Aug. 7, 2003 -- It's got people worried: Glassy-eyed millions are downloading, instant messaging, emailing -- and they're doing it 24/7. Hours and hours after logging on, they can't walk away.
When does harmless Internet surfing cross into overuse, or -- as some say -- Internet addiction?
Nathan A. Shapira, MD, PhD, a psychiatrist in the McKnight Brain Institute at the University of Florida in Gainesville, has been studying this social problem since 1997. His latest paper, published in the current issue of Depression and Anxiety, outlines theories about this phenomenon.
When the computer age burgeoned two decades ago, researchers looked into computer and technology dependence. But they didn't find the same damage -- especially to relationships -- that Internet overuse seems to cause. In fact, psychiatrists are still trying to figure out what's going on -- and how best to treat the problem, he says.
"It's disheartening," Shapira tells WebMD. "We have this wonderful, very prevalent technology, but no one really knows the effect it's having on us."
Positive Becomes Negative
It's no secret: Many people use the computer to satisfy, stir up excitement, release tension, or provide relief -- whether it involves sex or not, he writes. Surfing, chatting, playing interactive games -- that's where those long hours go.
Make no mistake: Surfing has its upside, much like exercise or meditation, Shapira writes. "It's just that when Internet use becomes excessive, it can -- like other impulse disorders -- be distressing and disabling," he tells WebMD.
There likely is a psychological dependence -- as happens with TV, exercise, sex, or gambling -- rather than a physiological dependence as with smoking and alcohol abuse, Shapira writes.
In fact, Internet abuse often dovetails with another psychiatric problem. People with obsessive-compulsive disorder -- the same ones who compulsively gamble or shop -- may find the Internet an outlet, he adds. Depression seems to lead others to overuse, creating a viscous cycle fed by isolation.
The problem is not likely to ebb, not any time soon, he says. "People get a rush from being on three computers at once, keeping different things going on each one. And as speed gets better, the problem will likely get worse. Speed is part of the enticement."
Looking for Trouble
If you've said it too many times, "Come to bed, it's 2 a.m.," you may be living with an Internet junkie. Here are symptoms of a serious problem:
- They have a preoccupation in which the Internet becomes "irresistible."
- Using the Internet for longer periods than planned. "They say they'll be off in an hour, but three hours later they're still at it," says Shapira.
- Preoccupation causes significant problems in relationships, work, or other important areas of functioning.
- They try to cut back but can't.
- They have excessive thoughts about it.
- They get a sense of tension or arousal before doing it, and get pleasure afterward -- much as kleptomaniacs feel after lifting something.
- Their other responsibilities, such as paying the bills, get neglected.
All this rings true for drug and alcohol addiction, too, says Kristin Kassaw, MD, associate director of the Baylor Psychiatric Clinic in Houston. "It would take something like a 12-step program to change the behavior," she tells WebMD.
In fact, therapy does work to curb the problem, Shapira says. Cognitive behavioral therapy -- which involves learning how to deal with feelings that lead to excessive Internet use -- helps people control their urges and manage their time better, he says.
Loved ones are always the first to identify this problem -- those glued to the screen rarely recognize it in themselves, Shapira tells WebMD. "Interpersonal relationships are the first to suffer."
If you're concerned about a family member or friend, talk to them about it and express concern about Internet addiction. Then help them find a psychologist, he advises.