inability to control how much you engage in a particular activity, even if there are numerous negative consequences, and both lead to urges and cravings to use or engage in the behavior. Additionally, people struggle to stop doing things like gambling in the same way alcoholics struggle to stop drinking.
Potenza co-authored a paper reviewing two decades of research in the field of behavioral addiction in 2013 and, as well as outlining these arguments, showed genetic and neurochemical similarities between the two types of addiction. He and his colleague found that some of the genetic mutations seen in those addicted to alcohol or drugs are also seen in those struggling with things like gambling addiction, and that the dopamine pathway in the brain is affected by both substances and problematic behaviors. This paper also covered Internet addiction, pointing out that it’s associated with the same type of impacts on the dopamine system as other addictions and genetic differences commonly seen in depressed individuals.
Is Internet Addiction Accepted as a Genuine Condition?
The question of whether the Internet could be considered addictive was raised much sooner than you might think. Back in 1997, when AOL dialup was the norm and loading a basic webpage took about as long as downloading a song does today, researchers had noticed addiction-like problems in some people. Some used the Internet so much that they struggled at work and school and also suffered social isolation and difficulties in their relationships.
By 2008, the accumulated data was sufficient for experts to recommend the inclusion of Internet addiction in the then-unreleased DSM-V, with papers arguing that the condition led to excessive use, tolerance, withdrawal and negative consequences — just like traditional substance addictions. In 2012, a study covering almost 12,000 adolescents from across Europe found that 4.4 percent suffered from “pathological Internet use” and another 13.5 percent displayed signs of problematic Internet use.
The DSM-V was released, and while pathological gambling was included, Internet addiction didn’t gain official recognition. The issue appears to be largely one of insufficient data, however. Psychologists now almost all accept the reality of behavioral addictions, but even gambling addiction took a lot of time to be recognized.
Problems Classifying and Treating Internet Addiction
First, what constitutes too much use of the Internet? Does being online for 12 hours make you twice as likely to be an addict as being online for six hours? If you excessively gamble online, are you addicted to gambling, the Internet or both? What about social media and online gaming—are these Internet addictions or social media and video gaming addictions, respectively? In essence, is the Internet the subject of the addiction or merely the medium through which the addiction is pursued? For all of these questions, the answer is far from obvious.
Potenza argues that it’s the “connectedness” of the Internet itself that creates the addiction, which would mean that the Internet was the subject of the addiction, but this is hardly a settled issue.
When it comes to treatment, there are similar problems. The Internet is an integral part of daily life, so an Internet addict can’t be advised to avoid going online in the same way as you’d tell an alcoholic not to drink or a problem gambler to steer clear of casinos. Imagine trying to treat a heroin addiction in somebody who had to shoot up each day as a crucial part of his or her job; that’s pretty much the challenge with Internet addiction treatment.
Using the Internet to Fight Internet Addiction?
The available evidence shows that Internet addiction is almost certainly a genuine condition, but it’s not one we can treat like drug or alcohol addiction. Perhaps one solution to the unique issue is to use the Internet itself to treat the condition. Apps exist that allow you to block specific websites or that help reduce the time spent on your smartphone, and Potenza suggests that such technologies could be used alongside traditional treatment to help Internet addicts. As long as research into the issue continues, the next DSM seems likely to include Internet addiction, and hopefully by that point there will be more tailored treatments available for those struggling with it.