We live in the age of technology, and much of our lives revolve around our screens. Working, studying, keeping in touch with our loved ones, shopping or paying bills – everything can be done with a click of the mouse or a phone. Our reliance on technology has made our lives much simpler; it also means that we may not be able to identify when our usage of technology moves from healthy, useful patterns (where we possess control over how we use technology), into unhealthy or addictive ones (where we lose control over our usage). The question is: How do you know when you stop controlling your habit, and when your habit begins controlling you?
Nineteen year-old Rohit was quite fond of his smartphone and wouldn’t let it go out of his sight for most of his waking hours. Like other teens, he used his mobile phone to send emails, text and chat with friends, surf the internet, and play games. Unlike most other teens, Rohit would spend at least six hours a day glued to the screen of his smartphone. He would receive at least 400 text messages per day, and send 200. He developed finger pain and eye strain due to increased screen-time, and was not able to sleep well because of repeated urges to check his phone for new messages. He would sleep during class hours. When he was awake, he was mostly distracted because his mind would be on the text messages. His grades went down. When his parents found out about the changes in his behavior, they were concerned. They soon found out that the changes were caused by Rohit’s addiction to texting.
This narrative has been created from a real-life story. Names have been changed to protect identity.
Tech addiction: Not a serious problem?
With technology being omnipresent, the line between healthy and unhealthy use is very fine, and it is not easy to say when a person has crossed over. The behavior is not always quantifiable, and the effects may be more visible only in the long term. This is possibly why we don’t consider technology and internet addiction to be as serious as other addictions.
We read about the dark side of technology addiction – people who buried themselves in debt with online shopping or parents who were so hooked onto video games that their children starved to death. What we sometimes don’t realize is that a sort of addiction that doesn’t seem to be so harmful – staying glued to the computer or phone for hours on end – can have some serious repercussions too.
More and more mental health professionals, however, are treating technology addiction similar to other addictions. Like substance abuse, technology addiction comes with its own behavioral signs, withdrawal symptoms and dysfunctional behavior. And like all other addictions, technology addiction begins as a habit, and when uncontrolled, can impact other aspects of our lives – general health and wellbeing, relationships and daily routines.
In Bangalore, the SHUT (Services for Healthy Use of Technology) Clinic run by the National Institute of Mental Health and Neurosciences (NIMHANS) sees an average of 15 cases every month.
What is technology addiction?
Medically, addiction is defined as a pattern in which a person becomes dependent on a substance which gives them pleasure. When the person becomes dependent on a substance, they are unable to focus on other areas of their life, including family, friends and work responsibilities. This creates problems for the person as well as those around them.
Technology addiction is a disorder in which a person is addicted to a certain technological medium. In India, most of the cases reported are of young adults, aged between 14 and 19, who are overly dependent on their mobile phones/computers for texting, watching videos or social networking.
With the increasing application of technology in all aspects of our daily lives, technology addiction can be challenging and complex because it is difficult to say when usage of technology to aid our activities can cross over into an unhealthy pattern of usage.
“As long as your technology use is related to a purpose – be it academics, profession or utility – and you are able to shift into other activities once the purpose is fulfilled, you fall into the category of normal use,” says Dr Manoj Sharma, additional professor, department of clinical psychology, NIMHANS.
Dr Sharma, who runs the SHUT clinic (Services for Helathy Usage of Technology) adds that there are some cues to look out for to see if your use is unhealthy: there is no defined purpose to use the technology, you may keep accessing it for no specific reason, and you cannot log off once you log in. You may also feel compelled to check your phone or email while you’re busy with other activities. The people around you – your friends, family, colleagues – may express concern about you not spending enough time with them, or being on the phone even when you’re having a conversation with them.
Rohit’s story, narrated above, is one of the many that the SHUT clinic has witnessed during the last year. Dr Sharma says that most teenagers who are brought to the clinic by their parents are neglecting their schoolwork, routines and general health due to dependence on texting, playing video games, social networking, or online pornography.
The youngest client at the SHUT clinic was a 14-year-old video game user who had been playing video games online from the age of six. He would spend all his time after school, and his entire weekend on playing video games. Initially, the parents didn’t consider this to be a serious problem. The teenager would not leave his room, even for food or water. He would not communicate with his parents or other family members. The parents – who thought this was just a growing phase -- realized that the matter was serious when the school told them that he was distracted, falling asleep in class, and was behind on his assignments. They reached out to the SHUT Clinic for help. The parents were upset and angry with their son. While their son received help to manage his disorder, they received support too. Having received some counseling, and getting informed about the disorder, they were able to view the situation with more objectivity. They were able to understand what their son was going through. They monitored his usage of the internet and made sure that he was paying attention to his academics as well as outdoor activities. Within a few months, their son was able to catch up on his schoolwork; the dysfunctional behavior came down drastically.
Do I need screening for technology addiction?
A person may need screening for their technology addiction if they display at least two of these three signs:
Craving: Being preoccupied with the internet/ technology and feeling restless when you are away from the computer or phone
Loss of control: Being unable to limit how much time is spent on the internet (i.e. spending more time on the internet than planned)
Compulsion: Spending a majority of their waking time online
In addition, they must also display at least four of the following signs:
Loss of interest in other activities
Lying about the amount of time spent online
Waking up in the middle of the night to go online, check emails or messages
Decreased attendance and productivity at work or school
Neglect of family and friends
Neglect of personal hygiene and self-care (forgetting to eat or sleep at regular intervals)
Effects of technology addiction
Technology addiction tends to begin as a hobby and if usage goes unchecked, develops into an addiction that takes most of the person's waking hours. The person shows dysfunction in one or more of the following areas:
Sleeping patterns: The person may sleep late because of the amount of time spent online; or may have disturbed sleep
Productivity: The person skips classes or work to catch up on sleep; they fall asleep during study or working hours; their grades suffer
General health: The person complains about health problems such as wrist pain, finger pain, eye strain, backache, fatigue, loss of appetite, or dehydration
Communication: The person tries to center their real-life activities around their online activities. They avoid going outdoors (or to any place where their online activities may be impacted negatively), may prefer to stay in their room, or avoid personal interaction even when out in social settings, choosing instead to stay glued to their phone screen.
At the SHUT clinic, clients fall into two broad categories:
The first, teens that already have psychological issues – those who are very shy, unable to cope with challenges, or have anxiety issues. They prefer to spend their time online because the chances of rejection are low.
Teens that are experimentative in nature, and need the thrill of trying something new. Many of these teens use social networking sites or play video games for the instant gratification it offers them.
“Usually, parents bring their children after they show significant distress or dysfunction. By then, they have tried to use other strategies to curb the use of technology, but they haven’t worked. The parents themselves aren’t against technology – they are only worried because their child is neglecting their health or other activities. They sound drastic or panicky when they get in touch, but when we speak to them we realize that most of them just want a balance between technology use and other needs,” Dr Sharma says.
Most clients who visit the SHUT clinic are young boys from the middle and upper-middle socio-economic background. Most of them belong to single-child families, and are likely to have developed the habit due to lack of adult supervision and outdoor activities, combined with easy access to technology.
Technology addiction and substance abuse
Addiction to technology may seem harmless when compared to substance abuse. However, experts are increasingly seeing technology addiction cases as being similar to that of alcohol, tobacco or drug addictions. The manner in which the habit develops can be similar to all these addictions: the person desires the substance (or technology), increases usage, and is unable to quit even if they want to. Stoppage of use leads to withdrawal symptoms – which are physical and emotional for substance abuse, and behavioral for technology addiction. All these addictions cause psychological distress and dysfunction in health, social engagement, behavior and productivity.
Management of technology addiction
Treatment for technology addiction is a psychological approach based on the treatment for substance abuse. Treatment helps the individual work on their motivation and their environment to create a lifestyle that is not heavily centered on the internet or their cell phones.
The treatment cycle usually follows three steps:
ASK: The first step, in which the person is taken to a counselor or a psychologist for help.
The expert undertakes an assessment to understand:
Following this, the doctor quantifies the person’s use. This is followed by psycho-education. This process focuses on educating the person and their family about the dangers of internet use, the dysfunctional behavior that arises from it, and any additional issues it may cause. The person and caregivers are counseled on how to reduce dysfunction and remedy problems such as weight loss, sleep or lack of appetite.
During this stage, it is important for the person or their caregivers to ask for information about technology addiction and understand how they can help.
Motivation enhancement is also an important part of the psycho-education process. The person is motivated to decrease usage of the technology they are addicted to. Unlike in the case of other addictions, persons with technology addiction may not be able to quit cold turkey; in most cases, the idea of someone else controlling their use can be uncomfortable or frustrating. So the person is asked to enter into a contract where they agree to use their mobile or the internet for a fixed period of time every day. These contracts are made for short periods of time (between a day and a week), and reviewed. It’s important that the person also has a say in the terms of this contract.
ACKNOWLEDGING THE PROBLEM:
Most persons with technology addiction are in denial – they do not think that their usage is harmful. So, rather than force them into complete abstinence, the mental health professional focuses on harm reduction: how the dysfunction caused by the habit can be reduced. In some cases, the patient is asked to go on an internet fast – however, this can be effective only if the person is motivated to stay offline and break their usage patterns. The person can effectively deal with their addiction only after they acknowledge that their usage is unhealthy, and they are facing problems due to it.
ALLOWING DEVELOPMENT OF OTHER ACTIVITIES:
The mental health professional also guides the person in creating a new lifestyle that has a routine for self-care and grooming, as well as space for outdoor activities, study/work and socializing. The most common problems that need to be tackled at this stage are: the lack of sleep, lack of socializing and lack of self-care (the person may have ignored their general health, hygiene and nutrition due to the addiction).
Most parents who acknowledge that their child is addicted to technology may be panicky, or be highly anxious. The counselor is also able to offer support to the parents to help them cope with the situation.
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