FOR many people, the Internet has become a crucial part of daily life. It is used for several purposes, improving tasks while also saving time. With the Internet, we can communicate with people living far away with extreme ease, and email and social networking are gifts that are highly cherished by many.

Research using the Internet is but a click away, with access to topics and references occurring in a few seconds. Further, the Internet has made doing homework easier, faster and more entertaining for children.

BENEFITS OF THE INTERNET

The Internet may provide education, with numerous books, references, online help centres, experts’ views, and other study-oriented material being made available. Online tutorials, lectures and video conferencing have removed the need for someone to show up in person to teach a class. Further, financial transactions over the Internet have reduced the length of the queues in banks, and purchasing and selling items is a much easier enterprise when done over the Internet.

Real-time updates of the news and other happenings worldwide, with some websites providing specialised information in areas such as business, sports, finance, politics, and entertainment, have now become the norm. Improved leisure through watching videos, listening to songs, playing games, and chatting online has also occurred in the Internet age. Exploring the world through satellite and mapping applications like Google Earth or travel sites, and live web cams showing other parts of the world have also become commonplace.

INTERNET ADDICTION DISORDER

Despite all these positive occurrences, however, a new phenomenon — Internet addiction disorder — has been studied in the USA, and there is now mounting evidence that it

has devastating consequences, particularly in teenagers. An extensive survey of the medical literature that was presented at the 2014 conference of the American Psychiatric Association revealed that people with Internet addiction disorder in general, and with an addiction to games on the Internet in particular, tend to have certain brain abnormalities.

The addiction disorder was associated with changes in blood flow in the brain, which saw increased blood flow to those areas of the brain normally associated with reward and pleasure, and a decrease in blood flow to areas involved in hearing and visual processing. The research showed that the prevalence of Internet addiction disorder among American youth was an alarming 26 per cent, and was higher than that for alcohol and illegal drug use disorders.

NEW PHENOMENON NOT YET CLASSIFIED

As it is a new phenomenon, Internet addiction disorder has not yet been classified in the medical literature as an established mental disorder, and so is not yet listed in the well-known Diagnostic and Statistical Manual of Mental Disorders, DSM-IV. However, one of the possible criteria for this classification is that the loss of control over the use of the Internet resulted in marked distress, preoccupation, mood changes, tolerance, withdrawal, and functional impairment, including impairment in social, occupational and academic performance.

Another possible criterion is spending more than six hours per day on the Internet, outside of the requirements of business or academic use, for more than six months. Even more striking, the research revealed a significant correlation between Internet addiction disorder and mental health problems such as depression, suicidal behaviour, obsessive-compulsive behaviour, eating disorders, attention-deficit/hyperactivity disorders, as well as alcohol and illegal

drug use disorders.

CHEMICAL CHANGES IN THE BRAIN

Chemically, Internet addiction disorder is linked to changes in dopamine — a substance vital for normal brain functioning. In the brain, dopamine functions as a neurotransmitter, a chemical released by nerve cells to send signals to other nerve cells. Studies indicate that prolonged Internet use causes excess dopamine, thereby stimulating the adjacent nerve cells, which may result in a euphoric effect. This result is also noticed in substance abuse and other addictive disorders.

The researchers emphasized that screening for Internet addiction disorder among teenagers with mental health problems was important, due to the prevalence of suicidal behaviour in this age group. Also, given the associated correlation with depression, treatment with particular anti-depressants may also be of value.

MORE RESEARCH NEEDED

Since we are all agreed that the Internet is here to stay, Internet addiction needs a lot more research. While personal computers have been around for some time, with the explosion of iPhones, instant messaging, and other new technologies, the Internet affects almost every aspect of our lives. It is therefore important for us to study the effects of the connectedness that we experience, and especially its effects on young people. We should note that while Internet addiction is not good, not all effects of Internet use are negative. There may be positive effects from our increased connectedness, and so we should also do research on these.

Derrick Aarons MD, PhD is a consultant bioethicist/family physician, a specialist in ethical issues in medicine, the life sciences and research, and is the Ethicist at the Caribbean Public Health Agency – CARPHA. (The bioethical views expressed here are not written on behalf of CARPHA)