Internet addiction

Julia Dobmeier is currently completing her master's degree in clinical psychology. Since the beginning of her studies, she has been particularly interested in the treatment and research of mental illnesses. In doing so, they are particularly motivated by the idea of enabling those affected to enjoy a higher quality of life by conveying knowledge in a way that is easy to understand.

More about the experts All content is checked by medical journalists.

Whether via smartphone or PC: Internet addiction is a behavioral addiction that is becoming increasingly common. Young people in particular are quickly drawn under the spell of the virtual world. Friends, family and school are becoming less important. Isolation from reality has far-reaching consequences for social and professional life as well as for health. Read all the important information about internet addiction here.

ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. F63

Brief overview

Description: Internet addiction (also cell phone addiction / online addiction) is a behavioral addiction.
Symptoms: neglect of tasks, social contacts, job, school and hobbies, drop in performance, loneliness, loss of control with regard to the duration and time of Internet use, irritability in the event of withdrawal
Causes: Social / family conflicts, loneliness, low self-esteem, formation of an addiction memory in the reward center of the brain.
Diagnosis: Based on addiction criteria such as loss of control, tolerance formation, loss of interest, further excessive consumption despite negative consequences, social withdrawal, neglect of tasks.
Treatment: Specialized behavioral therapy in groups and individual discussions, in milder cases outpatient, otherwise in specialized clinics.
Prognosis: With insight into the disease and perception of a specialized therapy, the addictive behavior can be controlled.

Internet addiction: description

The internet has become an integral part of today's world. Working, shopping, exchanging ideas with friends - almost every area of life is related to the Internet. Children and young people in particular are at risk of getting lost in the virtual world. It now accompanies you around the clock via smartphone. As the real world fades into the background, the internet threatens both mental and physical health.

The phenomenon of pathological use of computers, mobile phones and the Internet is still relatively new and has therefore only been researched for a few years. Internet addiction, also known as mobile phone addiction or online addiction, is a behavioral addiction. In contrast to alcohol or drug addiction, it is not the consumption of a substance that makes you dependent, but the behavior itself becomes an obsession. With Internet addiction, those affected use the Internet so excessively that they neglect other areas of life for it. Internet addicts hardly pay any attention to hobbies, friends and family, school and work. Despite the enormous life impact of the addictive behavior, those affected cannot stop doing it. The addiction becomes independent and the behavior becomes a compulsion.

An addiction with many faces

Online addiction, cell phone addiction, computer game addiction, computer-mediated communication addiction - there are many names for Internet addiction and many forms of addictive behavior on the Internet. The men are particularly fascinated by online and computer games. In "World of Warcraft" players can fight monsters and explore new worlds in a virtual parallel world. The addiction-enhancing means are rewards in the form of experience points or virtual objects that make them stronger in the game.

Girls prefer to spend their time online on social networks such as Facebook. You spend hours exchanging ideas with friends, but also with strangers on the Internet. The internet gives them the opportunity to present themselves as they would like to be. For many, it is tempting to be able to change personality and appearance. In addition, you are never alone on the Internet. Strangers become apparently good friends, even if you've never met them in real life.

Other forms of Internet addiction are the pathological use of games of chance and betting that takes place on the Internet. The compulsive use of erotic chats is known as cybersex addiction.

Who Does Internet Addiction Affect?

Internet addiction has not yet been adequately researched. Due to the inconsistent diagnostic criteria, the number of Internet addicts can only be estimated. The Federal Ministry of Health assumes that around one percent of 14 to 64-year-olds indulge in an abnormal use of the Internet and computer games. Internet addiction is most common among teenagers and young adults. Women are just as often affected as men. However, men prefer computer games, while women spend most of their time on social networks.

Internet addiction rarely comes alone

Studies in recent years show that around 86 percent of internet addicts have another mental disorder. Depression, ADHD and alcohol and tobacco addiction very often occur at the same time as online addiction (comorbidity). It has not yet been clarified whether the mental disorders increase the risk of Internet addiction or are the result of Internet addiction. Probably both are possible and differ from person to person.

Internet addiction: symptoms

Internet addicts have a constant need to be on the Internet. This has a number of negative consequences. The neglect of everyday tasks, friends and hobbies, but also physical and psychological difficulties, can be indications of an internet addiction.

Drop in performance

Researchers have found that teenagers who are addicted to the Internet perform poorly in school. Excessive use of the internet creates cognitive problems. Above all, this affects the ability to concentrate and alertness. Another reason for this, of course, is that most of the time is taken up by the addictive behavior, with little time left for schoolwork or other obligations.

In adults too, studies show that work performance falls due to Internet addiction and that there is little contact with work colleagues. The more pronounced the addictive behavior, the higher the risk of dismissal. The financial consequences can lead to existential threats.

isolation

The lack of time is also noticeable in the social area. Online addicts pay little or no attention to their friends and family. Often they get lonely without even realizing it. They live under the illusion that they have real friendships on the Internet. Sometimes friendships do indeed develop on the Internet, but usually no meetings take place in real life. The existing friendships in the real world break when the person concerned is only on the Internet. For people who have difficulty getting in touch, the internet seems like a good solution at first. However, research shows that this makes their situation even worse.

Damage to health

Because of their constant need to be online and the fear of missing out, many sufferers suppress their need for sleep. Online role-playing games also generate an increased level of arousal, which makes it difficult to fall asleep. Internet addicts often complain of insomnia. The lack of sleep in turn affects the ability to concentrate and also the mood. Those affected can develop depressive traits as well as aggressiveness and irritability.

In addition to sleep, those affected also neglect other basic needs, such as their diet. Many eat fast food or sweets because there is not much time left for eating. Some even forget entire meals. There are therefore internet addicts who are more likely to be overweight and others who are normal to underweight. The risk of obesity is increased by the lack of exercise.

Sitting in front of the computer all the time affects posture. Joint pain, neck pain and headache, as well as visual disturbances are other problems that internet addiction brings with it.

Withdrawal symptoms

There are also withdrawal symptoms in behavioral addictions. If those affected cannot access the Internet, they become depressed and listless, irritable and in a bad mood. Some get very restless and even aggressive.

Internet addiction: causes and risk factors

The causes of internet addiction have so far hardly been researched. As with other addictions, several factors probably play together in the development of Internet addiction. Many experts see the Internet or the computer not as the cause, but rather as the trigger of the addiction. According to this, the real causes should lie in deeper lying psychological conflicts. Another influencing factor is suspected to be a disturbance of the messenger substances in the brain. Scientists have not yet been able to clearly prove whether internet addiction also has genetic causes.

Search for contact

Researchers assume that social and family conflicts play an important role. Children and adolescents who find it difficult to socialize and who have a preference for the Internet are particularly at risk of developing Internet addiction. Because if you can't find friends in the real world, you look for them online these days.

Low self-esteem

People who withdraw socially often suffer from low self-esteem. On the Internet, those affected can not only give themselves a new face, but also become courageous fighters in computer games. The virtual world rewards the player and enhances his self-image. To a certain extent, this is also possible in social networks, in which you can only present yourself from your best side or even assume an invented identity. It becomes dangerous when the computer world becomes more attractive to the person concerned than real life.

Family conflicts

Some studies suggest that family conflicts encourage children's retreat to the Internet. Teens who are addicted to the Internet often only live with one parent. However, the exact relationships are unclear. What is certain is that in many cases there is a lack of social support.

Biochemical causes

Research shows that similar changes take place in the brain in behavioral addictions, as in alcohol addiction, for example. The increased release of the neurotransmitter dopamine in the brain also most likely plays a role in Internet addiction. If dopamine is released while playing on the Internet, it creates feelings of happiness: the behavior is rewarded. Over time, the dopaminergic system becomes increasingly sensitive to the behavior and reacts particularly strongly when the person concerned is on the Internet. Other stimuli cannot keep up with this feeling of happiness and are less and less taken into account. However, the Internet is being used more and more frequently to relive that good feeling.

Internet addiction: examinations and diagnosis

If you notice any signs of internet addiction in yourself or your loved ones or friends, you should contact a clinic or therapist as soon as possible. Using questionnaires in a conversation, they can determine whether the behavior is addictive or not.

The first interview

For Internet addiction, the time that the person concerned sits in front of the computer or surfs with the smartphone is not the only decisive factor. It is also decisive for internet addiction that the behavior is carried out out of an inner compulsion. The therapist could ask the following questions during an initial consultation:

Do you often resolve to spend less time online, but can't?
Do you feel restless or irritable when you are not on the internet?
Do people around you complain that you spend too much time online?
Are you neglecting your friends, hobbies or obligations in order to spend more time online?
Do you often think about what you do online when you are not online?

Apart from the specific questions about internet addiction, the therapist will ask about the family and professional situation. Especially with young people, it is necessary to involve the family. On the one hand, the family members can provide important information for the diagnosis. On the other hand, the family should also be informed about Internet addiction and learn how it can support the person affected.

Internet addiction diagnosis

Internet addiction is currently still included in impulse control disorders and is not an independent disorder in the classification systems. The question of whether Internet addiction can be counted as an addiction is still up for discussion. Because in contrast to substance-related addictions, such as alcohol addiction, internet addiction cannot lead to physical dependence on a substance. Many experts are in favor of defining addiction to the Internet as an addiction in its own right, as Internet addicts show a psychological dependence.

Since there are no standardized criteria for diagnosing Internet addiction, psychologists and doctors use the addiction criteria as a guide. A frequently used test to diagnose Internet addiction is Young's Internet Addiction Test (IAT). This is based on the dependency criteria of the Diagnostic and Statistical Guide to Mental Disorders (DSM).

Until internet addiction is recognized as a mental disorder in its own right, the DSM-V offers the following signs as diagnostic criteria for internet addiction:

Strong desire and constant preoccupation with the Internet
Withdrawal symptoms when internet access is taken away
Development of tolerance with increasing use of the Internet
Unsuccessful attempts to control internet usage
Continue to use the Internet, although the negative consequences are known
Loss of other interests and hobbies besides the internet
Using the internet to break down bad moods
Family members and other people are being lied to about the level of internet use
Endangering important relationships or the job through Internet use

At least five of these criteria must occur over a period of twelve months.

AICA-SKI: IBS is a very new tool for diagnosing internet addiction. The abbreviation denotes a structured clinical interview on Internet-related disorders. It was developed by the Media Dependency Association together with colleagues from the Mainz gambling addiction clinic.

Internet addiction: treatment

Which treatments are particularly effective for Internet addiction is still unclear due to limited scientific research on this topic. More and more therapists are now offering help specifically for online addiction. Some clinics, such as in Mainz or Bochum, have set up their own outpatient clinic for Internet addiction. As a rule, various forms of therapy such as individual and group therapy are combined for treatment.

Outpatient or inpatient treatment for internet addiction?

Internet addiction can be treated both on an outpatient and inpatient basis. Which form is more effective depends on the severity of the online addiction. An inpatient stay is recommended if the person concerned has hardly any contact with the outside world. When the Internet has become more important than friends, family, and job or school, treatment in a clinic is often the only solution. In the clinical setting, it is more difficult for Internet addicts to fall back into old patterns. The day is being restructured and the internet is no longer the focus of life.

Internet addiction cognitive behavioral therapy

An important part of treatment is cognitive behavioral therapy. The first step in treatment is to provide the person affected and their relatives with detailed information about Internet addiction and its consequences (psychoeducation). Knowledge of the disease should strengthen the patient's personal responsibility.

As part of cognitive behavioral therapy, the person affected should learn to recognize problematic thought patterns and to change them. Internet addicts are supported in unlearning the abnormal behavior and in achieving controlled use or even complete renunciation.

Many people who are addicted to the virtual world feel more comfortable there than in real life. A common view from patients is that they mean something online and not in real life. In therapy, the patient learns to self-critically question his role on the Internet. In online games such as "World of Warcraft", the person embodies a character (avatar) in the virtual world and builds friendships with other players there. As part of the therapy, the patient learns to distance himself from his avatar and to deal intensively with his real self. Another important component in addiction treatment is the establishment of social contacts in the real world.

Other internet addiction treatments

In addition to the individual therapeutic sessions, group therapy plays an important role in the treatment of internet addiction. The patient can talk to other affected persons about his problems there. The contact with real people and the cohesion in the group offer a substitute for the contacts on the Internet. For many patients, it is a relief to see that they are not alone with their problem. You also benefit from the experiences of the other sufferers in dealing with the addiction.

Internet addiction: disease course and prognosis

Internet addiction is not yet considered a disease in its own right, but the severity of the addiction should not be underestimated. The negative consequences of behavioral addiction have a huge impact on the lives of those affected. At the beginning the internet addiction is hardly noticeable. Many people spend a significant amount of the day at the computer and yet are not addicted to it. However, for some people, over time, the Internet becomes more and more the focus of attention. If the person concerned gives up leisure activities and friends for it, this is an alarming warning.

The number of internet addicts is steadily increasing. Due to the constant advancement of the media and technology, experts suspect that the problem of Internet addiction will continue to worsen.

The longer an internet addiction goes untreated, the more far-reaching the problems become. The loss of social contacts as well as dropping out of school or losing work drive those affected deeper and deeper into a vicious circle. The real world then hardly offers any incentive to switch off the computer.

Professional support can enable those affected to return to a normal life. The development of special help offers for Internet addicts in clinics has meanwhile significantly improved the range of treatments. So far, cognitive behavioral therapy has proven to be particularly effective for treating Internet addiction.

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