пятница, 2 марта 2012 г.

TREATMENT: ; One click at a time: Internet addiction

FALL CITY, Wash. - Ben Alexander spent nearly every waking minuteplaying the video game "World of Warcraft." As a result, he flunkedout of the University of Iowa.

Alexander, 19, needed help to break an addiction he calls asdestructive as alcohol or drugs. He found it in this suburb of high-tech Seattle, where what claims to be the first residentialtreatment center for Internet addiction in the United States justopened its doors.

The center, called ReSTART, is somewhat ironically located nearRedmond, headquarters of Microsoft and a world center of thecomputer industry. It opened in July and for $14,000 offers a 45-day program intended to help people wean themselves frompathological computer use, which can include obsessive use of videogames, texting, Facebook, eBay, Twitter and any other time-killersbrought courtesy of technology.

"We've been doing this for years on an outpatient basis," saidHilarie Cash, a therapist and executive director of the center. "Upuntil now, we had no place to send them."

Internet addiction is not recognized as a separate disorder bythe American Psychiatric Association, and treatment is not generallycovered by insurance. But there are many such treatment centers inChina, South Korea and Taiwan - where Internet addiction is takenvery seriously - and many psychiatric experts say it is clear thatInternet addiction is real and harmful.

The five-acre center in Fall City, about 30 miles east ofSeattle, can handle up to six patients at a time. Alexander is sofar the only patient of the program, which uses a cold turkeyapproach. He spends his days in counseling and psychotherapysessions, doing household chores, working on the grounds, going onoutings, exercising and baking a mean batch of ginger cookies.

Whether such programs work in the long run remains to be seen.For one thing, the Internet is so pervasive that it can be nearlyimpossible to resist, akin to placing an alcoholic in a bar, Cashsaid.

The effects of addiction are no joke. They range from loss of ajob or marriage to car accidents for those who can't stop textingwhile driving. Some people have died after playing video games fordays without a break, generally stemming from a blood clotassociated with being sedentary.

Psychotherapist Cosette Dawna Rae has owned the bucolic retreatcenter since 1994, and was searching for a new use for it when shehooked up with Cash. They decided to avoid treating people addictedto Internet sex, in part because she lives in the center with herfamily.

According to Dr. Kimberly Young of the Center for InternetAddiction Recovery in Bradford, Pa., addiction warning signs arebeing preoccupied with thoughts of the Internet; using it longerthan intended, and for increasing amounts of time; repeatedly makingunsuccessful efforts to control use; jeopardizing relationships,school or work to spend time online; lying to cover the extent ofInternet use; using the Internet to escape problems or feelings ofdepression; physical changes to weight, headaches or carpal tunnelsyndrome.

Exactly how to respond is being debated.

For instance, Internet addiction can be a symptom of other mentalillness, such as depression, or conditions like autism, experts say.

"From what we know, many so-called 'Internet addicts' are folkswho have severe depression, anxiety disorders, or social phobicsymptoms that make it hard for them to live a full, balanced lifeand deal face-to-face with other people," said Dr. Ronald Pies,professor of psychiatry at SUNY Upstate Medical University inSyracuse, N.Y.

"It may be that unless we treat their underlying problems, somenew form of 'addiction' will pop up down the line," Pies said.

There is debate about whether to include Internet addiction as aseparate illness in the next edition of the "Diagnostic andStatistical Manual of Mental Disorders," due in 2012, whichdetermines which mental illnesses get covered by insurance.

Pies and Dr. Jerald Block, of Oregon Health Sciences Universityin Portland, said there is not enough research yet to justify that.

"Among psychiatrists there is general recognition that manypatients have difficulty controlling their impulses to chat online,or play computer games or watch porn," Block said. "The debate ishow to classify that."

Cash, co-author of the book "Video Games & Your Kids," firststarted dealing with Internet addiction in 1994, with a patient whowas so consumed by video games that he had lost his marriage and twojobs.

Internet addicts miss out on real conversations and real humandevelopment, often see their hygiene, their home and relationshipsdeteriorate, don't eat or sleep properly and don't get enoughexercise, Rae said.

Alexander is a tall, quiet young man who always got good gradesand hopes to become a biologist.

He started playing "World of Warcraft," a hugely popular onlinemultiplayer role playing game, about a year ago, and got suckedright in.

"At first it was a couple of hours a day," he said. "By midwaythrough the first semester, I was playing 16 or 17 hours a day.

"School wasn't interesting," he said. "It was an easy way tosocialize and meet people."

It was also an easy way to flunk out.

Alexander dropped out in the second semester and went to atraditional substance abuse program, which was not a good fit. Hegraduated from a 10-week outdoors-based program in southern Utah,but felt he still had little control over his gaming.

So he sought out a specialized program and arrived in Fall Cityin July. He thinks it was a good choice.

"I don't think I'll go back to 'World of Warcraft' anytime soon,"Alexander said.

11 signs of addiction

* Increasing amounts of time spent on Internet

* Failed attempts to control behavior

* Heightened euphoria while on Internet

* Craving more time on Internet, restless when not there

* Neglecting family and friends

* Lying to others about use

* Internet interfering with job and school

* Feeling guilty or ashamed of behavior

* Changes in sleep patterns

* Weight changes, backaches, headaches, carpal tunnel

* Withdrawl from other activities

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