Relationship-related forms of Internet addiction from social media to pornography represent very prevalent aspects of online addiction. Many aspects of that particular type of relational content are highly addictive. However, people get addicted to all different types of Internet content, some of which aren’t relational at all. Gambling and media bingeing are just a few examples that we’ll explore in this chapter.
Like pornography, gaming straddles the line between being a solitary endeavor and one that’s social. People can become addicted to very simple games that they play online, such as Solitaire or Mahjong. However, the most addictive games are also highly interactive with other players. Gaming addiction is one of the most widely studied forms of Internet addiction. As we’ve seen, it’s the only form specifically listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Diseases (ICD) as a mental health disorder.
Some games are more likely to provoke addiction than others. Low-risk games include puzzle games like Tetris and physical simulation games like Guitar Hero. Midrisk games include basic educational, historical context games and “God games” such as The Sims. Higher-risk games include role-playing games like Legend of Zelda as well as first person shooter games and real-time strategy games. The games that are most likely to activate addiction are the massive multiplayer online role-playing games (MMORPGs) including RuneScape, EverQuest, and World of Warcraft.
In fact, World of Warcraft is frequently cited as the most problematic game when it comes to gaming addiction. In its first ten years, the game gained more than one hundred million subscribers around the world. It received $10 billion in gross income. People immediately loved this game, and it became far more than just a fad; for many, it became an addiction.
In World of Warcraft, there are two warring factions called The Alliance and The Horde, constantly battling it out in a mythical land called Azeroth. Players create their own avatars, but they do not play alone. They join guilds to play in real time with other players from all around the world. Your guild is your team. Together you fight monsters, complete quests, and explore the virtual world. Whenever your guild-mates are online, you want to be online as well. You don’t want them moving forward in the quest without you. This interactive nature enhances the addictive quality of games like World of Warcraft.
Interactivity and teaming up with others play right in to the brain’s tendencies. Much like social media, this satisfies the desire for approval from others and the brain’s urge to compare ourselves to others. Guild members can place a lot of peer pressure on one another to keep feeding the addiction, to stay online longer and skip other healthier, real-life activities. It’s a primal instinct to want to fit in with the crowd. But these games prey upon other primal instincts as well.
These games feature some of the most highly distracting qualities of any online activity. They constantly send signals of sound, sight, and movement to the brain. Movement, in particular, puts the brain on high alert. Back when we humans had to hunt for our food and protect ourselves constantly from external threats, our brains learned to stay alert for movement. When we engage with these movement-rich, highly stimulating games, our brains remain in constant high alert. This messes with our adrenaline and cortisol as well as with the brain’s neurotransmitters. We’re constantly stressed, and this stress confuses the brain in ways that increase the risk of addiction.
Players may readily admit to having a gaming addiction, although that doesn’t necessarily mean that they want to change their behavior. Author and gaming addiction expert Adam Alter reports that approximately half of the players in World of Warcraft consider themselves addicted to the game. In fact, there are online support groups specifically for people struggling with a World of Warcraft addiction. (Yes, there is some irony to an online group to help people stop online behavior, but it can be helpful, something we’ll look at more in Chapter 9.) But recognizing that there’s a problem doesn’t necessarily lead people to seek help or to succeed in ending in an addiction.
At the extreme end of gaming addiction, players may experience gaming-induced psychosis. Of all the online activities that can addict people, gaming is the one most likely to cause this most severe of effects. One of the most common forms of this psychosis is called Game Transfer Phenomena (GTP). As the name suggests, it causes the player to have trouble separating the game from reality. It is sometimes called the Tetris effect, after the game of the same name, because addicted players may see Tetris-style patterns in the mind when not playing the game. Other symptoms of GTP include the experience of involuntary sensations and reacting physically and reflexively as though in game play even when the game is not on. Players may hear sounds or see images from the game when they are not playing.
GTP is typically a temporary, short-term effect that will go away with extended rest from the game. However, it can occasionally become a severe case of psychosis, especially if combined with sleep deprivation from game play. The more interactive and stimulating a game is, the more likely it is that addicted players will play for hours and hours straight without breaks. There are multiple known cases of people gaming for well over twenty-four hours without breaking to go to the bathroom or eat a snack. In severe cases, patients have had to go into inpatient treatment. They may spend weeks or even months there, away from the game, receiving therapy and medication, before they are fully back in the real world.
It is no accident that online gaming is addictive. The gaming industry, like the social media industry, wants people online all of the time, and they go to great lengths to make their games more and more addictive. Companies will conduct user studies that seem innocuous, but what they’re really trying to figure out is how to make their games addictive. For example, they may measure a test subject’s heart rate during different stages of game play to learn how to get the heart rate going more effectively. Companies hire people from fields including psychology and neurobiology to further strengthen their ability to make games addictive. They prey upon what we know about human addiction to make the games addictive.
The result is an impact not only on behavior but also on the brain. In a 2001 study from the Indiana School of Medicine, researchers found that the brain changed after just one week of playing violent video games. Compared to a sample group that did not play the games, players who gamed for ten hours in one week had decreased activation in both the left interior frontal lobe and the anterior cingulate cortex. These are the areas of the brain that help to control emotion and aggression. That’s ten hours in one week; today’s gaming addict is more likely to exceed ten hours in one day.
So far, we haven’t talked much about aggression, but it’s another problematic side effect of some online addictions and is particularly prevalent among people who play violent video games. In the same way that an addiction to online pornography can desensitize the person to sex, addiction to violent gaming can desensitize a person to violence. Studies show that immediately after playing a violent game, people are more likely to show aggressive behavior and less likely to feel affected by violence around them.
Not only does violent gaming beget desensitization but violence in a game increases the likelihood of addiction as well. A study by author Jennifer Burek Pierce compared teenagers playing violent and nonviolent action games. The results found that in comparison the teens who played violent games had
These results happened whether they won the game, lost the game, or even paused the game in the middle. The effects continued even after game play ended. All of these changes in brain activity make a game more addictive.
In the current age, there is also another motivation for gaming addiction, which is that top-level players now have celebrity status. There is an entire genre of gaming called eSports, and people tune in to watch the masters at play. Regular gamers may strive to become a celebrity player, and the only way to do that is to practice excessively. They work hard to get the slightest edge over other players. For example, they will tweak their hand and arm positions to attempt to get just a fraction more speed in a game. They play and play and play. The more they play, the more they want to play, and thus an addiction can form.
Net compulsions refer to a variety of activities that addicts engage in repeatedly and obsessively. There is a fine line between addiction and compulsion in psychology. Compulsion, often but not always associated with obsessive compulsive disorder, is defined by a fear-based need to engage in specific behaviors. Compulsion is often one component of addictive behavior; the addict feels a compulsive need to keep checking on something or engaging in a behavior. An addict with a net compulsion may feel a constant need to check on the status of an online auction or the newest clearance items available on a site like Amazon. They may also feel the need to keep going back to a site, such as an online gambling site.
Gambling is actually the only behavioral addiction that’s officially defined as a problem by the DSM-5. This is separate from online addiction and refers to people with an addiction to gambling of any kind. In the twenty-first century, gambling can now take place online, leading to potential addictive behavior both online and offline. In other words, someone with a gambling problem may or may not have an Internet addiction; someone addicted to gambling online has an Internet addiction.
Interestingly, gambling in the real world preys upon many of the same brain weaknesses that we’ve discussed with regard to Internet addiction. The people who design casinos, for example, have taken a variety of psychological and neurological factors into play to increase a person’s tendencies toward addiction. The sounds of slot machines, the placement of tables in a casino, and the carefully controlled temperature—no part of the design is left to chance. In the same way that social media companies and video game designers try to get you to stay online longer, casinos try to get you to keep spending your money as long as possible. Video game designers have studied the casinos’ playbooks and implemented their most successful strategies.
So, it’s no surprise that online gambling is potentially addictive. These days you can bet online on everything from the outcome of a sports game to the gender of a celebrity’s next baby. Jarice Hanson reported that as of 2007, there were more than $14 billion globally in the world of online gambling. Also, of great importance, the author explains that people who are already addicted to some other aspect of the Internet are much more likely to become addicted to Internet gambling. If you have an addiction to social media or video games and you stumble into online gambling, then you’re at risk of addiction.
There are a lot of legal issues related to online gambling, which vary significantly from location to location. Online gaming website owners constantly change their tactics in order to be able to continue operating. For example, one law says that there’s nothing illegal about a U.S. resident placing an online bet as long as it’s on a site that itself is located in a different country, so gambling sites are typically hosted outside of the United States, but U.S. users can access them. There is a lot of money at stake here, and people are willing to go above and beyond to keep these sites up.
Online gambling is only one of many possible net compulsions though. Two of the other most common examples are online stock trading and participating in online auctions. These activities keep you online at all hours of the day and night, constantly checking and updating your activity. If you want to win the eBay auction, then you might set your alarm to remind you right before the auction is about to end so that you can stop whatever else you might be doing and get online to make some rush bids. Although it’s possible to automate many of these activities, the addict thrives on the rush of the compulsive behavior.
People can develop net addictions to all different types of content. Just a few more examples include the following:
In addition to all of the common consequences of any Internet addiction, people with net compulsions are those most likely to experience financial consequences. Many of the net compulsions involve spending money, whether that’s on gambling or shopping. As a result, people with this form of addiction often end up in extreme debt.
People can become addicted to any specific type of content, whether that’s pornography, gaming, or gambling. They can also become addicted to specific types of media that are available online. Streaming video, news, and health information are among the most problematic content types ripe for addiction.
One of the most fascinating changes in technology has been how seamlessly media now moves from one device to the next. For example, people used to watch all of their television on a TV set. However, in modern times, a person may access the same television show on their desktop, laptop, tablet, or phone. The devices are often synced so that you can pause a show on one device and pick up right where you left off using another device. Advances in streaming technology have made it possible to easily watch “live tv” on the go.
Netflix offers one of the best examples of a company that has changed with the times. The business emerged at a time when brick-and-mortar DVD and VHS stores such as Blockbuster were going out of business. Netflix created a mail-order service that allowed people to get DVDs sent right to their homes. The online component at that time was that you had an account where you looked for the videos that you wanted, set them up in a queue, and ordered them for home delivery. However, the technology continued to change rapidly, and it wasn’t too long before they launched their streaming service to watch television and movies directly on the website. They went on to create their own content, and those Netflix Originals are now some of the most popular streaming content.
As far as Internet addiction goes, the most relevant thing has been the emergence of the phenomenon of “binge watching.” Even the term itself suggests that this is a disordered behavior. After all, nobody typically thinks of “bingeing” as a positive thing. And yet, the phrase rapidly was adopted by people who regularly tell others about their viewing binges without any shame or concern. We use it regularly in everyday parlance. We don’t seem that concerned about the Netflix binge.
Obviously, you can binge any streaming TV/movie content; it doesn’t have to be on Netflix. Netflix just cornered the early market on the binge through smart choices that preyed upon the brain’s addictive nature. The design of the website, feeding you content that you might be interested in while also allowing you to collect your own content in your queue, is one of those smart choices. They were also brilliant when they first started releasing entire seasons of their own original content at one time. One of the early examples was Orange Is the New Black; new fans of the show did not have to wait from one week to the next to find out what would happen but instead could watch the whole first season (and then subsequent seasons) in just a day or two. We now see this model replicated across many different platforms, of which Netflix is only one.
Any type of content can become ripe for binge watching. In particular, content featuring real people (reality TV or docuseries) and content with fictional characters that you can really relate to are ripe for bingeing. What these have in common is that they provide an illusion that the characters are real people who viewers can get to know. In some cases, they are real people (like the Kardashians), but they are exaggerated and edited versions of those real people. This content is addictive in that the viewer constantly wonders what will happen next with the character. “Just one more episode” has become a common refrain in this society. The addict simply can’t stop, often foregoing sleep and socialization for that next episode.
This plays to the voyeur in people, to the point where some become more comfortable viewing lives on the screen than interacting with people in real life. They use the characters to replace real companionship. However, these one-sided relationships are ultimately unsatisfying. Therefore, the addict needs to watch more and more online television to get that same feeling of “connection.” They may participate in online discussions and fan groups and also follow the celebrity’s social media accounts to get even more time “with” them.
There once was a time, not all that long ago, when the day’s news was only available for an hour or so per day, with different versions across three or four channels. Then along came cable television and the start of the twenty-four-hour news cycle. You could tune into news all day long, getting different versions from various news anchors. It became addictive content. The addictive nature has only heightened now that news is available online. It’s always at our fingertips.
Online news comes in various formats. You can access mainstream news through online streaming services. You can view alternative points of view on various sites including YouTube channels. Add in podcasts, vlogs, blogs, and social media, and there is a never-ending stream of news that you can tune into at any time. In fact, with social media at play, it has become increasingly difficult not to be exposed to news, even if you aren’t actively seeking it. People constantly post and repost “news” based on an article’s headlines so that anytime you’re looking at your social media feed, there are items in there designed to capture your attention.
People become addicted to news for a variety of reasons. Fear of missing out (FOMO) is one big one. The addict insists that it’s important to stay on top of our society’s news and worries and that if they aren’t constantly checking it, then they are going to miss out on important information. There’s also an addictive quality to the feelings that news stirs up in us. Much of the news out there is “bad” news that produces fear and anxiety, and the addict has a compulsion to keep checking that news, perhaps hoping for something better but becoming addicted to the chemicals of fear that the headlines evoke.
Technology changes as fast as humans can come up with new ideas. Wearable tech is a relatively new technology that is already fairly pervasive in our society. People use smart watches, fitness tracker accessories, and apps on their cell phones to constantly monitor their own activity. On its own, there is nothing wrong with this technology. However, it creates one more way that we can become addicted to the Internet.
Specifically, this type of technology can lead to or enhance an exercise addiction. Apps constantly remind you of your activity so that you can consistently push yourself further and further in exercise. Someone who is already prone to guilt over inactivity may pass the tipping point when faced with a device that constantly reminds them of it. This can lead to self-destructive behaviors, such as pushing through an injury just to meet a goal and get that positive feedback from the app.
The “online” component makes this technology more addictive. Many of these tools don’t merely provide you with information about your own body. Instead, they also connect you to a community of peers. The idea is to provide accountability for exercise. However, it also means that you constantly have an audience, and you may feel like they are judging you on your performance. You may feel that you have to tune in and perform despite messages from your body that what you are doing is not healthy. Alerts from the devices combined with social interactivity prime you for addiction.
Exercise is just one type of health behavior that is ripe for online addiction. Another related content type is medical information. Perhaps you have experienced something like this; you have a pimple on your arm that won’t go away, and you have recently had a headache. These things are probably unrelated, and both will likely go away soon. However, you get curious, so you start searching online for medical advice as to what might be “wrong” with you.
You aren’t alone. Larry Rosen reports on a Pew Center study that found that searching for medical or health information is the third-most popular Internet activity behind only more general Internet searches and use of email. More than 80 percent of people search for information on health websites. So, you think that you might have something wrong with you, and you do a search. Before you know it, you are deep in an Internet hole, concerned that you might have a rare condition characterized by these two traits. Most people are eventually able to pull themselves away from the Internet and settle down, realizing that they are just scaring themselves over nothing. However, some people get addicted to researching this type of information, and they can develop a condition called cyberchondria.
Cyberchondria is a specific form of anxiety caused by looking up health-related information online. Although it is most common for people to research this medical information about their own symptoms, occasionally the anxiety arises when doing Internet searches to assist friends and family members; in such a case, the term for the condition is “cyberchondria by proxy.” The condition is a terrific example of how normal human behavior becomes amplified and exaggerated online, which can lead to a dangerous increase in the symptoms of certain psychological conditions, with the potential for serious physical health consequences that follow.
Cyberchondria stems from our brain’s natural tendency to consider the “worst case scenario” for potentially dangerous situations. This tendency is reasonable when considered from an evolutionary perspective. Using this adaptive tool allows us to predict danger and make choices to avoid it. For example, when we are walking at night and see that the street lights are out up ahead, we consider that there could be a mugger hiding in the shadows and adapt our route accordingly. Chances are there is no mugger, but our minds let us know of this outlier risk to prevent even the small chance of harm. In such an example, the brain has given us enough warning that we quickly identify the cause of our anxiety and make a shift that alleviates the anxiety. Unfortunately, this is the same part of the brain that gets triggered in cyberchondria, but the actions that we take in response actually increase our anxiety instead of quelling it.
Instead of pointing out the worst-case scenario and providing a means of escaping it, the online medical search highlights this scenario in such a way that we are drawn ever toward it. Imagine that you have a hoarse voice and a sore throat, and you initiate a web search to find out what might be wrong with you. Scanning the results of your search, you guess that the most likely culprit is all of the yelling you were doing at a concert the night before. However, before you turn off the screen, you notice that cancerous tumors in the throat also have the same symptoms. Your mind seeks to resolve anxiety over this worst-case scenario, so you dig to find additional information. With just a few clicks, you become convinced that you might actually have a tumor. You spend the entire night awake and terrified, rushing to your doctor first thing in the morning. The doctor assures you that it is unlikely to be a tumor, but your brain recalls all of the information from the Internet search and insists that you complete a wide variety of medical tests to be sure. The tumor is as unlikely as the mugger in the shadows, but there is no relief from taking another route home; treating the hoarse throat doesn’t rule out the tumor.
Cyberchondria itself is a challenging psychological condition. As with all forms of anxiety, it exists on a spectrum from mild to severe. Symptoms can range from being tired after a sleepless night of Internet searches to persistent fight-or-flight response in the body that causes muscle pain, migraines, and other physical ailments as well as changes in brain chemistry. This creates a vicious cycle; worrying that you are sick makes you sick.
Cyberchondria also has a number of additional consequences for both individuals and the greater community. The prevalence of this condition has led to a significant increase in the number of people visiting their doctors and a corresponding increase in the number of tests run on patients. This puts a strain on the medical system, which frustrates doctors, increases office waiting times for people with serious medical conditions, and raises insurance rates. People subject themselves to invasive procedures, including extensive surgeries, to treat their “medical issues,” all in a futile attempt to alleviate their own anxiety. This exacerbates physical symptoms that reinforce the belief that they are ill. Chronic pain, gastrointestinal dress, and cardiovascular symptoms are all common among people who believe that they are sick. Additionally, there is an increase in likelihood of depression.
Cyberchondria is an example of how the brain’s normal adaptive functions get derailed when interacting with technology. A fascinating sidebar to this is that our human behaviors teach computers to behave in a way that further exacerbates our anxiety. Computer search algorithms are designed to gather information about what humans search for in order to predict “better” search results for the next person. The problem with online medical searches is that the average person will be more drawn to find out about the tumor than the classic sore throat. Each time that a person clicks on the “tumor,” the computer records that this is the “better” response and feeds more information about tumors to people who are searching for information on hoarse throats. This leads an ever-increasing number of people to consider this worst-case medical scenario. Computer search engineers have been working on this issue, and changes are slowly being made to the technology to help combat the growth of cyberchondria. In the meantime, it is up to each individual to use common sense and sound in-person medical consultation to battle the anxiety that wells up every time a potential new “symptom” seems to manifest in the body. However, the more you indulge the urge to do this search, the more likely you are to fall prey to an addiction to keep doing it.
Searching for health information isn’t the only issue. There are so many different ways that we receive medical information from our devices these days. There are advertisements and commercials telling us about various heretofore-unheard-of conditions and recommending specific medications. Every streaming video option has some sort of medical-related television show. Even just posting on social media can become a problem because when you share that you are ill, others immediately sympathize, and that in itself can become addictive.
So, as you can see from the past two chapters, there are many aspects of the Internet that can provoke addiction. When you fall prey to one specific addiction, you may change your brain in such ways that make you susceptible to other online addictions.