Internet Addiction--Sign of a Medical Problem? | Psychology Today

Internet Addiction--Sign of a Medical Problem? | Psychology Today:

If preoccupation with the Internet is a new behavior, consider the possibility that there might be an underlying medical cause.

Dopamine-Agonist Medications in Patients with Parkinson’s Disease

The first report of Internet gambling addiction in a patient on dopamine-agonist medications for Parkinson’s disease was in 2005.

The patient was a 41 year-old computer programmer with Parkinson’s disease. Soon after reaching a therapeutic dose of the dopamine-agonist medication he became “consumed” with Internet gambling. He lost $5000 in just a few months. This behavior was entirely new and out of character for the patient. Once the medication was discontinued, the patient’s gambling obsession ceased--just as suddenly as it had begun.

In 2006, Dr. Andrew Larner published another case report entitled, “Medical Hazards of the Internet: Gambling in Parkinson’s Disease.” This patient was a man in his mid-40’s with Parkinson’s disease. After Dr. Larner increased the patient’s dopamine-agonist medication dosage, abehavioral change occurred. The patient became obsessed with gambling on the Internet. He also subscribed to several Internet services, including a pornography site. Again, this behavior was entirely uncharacteristic for the patient. Because the medication change had improved the patient’s mobility, it was only after the patient had accrued considerable debt that was he willing to stop taking it.

Individuals with Parkinson’s disease who are taking dopamine-agonist medications have an increased risk of developing an impulse controldisorder, most commonly: gambling, compulsive sexual behavior, and/or compulsive spending. In today’s world, the Internet may be utilized to give expression to these impulses.

Fronto-Temporal Dementia

In 2011, Mario Mendez and Jill Shapira published a letter in which they reported the case of a 55 year-old man who was compulsively addicted to Internet pornography.

The situation was extreme. This college-educated man had become obsessed with Internet pornography to the point of actually viewing pornography sites on his laptop in public places such as restaurants. This behavior was associated with other personality changes and had been going on for 2 years before he came to medical attention. This man had fronto-temporal dementia (FTD).

Individuals with FTD start to behave in ways that they never would have allowed of themselves before their brain disease began to manifest itself. The individual in this report had started to urinate in public places and also to masturbate excessively. He compulsively ate sweets and gained a striking 100 lbs. He began to wear the same clothes day after day. He failed to inquire about his dying father.

What is remarkable and crucial for readers to note is that this man’smemory for recent events was excellent. Also, when he was initially medically evaluated, his brain MRI (magnetic resonance imaging) was unremarkable. Evidence of brain disease was revealed only with a thorough neurological examination and PET (positron emission tomography) imaging.

Most people picture dementia as memory loss in an elderly individual; that is the usual course of Alzheimer’s disease. But fronto-temporal dementia (FTD) is different. Most often FTD begins in mid-life, although people may be affected in their 30’s or as late as in their 90’s. The personality changes come on gradually, and this leads people around the patient to interpret the new behavior as having psychological roots. Early symptoms are usually apathy and lack of initiative; this can look likedepression. Other early manifestations are impulsivity and decreased inhibition. Additional symptoms include: diminished concern about the consequences of actions, lack of empathy, lack of flexibility, and a dramatic absence of insight.

FTD is not a rare disease. It accounts for up to half of all the dementias in people who are under 65 years of age. Many components of FTD can contribute to Internet addiction: impulsivity, diminished inhibition, lack of regard for moral and social norms, a tendency toward compulsive behavior, and excessive self-involvement.

Conclusion

There are some needles in the haystack of Internet addiction.

Researchers have found a significant association between Internet addiction and a variety of psychiatric conditions: alcohol abuse, attention deficit hyperactivity disorder, depression, and anxiety. In addition, there are a small percent of people with Internet addiction who have medical conditions that are driving their behavior. As with any covert medical condition, an accurate diagnosis can be game changing.

Barbara Schildkrout, MD is the author of:

• Masquerading Symptoms: Uncovering Physical Illnesses That Present as Psychological Problems
• Unmasking Psychological Symptoms: How Therapists Can Learn to Recognize the Psychological Presentation of Medical Disorders.

Coping With Narcissistic Coworkers: Some Unique Strategies | Psychology Today

Coping With Narcissistic Coworkers: Some Unique Strategies | Psychology Today:

These self-centered, fabulously egotistical coworkers are a handful. Got skills?

Published on July 9, 2014 by Neil J. Lavender, Ph.D. in Impossible to Please

 The One-Way Relationship Workbook. . . by Neil Lavender, PH.D. and Alan Cavaiola, PH.D.

◊Narcissists at work present special challenges, but the difficulties depend most upon how much power, influence, and daily face-to-face contact exists. Thus, a narcissistic boss with whom you have constant contact will be a much greater challenge to you than a narcissistic coworker whom you rarely see. Because a good deal of your financial and emotional welfare depends upon your employment, destructive narcissistic relationships can be a little more critical than, for example, social relationships with the very self-centered. As a result, effective interactions can become even more important. The exercises in this chapter were designed with the workplace in mind.

The following strategies are designed not only to protect you from the narcissist’s toxins but also to make you a valued employee who is less likely to be dismissed from your job due to fallout from the narcissist.

If Possible, Avoid the Offender

Perhaps the most obvious way to deal with one-way relationships at work is to simply avoid them. If there is a narcissist in the lunchroom, eat somewhere else. If she is in payroll, avoid payroll. This may not be easy because people are drawn to narcissists, and there is usually a lot of action whenever they are around. Narcissists like to be seen as movers and shakers, and being around them often fills a need within us to be a part of it all. It makes us feel energized and important. Plus, narcissists always have some way of drawing you in. Remember though, narcissists are like Las Vegas: a lot of flashing bright lights with tons of excitement, but you usually walk away the loser. Better to stay away if you can.

Develop Talking Points and Stick to Them

Take a lesson from the politicians. When you are in a position where you have to interact with a narcissistic coworker, rehearse the discussion as much as you can beforehand. Have a strategy. Know exactly what you want to achieve and stick to that. Don’t let the narcissist suck you in to his own agendas or distract you with flattery. Politely acknowledge his agendas and get right back to your talking points. And keep the list of talking points short, two or three at best.

Stay in Your Lane

Another simple yet often overlooked strategy is to simply do your job and not to get distraced by the narcissist. We believe that this is always the best work strategy. Being known to your employer as a good and conscientious employee will protect you from the slings and arrows aimed at you by narcissistic coworkers. Don’t get involved in the office gossip about or with narcissistic people. If the narcissist invites you to do something outside the office, such as playing golf, politely decline. If the narcissist asks you to do special favors, simply say you are too busy doing your work. If she starts denigrating another of your coworkers, excuse yourself and go back to your job. It may take a while, but eventually the narcissist will get the picture and troll for supplies elsewhere. And don’t forget that when you stay in your lane, do your work, and resist the bait (“Wow, you’d make a great addition to my political action committee!”), you are supporting your organization’s goals, which makes you an invaluable employee who is worth protecting. Even from narcissists!

Don’t Get Taken in by the Flattery

Remember the process of splitting? After the narcissist adores you, he hates you. The narcissist will flatter the heck out of you in the beginning, projecting his fantasies of perfection onto you. If you have something that is valuable to him, he will think that you are wonderful. If you accept the flattery, you will have opened the door to a relationship. When the narcissist inevitably finds out that you are only human, he will become disappointed and then will totally devalue you, and you will be persona non grata. So, don’t be deceived by the flattery in the first place.

Lookout for Possible End Runs

If a narcissistic coworker is someone whom you have to work with or go through on a regular basis, sometimes you may choose to go around and not through her. For example, suppose you are doing a report with a narcissistic coworker who is grandstanding and wasting time by trying to expand her portion of the report. Rather than telling her to speed it up and risk a vitriolic and self-serving attack about how you cannot appreciate all the wonderful things she is putting into the report, go to the narcissist’s boss and ask the boss to ask your coworker to speed things up.

It helps to be a strong networker and to cultivate relationships with others who may have more influence over the narcissist than you do. You may be able to find common ground in your organization with key individuals. Although someone might be three layers of management above you, that person is your equal while the two of you attend the same church or when both of you collect and have an affection for old vinyl records or when both of you belong to the local Rotary Club. Maybe you have a mutual friend. It would be very difficult, indeed, for your narcissistic boss to abuse his boss’s outside-of-work associate, that being you!

Also, don’t forget the strategy of going over someone’s head. While we do not feel that this is a good strategy to use all the time, it is certainly handy when used strategically.

 The One-Way Relationship Workbook. . . by Neil Lavender, PH.D. and Alan Cavaiola, PH.D.