Yoga as an adjunct modality for promotion of healthy use of information technology

Dear Sir,

The Internet is a new technology that has impacted the world and provided many benefits. At the same time, it has had negative ramifications. Reports indicate that some online users were becoming addicted to the Internet in much the same way that others became addicted to drugs or alcohol, which resulted in poor psychological well-being, reduced work performance, social withdrawal, poor self-confidence, family problems, marital breakdown, poor diet, sleep deprivation, and cardio-pulmonological complications.[1,2] Other adverse consequences associated with Internet addiction (IA) include negative academic consequences. A study used pathological gambling as a model and defined addictive internet use as an impulse-control disorder that does not involve an intoxicant.[3]

In a survey among 350 (200 females and150 males), 24% had problematic usage of internet.[4] Another epidemiological survey on 2755 subjects from Bengaluru in the age group of 18–65 years (50.5% males and 49.5% females) found that addictive use was present among 1.3% (2% males and 0.6% females) for internet, 4.1% (5% males and 3.1% females) for mobile phones, and 3.5% for social networking sites.[5] It was observed that the hours spent on internet by dependent users were greater than those of the non-dependent users. Those dependent on internet scored higher than the non-dependent on the loneliness measures.[6] Similarly, screening of 621 students from class 11^th and 12^th in higher secondary schools of Ahmedabad city of India revealed that 12% were dependent on internet.[7]

In response to this fast emerging problem of Internet addiction, National Institute of Mental Health and Neurosciences, Bengaluru has started India's first technology de-addiction center called as the “SHUT Clinic” (Service for Healthy Use of Technology). SHUT Clinic has been getting 2–3 patients of IA/week with complaints of excessive use of internet that hampers their socio occupational functioning. Patients are chiefly belonging to male gender, in the age group of 14–19 years and from middle to upper socioeconomic status. Most common reported usages of internet are video gaming, mobile texting, social networking sites, and pornography using smart phones, computers at home, or cyber cafe. The average usage of internet varied from 10 to 12 h/day. Physical distress (body pain, dryness of eyes, and neck strain) is commonly reported dysfunction among the users. SHUT Clinic provides psychology-based support programs for the promotion of healthy use of technology on out-patient basis.

Research examined the risk factors associated with internet addiction in high school teenagers and identified male gender, drinking behavior, family dissatisfaction, and experience of recent stressful events as the major ones.[8] The study also shows that IA has a direct impact on depression, anxiety, and stress.[9]

Yoga, a holistic mind-body therapy that utilizes physical postures, breathing practices, meditation, and relaxation techniques have recently become popular as an important adjunct to conventional modalities of treatment for the management of various psychiatric disorders[10] including addictions.[11] Therefore, we incorporated yoga therapy as an add-on in SHUT Clinics. As a part of this approach, users (70 users who reported physical distress due to excessive use [10–12 h a day] of desktop/smart phone) were counseled to perform brief integrated yoga program, whenever the usages exceed more than 1 h/day. The integrated yoga program involved: Joint loosening practices with breath synchronization for 10 min (moving head forward and backward as well as clockwise and anticlockwise ten times each), blinking of eyes (twenty times), stretching of hand/legs and moving the wrist/legs clockwise and anticlockwise (ten times each) followed by Kapalabhati Kriya (skull shining breath) at 100 strokes/min for 2 min, Nadi-shuddhi pranayama (alternate nostril breathing) for 5 min, and Bhramari (humming breath) pranayama for 5 min. Subjects were also offered yogic counseling based on the principles of mind management from Bhagavad Gita.[12] These practices were demonstrated to them and supervised during sessions. The clinical interview revealed them to be at the action stage of motivation for these yoga practices. They were also motivated for lifestyle changes. The follow-up for assessing the efficacy of this program was carried out at 3 months interval for 45 IA subjects who continued the treatment. All of them reported reduction in the body pain and neck strain. Yoga practices also brought positive lifestyle changes in the form of regulated sleep, improved appetite, enhanced communication with others, and increased recreational activities outside the home. Due to these positive lifestyle changes and reduced physical symptoms such as neck strain and body pain, they reported 30–40% reduction in their technology use at the end of 3^rd month. Moreover, those under yoga program showed better compliance with conventional modes of management may it be drugs or psychotherapeutic techniques.

Since high-stress levels, physical distress, and unregulated lifestyle are important contributors toward internet addiction, integrated yoga program with its comprehensive holistic approach may serve as a useful adjunct to enhance the efficacy of conventional modes of treatment.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.