It was the early 2000s. After a hectic outpatient day, I was about to step out of my small-town clinic when a gentleman walked in. He was dressed immaculately, courteous in his manners, flashed his latest mobile phone and was enveloped by the fragrance of an imported ‘eau de parfum’. After initial customaries, he opened up about his symptoms; strange and unique indeed. Owning a mobile phone was considered luxurious in those days, and here was my patient complaining of ‘hearing strange sounds while holding the mobile’. Though perplexed with this first-time experience, after a preliminary assessment, I referred him to a specialist for further evaluation and care.
That case must have been an outlier in the early stages of technology adoption. But a decade and a half later, it’s a different world. Over the last fifteen years, the number of internet users has increased by 1000% and in the past five years, mobile data consumption in India has grown twenty four times. A study by London-based AT Kearney Global Research showed that continuous online connectivity is becoming a phenomenon in India with 53% of respondents saying they are connected to the internet every waking hour.
Amidst all the ‘tech-tonic’ changes the demography of India remains young, and adolescents (10-19 years) constitute almost 20% of our population. The phenomenal rise in accessibility and affordability of technology has the potential of creating havoc in our cognitive and behavioral patterns. World over there is an increasing trend of problematic internet usage or Internet Addiction Disorders (IAD). In general, IAD has various categories. The most commonly identified categories of internet addiction include gaming, social networking, e-mail, blogging, online shopping, and pornography. Global consensus on the diagnosis and treatment of such disorders is still pending but there is consensus that it’s the adolescent group who are most prone to such behavioral disorders.
Earlier, it was believed that brain growth of children ends by the time they reach the age of kindergarten. But recent research proves that the teen brain is only about 80% mature. The rest 20% especially in the frontal lobes of the brain makes them vulnerable to being moody, forgetful, impulsive and puzzling at times. In her book ‘The Teenage Brain: A Neuroscientist’s Survival Guide,’ Prof. Frances Jensen equates the teenage brain to a brand-new Ferrari, primed and pumped but not yet road tested. This phase of life also makes them more prone to addictions, because they still lack adequate self-control mechanisms that may prevent adults from developing such habits.
It’s the Nipah virus that’s giving sleepless nights now, but late last year it was the Blue-Whale game with its addictive and deadly consequences. A report by the Indian Council for Medical Research (ICMR) says that 12% of individuals using internet in India suffer from IAD while another study suggests that about 25% of adolescents have IAD. Recent newspaper reports from across the country have quoted psychiatrists and counselors stating that the number of people being treated for mobile addiction, mostly students in the age group of 13-24 years, has shot up to anywhere between 75-100% in the last one year. Reading through case reports and speaking to psychiatrists and neurologists was an eye opener indeed. Here is a teenage boy who said “I feel technology has brought so much joy into my life. No other activity relaxes me or stimulates me like technology.” Another who is obsessed with gadgets says, “books smell like old people”. There is a 14-year-old girl who slapped her father for taking her phone away for a day. When asked, she said her parents were always busy and most friends were also available for online chat only. There were reports of an 11-year-old boy slashing his wrists after his parents refused to hand him his phone. Not able to devote enough time to their young son, the parents gifted him a mobile phone at quite a young age that would keep him occupied.
It seems gamers aged between ten and fifteen years who played more than three hours per day were less satisfied with their lives, less likely to feel empathy towards others and less likely to know how to deal with their emotions appropriately. However, it needs to be noted that just because one uses the Internet a lot – watch a lot of YouTube videos, shop online frequently, or like to check social media does not mean that (s)he suffer from IAD. Trouble starts when these activities begin to interfere with daily life. It is not the amount of time spent on the Internet that is worrisome but how the Internet is being used.
Most societies refuse to sell alcohol or cigarettes to children but often overlook behavioral addictions like gaming. When it comes to behavioral compulsions on internet; we can learn a lot from our Asian neighbors. In fact China is the first country to declare IAD a clinical disorder and term it the number one public health threat to teenage population. Japan, South Korea and Vietnam all have nationally funded programs that operate clinics offering aversion and cognitive behavioral therapy. Korea’s “shutdown law” makes it illegal for any Korean under the age of sixteen to play video games between the hours of midnight and 6am. Psychiatrist Prof. Tao Ran who is considered father of internet addiction treatment in China says, “Parents fail to make friends with their children. We only ask them to study and cannot see their pain, stress or worries. So they make friends with screens and internet.” India too has many specialized IAD therapy centers now, a trend started by the ‘Service for Healthy Use of Technology’ (SHUT) set up by National Institute of Mental Health and Neuro Sciences (NIMHANS).
Betel-nut to Internet
We cannot wish away the fact that fifteen years ago, internet was an escape from real world. But now the real world is an escape from internet for many. According to journalist Maia Szalavitz, “Addiction is like misguided love. It’s like love with obsession but not the emotional support.” Whether it’s our addiction to betel-nut that started thirteen thousand years ago or the internet of modern age, Maia’s words may hold true. Till such time the medical fraternity and key stakeholders put a robust framework in place, it’s up to each of us to protect our young ones. We could start by befriending them, not letting them feel lonely and making them learn from people rather than screens. Fifteen or Seventeen, we can make it sweet for our girls and boys.