Internet Withdrawal Psychosis

Withdrawal from internet addiction, like withdrawal from drug use, can result in negative side effects including psychosis. Learn about symptoms and treatment options.

Internet addiction involves the excessive use of the internet, resulting in significant impairment and distress in daily life. Along with other behavioral addictions like pathological gambling, internet addiction is considered a process addiction characterized by an inability to control use despite being aware of the negative implications of the behavior.

Behavioral addictions, including internet addiction, share many similarities with substance use disorders, including tolerance, dependence, withdrawal and neglect of other activities. Withdrawal from internet addiction also shares many symptoms with drug withdrawal like craving for internet use, anxiety and depression. In certain case, internet withdrawal may lead to symptoms of psychosis.

Symptoms of Internet Withdrawal

Internet addiction is characterized by psychosocial problems involving depression, anxiety, impulsivity and social isolation. Like the withdrawal symptoms observed in substance use disorders, withdrawal from internet addiction or problematic internet use can also have adverse effects.

The symptoms of internet addiction withdrawal usually include:

• Increased anxiety
• Moodiness
• Increased negative mood
• Depression
• Craving for access to the internet (especially when gaming is involved)
• Psychosis in certain cases

The Emergence of Psychotic Symptoms

Psychosis is a psychological condition characterized by abnormal patterns of thinking involving a loss of contact with reality. Internet addiction or problematic internet use, in itself, is associated with the prodromal phase of psychosis. During this phase, a person begins to exhibit warning signs that are observed before the full onset of symptoms.

Case studies in the last decade have shown the emergence of psychotic symptoms in the immediate period after stopping internet use. Such psychotic symptoms involve paranoiac states with delusions that are often associated with the use of the computer or other associated technologies. Other psychotic symptoms may include auditory and tactile hallucinations that are often related to the content present in online games or chat sessions.

Similarities to Drug and Alcohol Withdrawal

A recent study showed that more than half of the individuals who were dependent on (or addicted to) drugs like cocaine, cannabis and amphetamines showed psychotic symptoms.

Drugs and alcohol, either directly or indirectly, increase the activity of dopaminergic neurons in the brain’s reward pathway. These dopaminergic neurons project to the frontal cortex and excessive activity of these dopamine neurons can harm the activity of neurons in the frontal cortex.

The frontal cortex, besides being involved with important cognitive functions like decision-making and impulse control, is also associated with the processing of sensory information. Therefore, changes in the frontal cortex may alter the processing of sensory stimuli, resulting in hallucinations and delusions.

Internet addiction also leads to changes in the dopaminergic system similar to those observed with substance dependence. Such changes in the dopaminergic system may explain the symptoms observed with internet addiction and drug addiction. Changes in the dopamine reward system may also be responsible for the symptoms of internet addiction withdrawal.

How Long Does Internet Withdrawal Last?

The psychotic symptoms emerging from internet withdrawal tend to gradually improve in the subsequent weeks after abstinence, with such symptoms lasting less than two weeks in the few cases reported so far.

However, internet addiction, especially when occurring with other behavioral symptoms, may serve as initial warning signs for other major mood disorders. In such cases, even after ceasing internet use, psychosis and other symptoms may persist unless appropriately diagnosed and treated.

Examples of Internet Withdrawal Psychosis

Internet addiction and the excessive use of the internet for gaming and communication is associated with psychosis. This connection has been observed even in individuals without pre-existing mood disorders, indicating a causal role of internet addiction in psychosis. However, there are only two examples of psychosis occurring as a consequence of internet withdrawal.

1. Internet Addiction Case: 15-Year-Old Indian Adolescent

In one case, a 15-year-old Indian adolescent who heavily used the internet started showing psychotic symptoms after his parents withheld his access to the internet. His withdrawal symptoms consisted of irritability, insomnia, destructive behavior and delusional beliefs. The individual’s delusional beliefs included that his parents had implanted a memory chip in the computer to track his activities and harm him.

The individual was treated with the antipsychotic drug aripiprazole, which resulted in complete recovery in the subsequent two weeks. Antipsychotic treatment was continued for a total of 12 weeks before discontinuation and resulted in normalization of social and academic behavior.

2. Internet Addiction Case: 25-Year-Old Korean Man

In another case, a 25-year Korean man had symptoms of internet withdrawal after he suddenly stopped playing an online game that he used to play eight to 12 hours a day over the previous two years. His symptoms included aggressiveness, delusions, disorganized thinking and sleep loss.

The man’s delusions included that electromagnetic waves from the computer were making him impotent and that his father must obey his orders. The individual also showed impaired perception of reality in a clinical test and was diagnosed with internet addiction disorder. He was treated with the mood stabilizer quetiapine for four days and subsequently showed a complete recovery from the psychotic symptoms.

Treating Internet Addiction Withdrawal

Psychological approaches to therapy are the mainstay of internet addiction treatment and can occur in a variety of forms, including psychotherapy, motivational interviewing, lifestyle changes, pharmacological interventions and more. 

• Psychotherapy. Psychotherapy generally involves cognitive behavioral therapy, which is more effective than other forms of psychotherapy in reducing relapse, achieving impulse control and reducing symptoms of depression. Cognitive behavioral therapy involves identifying patterns of thoughts and behaviors underlying internet addiction and learning to change these negative thoughts and actions. 
• Motivational Interviewing. Motivational interviewing is another form of therapy that involves raising awareness of the adverse effects of internet use and increasing personal motivation to overcome internet abuse and dependence. 
• Lifestyle Changes. Lifestyle changes such as exercising regularly and changing habits involving the use of the internet may also be helpful, especially when used with other forms of treatment. 
• Pharmacological Interventions. Pharmacological interventions in the treatment of internet addiction may involve the use of mood stabilizers and antidepressants. Antidepressants may be especially effective when the symptoms of depression and anxiety are present along with internet addiction.

The impact of the above therapeutic options on the specific treatment of symptoms encountered during internet addiction withdrawal is less understood. As observed in the case studies, the use of antipsychotics and mood stabilizers may be effective in ameliorating the effects of internet addiction withdrawal. Effective treatment of the symptoms of internet addiction withdrawal may be necessary to prevent relapse.

Individuals with internet addiction often have comorbid substance use and mood disorders. If you or your loved one has a drug or alcohol addiction and a co-occurring internet addiction, The Recovery Village can help. We offer comprehensive treatment for co-occurring conditions. Call today to speak with a caring representative and learn more about rehab.

Editor – Camille Renzoni

Cami Renzoni is a creative writer and editor for The Recovery Village. As an advocate for behavioral health, Cami is certified in mental health first aid and encourages people who face substance use disorders to ask for the help they deserve. Read more

Medically Reviewed By – Dr. Deep Shukla, PhD, MS

Dr. Deep Shukla graduated with a PhD in Neuroscience from Georgia State University in December 2018. Read more