Smartphone addiction is not a real diagnosis.

The Absurdity of Diagnosing “Smartphone Addiction”

The Absurdity of Diagnosing “Smartphone Addiction”

The citizen’s guide to the future.
Aug. 31 2015 11:39 AM
FROM SLATE, NEW AMERICA, AND ASU

The iPhone Intervention

Is smartphone addiction a diagnosis or just an excuse?

Photo illustration by Juliana Jiménez.
Disease or plain old bad habit?

Photo illustration by Juliana Jiménez. Photos by Thinkstock.

“The second time I got hammered and lost my iPhone last winter, I knew what I had to do,” says Kevin Allison, host of the not-safe-for-NPR podcast Risk. “I quit the booze, not the phone. What do I look like, a saint?”

The idea that we’re too dependent on our phones is nothing new—way back in 2007, we spoke of “crackberry addicts.” Around that time, some health authorities speculated that talking on a mobile for extended periods would expose the user to high doses of electromagnetic radiation, causing “an epidemic of cell phone induced tumors”—a public health crisis that failed to materialize. Nevertheless, as our phones evolved into more versatile tools, concern about them mounted. Employees were checking email after hours! Men could be using their phones to look at porn! The hand-wringing has only become more frenzied with the launch of each nifty new game, podcast, blog, social networking platform, streaming music service, productivity app, and synced device.

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The term smartphone addiction first gained currency in 2012, when Google searches for that phrase began a steep climb. The idea was at first more tongue-in-cheek social phenomenon than medical diagnosis. Truth be told, it remains a point of pride to clock more hourly screen checks than the next guy. But the continuous onslaught of alarming headlines and gloomy statistics seems to have colonized our common sense, leaving us susceptible to the silly notion that smartphone overuse truly is a medical disorder. Behavioral addiction specialists would like to make it official, placing mobile phone addiction alongside gambling, binge eating, temper tantrums, and a host of other nuisances now billed as full-on pathologies.

The process of medicalizing smartphone addiction was initiated when researchers began publishing dull academic discourses on what had hitherto been merely a pop culture curiosity. Experts coined angsty neologisms like ringxiety (anxiety caused by phantom ringing or vibration) and phubbing (phone snubbing—that is, rejecting present company in favor of your mobile). With straight faces, they introduced the Mobile Phone Problem Use Scale, the Smartphone Addiction Scale, and other instruments with which to gauge the severity of the condition. Leaders in the field of addiction medicine are calling for more research to suss out possible connections between smartphone use and anxiety, insomnia, depression, and other maladies.

Admittedly, mobile devices tempt us to rack up more screen time than a slots player with an oxygen tank and a Bally’s card. But in calling this bad habit an addiction, we are both exaggerating the problem and trivializing the burden of substance abuse.

Perhaps we’re keen on medicalizing our phone use because a diagnosis can be a handy excuse for obtuse behavior, such as the aforementioned phubbing. Medicalization extends the boundaries of illness, annexing new patients at every opportunity. It transforms certain commonplace human phenomena—disappointing physical functioning, unwelcome life transitions, unconventional behavior or personality traits, and troubling thoughts, for example—into treatable medical conditions.

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The reclassification of gambling disorder as an addiction, rather than a compulsion, marked a tipping point in the medicalization of behavior. This change to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, an influential catalog of mental illness, legitimized nonsubstance addiction as a diagnostic category. Unlike a disease, which has a direct, identifiable cause, a nonsubstance addiction is defined only in terms of its symptoms—it’s the egg without the chicken. As a result, “virtually almost everything may be considered pathological.”

And virtually everything has been. By now, we’ve all heard of sex, exercise, and work addictions. But what about addiction to suntanning, bodybuilding, fortune telling, or love? At what point, exactly, does one qualify as an addict, versus simply a dingbat, narcissist, sap, or schmuck? We’ve become soft, fretting about our mental well-being as if it were a vintage Jaguar—nice to have, but touchy, unreliable, and in need of continual repair and preventive maintenance.

The most insidious aspect of all this disease mongering, though, is its conformist nature. Turning ordinary behavior and emotions into diagnoses flattens the bell curve of human experience, quashing the quirks and idiosyncrasies that lie at the fringes. We either march in lockstep or venture into a no man’s land of mentally ill outliers. Sites like Anxiety.org and the Fix are already beginning to associate smartphone addiction with depression, anxiety, and sleep disorders, as well as with supposed physical conditions like “iPosture.”

Available treatment for cellphone dependence ranges from rehab to do-it-yourself weaning guides that help you evaluate your usage, set goals, and track your progress. A surrogate phone made of plastic or wood can be incorporated during the weaning process as a kind of electronic security blanket—the equivalent of holding an unlit cigarette while you’re trying to quit smoking. And Manoush Zomorodi, the endearingly neurotic host of the podcast Note to Self, suggests a series of pointless challenges intended to serve as a regression therapy, of sorts, for similarly high-strung listeners. At this level of absurdity, it can be only a matter of time before doctors begin treating patients’ complaints with Xanax, Prozac, Ambien, and the like.

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The medical literature on nomophobia (“no mobile phone” phobia) is a case study in the preposterous gravity surrounding this issue. Nicola Bragazzi and Giovanni Del Puente propose that nomophobia be listed as a new diagnosis in the next update to the DSM-5. Asked if such an inclusion might water down the concept of addiction, they skirted the question: “[The DSM-5] is evolving in order to capture new nosographies and contemporary diseases,” they replied. “The pervasion of smartphone[s] in our society is such that it was worthy [of] exploring [this] new diagnosis.”

In making the case for nomophobia, the authors employ a vocabulary worthy of the Lancet. They kick around possible comorbidities, discuss the differential diagnosis, and offer no less than 12 competing psychometric scales. To establish the epidemiology of the disorder, they cite a Daily Mail article that cites a U.K. Post Office survey claiming that 53 percent of people in Great Britain “suffer from” mobile phone addiction. If more than half the population is doing it, isn’t it just a thing?

Media coverage of smartphone addiction has whipped up our apprehension into a Y2K-like froth. John Laprise, a communications professor in residence at Northwestern University in Qatar, is one of the few voices of optimism in a sea of killjoy commentary on this topic. Writing from a sorely needed global perspective, he encourages us to regard our smartphones as instruments of self-efficacy. As we ride out the waves of change battering our social, economic, and political shores, the mobile phone represents connectivity, individuality, and choice, he says.

So what if it’s become a kind of irrational protuberance? “This is a completely new phenomenon,” Laprise reminds us. “People have never before had the opportunity to own such intimately personal technology that is so user-customizable and has such utility.” In other words, we’re attached to our devices because they’re useful and we like them.

Luddites predict we’ll come tumbling down from our collective iPhone bender when we tire of our little playthings. But we know better, don’t we? Whether we’re holding it, wearing it, or it’s implanted beneath our skin, each of us will be accompanied by a connectivity device more or less at all times for the rest of our lives. So let’s exercise some self-discipline, remember our manners, and quit carping about it, for Pete’s sake.

This article is part of Future Tense, a collaboration among Arizona State University, New America, and Slate. Future Tense explores the ways emerging technologies affect society, policy, and culture. To read more, visit the Future Tense blog and the Future Tense home page. You can also follow us on Twitter.