Should ‘internet addiction’ be treated with drugs?

Somewhere, a committee is trying to draw a line in the sand:  check your email so many times a day and you’re healthy;  check it so many more and you’re an addict in need of mental health counseling, and  possibly drugs. 

One year ago the American Journal of Psychiatry published an editorial calling for recognition in the upcoming DSM (Diagnostic and Statistical Manual of Mental Disorders) – the “Bible of psychiatry” – of “Internet addiction” as a mental disorder.  Late last month, Psychology Today blogger Christopher Lane noted that the effort to include Internet addiction in the DSM is still ongoing … and fairly uncontroversial among the psychiatric community. 

For Lane, it should be controversial – and the idea of treating Internet addiction with drugs is ludicrous.  Here at Saybrook, the PsyD classes led by Art Bohart are presently examining this very issue:  is Internet addiction “real”?  If so, what kind of disorder is it?  And how can it best be treated?

For Bohart, the very approach taken by psychiatry is the problem – and that has nothing to do with exactly what “Internet addiction” is.

“Psychiatry is expanding its diagnostic system to make virtually anything a mental disorder,” he says.  “All of us have problems in living.  If we want to turn every bad habit into a mental disorder, then just about all of us will find ourselves in the DSM.  This morning I was reading an article on bacon fanatics.  Since bacon is not very good for you, should we have ‘bacon disorder’ in the DSM?  What about ‘football-watching couch potato disorder’ or ‘gossip disorder’ or ‘laughing too loud disorder?’  All of these could be said to be harmful in some form or the other – but just saying ‘it’s a disorder’ doesn’t really tell us what it is, whether it’s really harmful, what could be going, or how to treat it if that’s called for.”

PsyD student Jo Mactaggart, who hopes to specialize in pediatric and adolescent care, has been following the lives of a group of young students ages 19-25 for a period of years, and regularly interviews them on topics in their lives.  Talking to them about the Internet, Mactaggart has found that many of these students admit they have a problem with too much time spent online, but reject the notion that “Internet addiction” per se is at the root of the problem.   It’s a perspective she has come to share.

“Talking with them, I get the sense that over attachment to the Internet is more like how people cling to CNN after a disaster, have the radio or TV going all the time, use cell phones for so many hours and in inappropriate conditions. It is a connection to other human beings,” Mactaggart says.  “The perception that the people on the other end are real and their friends may or may not be factual – but the sense of a meaningful connection to other people is the crucial thing.”

Some of the 19-25 year olds Mactaggart has interviewed have stolen Internet access   in order to keep that sense of connection, and clearly at that point they have a problem.  “But,” Mactaggart says, “the Internet is just the Clydesdale drawn wagon carrying the brew – the enticing vehicle that delivers the goods.  Are we attached to the Internet or to the feelings from the relationships and activities it provides us?”

If it’s the latter case … if it’s not “the Internet” that people are “addicted” to, but a sense of human connection that they’re not finding elsewhere in life … then, Mactaggart suggests, the DSM is focusing on the symptom rather than the cause.

“The overwhelming picture of a person attached to the Internet to the exclusion of other activities is one of loneliness, feeling misunderstood, isolation and social withdrawal- which are indicators of unfulfilling relationships with self and other,” Mactaggart says.  “There are no medications for that.”