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Harvard Commentaries
Harvard Commentaries
Reviewed by the Faculty of Harvard Medical School

Minding Your Mind Minding Your Mind

Keeping -- Or Not Keeping -- Your Internet Use Under Control

October 14, 2012

By Michael Craig Miller M.D.

Harvard Medical School

Some mental health professionals continue to worry about the activity you're engaged in right now — using the internet. They worry it has become a breeding ground for addiction. The phenomenon has been labeled "Internet addiction." Many addiction experts recommend using the term with caution, because it's so easy to find people who spend huge numbers of hours connected to the Internet. After all, the Internet has become an indispensable part of how we work, play and communicate with one another.

Behavior addictions, and in particular internet use associated with gaming, may appear in upcoming editions of the official manual of psychiatric diagnoses. But we should hope that people will be careful about how they apply any such labels to complex human experiences. And remember — the Internet is a fairly new historical development — 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.

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How Is Addiction Related to the Internet?

The Internet is a very efficient way for people to engage in addictive behaviors. Gambling, gaming and shopping are popular examples. Sex is such a presence on the Internet that some technology experts find that sexual content has been a leading driver of Internet expansion, if not the leader.

The way people use the Internet is so varied that we don't know exactly what so-called Internet addicts are addicted to. It is likely, experts say, that people are addicted to the rewards or pleasures that they have access to over the 'net, rather than the Internet itself.

And access is what the Internet provides — to the max. 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.

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The Broad View of Addiction

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.

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Signs of a Problem

"Do I have an Internet addiction?" is probably not the best 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 get help.

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. Consider the following:

  • One person's idea of time spent productively — learning new information and skills — may be another's idea of wasting time.


  • People chatting online may be making important social connections or finding sources of support that are not available elsewhere. Or they may be avoiding responsibilities in family relationships.


  • A person may use pornography to avoid higher-risk behavior (such as cruising for sex and visiting prostitutes).

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Getting the Right Kind of Help

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 (school or job failure, relationship conflicts or money problems) and my Internet use?

The answer to these questions are not going to tell you whether or not you have "Internet addiction." But the specific answers and your degree of concern may lead you to get personalized assistance. That is, a clinician or other supportive advisor can use the information to help you think seriously about how the Internet works or doesn't work in your life.

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. That will be the first step toward finding the right kind of help.

Michael Craig Miller, M.D. is Editor in Chief of the Harvard Mental Health Letter. He is also associate physician at Beth Israel Deaconess Medical Center and assistant professor at Harvard Medical School. He has been practicing psychiatry for more than 25 years and teaches in the Harvard Longwood Psychiatry Residency Program.

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