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Trapped by an internet 'addiction,' obsessed surfers seek rehab help

By Ami Schmitz and Jessica Hopper
Rock Center

Brett Walker says he knew he was hooked to using his computer when his virtual life nearly destroyed his real life. He was unemployed, had started to neglect his personal hygiene and says he had no friends all because of his online game of choice, “World of Warcraft.”

“Whenever I went online, it really was like getting high on a drug,” said Walker in an interview with Dr. Nancy Snyderman. “I mean, I would log in and I could just feel the dopamine start coming as soon as I was typing in my password and stuff, just waiting for it to log in.” 

Walker, 28, said that he started playing online games when he was 11. By his early twenties, the Texan devoted up to 16 hours a day to “World of Warcraft,” a game that has millions of players around the globe. As he got better at the game, he said, his life away from his keyboard crumbled.

“Whenever I was on the computer I would feel great,” said Walker in an interview airing Thursday, Nov. 8 at 10pm/9c on NBC's Rock Center with Brian Williams. “I was in this whole other world.  I was excited.  I was happy for that brief moment, but whenever I’m lying in bed at night, I would always … just think about how that day I hadn’t accomplished anything, about how I wasn’t what I wanted to be in life and that I was really, you know, miserable."

Was Walker suffering from a true addiction to the Internet or just a bad habit? An emerging area of research has developed to study those who are obsessed with logging on to the World Wide Web. Scientists say brain scans of heavy Internet users reveal changes in both the size of certain parts of the brain as well as its function.  They say it is possible to become addicted to the Internet.

“The new research, whether it's imaging research or genetic research or other kinds of research, [is] pointing to a biological disposition, something in our biology that makes it easy for us to fall in love with a video game or with the Internet.  And for a proportion of us, this love affair can start looking like an addiction,” said Dr. Elias Aboujaoude, who runs Stanford University’s Obsessive Compulsive Disorder Clinic and Impulse Control Disorders Clinic and recently completed one of the largest studies to examine how common problematic Internet use is in the United States.

“When we talk about problematic Internet use, one common complaint is that there's nothing really different about it, that it's similar to, you know, when radio first came around or TV or even novels,” Aboujaoude said.  “But I really do believe the Internet is different.  It's different in that it engages you a lot more.  You're immersed in it.  It talks back to you.  It's also different in terms of its penetrance, how incredibly common it is and how much access we have to it.”

Aboujaoude's research found that up to 13 percent of Americans experience some degree of negative impact from overuse of the Internet. 

“Examples of this negative impact include things like damage to their personal lives because of their online patterns of use or feeling, that they cannot go for an extended period of time without logging in and that in and of itself has negative consequences,” he said, adding that other countries, such as China, have made the study of excessive use of electronic media a priority.

Chinese researchers recently compared the brain scans of average Internet users to the brain scans of Internet obsessives.  The small study found changes in the areas responsible for decision-making, emotions, and self-control – the same areas that are affected in substance abusers.

Seeking treatment

Walker chose to get help for his problem, turning to reSTART, the first residential treatment program in the United States that helps people with Internet obsessions.  Founders Hilarie Cash and Cosette Rae are among a growing number of mental health professionals who believe in the controversial theory that it is possible to become addicted to the Internet, just as some people get hooked on drugs, alcohol or gambling. Their program focuses on people hooked on online games, chat rooms, even blogs.

“We’re talking about a lot of young people who come to us who’ve actually gotten addicted at age five, six, seven, eight,” Cash said, “and so their brain development has been profoundly impacted because of that early onset of addiction.”

This year the American Psychiatric Association added “Internet Use Disorder” to the appendix of the Diagnostic and Statistical Manual of Mental Disorders, the standard text of the profession. The APA also said that more research needs to be done.

But critics question whether these behaviors constitute a real addiction or are just an unhealthy obsession.

WATCH VIDEO: Rehab focuses on treating Internet addicts

“Not every passionate interest in life is an addiction,” said Dr. Allen Frances, a psychiatrist and professor emeritus at Duke University who has been fighting efforts to add the diagnosis of Internet addiction to the manual.

“I’m not arguing against the fact that there’s a small group of people who suffer horribly from this,” Frances said. “What I’m arguing is that when you introduce a diagnosis into the system, it’s very likely to take off in directions you never imagined, and become a fad.”

“Where do you draw the line?” he added.  “Why not include work addiction, sex addiction, shopping addiction, golf addiction, model-railroading addiction?” 

The founders of reSTART say that Internet addiction is real and dismissing it is similar to the way some originally viewed drug and alcohol abuse.

“Isn’t that what we did to substance users, like, 40, 50 years ago?” asked Rae.  “And we’ve now had plenty of research to show that drug and alcohol addiction is real and exists.”

Rae and Cash’s treatment is a major commitment, consisting of residential therapy for a minimum of 45 days in a seven-bed facility outside of Seattle, Wash. It is also expensive – and the nearly $400-a-day treatment is rarely covered by health insurers. 

From young adults to middle-aged women, a range of people arrive to unplug. They often enter the program sleep-deprived, depressed and with a string of professional and personal failures tied to their inability to log off.  In addition, they’ve often ignored health issues, such as having either lost or gained significant amounts of weight.

The withdrawal process can be brutal, Cash said.

“It takes about three weeks for the brain to make its adjustment and go through withdrawal and then after about three weeks, they start to be much more relaxed,” he said. “They’re not so depressed and anxious.” 

Cash and Rae said that part of what turns computer use from a thing of enjoyment to an addiction is the “social factor.”   ReStart patients say they find it easier to make friends with people online, than in person.

“We're social animals, right? So they find that in these games they can connect with people and try to meet their social needs that way.  And that's a huge element in the addiction,” Cash said.

For Walker, the relationships he’d developed through online gaming were so important that he said it impacted the timing of when he got treatment.

“[I] actually waited until the end of the season....to leave so I wouldn’t just leave my teammates hanging.  So I told them, you know, once this season ends, you know, I’m gone,” Walker said.  “That’s how much my friends meant to me online.  I mean, in real life, you know, my commitments didn’t mean anything to me.”

Stacey, a Washington woman who recently completed the reSTART program, said that her continued connections with friends she met online have led her to relapse.  She is hooked on the AOL card game, Spades.

NBC News

Stacey, addicted to online card game, Spades.

“I still am friends with the online friends that I had made,” said Stacey, who asked Rock Center not to use her last name. “That probably is part of the problem, yes.  But it’s one of the parts that I don’t know if I’m willing to give up. It’s sad to say.”

The teacher and mom of two said that she spent so much time in bed playing Spades that it led to divorce from her husband of 18 years.  When Stacey moved out, her two daughters stayed with her husband. Stacey said that her obsession cost her at least five years of experiencing their childhood.  

“When I’d go out shopping with the girls at the mall, all I could think about was going back and playing on the computer again.  So, even if I was physically present, my brain was still on the computer,” Stacey said.

ReSTART has treated 500 people since it opened in 2009.  To help patients get off line for good, therapy at reSTART focuses on socializing and patients are encouraged to go outside after having often been trapped for years alone in rooms with computers. 

But  Cash and Rae say that re-entering an increasingly digital world can be hard.  

“So I don't think that abstinence is possible, not from all the technology in this modern age,” Cash said. “They can define what are those aspects of Internet use that are problems for them and be abstinent from those and then define for themselves how they're going to use computers and the Internet in a way that is healthy and sustaining,” Cash said.

Editor’s Note: Dr. Nancy Snyderman’s full report airs Thursday, Nov. 8 at 10pm/9c on NBC’s Rock Center with Brian Williams.