A decade into the iPhone age, such devices feel like extensions of our bodies. Screens stay so attached to us — whether in hand, in pocket, or strapped to the arm on a morning jog — that concerns of addiction can seem quaint.
They shouldn’t, said Edwin Salsitz, M.D., an addiction medicine specialist at Mount Sinai Beth Israel in New York City.
Psychiatry’s so-called Bible of mental disorders, the DSM, doesn’t mention phone addictions, Salsitz points out, nor does it address addictive behaviors around shopping, porn, or food. Many think it should, though, he said.
“Clearly something potentially damaging is going on with us in regards to screens,” said Salsitz, who’s spent decades treating addiction.
All addiction starts with pleasure, Salsitz said. New texts, tweets and Instagram likes flood the brain with dopamine, a key chemical in addiction, he said. Such tech-fueled pleasure rushes can create a heightened new norm that, unsustained, leaves us able to plunge into feelings of disappointment.
The brain doesn’t like that, Salsitz said.
“The brain likes a pretty steady, smooth level of dopamine,” he said. “So a lot of screen activity time, I think, is a hectic way to live, to constantly be checking and thinking about it.”
Salsitz knows many can’t work without mobile devices, with employers increasingly requiring round-the-clock availability. He thinks that pressure may one day wane (look at laws alreadyregulating phone use while driving, he said). But not all phone use leads to addiction, he said, just as not all drinking leads to alcoholism.
So how do you know? There’s a golden rule of addiction, Salsitz said: If it’s not harming you or others, it can’t be called an addiction.
Here are five questions to ask yourself if you think you might be addicted to your phone:
- Am I too preoccupied with the device? “Can I put the phone away for two hours and not think about it? Can I go to sleep without the phone in my bed?” Salsitz said. “Can I wake up in the morning and brush my teeth without checking my phone? The answer to those will be ‘no’ in people likely have an addiction to their phones.”
- Can I put the phone down for a while? “At a restaurant, I’ll see four people at a table not interacting, just looking at their screens throughout the meal. If they put it down, they pick it (right) back up. If that’s a persistent behavior, then the word ‘addiction’ would be neurobiologically appropriate.”
- Do I get withdrawals when not using it? “If I take the phone away form you, are you going to fear irritable, like you're missing something, like you have to get the phone back because you haven’t checked it in 10 minutes?” he said. “We can have a withdrawal, like you experience with opiates. It’s not a physical withdrawal, but it’s an emotional withdrawal.”
- Am I hiding my phone usage from others? “People who are addicted know it’s a problem,” Salsitz said. “The way you can tell that they know is they tend to hide it … they might go into their room to use a screen rather than doing in a room with other family members.”
- Do I use my phone when bored or depressed? People eat, drink and smoke for the same reasons, Salsitz said: “If that’s what’s happening, that’s not a good thing. It’s very dangerous. Because you’re having negative emotional states and you’re thinking this is going to be the answer to your problem, which it will never be. You’ll keep getting in worse and worse state.”
There are caveats to any discussion on phone addiction, Salsitz said. For a shut-in, a smartphone may provide a healthy portal to social interaction. Getting email push alerts could simply be a smart move for your career.
“There are no absolutes in the addiction field; everything has to be put into context,” he said. “It’s not a yes-no. It’s a continuum.”