Viterbo, October 2017
Nevertheless, as a kind of mass media, the net is not, however, free from bad uses and abuses which, during the last years, have led to a kind of addiction, known as the Internet Addiction Disorder (IAD) (1), which is included in all other mental disorders. The psychopathology defines this phenomenon as “craving”, which means an uncontrollable push to take an action or to get a drug. Especially for teenagers internet represents a new way to communicate which may have pathological consequences that do not depend mainly on the hours spent on it, but rather on the intensity and quality of the social avoidance in where the mind dissociates functionally from the body.
Technically, internet does not work anymore as an information container (for instance to check emails or getting information) but it becomes a vehicle of emotions which are not easily controlled. It gets a transformative path which lead to a pathology, when the person reaches a social avoidance, a detachment from reality, with reduction of multiple activities until he/she totally ends up (for instance, school dropout). Internet has changed the way people experience time and space, invalidating the capability of waiting and listening.
The internet addiction for adults shows characteristics which are different from those ones related to teenagers and children, creating a real behavioural pathology characterised by compulsive push which may go beyond the discernment clearly (for instance gambles, relational and sexual addictions).
According to Young (2), there are 5 kinds of Internet Addictions which are typical of adults: cyber sexual addiction; cyber-relational addiction; net-compulsions (gamble); cognitive overwhelming (compulsive search for online information); videogames. The youngsters, on the contrary, do not show any pathological addiction but internet represents a way to think and communicate which may have side effects, even pathological, if there’s a “gap” into the childhood affective roots (3).
We may therefore conclude that children are the “Digital Natives” and adults the “Digital Immigrants”.
Generally the online game and social network addictions involve the youngsters while cybersex and gamble are more popular among adults. To better understand the possibility of expansion of this pathological phenomenon, it is reported that the number of net-surfers has increased until 376% in the last ten years and that, until 2011, there were more than five hundred millions of users (6) . Several tests can diagnose which are the people affected by IAD, who spend hours and hours of their time out of the real world, to the detriment of their own social and working role, their health and waking-sleep rhythms.
A clinical evidence underlines that, in many patients’ story, several problems are often interconnected, going together with other kinds of addictions or further psychotic disorders.
2. The role of the nurse
The person affected by IAD must be supervised on a multiprofessional level, because the problem involves many aspects of someone’s health, from the psychological and social ones up to the physical aspects. The intervention of different experts, everyone with special competences, is essential and the main goal have to be the best as possible management of the emotional luggage hidden in the internet addiction (7). The nurse, thus, represents the professional who works as a sort of conjunction ring among the members of the team that is taking care of the patient. The nurse must deeply know the typical aspects related to the internet addiction and understand the special meaning of specific attitudes or sentences told by the patient. The health worker becomes a sort of translator of the implicit language of this addiction disorder. The internet addiction is in fact a phenomenon which has its roots in the inability/impossibility to express certain inconveniences, (above all, related to the own family), which the patient (generally a teenager) lives in total passivity and indifference.
IAD is a real addiction, and thus withdrawal symptoms may occur. Such episodes are physiological and they must be observed, elaborated and used to help the patient in the future (10). The autistic-like shelter in the virtual world, responsible for a strong and serious alienation from reality, may be gradually interrupted promoting the establishment of new significant relationships among the members of the rehabilitation group. Sharing new emotional contents may promote the creation of emotional competences.
In these cases medical prescriptions are not anyway recommended. Only in a few cases (i.e. a strong isolation, forerunner of a psychotic evolution), a low dosage prescription of tranquillizer and neuroleptic drugs might be useful to reduce anxiety and crisis, strictly under medical control (14).
The goal of the nurse’s job is to give back to patients their own self-control, to lead the correct management of their time given to internet, understanding its real role which is just a virtual window on the world made to inform, interact, abolish distances and not instead to create walls among people.