High above the frozen Potomac River in the nation's capitol, Ryan Van Cleave stood on the Arlington Memorial Bridge, contemplating his life. It was New Year's Eve 2007, and the married father of two asked himself, "Is this really something I'm thinking about? Is my life really this out of control?"
At the precise moment he decided not to jump, Van Cleave slipped on a patch of ice and nearly fell to his death, 100 feet below. Then he took a deep breath and stepped back from the edge.
Van Cleave, an accomplished writer and college professor, had been laid off by his prestigious university as he descended into the depths of Internet addiction. He was playing online games for up to 80 hours a week. He was avoiding his real-life friends and ignoring his wife.
"I got so far into it," he says, "I couldn't realize how I got there."
Like many others who say they are addicted to the Internet, Van Cleave likens his addiction to alcoholism.
"A beer a day becomes a case a day," he says. "You can't stop, no matter how much you want to."
"The real problem," Van Cleave adds, "is that most people laugh at you and don't consider it a serious thing."
That sentiment could change on Monday, when the country's first inpatient treatment program for Internet addiction opens at Bradford Regional Medical Center in Pennsylvania.
"I've been studying Internet addiction since 1994," says Dr. Kimberly Young, a professor at St. Bonaventure University and the psychologist who founded the program at Bradford Regional. "When you talk about the controversy behind it, laughing it off, that's often been the case with my work."
The program is designed to accommodate four patients at a time, who all begin and end their treatment on the same day. The addicts' 10-day stay begins with a 72-hour "digital detox," followed by a full psychological evaluation.
Facebook addiction? Young and Dr. Roger Laroche, the medical director of Bradford Regional's Psychiatry department, expect to see withdrawal symptoms in their patients similar to those seen in hardcore drug addicts. Some, they say, will need to be medicated to make it through the detox.
"We're really behind other countries in treating this problem," says Young. "China, Korea and Taiwan all have treatment centers. Here in the United States, people who need treatment don't have anywhere to go. Now, we finally have something to offer people."
Because Internet addiction is not classified as a mental illness in the American Psychiatric Association's Diagnostic and Statistical Manual (often referred to as the "psych bible"), none of the program's $14,000 cost will be covered by insurance.
Dr. Allen Frances, the chairman of the DSM-IV and professor emeritus at Duke University, says there's little doubt that some people could indeed suffer from an Internet addiction. But he believes the research is premature.
"The concern is that there will not be a clear, bright line in between a true Internet addiction and the rest of us, who are using it recreationally," he says.
"People can spend 10 hours a day in front of a screen, blow off their wives, blow off their work, but that doesn't necessarily mean they're addicted," says Frances. "Addiction implies a pattern of use that you can't stop." The compulsion continues, even though time spent online is no longer productive or enjoyable.
Some studies show that the same areas of the brain that light up when alcohol and drug addicts get their fix light up when Internet addicts log on. An addict, by nature, is seeking a rush of dopamine, the neurotransmitter that is associated with feelings of reward and pleasure.
"That is a very critical aspect, as far as what separates addiction from just a bad habit," says Laroche. "We literally are talking about someone who has jeopardized his life and every aspect of it."
Dig deeper into the new Diagnostic and Statistical Manual, the DSM-V, and you'll find an entry for "gaming disorder" in Section III, meaning the American Psychiatric Association believes the condition warrants further research before it can be formally classified as a mental disorder.
Most Internet addicts, it seems, are plagued by an addiction to online games, more so than other online activities such as looking at porn, shopping or using social media.
Such was the case for Van Cleave, who chronicled his experience in "Unplugged: My Journey into the Dark World of Video Game Addiction."
Van Cleave began gaming when he was a child.
"At college," he says, "I suddenly had a lot of unsupervised time. I started gaming exponentially more. If you don't study much, you have even more free time."
Eventually, Van Cleave reached a "crisis point," buried for up to 80 hours a week in World of Warcraft (a role-playing game in which you can "join thousands of mighty heroes in an online world of magic and limitless adventure.")
Van Cleave lost his job, some friends, and was barely able to save his marriage. "I pushed it awfully close to the line by not being available for a long time," he says.
"It was so obvious these things were happening, but I couldn't see it because I was knee-deep in the problem."
The foreword for Van Cleave's book was written by Dr. Mark Griffiths, a professor at Nottingham Trent University in the United Kingdom, who studies behavioral addictions in the School of Social Sciences. He says Internet addiction has five key criteria:
1. Salience: The Internet becomes the most important activity in the person's life, affecting feelings, behaviors and thoughts.
2. Mood modification: The person receives an emotional "buzz" from using the Internet.
3. Tolerance: The person becomes acclimatized, requiring increasing amounts of Internet time to get that "buzz."
4. Withdrawal symptoms: Abruptly ceasing Internet activity can cause the personal emotional or physical distress.
5. Relapse: The addict tends to fall back into the same behavior very easily, even after years of abstinence or control.
"When you see that behavior," says another recovering addict, Kevin Roberts, "it's only the tip of the iceberg. You're often going to find underlying issues."
In Roberts' case, the underlying mental health issues turned out to be ADHD and anxiety, which both went undiagnosed until his Internet addiction spun out of control.
It was good friends who had been through AA, dealing with addiction themselves, who recognized Roberts' categorical consumption with gaming had reached addictive proportions.
Unlike van Cleave, Roberts went on binges.
"I would go through periods when I wouldn't indulge," he says. Other times, he would play real-time strategy games for weeks at a time, at least eight to 12 hours a day. These binges were usually set off by an emotional trigger. "I would often be sleep-deprived, sometimes going a whole day or two without sleeping."
Roberts likened himself to a functional drunk.
"I held a job and paid my bills," he says. "I wasn't real successful at relationships, because of 'the screen,' but I didn't know that at the time."
While he was able to keep it together for a while, thanks in part to his being self-employed, Roberts eventually began to lose clients.
"I even lost money after performing work for someone," he says, "because I was too busy gaming to send out an invoice."
He lost standing in his profession that he may never gain back.
"I eventually stopped gaming," Roberts says, "because the thrill became less and less, even as I played more and more."
He and Van Cleave are among the minority of Internet addicts, experts say, who have been able to break their bad habits without an extreme intervention.
Roberts wrote a book about his experience, "Cyber Junkie: Escaping the Gaming and Internet Trap." Perhaps more importantly, he joined a cyberaddiction support group. "We're always there for each other," he says. "It's our 'Vitamin C,' C being for community."
It's that sense of camaraderie that Young hopes to evoke from her patients at Bradford General. "There's a group dynamic in having them be in a class together," she says. "There's a support system that builds up."
It's worth noting that reSTART, the country's first retreat center program for Internet addiction, opened in 2009. A 45-day retreat to "disconnect and find yourself" at reSTART costs $22,000, after which patients have the option to extend their retreat for $421 a day, depending on their individual treatment needs.
Van Cleave underscores the importance of getting professional help and learning, quite simply, how to properly think and function again in daily life. "Alcoholics can stay out of bars and restaurants that serve booze, but an Internet addiction is like an eating disorder," he says.
"They have to relearn how to eat, what foods to avoid, what stores to avoid," says Laroche, employing the same metaphor.
But Frances is worried a treatment regimen that could and should be applied to tens of thousands of people will instead be applied to millions. "I'm concerned there's so much publicity about these four lousy beds," he says. "This is being commercialized prematurely."
"Before developing clinical programs, we should have the research," says Frances. "This is a dangerous sign of a fad diagnosis. Unfortunately, the history of psychology is a history of fads like this."
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