Last Friday I walked into the most recent inpatient Internet addiction treatment center to open in the United States and asked a really dumb question. "Do you have Wi-Fi here?" I bumbled, prompting an awkward smile from the man who opened the door at the Fall City, Wash.-based ReSTART Internet Addiction Recovery Program. It was the equivalent of walking into an Alcoholics Anonymous meeting and asking for a single-malt Scotch.
It was also revealing. I hadn't checked my e-mail, Facebook, or Twitter accounts for nearly 14 hours by the time I showed up at the wooded five-acre retreat, situated with some irony less than 15 miles from Microsoft Corp.'s Redmond headquarters. That drought had begun to eat away at me enough that by the time I walked through the door I was so fixated on plugging back in that my brain was able to push past the blatant insensitivity it took to ask such a question.
Most of my friends smirked when I told them I was heading up to Washington to write a story about the newly opened center, which sits on a wooded parcel of property adorned with a 3,500-square-foot craftsman house, Western red cedar treehouses, chicken coops, and goat pens. We all kid about being hooked on Facebook, but it doesn't really seem like the kind of thing anybody would need to drop $14,000 (the cost of a 45-day stay at ReSTART) on to quit cold turkey. The fact is, though, I have believed for some time now that Internet addiction is a very real phenomenon. And not just because I've read stories about the well-established and at-capacity treatment centers in China and South Korea, or because I know antisocial kids who routinely put in 14-hour shifts playing World of Warcraft. Internet addiction is the reason my 36-year-old brother has been homeless for most of his adult life.
I hadn't really understood this until recently, because having a homeless brother always terrified me too much to make any real effort to understand why Andrew could never get his life together. A couple of years ago I decided I'd protected myself from this depressing truth long enough. I contacted my brother and said I wanted to spend a day with him, from the moment he awoke to the time he went to sleep, to see what his life was like. I approached the trip with a journalist's curiosity and method—a pen and steno pad—but it was obviously going to be a personal expedition.
Andrew, who is four years older than I am, sleeps in a roomy tent, atop three mattresses he's acquired from one place or another, between a set of railroad tracks and Oregon State Highway 99, in a clearing ringed by blackberry bushes. He lives most days the same way. He gets up when he feels like it, walks to the local Grocery Outlet, and uses food stamps to buy a microwaveable meal. Then he treks over to the local soup kitchen and enjoys a free lunch, answering the greetings of his other homeless pals, who speak to me highly of the obese, bearded man they call "Ace."
When the rest of his buddies head off to the park to suck down malt liquor or puff weed, Andrew eyes a different fix at the Oregon State University computer lab, which is open to the public. He'll spend the next 10 hours or so there, eyes focused on a computer screen, pausing only to heat up that microwaved meal. He plays role-playing videogames such as World of Warcraft, but he's also got a page of RSS feeds that makes my head spin, filled with blogs he's interested in, news Web sites, and other tentacles into cyberspace. He goes "home" only when the lab closes. He's recently acquired a laptop, after much fundraising from sympathetic relatives, so he can now stay connected day and night, if he can find an open Wi-Fi hot spot.
Through the day I peppered him with questions, all meant to answer this one: why had he failed to make something of himself, and I hadn't? It was a complicated question, but it was pretty clear by the day's end that the most detrimental influence in his life, from an early age, was videogames and the Internet. We were both exposed to computers early on, but he had let them consume his identity.
Andrew was a child of Commodore 64s and online bulletin boards, and he was fascinated with them as far back as I can remember. With his early knowledge of computers and programming, I like to think he could have become an heir to Bill Gates, but he spent most of his time online goofing off, not developing software. Though my brother has never been officially diagnosed as an Internet addict, he readily admits that he demonstrates all of the signs and symptoms of the compulsion. His was a world of constant refreshing, immediate access to new information and stimuli. Before long, the real world couldn't hold his attention span. He dropped out of high school and spiraled down a path that eventually led him to homelessness.
The Internet is addicting, says psychologist David Greenfield, founder of the Center for Internet and Technology Addiction in West Hartford, Conn., because it works on a "variable ratio reinforcement schedule," which is a fancy way of saying that it gets you high every once in awhile. This is based on a theory first espoused by renowned psychologist B. F. Skinner—not knowing whether a reward is coming is actually more compelling than being able to count on results every time.
"It can be as simple as finding an e-mail you like, hearing from somebody you love, being told a cousin is coming to visit, interspersed among a lot of neutral, less-salient information," Greenfield says. "You don't know how desirable that will be or when you're going to get it."
Greenfield's survey of 18,000 Web users, conducted in 1999, found that 5.9 percent of them demonstrate the symptoms of being addicted to the Internet. Since that survey, there hasn't been much comprehensive research on the topic, says Kimberly Young, founder and director of the outpatient Center for Internet Addiction Recovery because there aren't enough treatment centers from which to acquire comprehensive data.
That's partly because there remains some skepticism about whether Internet addiction qualifies as a real condition. Greenfield says he's spent plenty of time trying to convince colleagues that Internet addiction is genuine, and Seattle psychotherapist Hilarie Cash, one of ReSTART's cofounders, says she often hears from therapists who suggest that the issue isn't the Internet but whatever anxiety or depression compulsive users are suffering that may lead them to overindulgence. Still, as Cash notes, both China and South Korea have declared Internet addiction their countries' No. 1 public-health threat.
What is it about this modern invention that crosses the line from entertainment and simple utility to an addiction that can cost people their jobs, their shelter, and even their health? I don't remember being hooked on Monopoly or checkers, but I do feel something gnawing at me when I've let my e-mail inbox collect messages for too long. I spent many a long day in college playing first-person shooter games until my thumbs were sore. For real addicts, there are even more serious medical issues at stake: there have been at least 10 documented cases of people dying from blood clots caused by sitting in front of a computer for too long, Cash says. Cosette Dawna Rae, who cofounded ReSTART with Cash, got a call recently from a woman whose Internet-obsessed son had to have his leg amputated after a clot.
The Web may be dangerous for some people because it can feed or spur existing addictions, making gambling, shopping, and sex readily available to those who have already developed the compulsion to binge on those things. And now that going online is a part of everyday life, it may not be easy to escape the temptation. You can drive past a bar, but it's hard for many of us to keep a Web browser closed for more than a week at a time. "It's the delivery system," Cash says. "It's available, acceptable, affordable, and accessible."
The Internet also activates the same pleasure pathways in the brain as drugs and alcohol. As you continue to be rewarded, for completing the next level of a videogame or finding out a new piece of information, the connectors to the limbic system of the brain are stimulated, releasing euphoria-causing dopamine into the body. The brain remembers that happy feeling, encouraging you to keep going back for it.
ReSTART's clients operate on a 12-step program model, but they also do delayed-gratification tasks that many of us take for granted: they cook, clean, feed animals, and build things. The best way to break from virtual reality, believe the center's directors, is a healthy dose of actual reality. By checking back in to how normal people live their lives, clients—there have been only been three so far since the center opened earlier this summer—can in theory wean themselves off the constant rush they once got from the Web. Otherwise, it's daily psychotherapy sessions, to help them understand their addictions and the addictions' underlying causes.
It's a difficult problem to treat, says Jerald Block, a clinical psychiatrist at Oregon Health Sciences University who specializes in compulsive computer use. Among the three most common methods are antidepressants, treatment for attention deficit/hyperactivity disorder, and extended retreats from the computer. Cutting off access too suddenly or without other treatment worries Block, he says, because the computer has often become a container for aggression and a major relationship for an addict. Removing those can lead to some very aggressive behavior, including suicide or violence against others, he says: "You're cutting the way they're dealing with all of their emotions."
My brother is outwardly content with his existence, rationalizing it by giving himself pep talks that at least he's not slaving away for some evil corporation at a wage that's beneath him. Andrew got his GED and tried several times to get a college degree, but anxiety and depression—two of the underlying symptoms that likely made computers and the Internet an appealing escape—kept him from being able to keep to a structure and conform. My mom had him tested for Asperger's syndrome once and he showed symptoms but wasn't diagnosable. He has been treated in the past for depression and anxiety, but says he never found the medications he was prescribed helpful. Is his obsession with the Internet an extension of these illnesses? It's hard to say, but either way, the effect is real: once he finally gave up on college, he found it nearly impossible to find jobs that paid a livable wage.
But I know that homelessness, financially independent as it may be, will kill my brother someday. When the temperature dips below freezing in January, he's still in that tent. It can't be fun pulling those blankets off in the morning and wrestling on his clothes in the middle of an Oregon rainstorm. He's had his camp burned to the ground by paranoid "neighbors." Teenagers once beat him up, for no other reason than that he doesn't live in an apartment. Just this month, somebody set fire to a homeless man in Eugene, and I wondered whether it was Andrew. Perhaps if my brother were to go to ReSTART, he could learn how to reconnect with the real world. Then again, he's been consumed by computers for most of the past two decades. Maybe he's a lost cause.
A big question for ReSTART clients is what happens when they leave. The Internet is a nearly inescapable temptation. Do they avoid jobs that involve computers? Vow never to look at a computer screen again? Rae and Cash have developed plans for clients who have graduated. They mostly advise establishing discrete sessions on computers—say, two hours a day—as a way to curb the dangers of the habit. But would you tell a heroin addict he can only smoke a gram a day? And could you keep your own browsing habits to under 120 minutes? "We work with each individual to develop a recovery plan," Cash says, keeping in contact with them about how to set limits on their personal use of the Internet or, if necessary, avoid it except for work-related tasks.
People who have a job that puts them in front of a computer will obviously have a tougher time regulating Internet compulsion, Greenfield says. The most important step is to be conscious that the behavior's dangerous; be aware that you may be getting high from it. Then, it's about changing patterns of use to make sure you're only using the Web when necessary, "not to medicate yourself because you're bored, scared, tired, or angry," he says. "You also have to work to fix the parts of your life that have atrophied due to the use of the Internet. I have cases where lives are essentially shut down because of it."
Intense therapy may be required for an extended period of time, Cash says, and there is a piece of hardware available at www.pcmoderator.com that shuts down the display on PCs once a user has surpassed a preset time limit. The adapter isn't available for Apple computers yet.
As Cash talks to me at ReSTART, I wonder, as I've spent parts of my entire life wondering, whether I could ever wind up like this. I spent hundreds of my childhood hours at an arcade, schooling adolescent competitors at Street Fighter II at the expense of my schoolwork, and during college I discovered a highly addictive site where I could while away my free time playing online spades. There were many 12-hour-long sessions before I finally worked up the nerve to walk away for good. I took a quiz on ReSTART's Web site, and I don't qualify as an addict, despite my frequent use of the Net, mostly because I don't feel truly compelled to stay plugged in and there's nothing detrimental about my time spent online.
I also wonder how many other people are addicted to the Internet without even knowing it. Research from Greenfield and others suggests that as much as 6 percent of the Internet-using population may have an addiction issue. The quiz is one good way to get an idea whether you have a problem. It's based on the same methodology as other surveys to detect addiction. If you had to stop checking your e-mail for a week (let's assume that you didn't have to do so for work), would it bother you? "People are starting to self-examine," Rae says. "Do I play too much? What would that look like?"
The next volume of the Diagnostic and Statistical Manual of Mental Disorders, the psychology bible, will likely have a new category for nonsubstance addictions, which has already kicked off a debate among psychiatrists about what should fall under that heading. Does bingeing on social networking qualify as an addiction? That such questions are being asked is a sign that Internet addiction, no longer a wink-and-nudge kind of subject, is being considered a more legitimate disorder in America. Inclusion in the DSM will hopefully lead to increased awareness of the problem and more options for treatment, says Cash. "There aren't 12-step meetings readily available," she says. "I'm looking forward to the day when those groups abound."
So am I, because there's nothing chuckleworthy about this condition. I did feel a slight rush after I left ReSTART and hopped back online, but I don't think I'm to the point of needing treatment—yet. My brother, on the other hand, could have used some help a long time ago.