Guest Post by Stephanie Newman, Ph.D.
Most stories about adolescents and the internet underscore the very real dangers of cyberbullies, sexual predators, and on-line scams that imperil unsuspecting, vulnerable teens. Another risk? The teens themselves. Many spend hours on-line, e-mailing, instant messaging, downloading music, and updating Facebook pages, with some visiting game sites, shopping, and gambling on-line. All of this access can be dangerous; those who abuse the internet can become trapped in a cyber riptide of sorts, pulled in further and further as their time on-line increases, their school performance declines, and their family and peer relationships begin to suffer.
Take Melanie (not her real name), a sixteen-year-old Greenwich Village student, who spent up to seven hours a day updating her Face book page and instant messaging with friends. When her previously high grades began to drop, her parents confiscated her desktop, and Melanie threatened to leave home.
"For an entire year I saw nothing but the back of my daughter's head," Melanie's dad explains. "So I took the computer away. When she became inconsolable and accused us of ruining her social life--she couldn't update her Face book page--we knew there was a serious problem."
Turned out, Melanie was down and out over a flirtation with a boy that had gone nowhere. Once she and her parents began to talk about what was bothering her, their home situation improved dramatically.The family worked it out and she stayed put--with the help of intensive outpatient therapy.
Was Melanie's a case of harmless teen tweeting and more, or a sign of a dangerous problem? Many parents and stepparents wonder, how much on-line activity is too much? Though internet addiction is not yet a bona fide psychiatric diagnosis, psychiatrists and psychologists are calling for more research, so they can include it in future editions of the Diagnostic and Statistical Manuel (DSM), the bible and last word on diagnosis and disorders for therapists, hospitals, clinics, and insurers.
Who is at risk? Experts agree teens who struggle with internet overuse do not fit a single profile. Heavy users can be socially linked-in, popular adolescents who make good grades. They might spend hours chatting online with friends, posting photos and updates on social media sites. On the other end of the continuum are the isolated, socially anxious teens. They might be teased, bullied, and avoid school altogether. Desperate to meet people and connect, they might surf the web and visit chat rooms and game sites to the exclusion of all else.
How to determine if your teen has a problem? Take a long hard look at all of his behaviors and hobbies. While all may seem well, overuse of the internet might be hidden behind deeper problems such as depression, anxiety, substance use or eating disorders, and learning or conduct problems. Experts agree that internet overuse does not occur in a vacuum.
Often the problem becomes first apparent in the school setting. "Parents might first notice slippage in school performance. They eventually throw up their hands when any attempt to regulate computer use or limit access quickly devolves into defiance and angry outbursts," says Dr. Eric Teitel, a child and adolescent psychiatrist in Manhattan, and a faculty member of the NYU School of Medicine.
In older adolescents (18-25), the profile might differ-though just as with a younger adolescent you might first notice absenteeism from work or school. For people in this age group, internet use is frequently intertwined with sex, gambling, eating disorders, or drug problems, as well as depression or anxiety, according to Dr. Joanne Fishman, Clinical Director of the New York City office of Four Winds Hospital. Meaning, some older adolescents might use a potent substance like crystal meth before trawling chat rooms in search of hook-ups. Others might spend hours playing on-line poker or shopping, and become increasingly single-minded and isolated.
When to worry? If a child disappears into her room for hours on end, parents should be concerned about what is going on behind her closed door. "Though the problem most often occurs during the transition from Jr. High to High School (kids ranging in age from 14-15 years old), I have seen internet overuse in kids as young as 12," says Dr. Teitel. "If school performance is declining, if a child cannot leave the computer and becomes anxious or argumentative when internet access is limited, parents should be concerned," he advises.
Teens might be on-line because they are already depressed, anxious, and lonely. Or they might become so, if forced to give up their habit. Signs and symptoms of withdrawal anxiety in a child include: difficulty concentrating, pacing, irritable and stressed mood, and fidgeting.
"You might wonder whether your teen has a problem if he cannot pull himself away from the internet and transition to another activity," notes Dr. Alicia Rieger, a Westchester pediatrician.
Other signs your child could have a problem with internet overuse? In addition to a decline in school performance and grades, signs might include repeated surfing or e-mailing during class time, difficulty concentrating and falling asleep in class, hours of night-time use, frequent complaints of being tired, school lateness or absenteeism, and withdrawal from all activities such as sports practices, friends, social engagements and music lessons. Racking up bills for such things as on- line gambling or shopping is also a sign your child is spending too much time on-line.
What can parents do?
Talk to your teen.
Experts agree, if you suspect your teen is up half the night chatting on- line, something else might be going on. "Teens who spend significant amounts of time on line can suffer from depression, anxiety, feelings of loneliness, and social isolation, and can fall victim to dangers such as sexual predators," says Dr. Rieger. And cyber bullying. And we know how some of those cases have played out. So, find out more. Was your daughter cut from the team? Did your son suffer a recent break-up? Don't let a difficult situation fall through the cracks.
While it may sound obvious, limiting computer time and access is key. If a teenager has a computer in her room or a laptop at her disposal, what she does once her parents are asleep can spell trouble. It's common sense: when you go to sleep at 10:30 in the evening, you have no idea what your teen is doing-- on-line or otherwise-- between the hours of 11 p.m. and 2 a.m. If this is when overuse is occurring, and if it is interfering with school or socializing, time to remove the desktop or lock up the laptop.
If that does not work, or if fighting or discipline problems arise, seek treatment with a psychologist, psychiatrist, or other mental health professional. Parents should also take this course of action if they notice any other compulsive or dangerous behaviors. "If you see a complementary diagnosis such as gambling, sex addiction, or a drug problem, it's time to make inquiries about time on the internet," says Dr. Fishman. "Treat the drug, gambling, sexual compulsion, or eating disorder, and the internet problem usually remits."
For all families, even those with limited financial resources: adolescents can post confidential questions and receive a response from a qualified professional within 24 hours for free at www.TeenCentral.net, a website operated by Kidspeace, a Pennsylvania treatment center for dually diagnosed adolescents.
If reading this has got you worried, take heart. Experts agree that talking, limiting access, and seeking therapy can go a long way. Parents usually hold more sway with their adolescents than they might think.
Treatment Centers for adolescents with depression/anxiety, substance, gambling, or eating disorders and co-morbid internet overuse:
Four Winds Hospital, Katonah, NY - 800 528-6624
New York Hospital, Westchester, NY -888 694 5700; 914 997 5882
Mt. Sinai Hospital, New York, NY - 212 423- 2981
Bellevue Hospital, New York, NY- 212 562-4991 (outpatient) and 212 562- 4507 (inpatient)
Princeton House, Princeton, NJ - 800 242 2550
Caron Foundation, Allentown, PA - 610 678-2332
Kidspeace, Orefield, PA - 800 25 peace
Father Martin's, Baltimore, MD 800 799-4673
Promises Malibu - 310 390 2340
Sierra Tucson 800 842-4487
Stephanie Newman, Ph.D., is a clinical psychologist/ psychoanalyst who practices in Manhattan and Westchester, New York.