Digital Dependency and Addiction
We have all heard friends, classmates, or colleagues say that they are addicted to some device or app, or they know someone who is. We may have said it about ourselves. What we seem to mean when we use the word in this way is that the “addicted” person is a heavy user and is unhelpfully or unhealthily dependent on that device or app. The person in question finds it hard to stay off email or Facebook, or spends an inordinate amount of time playing video games, or can’t go anywhere without his or her phone.
Apart from these common ways of talking, however, the scientific community has developed its own understanding of addiction as a clinical phenomenon, which isn’t the same as the everyday references we so often make. What’s more, scientists and clinicians are now engaged in a debate about whether there is such a thing as a digital addiction. The focus has been on the problematic use, the abuse, of video games and, more generally, the Internet. Two clinical diagnoses have been proposed: Internet Gaming Disorder and Internet Addiction Disorder.
Internet Gaming Disorder (IGD): The American Psychiatric Association (APA) lists Internet Gaming Disorder in the most recent edition of its diagnostic manual (the Diagnostic and Statistical Manual of Mental Disorders, or DSM-V). In a fact sheet, the APA identifies IGD as “a condition warranting more clinical research and experience before it might be considered for inclusion in the main book as a formal disorder.” The jury, in other words, is still out. The same fact sheet gives a brief, informal description of the phenomenon: “Recent scientific reports have begun to focus on the preoccupation some people develop with certain aspects of the Internet, particularly online games. The ‘gamers’ play compulsively, to the exclusion of other interests, and their persistent and recurrent online activity results in clinically significant impairment or distress. People with this condition endanger their academic or job functioning because of the amount of time they spend playing. They experience symptoms of withdrawal when pulled away from gaming.”1
Internet Addiction Disorder (IAD): One succinct definition of Internet Addiction Disorder is “the inability of individuals to control their Internet use, resulting in marked distress and/or functional impairment in daily life.” In 2012, the American Psychiatric Association proposed that a condition called Internet Use Disorder be included in the DSM-V and treated like IGD, as warranting further study. Criteria for identifying the condition included withdrawal symptoms when the Internet is taken away, and continued, excessive use despite “negative psychosocial problems.” The proposal was not accepted, and there is no mention of Internet addiction in the DSM-V.2
Critics of these conditions make two arguments. The first has to do with the nature of addiction itself. The scientific community takes unhealthy dependence on substances, such as drugs and alcohol, as the primary (and possibly the only) form of addiction. There is a longstanding debate about whether there is such a thing as a behavioral, as opposed to a chemical, addiction—whether one can be addicted to an activity, such as shopping or sex. (As one critic says, behavioral addiction “is a problematic construct, as it implies that any behavior that is rewarding can be addictive.”) Addiction to video games or the Internet would surely count as a behavioral addiction. Granting that behavioral addictions may exist, the second argument takes issue with the nature of the addiction. Critics say that one can’t be addicted to the Internet, which is merely the medium or the delivery mechanism through which specific problematic activities are engaged. Instead, “Internet addiction should be replaced by addictions to specific online activities,” such as shopping or pornography.3
No one in this debate seems to be denying that people can get into serious psychological trouble through their use of digital devices and apps. But there can be significant consequences resulting from how these discussions and debates, which are largely internal to the scientific and clinical communities, are resolved. Professional treatment follows from diagnosis, and the scope of the problem will depend on how the conditions are defined. (Estimates of the extent of Internet addiction in the United States vary widely, pointing to the current problem in defining and measuring the phenomenon.)4
I have no idea how the professional community will resolve these debates. But I can tell you how I approach the subject of addiction in my own work. Whether or not behavioral dependence should be considered addiction, I have no doubt that some people become dependent on their digital devices or apps in ways that are deeply dysfunctional. But extreme cases of addiction or dependency haven’t thus far shown up in my world. (Could it be that some students or working adults I encounter are dangerously dependent? Yes, of course. But I have yet to be told about it—although people will sometimes tell me that someone they know had or has been exhibiting signs of serious dependence.) Instead, what I hear, quite regularly, are people’s descriptions of their difficulty in letting go of some digital device, app, or practice. (You have seen many examples of this in this book, and may well have noticed it in yourself.) Someday, science may determine conclusively that the same brain mechanisms involved in chemical addiction are at work in behavioral dependence. Moreover, the science may show that these mechanisms are at work in lesser forms of dependence—when I check email many times a day despite feeling that it is an unnecessary and even unproductive practice. But for these lesser forms—the kind that we have been exploring in this book—I don’t believe that we need a scientific explanation of the phenomena. What we need is honest observation, a commitment to make changes in the service of greater health, and the caring support of others around us.