Is Internet Addiction Real?

Internet addiction. Phone addiction. Technology addiction. Whatever you call it, a lot of parents are expressing worries that their children are addicted to their devices.

Is the behavior that parents are concerned about really addiction?

What parents are alarmed about is usually two things: the sheer amount of time their kids spend on screens, and their kids’ resistance to cutting back on that screen time. Getting them to put away their devices and come to dinner, engage in other activities, go outside or do their homework (without also checking social media and streaming TV shows) seems to be an increasingly uphill battle.

Kids sometimes use the word “addiction” to describe their own behavior, too. In a 2016 survey by Common Sense Media, half of teenagers said they “feel” they’re addicted to their mobile device. Three quarters of them said they felt compelled to immediately respond to texts, social media posts and other notifications.

“More often than not, when people say that someone is addicted to the internet or addicted to their phone, they’re using it colloquially,” notes David Anderson, PhD, a clinical psychologist at the Child Mind Institute. By calling it addiction, parents are often communicating their concern that so much screen time is unhealthy, as well as their feeling that they’re powerless to stop it.

But beyond this kind of problematic internet use are some kids whose involvement becomes so intense it interferes with their functioning, leading to withdrawal from other activities and a spiral into depression and even suicidality.

There is, officially, no such thing as internet or phone addiction. Some in the psychiatric community have proposed a new disorder called internet gaming disorder, to recognize unhealthy patterns of game-playing. But it would rise to the level of a disorder, Dr. Anderson notes, the behavior only if it’s extreme, and seriously impairing to a child’s life.

That would mean an amount of screen time that’s not only more than parents feel comfortable with, but that crowds out other age-appropriate activities, like socializing, sports, school work — even hygiene and sleep. “We would be looking at adolescents who are pushing everything else out of their lives,” explains Dr. Anderson.  “They are not having friendships, not engaging socially — at least offline — and they may be failing in school.”

Some parents may see addict-like behavior, Dr. Anderson adds, when kids get angry if they’re required to stop, insist on more screen time than they’re allowed, and spend a lot of offline time thinking about how and when they will get back online. But these kind of behaviors can be prompted by many pleasurable activities, and don’t constitute an addiction. “More often than not, what I see are parents who are concerned about their teenager’s behavior around screens use the word addiction when it doesn’t really fit.”

One reason to be cautious about using the term, he added, “is that we have a tendency right now within the zeitgeist to pathologize normal adolescent behavior.”

But psychologists and addiction experts are reporting seeing more and more teenagers whose behavior looks alarmingly like addiction, and some predict that internet addiction will soon become an official diagnosis.

Anna Lembke, MD, a Stanford University psychiatrist and assistant professor in addiction medicine, told NPR she is seeing a classic addictive pattern of behavior in many of her patients who compulsively use the internet. “Addiction begins with intermittent to recreational use, then progresses into daily use, and then progresses into consequential use, which in some cases will progress to life-threatening use,” Lembke says.

The amount of time teenagers typically spend on phones and other devices can be misleading as a measure of whether they are unhealthily engaged. That’s because many of the things kids do on those devices are age-appropriate activities that in the past have been done offline: socializing with peers, exploring personal interests, shopping, listening to music, doing schoolwork, watching movies or TV.

Texting and use of social media sites, for instance, have become important channels for adolescents connecting to others and being validated. Role-playing games allow kids to interact not only with friends, but to people around the world. A 2016 report by Common Sense Media concluded: “What looks like excessive use and distraction is actually a reflection of new ways of maintaining peer relations and engaging in communities that are relevant to them.”

When a child seems unhealthily focused on video games, to the point of social isolation, the behavior may be, rather than addiction, a product of other mental health problems.

Dr. Anderson reports that he finds himself saying to parents, “We understand your hypothesis that your kid is addicted to games, but it may be that he is socially anxious. It may be that he is depressed. It may be that he has a learning disorder.”

Dr. Anderson recalls treating a 16-year-old whose mother was adamant that he was addicted to video games. “I was doing in-home sessions with him, and it was, indeed, very hard to get him off playing Call of Duty to even have the session. But what I realized very quickly was that he had both ADHD and depression, and he had been failing school for as long as he could remember.”

Call of Duty was actually a positive in his life, Dr. Anderson said, “the only thing that provided solace, a sense of belonging. He had joined a crew of people who play Call of Duty and post YouTube videos of them playing.”

Once his ADHD and depression got appropriate treatment, he was able to cut back on Call of Duty, and make offline friends. “He joined the football team at school. His grades improved,” said Dr. Anderson. “In that sense, it was treatment of ‘internet addiction’ through treatment of the actual underlying conditions.”

While experts say that parents should remain skeptical of the notion of addiction, they also argue that parents should be alert for potential negative fallout from screen use. Apps and games are designed to keep us engaged as much as possible, and it can be hard for children to exercise self-control when their impulse is to keep scrolling.

There is ample evidence that intense social media use is correlated with an increase in anxiety and depression as teenagers, especially girls, compare themselves unfavorably to their peers and worry about missing out.

Research shows that excessive gaming — spending two-thirds or more of free time — is correlated with negative mental health outcomes, including higher incidence of anxiety, depression and substance use.

There is evidence that multitasking — using social media, texting, watching tv while doing homework — undermines cognitive functioning and decreases learning.

And, of course, experts note constant attention to devices comes at the cost of other activities that are ultimately more valuable, and developmentally important.

“Our brains are hardwired to like things that are novel and stimulating, and the phone captures that,” notes Matthew Cruger, PhD, a neuropsychologist at the Child Mind Institute. “It’s easier to engage in constantly checking your phone or playing a game than tasks that require more mental effort, though those are ultimately more rewarding for a lot of people.”

Dr. Cruger sees an anaology to gambling in that checking devices is only intermittently reinforcing. “People spend a lot of time looking briefly at things, not diving down, hoping it’s going to be rewarding, though often it’s not.”

Why would you pick up a book if you’re stimulated by Instagram or Candy Crush, Dr. Cruger asks. “You still retain the capacity to apply more mental effort to things but the opportunity is lost when you’re constantly superficially engaged.”

“There are absolutely alarms to be sounded,” concludes Dr. Anderson, “but the vast majority of kids are engaging in screen-related behaviors that may not be either pathological or damaging.”

The key, he notes, is to help parents set appropriate boundaries around screens, to understand what their kids are doing online, to feel confident that  they are is engaging in the right developmental tasks — online or off.