Can’t stop clicking

P Anima | Updated on March 10, 2018

Virtual trap: As more Indians discover the joys of the online world, for a few, at least, the relationship with the gadget has mutated from necessity to dependence. Photo: R Ravindran   -  The Hindu

The country’s premier medical institute AIIMS opens a treatment centre for internet addicts

At the outpatient department (OPD) of the All India Institute of Medical Sciences (AIIMS), New Delhi, crowds disentangle from the ground-floor melee to stream into multiple stairs and corridors. The narrow passage bisecting the second-floor hall is crammed with patients. By the time one reaches the passage’s end, it’s not swarming anymore. The crowd changes, so too the profile of the patients. Two young men remain engaged with their iPhones. A couple of others deeply discuss depression. A timid young woman occasionally whispers to her companion. Minutes later, she walks into Room 15 and the door closes after her. The sterile silence in the corridor is broken only by the muffled sounds of her angry outbursts.

Yatan Pal Singh Balhara, assistant professor of psychiatry, has had more than one volatile patient this morning. This is the special psychiatric OPD for internet addicts, jointly run by Balhara and Rachna Bhargava, faculty of clinical psychology. The institution’s Behavioural Addiction Clinic is just over a month old. The trial run, though, had begun earlier.

When the country’s premier medical institute opens an OPD for online addiction, it means the devil is at the door. In a country with an estimated 500 million internet users and over a billion mobile phone subscribers, for a few, at least, the relationship with the gadget has mutated from necessity to dependence. For a few years now, there have been nascent attempts at tackling internet addiction. NGOs opened counselling centres. Programmes at the Bengaluru-based National Institute of Mental Health and Neuro Sciences help patients engage with technology at a healthy level. A behavioural addiction clinic and weekly OPDs at AIIMS imply the problem now demands greater intervention.

“We haven’t started early. But we aren’t very late either,” Balhara reasons.

Doctors in India cite the 16-24 age group as the most susceptible. Many parents, however, remain clueless about the extent of the problem or the availability of treatment. A dedicated clinic serves as a signboard. “One has to see it in the context of psychiatric disorders,” says Balhara. Initially there was some apprehension that terming it a ‘disorder’ would discourage those affected from seeking help. On the contrary, however, the OPD has received an encouraging response.

Last Saturday, Balhara had three new patients. Nikhil (name changed) is a 17-year-old who dropped out of school when he was in Std XI. He kept failing in his subsequent attempts to clear his exams and his parents knew that gaming was to be blamed. Unable to stop him, for two years they watched as Nikhil refused to meet friends, missed birthday parties and bunked movie outings to stay rooted in front of his Play Station. As he progressed from version 2 and 3 to 4, he demanded a smart phone and broadband connection. “The parents couldn’t even think of shutting down the PlayStation as it created a scene at home,” says Balhara. The family finally saw a way out after it came across news reports on the AIIMS clinic.

Typically, parents tend to approach the clinic only when their child’s dependence results in a slump in academics. Until then, they dismiss it as merely an undesirable habit.

For instance, the young woman at the clinic who was having an angry meltdown, was brought in only after she failed to clear her medical entrance test. She was spending an inordinate amount of time on Facebook and WhatsApp, and her parents’ attempts to restrict her online activity were met with meltdowns, anger and violence.

“The young woman is calm when you let her remain on FB and WhatsApp. When you confront her, take her out of her comfort zone and take away ‘the thing’ that’s her world, she retaliates. It is common to all behavioural problems,” Balhara explains.

Another 22-year-old engineering college dropout had to be hospitalised after he began to have violent outbursts whenever his gaming was interrupted.

Often, getting the patient to the clinic — to peel them away from online activity — has been a major challenge. A long process of intervention follows.

“It’s not a one-time therapy,” says Balhara. Spread over six-eight weeks, the treatment involves counselling, behavioural therapy, time scheduling and stress management.

In some instances, internet addiction is a manifestation of deeper psychological problems. The healing has to start from within.

As Balhara puts it, the moment it dawns on you that the game is playing you, and not vice versa, that’s the moment you seize and you start to co-operate with the treatment.

Treatment is tricky, as the doctors cannot possibly remove the cause — the internet. “Internet may be the problem, but it’s also a necessity. Therapy has to empower the patients to use it when needed and not out of compulsion.”

Japan and Korea have specific treatment protocols for online addiction, which is the most common psychiatric disorder among adolescents there. In India, there have been few systematic studies to gauge the extent of the problem.

Worried queries, however, keep coming... from Kolkata, Mumbai and many other places. The one clinic at AIIMS will no longer be enough, says Balhara. “We need more clinics at other government and private hospitals.”

Published on November 11, 2016

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