Healthy living Online addiction
ICD codes: F63.8 What are ICD codes?
Most people associate online addiction with computer games. However, people can also become dependent on other online activities, such as online shopping and social media. Internet use becomes problematic if it begins to limit people’s lives and cause them suffering.
At a glance
- Online addiction is a mental health condition.
- Adolescents are especially at risk.
- In many cases, other mental health conditions, such as anxiety disorder and depression, occur at the same time.
- There are criteria that can be used to diagnose online addiction.
- The treatment depends on the severity of the condition.
Note: The information in this article cannot and should not replace a medical consultation and must not be used for self-diagnosis or treatment.
What is meant by online addiction?
Email, YouTube, TikTok, Wikipedia and weather apps – the internet is as much part of everyday life as eating and sleeping. People use it to listen to their favorite music, book vacations, and shop. People watch series, look for the love of their life on Tinder, share ideas with other users or battle virtual monsters alongside other players. With its infinite possibilities, the internet permeates every aspect of life. The danger is that people can also become dependent on it. But when does internet use become problematic or, in medical terms, pathological?
This question is quite difficult to answer, because this is a relatively new area of medical research. This is clear from the wide range of terms used in this field, including smartphone addiction, pathological internet use, online addiction, internet-related addictive behavior and internet addiction disorder (IAD). The term “internet use disorder” is becoming increasingly established in medical terminology. But what exactly does it mean?
An internet use disorder is a mental health condition. It refers to harmful or improper use of the internet. It also includes online gaming addiction, which involves various risks and negative consequences. To date, most research has been conducted on online gaming addiction. The World Health Organization’s (WHO) International Classification of Diseases (ICD) classifies gaming disorder as a distinct disorder.
Many researchers believe that the mechanisms underlying online gaming addiction are similar to those involved in other internet-related disorders. For this reason, findings from research on online gaming addiction are also used to understand other uses of the internet. The feature that all have in common is loss of control. The most common online addictions are to computer games, social networks, online shopping, and pornography.
When does internet use become problematic?
Everyone has seen cartoons or photos of people who are all staring at their smartphones at the same time. It can be like having a mirror held up to yourself: you find it funny, but you also feel validated. After all, if everyone else is doing it, it can’t be that bad. Or can it? In fact, the lines between frequent internet use and dependence are blurred.
Early indications of a problematic development are negative impacts on different areas of life: people begin to neglect school and work, hobbies, healthy eating or their real-world social life in favor of their online activities. They have a strong urge to be online and increasingly begin to lose control over this urge. Doing without the internet is unimaginable for them. Another typical characteristic is that their online activity continues even though they are already experiencing negative consequences.
Scientists still disagree to some extent as to whether internet use disorder is really an addiction. Critics believe that the internet cannot be compared with a drug such as alcohol. Rather, it is a medium that provides access to virtual content or enables social interaction.
They therefore argue that the purpose for which the internet is used is crucial: whether it is used for work, gaming or social interaction makes a difference. Accordingly, it is the user’s behavior and not the technology that creates dependence.
Most experts agree that online addiction is a behavioral addiction with similarities to drug addiction. Gaming disorder (computer gaming disorder) has also been recognized by the WHO as a disorder due to addictive behavior and classified accordingly. This means that it can be treated using forms of therapy that have had proven results with mental health conditions.
How common is internet use disorder?
Increasing numbers of people are developing internet-related disorders. A systematic review in 2020 reported that around 7 percent of people globally have an internet use disorder.
Young people are at an especially high risk. During the pandemic in particular, children and adolescents spent much more time on the internet and computer games than before. Since then, daily usage times have decreased somewhat. However, people are still spending more time on social media than before the pandemic.
Risky gaming behavior
In 2024, around 9 percent of children and adolescents in Germany showed patterns of risky gaming behavior. That corresponds to more than 700,000 children and adolescents aged 10 to 17. Gaming disorders tend to affect more boys than girls.
Social media
In 2024, almost all children and adolescents between 10 and 17 in Germany used social media regularly, in most cases every day. 21 percent of children and adolescents used social media to an extent considered risky. That corresponds to over 1.3 million children and adolescents in Germany. These children and adolescents either already have serious problems related to their social media use or are at risk of developing them.
How is an internet use disorder diagnosed?
Simply looking at how much time is spent online is not sufficient to determine whether someone has a problem. It is more important to ask whether they are suffering as a result of their internet use and if their daily life is being impacted.
If a disorder is suspected, the person may be asked, for example, if they are having difficulty controlling their internet use and whether their internet use is cutting into the time they should be spending on other activities. People are likely to have a disorder if they continue using the internet despite it having obvious negative consequences for them. These negative consequences may include, for example, poorer performance in school or at work.
Other signs that people may have an internet use disorder include:
- feeling bad when they are unable to use the internet as they normally would
- spending more and more time online
- deceiving family and friends about how much time is being spent online
- spending time online to help cope with negative emotions
Important: It is notable that an internet-related disorder is often accompanied by other mental health conditions. For example, people with ADHD have an increased risk of developing an internet use disorder. On the other hand, mental health conditions such as depression or anxiety disorders may develop over the course of an internet use disorder.
You can use an online test from the DIA-NET working group (in German), which takes about 20 minutes to complete, to find out whether you or your child may be internet-dependent. The test assesses your internet usage using diagnostic criteria.
How is online addiction treated?
Treatment of an online addiction depends on how severe it is, i.e., how many of the diagnostic criteria are met, and whether there are any co-occurring conditions, for example, depression.
The treatment aims to:
- reduce time spent online
- direct the focus towards other possible occupations
- strengthen self-worth and self-esteem
- reduce potential anxiety about social connection
The following treatment options are available:
- self-help
- early intervention
- outpatient therapy
- inpatient therapy
Parents have an important role to play in modeling healthy social media use for their children. In many cases, parents also play an important role in setting rules for their children’s internet use. Parents or other family members should therefore be involved in their treatment.
Self-help
Online self-help options offer accessible support. For example, various websites provide introductory information on this topic. Self-assessments can help you to better understand your own internet use.
In addition, online and offline counseling services, online training and online self-help groups and forums are available. These services are also aimed at parents and other family members.
Early intervention
Early intervention is aimed at people who have an increased risk of developing an internet use disorder or are already showing symptoms. Currently, programs based in schools, universities or special counseling services, for example, are provided for adolescents and young adults in particular.
Early intervention may take the form of special group programs for adolescents at risk of developing an internet use disorder. As part of these programs, adolescents learn about the disorder and about topics such as boredom, loneliness and anxiety.
Motivational interviewing is another approach that is sometimes used for early intervention. This method aims to support the person. The therapists act as partners who do not exert any pressure or impose any rules. Rather, they try to motivate the people they are working with to reflect on their own behavior and change it.
Outpatient therapy
Outpatient psychotherapy is recommended when the dependence is pronounced, certain co-occurring conditions are present, or an earlier treatment has been unsuccessful in the long term. Cognitive behavioral therapy is generally recommended. With this approach, people come to understand the mechanisms of their addictive behavior, which may in turn help them to change it. Problem management strategies are also taught, and social and interpersonal skills are strengthened.
Inpatient therapy
When a dependence is severe, it can make sense for treatment to be provided on an inpatient basis. The main benefit is being removed from the everyday environment in which the problematic internet use occurs. The therapy can help with relearning day-to-day structures, developing alternative behaviors, and finding strategies that can be used to control internet use.
Information about contacts, where to seek help, and all forms of therapy is available on the DIA-NET working group website (in German).
How can an online addiction be prevented?
Everyone can incorporate simple things for healthy internet use into their everyday life.
The following measures help to prevent online addiction:
- Log time spent online for one week to get an objective overview of your own behavior.
- Take offline breaks, known as “digital fasting” or a “digital detox”.
- Avoid triggers: i.e. disable visual and audible notifications that indicate new messages have arrived, or simply put your smartphone on silent. These triggers act on the brain’s reward center, and can therefore have an addictive effect.
- Put the smartphone aside at meals and in bed.
- Keep the smartphone where it cannot be quickly accessed, for example in a rucksack, when you are out and about.
- Remember pastimes or hobbies that used to be enjoyable, and take them up again.
Education-based prevention
Services based in schools and universities are other appropriate means of preventing internet use disorders. These are aimed primarily at young people who are already showing a tendency towards problematic internet use. Prevention programs should explain the risks and consequences of an internet use disorder.
Improving media literacy in school can also help prevent excessive internet use.
Where can I find more information and support?
The Federal Institute for Public Health (Bundesinstitut für Öffentliche Gesundheit, BIÖG) provides extensive information about media and internet use.
For example, parents and young people can order free brochures from BIÖG.
The Federal Institute for Public Health also runs various websites aimed at particular target groups:
The website www.ins-netz-gehen.de provides information about media use as well as online counseling for adolescents.
Other options
The DIA-NET working group at the University of Lübeck provides information, checklists, support options, and material about internet addiction based on the latest research (in German).
The Section for Addiction Medicine and Addiction Research at Tübingen University Hospital has created the German-language portal Erste Hilfe Internetsucht – a searchable database of help options. The University Hospital of Tübingen also provides free online training for parents whose children are showing symptoms of an internet use disorder.
The German Association for Inpatient Addiction Support (Bundesverband für stationäre Suchtkrankenhilfe) can help with finding a therapy place in a hospital.
- Bischof G. Besser B. Bischof A et al. Behandlungsmanual Internetbezogene Störungen. Universität zu Lübeck 2017.
- Deutsche Gesellschaft für Suchtforschung und Suchttherapie e.V. (DG-Sucht). S1-Leitlinie Diagnostik und Therapie von Internetnutzungsstörungen. Stand 20.11.2024.
- Die Drogenbeauftragte der Bundesregierung. Jahresbericht 2021. August 2021.
- Petersen K, Hanke, S, Bieber L, Mühleck A et al. Angebote bei internetbasiertem Suchtverhalten in Deutschland (AbiS). Pabst Science Publishers: Lengerich 2017.
- Rumpf HJ. Bischof A. Handreichung Expertenworkshop Internetbezogene Störungen (EXIST) 2018. Universität zu Lübeck. Klinik für Psychiatrie und Psychotherapie.
- Wiedemann, H., Thomasius, R., Paschke, K. Problematische Mediennutzung bei Kindern und Jugendlichen in Deutschland: Ergebnisbericht 2024/2025. Ausgewählte Ergebnisse der siebten Erhebungswelle im September/Oktober 2024. 2025.
