Could an Internet addiction be keeping you up at night?

Like most people, I use the Internet all the time. I check email what seems like a million times a day, do research for my work, and catch up on the news online. And yes, occasionally it keeps me up at night when I get involved in reading something and the clock ticks well past my bedtime. But according to the article below by my good friend and psychiatrist colleague Dr. Michael Miller, I am not an Internet addict in the true sense of the word. Read on to find out what the symptoms of this addiction are. And remember to get away from your computer a few hours before you want to fall asleep, so you can unwind and get your body and mind ready for bed. I'm going try to follow my own advice! Here's Dr. Miller: 

Mental health professionals worry that a relatively new and increasingly common behavior — one that you're engaged in right now — has become a breeding ground for addiction. The phenomenon has been labeled "Internet addiction," a term many addiction experts recommend should be used with caution.

It's easy to find people who spend huge numbers of hours connected to the Internet. The Internet has become an indispensable part of how we work, play and communicate with one another. "Internet addiction" is a catchy term. But I am not a fan of trendy labels to describe complex human experiences. Since the Internet is a fairly new historical development, however, we don't yet understand whether its impact on human behavior is positive or negative. There are plenty of anecdotes and surveys, but few — if any — truly controlled studies.

It's worth looking at what we do know about Internet use. It might help us take a common sense approach to problems that come up.

Think of it this way: Narcotic addicts are addicted to heroin, not the needle. "Internet addicts" are drawn to the content, not the 'net. Like a needle, the Internet is a very, very efficient delivery system. Shopping, gambling, pornography — whatever a user seeks — is available instantly and in great quantity, anywhere, anytime.

Howard Shaffer, Ph.D., a Harvard Medical School faculty member and Director of the Division of Addictions at the Cambridge Health Alliance, has a helpful suggestion. He urges us to get away from the idea that addiction is a property of a given drug or behavior. After all, everything that is pleasing tends to activate the same circuits in the brain.

All behaviors that are called addictive share three basic elements: Craving, loss of control and painful consequences. No matter how we access them, addictions are more similar than they are different. People who suffer with addictions are also prone to trouble with other mental disorders, such as depression, anxiety, attention deficit disorder, impulse control problems or personality disorders.

Taking a broad view is very useful for anyone who is concerned about over-using the Internet. Remember: All addictions are complex behaviors that are embedded in a human context. It should be no surprise that the Internet has gotten folded in to addictive behaviors (and other mental disorders) that have been part of human existence forever.

"Do I have an Internet addiction?" is the wrong question to ask. Rather than looking for a name for the behavior, think about the effects of the behavior. Any activity that pulls you away from important relationships or work responsibilities, whether it involves the Internet or not, can cause conflict, distress, and loss. Pay attention to signs, such as losing sleep or time because you can't log off. Certainly, if you can link your Internet use to money or marital troubles, school failure or a job loss, it's time to consult a mental health professional.

It's not easy to figure out how much Internet use is "too much." There is no clear boundary between what is a simple and worthwhile pleasure and what is a problem.

Often the best approach to a problem is to rely on basic principles rather than inventing new terms. Ask yourself the following questions:

• What am I using the Internet for?
• Am I preoccupied with a particular activity that pulls me away from social or work responsibilities?
• Do I feel productively engaged while using the Internet or do I feel anxious or guilty?
• Is my sense of well-being undermined by my Internet use?
• Am I losing sleep?
• Is my sense of time distorted, that is, do I underestimate how much time has passed while I'm online?
• Do I feel depressed, lonely or isolated?
• Is there a connection between my real life problems (such as school or job failure, relationship conflicts or money problems) and my Internet use?

You may decide that your Internet use is a boon. It brings you rewarding experiences. It helps you finish your work more successfully or efficiently. It may simply be fun! If you're suffering, however, take the broad view. Rather than seeking trendy cures for "Internet addiction," consult with a professional who can help you define the problem specifically. Once you define the problem specifically, it's much easier to find the right kind of help.

Do you find yourself staying up later and later because you can't get away from your computer?

Julie K. Silver, M.D., is an assistant professor in the Department of Physical Medicine and Rehabilitation at Harvard Medical School. She is also the Chief Editor of Books for Harvard Health Publications.

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