Are anxious or depressed people more likely to use the internet? Are they also more likely to be addicted to it? In this article I discuss the psychology of the controversial topic of addiction to internet.
Let me start by talking about what makes internet attractive and perhaps addicting. For one thing, internet is easily accessible. Nowadays you can access internet from almost any place (on the bus, at home, at work, on vacation, etc) and using any of numerous devices.
Secondly, internet is anonymous. What that means is that you can pretend to be whoever you want to be online. You can be the very opposite of yourself. You can be the best version of yourself. You can even be two people or five or twenty.
Thirdly, internet can serve as an escape from the real world. Escape from work issues, family problems, from the daily routine, from the many unsatisfactory aspects of life. People can lose themselves in the world of gaming, gambling, shopping, anonymous socializing, and virtual sex.
But is excessive internet use an addiction?
The American Society of Addiction Medicine defines addiction as a disease associated with an “inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response.”¹
But excessive internet use can not be considered a typical addiction. Indeed, internet addiction is often categorized as a behavioral addiction. These are addictions that do not involve the use of an external chemical substance. Other examples include work or shopping addiction.
There is a lot of debate about whether behavioral addictions are true addictions.
Some researchers believe that an addiction must involve the use of a substance. Others believe that as long as we can observe certain reactions, like tolerance (which refers to body adapting to previous levels of addictive behavior, thus making higher levels of that behavior necessary in order to experience the same degree of pleasure as before), or withdrawal (discomfort experienced when we suddenly stop doing the addictive behavior), then it is an addiction.
So what is Internet Addiction (IA)? IA refers to an excessive preoccupation with internet access and usage. According to an influential paper published in 2008, IA has four components:²
- Excessive use (e.g., to the point of neglecting eating or sleeping)
- Withdrawal (e.g., feeling angry/depressed if unable to use the internet)
- Tolerance (e.g., spending more and more time on the internet)
- Negative repercussions (e.g., fatigue, anxiety, social isolation, etc)
There is no consensus, however, on the exact criteria that should be used for diagnosing IA.
Because researchers use different criteria to define IA, it is also difficult to determine how prevalent IA really is. I have looked at dozens of studies, and as expected, the estimates vary significantly. Kuss and colleagues, looking at 27 studies involving children/adolescents, noted that the prevalence of IA ranged from 0.8% (in Italy) to 26.7% (in Hong Kong).³
IA and mental illness
IA has been associated with low self-esteem and emotional stability.³ It has also been linked with depression and anxiety disorders, and in particular with social anxiety, which I discussed in last week‘s post.4
Why do socially anxious people prefer the online environment? Perhaps because they have greater control over how they come across, especially during text-based communication (because others will not be able to observe/judge the person’s appearance and body language).
The good news is that research shows that both psychological treatments (e.g., cognitive behavioral therapy) and pharmacological treatments (e.g., antidepressants) are effective in improving IA and reducing the associated depressive and anxiety symptoms.5
Internet addiction refers to use and preoccupation with internet, usage that is so excessive that it interfere with one’s daily activities and results in various problems in one’s personal, professional, and social life.
There is debate as to whether IA is a true addiction and a true mental illness. Nevertheless, IA is associated with a number of mental health conditions, like depression and anxiety. Medications and psychotherapy appear to be effective in treating IA and related anxiety and depression.
1. American Society of Addiction Medicine (2011, April 19). Public policy statement: Definition of addiction. Retrieved from www.asam.org
2. Block, J. J. (2008). Issues for DSM-V: Internet addiction. American Journal of Psychiatry, 165, 306–307.
3. Kuss, D. J., Griffiths, M. D., Karila, L., & Billieux, J. (2014). Internet addiction: A systematic review of epidemiological research for the last decade. Current Pharmaceutical Design, 20, 4026–4052.
4. Prizant-Passal, S., Shechner, T., & Aderka, I. M. (2016). Social anxiety and internet use—A meta-analysis: What do we know? What are we missing? Computers in Human Behavior, 62, 221-229.
5. Winkler, A., Dörsing, B., Rief, W., Shen, Y., & Glombiewski, J. A. (2013). Treatment of internet addiction: A meta-analysis. Clinical Psychology Review, 33, 317–329.