Anyone familiar with South Park's 2007 Emmy winning episode Make Love, Not Warcraft knows that popular culture has already started to recognize that addiction can come in virtual forms, especially with the ever-expanding online world.  The medical community remains divided, though, on whether to treat internet addiction as a serious mental illness akin to gambling, alcohol, or sexual addictions.

One psychiatrist is speaking out on the topic and lobbying for the problem to be classified as an officially recognized mental illness.  Dr. Jerald Block, a psychiatrist at the Oregon Health and Science University in Portland wrote a controversial editorial, published in this month's issue of the American Journal of Psychiatry, which calls upon the medical field to add internet addiction to psychiatry's official guidebook of mental disorders.

Dr. Block describes internet addiction as "excessive gaming, sexual pre-occupations and e-mail/text messaging". Though stopping short of discussing what is classified as "excessive", Dr. Block states that these imbalances form a classic example of an obsessive compulsive disorder.  He says that akin to other addictions, users go through cravings, urges, withdrawal and tolerance.  These symptoms manifest themselves in desires for more and better hardware and software, as well as more hours online.

The addiction can cause people to lose all track of time.  He writes that addicts may neglect "basic drives" such as the need to eat and sleep.  He states that relapse rates for this addiction are particularly high.  Perhaps most controversially, he states that victims of the illness may need psychoactive medication to control their urges and may need to be hospitalized.

He says that of the internet-addicted population, 86 percent have some other form of mental illness.  This rate is rather high, but many addictions share a correlation between addict populations and rates of mental illness incidence.  He states that these other mental illnesses often mask the serious problem of internet addiction.  He argues that few in the psychiatry and psychology community will even pick out a person's internet addiction, unless they are specifically looking for it.  He argues that this oversight needs to be put to an end, with the addition of the illness to the Diagnostic and Statistical Manual of Mental Disorders, the psychiatry profession's dictionary of mental illnesses.  The book's next edition is due out in 2012, with a public draft coming next year, open to public comments.

Whether internet addiction will indeed be added to the draft is uncertain.  Many psychiatrists take issue to Dr. Block's remarks and argue that the research into internet addiction is in its infancy.  They argue that without further research it is impossible to determine where the line is crossed between intended use and addiction, and that classifying the illness prematurely will lead to inaccuracy and confusion.

British psychiatrists recently published a study in the journal Advances in Psychiatric Treatment which stated that a "significant minority" of five to ten percent of internet users are addicted to the internet.  A similar study in America found that 1 in 8 people may be internet addicted.  If this were the case, it would make the mental illness have a rather large population numbering in the millions in the U.S. alone.  Interestingly, early research into the disease stereotypically suggested that the most vulnerable population was highly-educated, highly-introverted males.  However, more recent research has dismissed this as inaccurate; stating that the most effected population is surprisingly middle-aged women on home computers.

John Macdonald, of the Centre for Addiction and Mental Health in Toronto, an expert addiction therapist, states that the line between use addictions is crossed when the user experiences negative effects in their life due to overuse.  McDonald states that preoccupation with getting and staying online is one sign of addiction.  McDonald questions, "If they're not able to engage in it, is it emotionally upsetting for them?"

He concludes, "The real proof in the pudding: is the amount that you do causing any problems in your life?"

In China and Korea, the problem is already officially recognized by the nations' medical communities.  These countries were spurred to action following 10 deaths at internet cafes in South Korea alone from cardiopulmonary-related illnesses induced by compulsive internet use.  Over 7 of the deaths have been attributed to online gaming.  Dr. Block cited South Korea's response in his editorial-- the nation has addressed the threat by deploying 1,000 additional counselors specifically trained in dealing with internet addiction.