Internet addiction and health risks: symptoms and treatment

Internet addiction is a compulsive and uncontrollable need to use the internet regardless of the consequences and problems it causes. This type of addiction is associated with many health risks such as physical health issues, sleep disturbances, risk of addiction transfer, mental health disorders, cyberbullying and online harassment, cognitive problems, financial problems, social consequences, academic or work-related issues, and reduced quality of life.

The signs of internet addiction include spending most of the time online, unsuccessful attempts to reduce internet use, concealing internet use, refusing to admit the presence of a problem, loss of interest in activities once enjoyed, neglecting responsibilities, poor hygiene, pains and aches, sleep problems, and withdrawal symptoms when unable to use the internet.

Internet addiction treatment mainly involves cognitive-behavioral therapy (CBT), inpatient programs, outpatient programs, and support groups. 

What is internet addiction?

Internet addiction is defined as the compulsive need to spend time on the internet despite negative consequences in relationships, health, and quality of life. The person with internet addiction becomes dependent on being online and gradually increases the time spent on the internet to achieve the same “high” or positive effects, explains an article on internet addiction from the Better Health Channel. In their paper from the May 2008 issue of CNS Drugs, Martha Shaw and Donald W. Black explained internet addiction is characterized by poorly regulated preoccupations, urges, or behaviors associated with computer use and internet access leading to distress or impairment.

Internet addiction is a broad term that involves different kinds of addictive behaviors online. Examples of internet addiction include cybersex addiction, net compulsions, compulsive information seeking, cyber relationship addiction, and internet gaming addiction.

The internet was officially invented on January 1, 1983, but the idea has been present for decades before that. However, the World Wide Web became available to the public on April 30, 1993. Just a few years later, internet addiction was first described. The history of internet addiction is associated with two names: Dr. Ivan Goldberg and Dr. Kimberly Young. In 1995, the New York-based psychiatrist, Dr. Ivan Goldberg, was the first to coin the term internet addiction disorder alongside the list of symptoms. The same year, Dr. Kimberly Young carried out a study of 500 heavy users of the internet and compared their behavior with diagnostic criteria for gambling, as reported by a paper that Caroline Flisher published in the October 2010 issue of the Journal of Paediatrics and Child Health. 

Dr. Kimberly Young published a book in 1998 titled “Caught in the Net: How to Recognize the Signs of Internet Addiction – and a Winning Strategy for Recovery” which was one of the first descriptions of problematic use of the internet as an addictive disorder. In her book, Dr. Young explained that internet addiction can negatively affect people and their families, just like addiction to alcohol and drugs. Moreover, Dr. Young also developed an assessment scale to identify internet addiction, just like Dr. Goldberg.

At this point, internet addiction is not included in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) by the American Psychiatric Association. In DSM-5, however, internet gaming addiction is identified in Section III as a condition that warrants more clinical research. 

According to a July 2023 post written by Deyan Georgiev for Tech Jury, studies found 1.5% to 8.2% of persons globally have internet addiction in 2013. This number was alarming at the time. Internet addiction has grown in recent years. When COVID-19 hit, everyone stayed home and used the internet to keep connected. That increased Internet reliance, resulting in 36.7% Internet addicts. According to the abovementioned paper by Shaw and Black, the prevalence of internet addiction in the United States ranged from 0.3% to 0.7%

What are the health risks of internet addiction?

The health risks of internet addiction are listed below:

• Physical health issues
• Sleep disturbances
• Risk of addiction transfer
• Mental health disorders
• Cyberbullying and online harassment 
• Cognitive problems
• Financial problems
• Social consequences
• Academic or work-related issues
• Reduced quality of life

1. Physical health issues

Physical health issues are problems with the normal functioning of the body and are referred to as illnesses or diseases. The disease is an identifiable problem in the tissues or organs in the body that causes symptoms a person is experiencing. These problems may stem from hormonal imbalances, genetics, and other causes such as lifestyle factors. Addictive behaviors may harm physical health and internet addiction is not the exception.

Physical health issues become a health risk in internet addiction because this type of addictive behavior is associated with an unhealthy lifestyle, which jeopardizes physical health and well-being. Internet addiction is strongly associated with a sedentary lifestyle (low physical activity) and obesity, according to a study that K. Eliacik et al. published in the October 2016 issue of Eating and Weight Disorders – Studies on Anorexia, Bulimia, and Obesity. This is important because lack of physical activity and excess weight put a person at a higher risk of health problems including diabetes and cardiovascular diseases.

In their study from the March 2021 issue of Life (Basel), Gabor Toth et al. revealed that internet addiction was associated with the presence of illnesses such as diabetes. The relationship between the two could arise from an unhealthy lifestyle linked to excessive internet use. People with internet addiction may eat unhealthy diets and avoid exercising, which makes them more susceptible to weight gain and related problems such as diabetes.

Isa Celik and Murat Bektas published a study in the May-June 2023 issue of the Journal of Pediatric Nursing confirming that digital game addiction can trigger an incidence of diabetes, cancer, and cardiovascular diseases later in life. The authors of the study explained that due to a sedentary lifestyle and unhealthy diet, this type of addiction can lead to insulin resistance, and hypertension (high blood pressure), which can cause diabetes and cardiovascular problems.

Speaking of health risks associated with internet addiction, self-reported immunity is also worth mentioning. In the study that Phil Reed et al. published in the August 2015 issue of PLoS One, internet addiction was linked to decreased self-reported immune function. The same paper confirmed excessive internet use can harm the immune system through higher levels of stress hormone cortisol, which can act as an immune-suppressant.

Physical health risks of internet addiction extend to musculoskeletal pain due to improper posture that puts excess strain on tendons, discs, and muscles, according to a study that Guang Yang et al. published in the September 2019 issue of Frontiers in Psychology. People with internet addiction may feel pain in their neck, shoulder, elbow, wrists, and hands.

In the study from the August 2022 issue of Medicine (Baltimore), Siyu Liang et al. revealed internet addiction can lead to increased fatigue due to musculoskeletal pain, inflammation, and lack of sleep. When it comes to pain, internet addiction was linked to migraine with aura in the study that Tathiana Correa Rangel et al. published in the February 2022 issue of Neurological Sciences. A migraine with aura is a recurring headache that occurs during or after sensory disturbances called aura (flashes of light, blind spots, vision changes). Internet addiction may contribute to migraine due to exposure to bright lights from screens that cause eye strains and may show potentially flickering images.

2. Sleep disturbances

Sleep disturbances are disorders of initiating and maintaining sleep e.g. insomnia, disorders of excessive somnolence or sleepiness, disorders of sleep-wake schedule, and impairments regarding sleep, sleep stages, and parasomnias. A wide range of causes can impair sleep duration and quality. Good examples are physical diseases, stress, and addictive behaviors such as internet addiction.

Sleep disturbances become a health risk in internet addiction due to exposure to blue light, suppressed melatonin, and mental health issues associated with this type of addiction. Internet addiction is associated with poor sleep quality and disturbed sleep, according to a paper “Digital Addiction and Sleep” in the June 2022 issue of the International Journal of Environmental Research and Public Health. People with addiction to the internet are prone to insomnia among other problems such as depression, as per a study by Marietta Pohl et al. in the January 2022 issue of the same journal. The negative link between internet addiction and sleep quality was also confirmed by the study that Amrita Nayak et al. published in the July-September 2021 issue of Clinical Epidemiology and Global Health.

Internet addiction involves increased exposure to blue light. Blue light negatively affects circadian rhythm because it stimulates parts of the brain that promote alertness, but it can also contribute to increases in body temperature and heart rate, a 2023 article on how blue light affects sleep published in the Sleep Foundation explained. Moreover, blue light can suppress the release of the hormone melatonin, whose job is to regulate circadian rhythm and helps us sleep. In their study from the September 2003 issue of The Journal of Clinical Endocrinology and Metabolism, Steven W. Lockley et al. confirmed that exposure to blue light suppresses melatonin. For that reason, a person with internet addiction may struggle to fall asleep or get enough sleep during the night. 

Besides blue light exposure and melatonin suppression, internet addiction disturbs sleep due to stress and mental struggles, which are going to be discussed below. Chronic sleep problems can negatively affect physical health and contribute to fatigue, weight gain, diabetes, or heart disease.

3. Risk of addiction transfer

The risk of addiction transfer refers to the act of trading one addiction for another. It may happen when a person is in recovery and tries to substitute their addiction with a different addictive behavior e.g. quitting alcoholism by getting addicted to eating sweets. Internet addiction may also cause this problem.

The risk of addiction transfer becomes a health risk in internet addiction because an affected person may attempt to reduce internet use or screen time by engaging in a different kind of addictive or risky behavior. According to a study that Robert Svensson and Bjorn Johnson published in the August 2020 issue of Drug and Alcohol Dependence, internet activities are associated with drinking. Self-presentation and online sociality are involved in the relationship between internet addiction and the consumption of alcohol. Additionally, problematic internet use increases the risk of addictive behaviors such as smoking, confirmed the study by Phoenix Kit-han Mo et al. in the December 2019 issue of the International Journal of Environmental Research and Public Health. The researchers explain that internet addiction may interfere with normal, adaptive functioning thereby leading to engagement in risky behaviors.

In their study from the November 2016 issue of International Gambling Studies, Orestis Giotakos et al. found that internet addiction substantially predicted participation in online gambling, substance use in general, and specifically cocaine and heroin usage.

Important information to keep in mind is that the relationship between internet addiction and addictive behaviors is complex. In the same way, internet addiction can increase engagement in risky or addictive behaviors, vice versa can happen too. For example, substance abuse may precede internet addiction according to a paper that Young Sik Lee et al. published in the April 2013 issue of Addictive Behaviors.

4. Mental health disorders

Mental health disorders are major disturbances in cognition, behavior, and emotion regulation. They are associated with distress or problems in important areas of functioning. People develop mental health disorders due to trauma, chronic diseases, major stress, and other causes such as addiction.

Mental health disorders become a health risk in internet addiction because excessive use of the World Wide Web, especially social media platforms, can affect self-esteem and confidence, and make a person more vulnerable to mental illnesses. Digital addiction causes a chain of reactions in the brain that may involve reduced levels of the neurotransmitter serotonin, according to a study by Birgitta Dresp-Langley and Axel Hutt in the June 2022 issue of the International Journal of Environmental Research and Public Health. Serotonin participates in functions such as mood regulation. Low levels of this neurotransmitter may cause depression.

People with internet addiction may spend a lot of time on social media where they are exposed to unrealistic standards of beauty, body image, and even career or success. They may compare themselves to influencers or colleagues, which leads to problems with self-esteem and increased levels of stress. When this happens regularly, a person becomes more prone to mental illnesses such as anxiety and depression. Mental health disorders in internet addiction may also stem from deeper issues such as loneliness. 

5. Cyberbullying and online harassment 

Cyberbullying is defined as a type of bullying wherein one or more individuals repeatedly cause harm to another person intentionally via digital technologies. Victims of cyberbullying are harassed online, receive threats via messages, or are publically humiliated. This type of bullying affects all age groups, but it is primarily present among adolescents. 

Cyberbullying and online harassment become health risks in internet addiction because the increased online exposure simplifies online victimization by peers and due to the release of dopamine. In the study from the April 2020 issue of BMC Psychiatry, Ling Lin et al. confirmed the relationship between internet addiction and cyberbullying. The authors also explained excessive internet use simplifies victimization, and cyberbullying can lead to negative health consequences. Moreover, higher social media addiction scores and being a male predicted cyberbullying perpetration in a study that Amanda L. Giordano et al. published in the February 2021 issue of the Journal of Child and Adolescent Counseling. Internet addiction, which often involves problematic social media use, may contribute to cyberbullying and online harassment because people can remain anonymous and avoid retaliation. Cyberbullies tend to feel less remorse or empathy because they can’t directly see the consequences of their actions. 

Exposure to an addictive substance or behavior, in this case, the use of the internet, triggers the release of dopamine. Neurotransmitter dopamine regulates the brain’s reward center and produces positive emotions such as satisfaction and pleasure. The use of the internet, particularly social media platforms, is meant to give people that dopamine boost. A person with internet addiction may compulsively look for that dopamine hit. They may resort to cyberbullying as a way to get attention (and thereby positive emotions) through likes, comments, and shares. 

Internet addiction is associated with aggression and impulsivity. This type of addiction was found to be related to an increased tendency to violence in the study that Mahmut Evli et al. published in the March 2023 issue of the International Journal of Social Psychiatry. Aggression, impulsivity, and tendency to violence can all contribute to online harassment and cyberbullying.

Not only can internet addiction lead to cyberbullying perpetration, but also victimization, according to a paper “Association of Cyberbullying and Internet Use Disorder” in the September 2022 issue of Current Addiction Reports. Problematic internet use increases a person’s exposure to online bullies and makes them vulnerable to harassment, especially if they already have problems with mental health.

6. Cognitive problems

Cognitive problems are impairments in cognitive functions including memory, focus and concentration, attention, solving problems, or making decisions. People experience cognitive problems due to mental illnesses, physical illnesses like Alzheimer’s disease, drug abuse, and even due to internet addiction.

Cognitive problems become a health risk in internet addiction because excessive use of the internet can change the way the brain works. Problematic internet use causes cognitive deficits such as impairment in inhibitory control, decision-making, and working memory, according to a study that Konstantinos Ioannidis et al. published in the November 2019 issue of The British Journal of Psychiatry. The authors explained cognitive problems in internet addiction could be associated with dysfunction of frontostriatal brain circuitry, the region that plays a key role in motivation, emotion, movement control, and cognition. 

Excessive internet use impedes task-switching ability due to a person’s increased susceptibility to distraction from irrelevant environmental stimuli. Too much time spent on the internet jeopardizes cognitive functions through several mechanisms such as reduced engagement with academic and social activities, disrupted sleep, or decreased opportunity to engage in creative thinking, according to a paper that Joseph Firth et al. published in the June 2019 issue of World Psychiatry. The same paper explained heavy internet use can impair memory because the internet has become a supernormal stimulus for transactive memory that makes all options for cognitive offloading (e.g. books or community) redundant. The internet doesn’t place responsibility on the user to retain specific information but acts as a single entity responsible for holding and retrieving factual information. That way a person doesn’t have to remember where the information is located.

A paper from the August 2019 issue of the Journal of Injury and Violence Research confirmed that internet addiction disorder causes working memory impairments. Authors Ali Reza Shafiee-Kandjani et al. concluded problems with working memory may negatively affect the educational functioning of people with internet addiction.

Excessive use of the internet may harm short-term memory and attention because it interferes with a person’s ability to focus on a specific cognitive task for extended times, according to a February 2020 post by Rawan Taraweh, MD on the website of The Ohio State University Wexner Medical Center.

In people with internet addiction, brain areas such as dorsolateral prefrontal cortex (involved in working memory, planning, inhibition, task-switching), cingulate gyrus (involved in emotion and autobiographic memory), and medial prefrontal cortex (mediates decision-making) are more active when they are in the internet state. Activation of these brain areas may diminish cognitive executive control and also induce a strong craving response to the network, according to a paper by Hao Chen et al. in the February 2023 issue of Frontiers in Psychiatry. Individuals with internet addiction, according to the same paper, have decreased density of white and grey matter in the inferior frontal gyrus and insula. These brain areas assess the link between reward and risk and also regulate decision-making. Meanwhile, persons with internet addiction exhibit a lowered aversion to risk and are unable to properly evaluate the potential loss behind risky choices, which can also impair the decision-making process.

7. Financial problems

Financial problems refer to a situation wherein a person is unable to pay their bills on time or afford necessary basic needs. A wide range of situations and behaviors can contribute to financial problems including medical expenses, unemployment, improper financial planning, poor spending habits, gambling, and other addictive behaviors such as internet addiction.

Financial problems become a health risk in internet addiction due to increased spending online, engaging in behaviors such as gambling, and as a consequence of work-related problems. A person with internet addiction may spend a significant amount of money on purchasing new devices to ensure a better online experience. Their spending habits may put them in debt and cause financial problems. 

Internet addiction may contribute to impulsive shopping or increased spending online. A study by Wei Jie et al. in the August 2022 issue of Frontiers in Psychology revealed that internet usage significantly and positively influences impulsive buying behavior. People rely on the internet to make buying choices and spend a lot of time on social media where they are exposed to product placement. All these things can increase their spending and lead to impulsive shopping. Heavy internet use can thereby lead to more serious problems such as shopping addiction. Problematic online buying behavior is associated with addiction to the internet and mediated by factors such as low self-esteem and self-regulation, negative emotional state, enjoyment, cognitive overload, and social anonymity, according to a paper that Susan Rose and Arun Dhandayudham published in the June 2014 issue of the Journal of Behavioral Addictions.

In an attempt to seek more thrill online, a person with internet addiction may start to gamble. This can lead to financial losses that worsen their money-related struggles. In her paper from the April 2015 issue of Current Addiction Reports, Sally M. Gainsbury explained that internet gambling is the fastest-growing mode of gambling and is changing the way gamblers engage in this behavior. It further shows that people with problematic internet use or addiction spend their money in different ways, all of which put them in financial trouble. Plus, a person with internet addiction may prioritize time spent online over job-related responsibilities. They may lose their job and worsen their financial status.

8. Social Consequences

Social consequences are negative outcomes of a specific activity or behavior on the social life and relationships of an individual. A person’s actions have a deep impact on their social life and companionships, friendships, and personal relationships. Behaviors such as gambling, compulsive shopping, drug seeking, and risk-taking actions can affect relationships with other people including family and friends or colleagues. Internet addiction can do the same.

Social consequences become a health risk in internet addiction because this addictive behavior may lead to loneliness and social isolation or withdrawal. According to a study that Arzu Sarialioglu et al. published in the March-April 2022 issue of the Journal of Pediatric Nursing, internet addiction has become an important risk factor in loneliness. At the same time, loneliness pushes people to excessive internet use and may contribute to internet addiction.

In the meta-analysis and systematic review from the December 2021 issue of SSM – Population Health, Hossein Mozafar Saadati et al. confirmed that individuals with internet addiction had higher scores of loneliness. That happens because people with internet addiction spend more time online, which leads to isolation from family and society. Gradually, these people become lonelier. Moreover, loneliness in internet addiction may also stem from mental health problems that a person is experiencing e.g. depression. Lifestyle and dietary behavior may contribute to loneliness in people with internet addiction. A person with this type of addiction has a sedentary lifestyle and loses interest in activities once enjoyed. That means they become less interested in spending time with their family or friends, hanging out, or meeting them for a meal. 

A positive correlation between internet addiction and problems with personal relationships was found in the systematic review published by Qing-hong Hao et al. in the March 2022 issue of Frontiers in Psychiatry. The reason for problems in relationships could be over-reliance on the internet which makes up most of the addict’s time and results in lowered social participation. Other factors associated with internet addiction and problems in relationships include low self-esteem, shyness, pressure, and anxiety. People with internet addiction may prefer communicating online rather than real-life interaction, which negatively affects their social life. 

Difficulties in relationships may also stem from frequent arguments and disagreements over internet use, when friends, family, or coworkers express their concerns and the affected individual refuses to acknowledge they have a problem.

9. Academic or work-related issues

Academic or work-related issues are problems at school or in a professional career due to a specific reason. These can include difficulties learning, poor grades, behavioral problems in school, reduced productivity at work, and overall poor performance in school or work. People with academic or work-related issues are at risk of getting fired or being expelled from school. Addictive behaviors such as internet addiction are major contributors to these issues.

Academic or work-related issues become a health risk in internet addiction due to a lack of interest and because internet use is the biggest priority in a person’s life to the point all their responsibilities are neglected. Internet addiction hurts academic performance; students with addiction to the internet had lower scores in their exams, according to a study that Arslaan Javaeed et al. published in the January-February 2020 issue of the Pakistan Journal of Medical Sciences. The same study revealed that internet addiction can cause loneliness, depression, and shyness, all of which can make the development and maintenance of social relationships with academic supervisors and peers difficult.

Internet addiction impaired students’ intrinsic value, utility value, and satisfaction with academic performance in a study by Diya Dou and Daniel T.L. Shek in the December 2021 issue of Frontiers in Psychology.  Students with more severe internet addiction symptoms regarded school work as boring and consequently felt less satisfied with their performance. More precisely, a person with internet addiction may lose interest in their school (or work) because it is not as interesting as their online activities; school or work doesn’t produce the thrill they experience online and they are not motivated to engage in their tasks or responsibilities. 

Internet addiction has a negative effect on job and job-related satisfaction, according to a study that Henrique Pereira et al. published in the July 2021 issue of the International Journal of Environmental Research and Public Health. Symptoms of internet addiction are also associated with mental health problems. This is important because mental health symptoms can also affect job satisfaction and performance. The same paper reported that being heavily dependent on technology can negatively affect productivity. 

Men and women with internet addiction may spend increasing amounts of time on the internet, which harms their productivity at work or school or they may lose interest and neglect their responsibilities. When left unresolved, these problems can be serious and threaten their academic or professional life. 

10. Reduced quality of life

Reduced quality of life is the state wherein a person’s overall well-being and happiness are decreased due to factors such as physical or psychological issues, financial difficulties, and social isolation. Addictions and addictive behaviors can negatively affect the quality of life. Internet addiction can also decrease overall well-being and satisfaction in the life of the affected person. 

Reduced quality of life becomes a health risk in internet addiction because excessive use of the internet prevents a person from enjoying life and negatively affects their physical and mental well-being. People with high internet addiction scores have lower quality of life scores, according to a paper that Farzaneh Noroozi et al. published in the December 2021 issue of The Scientific World Journal. Quality of life becomes lower as internet addiction becomes more severe. Internet addiction decreased the quality of life in physical, psychological, social, and environmental aspects. Internet addiction reduced quality of life due to long-term lack of sleep, deteriorated physical health, impaired concentration at work, and decreased intimacy with family members.

In the meta-analysis from the December 2014 issue of Cyberpsychology, Behavior, and Social Networking, authors Cecilia Cheng and Angel Yee-Iam Li wrote that internet addiction is associated with subjective (life satisfaction) and objective (quality of environmental conditions) reductions in quality of life. The paper showed internet addiction is positively associated with traffic commute time consumption and pollution. Inefficient transportation and high levels of pollution increase stress levels, which further worsens internet addiction and negatively affects the quality of life. 

People with internet addiction spend a lot of time online or think about their internet-based activities, which prevents them from paying attention to real-life events. They neglect responsibilities that lead to the abovementioned problems at work or school and are at a high risk of physical and psychological conditions. All these factors negatively affect a person’s quality of life. Moreover, quality of life reduction resulting from internet addiction may also involve engaging in risky online behaviors. For example, a person may start gambling, shopping compulsively, or engaging in risky cybersex practices, which affects the quality of life as well. 

What are the common signs and symptoms of internet addiction?

Common signs and symptoms of internet addiction are behavioral, psychological, and physical, and they are listed below.

• Spending most of the day online
• The feeling of losing control of time spent online and difficulty logging off even when attempting to do so
• Continuing spending time on the internet regardless of the consequences
• Strained or ruined relationships due to excessive internet use
• Poor performance at work or school due to time spent online
• Avoiding spending time with family or friends in favor of internet-related activities 
• Losing interest in activities or events once enjoyed due to heavy internet use
• Attempting to hide how much time is spent online 
• Denying presence of the internet use-related problem
• Using the internet as an escape from negative emotions or moods
• Experiencing withdrawal symptoms (irritability, anxiety, restlessness) when not able to use the internet
• Memory difficulties
• Worsening of the existing mental health problems
• Sleep deprivation due to excessive internet use at night
• Aches and pains due to a sedentary lifestyle
• Poor hygiene and an unkempt appearance
• Weight changes due to altered dietary pattern
• Dry eyes resulting from staring at the screen

How does internet addiction affect mental health?

Internet addiction affects mental health because it causes an imbalance of hormones and neurotransmitters that negatively affect psychological well-being. Excessive internet use increases stress levels due to elevated levels of the hormone cortisol and sleep deprivation. In fact, internet addiction may cause blunted cortisol responses in acute stress settings, according to a research article by Hideki Tsumura et al. in the December 2022 issue of Heliyon. This finding matters because blunted cortisol reactivity to stress could represent a marker of suicide risk. Internet addiction is also associated with a higher risk of suicidality even after adjusting for variables such as depression, according to a meta-analysis by Yu-Shian Cheng et al. in the June 2018 issue of The Journal of Clinical Psychiatry.

The impact of internet addiction on mental health also extends to feelings of restlessness, especially when a person is attempting to stop or reduce time spent online. 

Moreover, internet addiction is associated with increased release of the neurotransmitter dopamine. Our brains release a certain amount of dopamine when we engage in internet activities such as social media platforms. Dopamine is in charge of the brain’s reward system meaning its release produces positive emotions such as pleasure and satisfaction. The role of dopamine in the development and maintenance of internet addiction is also confirmed by a paper that Min Liu and Jianghong Luo published in the June 2015 issue of the International Journal of Clinical and Experimental Medicine. However, dopamine plays an important role in other processes and good examples are increased aggression and impulsivity. That explains why people with internet addiction have a tendency to aggression and are prone to impulsiveness e.g. impulsive shopping, which can also lead to bigger problems such as shopping addiction.

Internet addiction is linked to higher levels of loneliness, low self-esteem and confidence, shyness, lack of social skills, and behavioral maladjustment, all of which negatively affect mental health. 

Can internet addiction lead to mental disorders?

Yes, internet addiction can lead to mental disorders or worsen existing psychological problems. Internet addiction is associated with mental disorders such as anxiety, depression, and bipolar disorder.

Internet addiction was positively associated with stress, anxiety, and depression in the paper that Beata Gavurova et al. published in the June 2022 issue of Frontiers in Public Health. The relationship between internet addiction and mental disorders results from psychological distress triggered by excessive internet use, the researchers explained. 

The January-June 2018 issue of the Industrial Psychiatry Journal featured a study by Manish Kumar and Anwesha Mondal, which confirmed that internet addiction is linked to symptoms of anxiety and depression as well as interpersonal sensitivity. The study showed that severe internet users exhibit higher psychopathological symptoms in obsessive-compulsive, depression, interpersonal sensitivity, and anxiety domains. The link between internet addiction and mental illness could stem from poor mental well-being due to criticism by others, shyness, a sense of discomfort when being criticized, or lower social support. These factors make a person’s psychological well-being vulnerable. At the same time, internet addiction may cause changes in the brain and an imbalance of neurotransmitters such as dopamine, which can also contribute to mental health disorders.

Patients with internet addiction are at a higher risk of developing bipolar disorder, according to a study by Klaus Wolfling et al. in the June 2015 issue of the Journal of Behavioral Addictions. At the same time, people with bipolar disorder are more likely to exhibit problematic internet use, as per a study by Claudia Carmassi et al. in the April 2021 issue of Frontiers in Psychiatry.

It’s also useful to mention that problematic internet use could be a predictor for eating disorders such as anorexia nervosa, bulimia nervosa, binge-eating disorder, food preoccupation, loss of control eating, and dieting, as reported in a systematic review by Francisco-Javier Hinojo-Lucena et al. in the September 2019 issue of Nutrients.

The relationship between internet addiction and mental disorders is bidirectional. Not only does internet addiction increase the risk or worsen disorders such as depression, the vice versa can happen too. People with internet addiction tend to have comorbid psychiatric disorders such as depression, attention deficit and hyperactivity, generalized anxiety disorder, social anxiety disorder, dysthymia, eating disorder, alcoholism, obsessive-compulsive personality disorder, borderline personality disorder, and avoidant personality disorder, according to a paper by Veruska Andrea Santos et al. in the January-March 2016 issue of JMIR Research Protocols.

What are common treatments for internet addiction?

Common treatments for internet addiction are listed below.

• Inpatient (residential) program: a treatment approach that requires patients to be admitted into a rehab center to treat their addiction in a controlled environment, with supervision. Patients live in a rehab center throughout the treatment. The integral component of inpatient treatment is therapy but also includes skills learning, relapse prevention, a structured schedule, focus on oneself and their recovery, peer support, and constant professional support. The duration of the inpatient residential program is 30, 60, or 90 days.
• Outpatient program: a treatment approach that provides support to patients, but without living in a rehab facility. Patients maintain employment or keep going to school and live at home. Like an inpatient program, it focuses on therapy, which patients are required to attend regularly. The benefits of this approach include more freedom, learning skills, and the opportunity to manage triggers in a real-life setting. The outpatient program can last three to six months.
• Support group: a gathering of people with the same problem e.g. internet addiction. It relies on peer support. Members both offer and receive support, share stories, inspire, and get inspired to work on their recovery. Stories of other members serve as motivation to overcome the challenges of addiction and treatment. Support groups show a person is not alone and make it clear that successful recovery from internet addiction is possible. People can attend support group meetings indefinitely. 

What role does cognitive-behavioral therapy (CBT) play in treating internet addiction?

Cognitive-behavioral therapy plays a crucial role in treating internet addiction because it works by encouraging people to identify negative/irrational thoughts and triggers of their addiction. Once they identify negative thinking patterns, patients learn skills to replace them with more positive relationships. 

CBT combines cognitive therapy and behavioral therapy to help patients learn how their thoughts influence emotions and behaviors thereby contributing to addiction. As a result, a patient is empowered to make positive changes in order to overcome addiction and prevent relapse. Moreover, CBT works toward regular goals thereby giving patients a tangible sense of progress and achievement.

How effective are treatments for internet addiction?

Treatments for internet addiction are highly effective, particularly when they are part of a well-structured program. Current research focuses primarily on CBT. CBT programs can successfully reduce symptoms of addiction including overuse of the internet, reported Qutaiba Agbaria in a paper from the January 2022 issue of the International Journal of Mental Health and Addiction. The same paper confirms CBT is the most common type of therapy used for people with internet addiction and it can reduce internet use while strengthening self-perception.

Cognitive-behavioral therapy for internet addiction successfully ameliorated symptoms after 12 weekly sessions and consistently over one month, three months, and six months after therapy, according to a paper by Kimberly S. Young in the December 2013 issue of the Journal of Behavioral Addictions.

CBT can enhance awareness and mental health among people with internet addiction, according to a paper that Seyyed Salman Alavi et al. published in the January-March 2021 issue of Trends in Psychiatry and Psychotherapy.

China and South Korea have inpatient Internet addiction programs, although there is little scientific proof they function, according to a 2009 article by Roger Collier published in the Canadian Medical Association Journal. 

From the same paper, Dr. Elias Aboujaoude, director of the Impulse Control Disorders Clinic at Stanford University School of Medicine in California, says such programs’ success percentages are typically reliant on information provided by their operators, which does not justify their high costs. Aboujaoude first advises cognitive behavioural treatment for Internet addiction to his patients.

An outpatient treatment program that works around the busy plans of people who are addicted to the internet may also help them get better faster.

Finally, support groups like Internet and Technology Addicts Anonymous may help problematic internet users cope with their circumstances from the perspective of those who understand them.