Teen Internet Addiction: Signs & Recommendations

Andrew is a depressed 13-year-old boy whose grades are slipping. He knows his parents wouldn’t approve but he just keeps doing the same things. When they ask him to stop he snaps at them. If pressed, he admits he has tried to stop because he’s been so tired that he’s fallen asleep in class, but he stays up late doing it anyway and hides it from his family.  These types of behaviors are commonly seen in children who use illicit drugs or alcohol, but they are also seen in children addicted to gambling, gaming or the Internet. Limited studies of the nervous system suggest that substance use disorders and behavioral addictions like Internet addiction even share the same pathways in the brain.

The Internet, just like television, can be a source of fascinating information, a powerful research tool and great entertainment. However, just like television, lots of use can be detrimental to children’s developing minds. The American Academy of Pediatrics recommends no more than two hours of screen time a day, which includes the Internet, computer games, console games, television, etc.

Multiple studies have shown that as the amount of time a child spends looking at a screen increases, so does his or her risk for having sleeping, attention and aggression problems, and difficulty with interpersonal relationships. Some of these effects may be due to the rapidly changing intense imagery of television while others could be attributed to decreased time interacting with other people in favor of screens.

Although Internet Addiction is not a universally recognized psychiatric disorder, an increasing number of psychiatric professionals advocate for such recognition.
Most professionals would suggest that Internet use rises to the level of addiction when a child:

1. Uses the Internet excessively;
2. Shows signs of withdrawal, including feelings of anger, tension or depression when the computer is inaccessible;
3. Needs to use the Internet more and more and feels a need for better computer equipment, more software, more games, more consoles, etc.;
4. Has adverse consequences from Internet use like increasing arguments, lying, poor school or vocational achievement, social isolation and fatigue.

It is unclear how many people are addicted to the Internet. Some studies suggest that among Internet-using adolescents the rate could be 10 percent or higher. Teens that are addicted to the Internet have increased rates of depression, ADHD and excessive alcohol use. It is not always clear whether Internet use is the cause or the effect of these other problems.  Sometimes the Internet is used as a coping mechanism for disorders already present; sometimes Internet use leads to these problems in susceptible individuals. Rates of ADHD in those with Internet addiction have been as high as 25 percent in some studies.

There is very little known about the treatment of Internet addiction, but we do know that home monitoring of Internet use is important to avoid a wide range of negative consequences, including  predation, bullying, loss of privacy and the risk of addiction. Keeping computer use limited to public areas of the house is a straightforward way to make sure Internet use is monitored. Such monitoring is no different than helping children make good choices with their television use. In combination with encouraging face-to-face interactions vs. Facebook interactions, parents can help children develop the skills necessary to build and maintain strong interpersonal relationships as well as decrease the risk of depression.

Recommendations:

1. Limit Internet access to public areas at least for certain times of the day and avoid having televisions and computer games in bedrooms.
2. Plan screen time, whether television or Internet use. For television, that’s easy in the era of DVRs. Sit and watch a show you like then stop watching. For the Internet, which is more free-flowing, use an egg timer. Do the same for video games.
3. Stress to children that they shouldn’t put anything on the Internet that they wouldn’t want on the home page of Google, YouTube, ESPN, StLtoday.com, etc. (Nothing on the Internet is truly private.)
4. During exam times or other times when kids need to avoid screen time, delete games or programs or install passwords so the temptation isn’t there. Reinstall/remove passwords when exams or a report are complete.

If a child is having difficulty with the Internet or screen time and none of the above recommendations are helping, contact your pediatrician.

For more information, visit www.essehealth.com.

By John Madden, M.D., PhD, Esse Health Pediatrician
Esse Health Pediatric & Adolescent Medicine at Watson Road
9930 Watson Road, Suite 100
St. Louis, MO 63126
Phone: 314-965-5437

References:

1. Introduction to Behavioral Addictions  Grant et al The American Journal of Drug and Alcohol Abuse 36:233 (2010)
2. Non-Substance-Addictive Behavioras in Youth:  Pathological Gambling and Problematic Internet Use Brezing et al.  Child and Adolescent Psychiatricd Clincs of Norath Americal 19:625 (2010)
3. Internet Addiction or Excessive Internet Use  Weinstein and Lejoyeux   The American Journal of Drug and Alcohol Abuse 36:277 (2010)
4. Television Viewing and Its Impact on Childhood Behaviors  Jolin and Weller Current Psychiatry Reports 12:122 (2011)
5. Pathological Video Game Use amoung Youths:  A two Year Longitudinal Study Gentile et al Pediatrics:127e319 (2011)