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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by uncouth on July 27, 2008, at 21:27:23
Hi there,
Cutting to the chase, been depressed for 5 years, many med trials, SSRI, TCA, MAOI (just starting on parnate this week).One of the biggest problems I've had, that has been more or less common throughout the times i've been really depressed and during the times i've been more or less successfully treated (excepting the apathy, anhedonia, amotivational aspects of SSRIs which I hate), has been internet addiction. And before you ask, there is a portion of it that is sexual/porn, but its mostly just 'internet' in general. It has cut into my social life, my growth as a young adult, my ability to extract pleasure from normal things in life, etc. It has been difficult to get it under control simply becuase it's a part of my life and part of my job and communication as well.
Anyone have any experience with successfully treating internet addiction? One fo the reasons of trying an MAOI is to hope that the dopamine helps with self-control and internet addiction, as well as the depression.
Is that true? Any other advice? What about buprenorphone or naltrexone?
Thanks
Posted by dbc on July 28, 2008, at 0:31:10
In reply to Internet addiction - help!, posted by uncouth on July 27, 2008, at 21:27:23
No drug has ever even come close to putting a dent in my sweet sweet internet addiction. No amphetamine, no sedative, no SSRI/SNRI, no anti-psychotic, no mood stabilizer. Infact i think the only thing that came close to stopping it was high doses of morphine and then it simply was because i was nodding off every 3 minutes and couldnt type out the URLs.
Not to get side tracked but unless you're watching porn for hours at a time im not quite seeing the problem here unless you're religious.
But look at it this way it could be much worse. You could be playing World of Warcraft.
Posted by Marty on July 28, 2008, at 0:45:50
In reply to Re: Internet addiction - help!, posted by dbc on July 28, 2008, at 0:31:10
> But look at it this way it could be much worse. You could be playing World of Warcraft.
---
I think he DIDN'T mention him NOT playing WoW. Let's wish this will not get him down further if it's the case.BTW, I'm also "addicted" to the net. And I wouldn't consider this a real addiction just like heroine, nicotine and gambling. It only a 'refuge' that you need to stop overabusing by accepting the pain that comes from doing the OTHER things in life. Less intellectual, more physical activities helps a lot when trying to break this vicious circle.
/\/\arty
Posted by blueboy on July 28, 2008, at 11:53:11
In reply to Re: Internet addiction - help! » dbc, posted by Marty on July 28, 2008, at 0:45:50
>
> > But look at it this way it could be much worse. You could be playing World of Warcraft.
> ---
> I think he DIDN'T mention him NOT playing WoW. Let's wish this will not get him down further if it's the case.
>
> BTW, I'm also "addicted" to the net. And I wouldn't consider this a real addiction just like heroine, nicotine and gambling. It only a 'refuge' that you need to stop overabusing by accepting the pain that comes from doing the OTHER things in life.
>I'd disagree somewhat, but not enough to get into a silly argument :) On the other hand, although I might use the term addiction, I'd say it has an OCD component, at least in my case. And also, like a lot of behavior addictions such as gambling, it is not classical "addiction" since it can be discontinued for periods without pain.
Still, my life revolved around Everquest (an earlier game similar to WoW) for two or three years.
And, for sure, there is an aspect of anxiety relief or depression relief -- but that's true of most addictions. I'd even go so far as to say many addictive drugs (including alcohol) are outstanding drugs for temporary relief of many forms of anxiety/depression. Many people on these boards (including me) use opiates or benzo's for treatment. But the potential problems are well known . . .
BTW, I'm a recovering alcoholic, and let me tell you, drunk is the best I've ever felt. I just hate those pesky side effects, such as death.
Posted by dbc on July 28, 2008, at 13:28:46
In reply to Re: Internet addiction - help!, posted by blueboy on July 28, 2008, at 11:53:11
I played WOW for three years and just recently quit within the last 3 months. It would be totally normal for me to play 14 hours a day and im not an extreme case or even abnormal for probably 25% out of the 10 million people that play WOW.
Almost everyone i played with did nothing else in life outside of say school or a part time job except play WOW. It was always a joke to people
<player1> i went to the store today and bought some vodka for the raid tonight
<player2> i cant remember what the outside looks like
Posted by Bob on July 28, 2008, at 15:57:31
In reply to Re: Internet addiction - help!, posted by blueboy on July 28, 2008, at 11:53:11
> I'd disagree somewhat, but not enough to get into a silly argument :) On the other hand, although I might use the term addiction, I'd say it has an OCD component, at least in my case. And also, like a lot of behavior addictions such as gambling, it is not classical "addiction" since it can be discontinued for periods without pain.
>
> Still, my life revolved around Everquest (an earlier game similar to WoW) for two or three years.
>
> And, for sure, there is an aspect of anxiety relief or depression relief -- but that's true of most addictions. I'd even go so far as to say many addictive drugs (including alcohol) are outstanding drugs for temporary relief of many forms of anxiety/depression. Many people on these boards (including me) use opiates or benzo's for treatment. But the potential problems are well known . . .
>
> BTW, I'm a recovering alcoholic, and let me tell you, drunk is the best I've ever felt. I just hate those pesky side effects, such as death.
I too have an obsessive component to my disease that I've always theorized has an OCD component to it. I've never been diagnosed as such because the pdocs are always careful to state that OCD almost never involves an activity from which pleasure can be gained, like acting out sexually, or sexual thought. For them, the behavior also has to meet the compulsion criteria with anxiety alleviating rituals.I kinda wonder about the strict diagnostic criteria as I think there is overlap for certian behaviors like addiction to gambling, sex, and the internet. In any case, I don't have the classic form of OCD as they define it.
Posted by Phillipa on July 28, 2008, at 17:13:55
In reply to Re: Internet addiction - help! » blueboy, posted by Bob on July 28, 2008, at 15:57:31
Humm I do have rituals like drinking the same amount of water and doing things same as usual It reduces my anxiety. No not sex, gambling or drinking anymore. And I love to be outside so not addicted to computer unless stuck inside. Love Phillipa
Posted by yxibow on July 29, 2008, at 2:27:54
In reply to Re: Internet addiction - help! » dbc, posted by Marty on July 28, 2008, at 0:45:50
>
> > But look at it this way it could be much worse. You could be playing World of Warcraft.
> ---
> I think he DIDN'T mention him NOT playing WoW. Let's wish this will not get him down further if it's the case.
>
> BTW, I'm also "addicted" to the net. And I wouldn't consider this a real addiction just like heroine, nicotine and gambling. It only a 'refuge' that you need to stop overabusing by accepting the pain that comes from doing the OTHER things in life. Less intellectual, more physical activities helps a lot when trying to break this vicious circle.I would mostly concur. I can't say its less intellectual -- I gather knowledge for projects and the like from Wikipedia which is a great source of information -- on the other hand I can go on a Wikipedia binge and click and click through URLs until I know the trivia of the most northern island in Scotland or something.
And yes, though PBabble is a great source of therapy it can also be a "refuge" as you put it from doing other things in life.All in moderation.
Remember, people use the internet for coding, building web pages, work related internet use, distributing videos, I dare say creating porn sites for profit (which is probably one of the most lucrative things out there [g]).
The one thing I notice though is that the more I get interested (as I am typing), the likelihood of staying up later and getting my sleep clock all messed up is going to occur. Which means I probably should get to sleep sometime soon :)I don't know, that's my 2c
-- Jay
Posted by uncouth on July 29, 2008, at 9:28:38
In reply to Re: Internet addiction - help! » Marty, posted by yxibow on July 29, 2008, at 2:27:54
This was mean to be a serious question and thread with hopes for some serious solutions, pharmaceutical or otherwise.
"Addiction" may not be the best term -- perhaps compulsion is. All I know is that for the last five years the first thing I do when I wake up is grab my laptop, and get back into bed. Sometimes it's for 10 minutes, othertiens (say on weekends) its for 2 hours. It happens before I even know what I'm doing. And what I do on it usually has no predetermined goal or aim.
Seems like classlic defensive/compulsive behavior, and in some form it's gone on since highschool probably.
I did notice that on a 3 month trial of Emsam, the amount of time I used the computer decreased, and the sense of being "stuck" or zombified was reduced. Almost like I had more choice or an increase in will....which i'm sure is how an alchoholic or any other addict would describe any med that helped his/her addiction.
So now that i'm not on Emsam anymore, and am looking for other pharmaceutical interventions, can anyone provide any useful suggestions? Willing to try buprenorphine or naltrexone, but not sure if those have ever been used for internet addiction, although they seem to have some positive effects for depression.
General idea is to treat a compulsion to use the internet that is likely a manifestation of both a depressive defense against negative affect, depressive boredom, and an attentional problem (need those squirts of dopamine).
Internet/computer use is complex and I was hoping to get some more helpful responses here!
Uncouth
Posted by blueboy on July 29, 2008, at 9:55:58
In reply to Re: Internet addiction - help! » blueboy, posted by Bob on July 28, 2008, at 15:57:31
> I too have an obsessive component to my disease that I've always theorized has an OCD component to it. I've never been diagnosed as such because the pdocs are always careful to state that OCD almost never involves an activity from which pleasure can be gained, like acting out sexually, or sexual thought. For them, the behavior also has to meet the compulsion criteria with anxiety alleviating rituals.
>
> I kinda wonder about the strict diagnostic criteria as I think there is overlap for certian behaviors like addiction to gambling, sex, and the internet. In any case, I don't have the classic form of OCD as they define it.I had never known about the OCD/pleasure dichotomy. Thanks for the info.
But let's say you pursue a "pleasure" activity to the point where it's no longer pleasurable. I guess it could still be "pleasure seeking" though. I have to say, there is a good chance your pdoc and DSM could be right about this, despite my preconception.
Posted by Bob on July 29, 2008, at 12:37:04
In reply to Re: Internet addiction - help!, posted by blueboy on July 29, 2008, at 9:55:58
>
> I had never known about the OCD/pleasure dichotomy. Thanks for the info.
>
> But let's say you pursue a "pleasure" activity to the point where it's no longer pleasurable. I guess it could still be "pleasure seeking" though. I have to say, there is a good chance your pdoc and DSM could be right about this, despite my preconception.
>
>
Don't quote me on any of this, as I'm certainly no expert, but apparently there is a difference between the obsession that goes with pleasure seeking addictions like euphoric drugs, sex, alcohol, and gambling, versus checking to see if the front door is locked 100 times per day. The later is more purely an anxiety related obsession related to the terrible things that could happen if you accidentally left the door open.
Posted by dbc on July 29, 2008, at 12:40:42
In reply to Re: Internet addiction - help!, posted by blueboy on July 29, 2008, at 9:55:58
I think were going to far and assuming all aberrant behaviour is a disorder. In the 20 - 30 age bracket were becoming so integrated with the net and its stores of information that soon we'll have constant access 24 hours a day no matter where you are. Probably via some sort of very small sunglass lense.
Cyberpunk is becoming very close to being a reality.
Posted by yxibow on July 29, 2008, at 14:46:22
In reply to Re: Internet addiction - help!, posted by uncouth on July 29, 2008, at 9:28:38
> This was mean to be a serious question and thread with hopes for some serious solutions, pharmaceutical or otherwise.
>
> "Addiction" may not be the best term -- perhaps compulsion is. All I know is that for the last five years the first thing I do when I wake up is grab my laptop, and get back into bed. Sometimes it's for 10 minutes, othertiens (say on weekends) its for 2 hours. It happens before I even know what I'm doing. And what I do on it usually has no predetermined goal or aim.
>
> Seems like classlic defensive/compulsive behavior, and in some form it's gone on since highschool probably.
>
> I did notice that on a 3 month trial of Emsam, the amount of time I used the computer decreased, and the sense of being "stuck" or zombified was reduced. Almost like I had more choice or an increase in will....which i'm sure is how an alchoholic or any other addict would describe any med that helped his/her addiction.
>
> So now that i'm not on Emsam anymore, and am looking for other pharmaceutical interventions, can anyone provide any useful suggestions? Willing to try buprenorphine or naltrexone, but not sure if those have ever been used for internet addiction, although they seem to have some positive effects for depression.
>
> General idea is to treat a compulsion to use the internet that is likely a manifestation of both a depressive defense against negative affect, depressive boredom, and an attentional problem (need those squirts of dopamine).
>
> Internet/computer use is complex and I was hoping to get some more helpful responses here!
> UncouthI wasn't trying to trivialize it at all, I was pointing out that even "the unafflicted" browse the net at work. There is no pill that is going to take away internet addiction, if you truly define it as that. There never is a magic bullet. I have hard-wired OCD, like most people with it.
Its hard work and behavioural therapy would work more than throwing tons of psychotropics at it. But that's just my opinion, having gone through behavioural therapy at one point. You learn from it things you can learn for life.
The OC Foundation is a good place to start
-- best wishesJay
Posted by okydoky on July 30, 2008, at 19:16:18
In reply to Internet addiction - help!, posted by uncouth on July 27, 2008, at 21:27:23
I am trying to understand when this started? Did it start after you became depressed and continue in the periods when the depression was "successfully" treated, or did it start before the depression?
Do you think that it had a constructive place in your life during a time when it was not interfering with "social life, my growth as a young adult, my ability to extract pleasure from normal things in life, etc." and now that the need no longer exists the behavior has become routine? Perhaps it is as simple as changing your routine. I am not saying it is easily done. Sometimes when something outlasts its usefulness in our lives it is difficult to change our routine.
For example women with empty nest syndrome. All the routines they had existing around the need to care for their children become obsolete when the children can take care of themselves. Things in their lives that were once put on hold now need to be reinitiated or reexamined. The consequence of continuing in the same routines leaves their lives stagnant.
I dont know if this was a helpful analogy or not. I dont think it makes a hoot of difference what label you choose to give it. For some reason you are behaving in a way that is interfering in your life. Is that a pattern for you?
How long have you thought it was interfering with your life?
It is great that you recognized it. A lot of us are not able to do so. It is a big step. Being able to change it is your next step. From what you say it sounds like you are motivated. Beyond that, changing routines takes time and commitment.Do you see a therapsit you can discuss this with?
Posted by Marty on July 30, 2008, at 19:21:00
In reply to Re: Internet addiction - help!, posted by okydoky on July 30, 2008, at 19:16:18
I've just randomly stumble upon that site discussing possible causes of Internet/TV addiction: http://causeof.org/Ever heard of "serotonin irritation syndrome" caused by positive ions coming from your CRT monitors and TV ? This is actually interesting!
Many hypothesis are discussed on the site.
/\/\arty
Posted by yxibow on July 31, 2008, at 0:45:11
In reply to Re: Internet addiction - help! » okydoky, posted by Marty on July 30, 2008, at 19:21:00
>
> I've just randomly stumble upon that site discussing possible causes of Internet/TV addiction: http://causeof.org/
>
> Ever heard of "serotonin irritation syndrome" caused by positive ions coming from your CRT monitors and TV ? This is actually interesting!
>
> Many hypothesis are discussed on the site.
>
> /\/\artyI dunno -- more than ten years ago it was merely proposed as a ruse to include it into the DSM.
There is a stalwart (yes, religion again) Catholic, "Kimberly Young, Psy. D" who is campaigning against Catholics and internet addiction.
Neither the AMA nor the APA, nor the American Society of Addiction Medicine believe in including it in the DSM-V
Instead they grouped it into a category of not completely true addictions such as video game addiction and lumped "internet addiction" into it.
There's dependency, I'm sure -- on any medium. As a communications person, I don't know if anyone is old enough to know "The Medium is The Message". McLuhan though ahead of his time, wavered between a futurist and a luddite and religious views -- he was a crafty Canadian and a deserved scholar of communications.
If you're spending 4-6 hours playing MMORPGs such as Warcraft instead of doing your studies, you have a "videogame addiction" or habit on your hands.But as someone who happens to be connected with an institution that was on the nodelist for the DARPAnet, what would become the Internet, I can't say what we have seen in the past 30 years of use of the internet brings it to something that is addictable any more than eating a pound of brie or binging out on cereal.
I saw personally the birth of the WWW and also the beginings of arguments for .com at the same time and was sort of dismayed because I felt it should be left for academia.
But here we are today, a world society using, working with and making money on, the Internet, a project originally meant to be a redundant place for cold war scenarios.
I think there is too much restriction in corporate America and in the eyes of parents on just what people should be seeing and watching -- nannying can go quickly to fascism as we look towards China which has millions of internet users of which only the upper eschelon know how to get around the firewalls everywhere.But I digress -- whether you call it a true addiction or not my point still stands, if you believe it is a true addiction, then behavioural management and therapy or 10/12 step programs if you believe in them are ways to go, not blasting yourself with medicine passively as if it will go away (which if it is OCD, I can tell you, it won't).
Yes -- I roam the net at night, sometimes too late -- Wikipedia as noted before is a favourite -- but there's an easy control for that -- set yourself an alarm to pop up, etc. Limit your time that you even spend on here, even if you get a lot of therapy out of it, if you believe there are negative consequences.
There will always be small sites without the HON code posting or similar medical vetting saying that something is the end of the world -- I'm not trying to trivialize it, but everybody has a theory to promote and you do have to read through information on "medical" sites with a fine tooth comb.
We live in a day and age now when we can't pull the cord out of the wall. A computer is basically useless without a) an expensive corporate program like a video editing turnkey machine or b) a home user's internet hookup, today, to name countless examples.Once you've finished playing solitaire, there's not a whole lot to do with it. Hence, the need for finding a provider, etc.... I'm not saying anything anybody doesn't know.
I guess it comes down to using common judgment, and if you feel that you are having trouble using it, join some group that will pull you away from it, doing two things -- one helping you, and two, for people with anxiety and depression, actually helping you meet some new friends.
I don't know -- as they say your miles may vary and this is just my view on this subject, but I have never been able to see past it any more than the number of hours watching TV instead of doing something else. In the end, we find ways of doing things we want to do, rather than doing things we need to to do. It would be great if the two were the same, that would be -- an enjoyable job for example.
-- tidingsJay
This is the end of the thread.
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