As many as 10 percent of Internet surfers are pathologically addicted to the Web, and although it can disrupt their lives, many doctors and mental health practitioners are unaware of the dangers, according to an article by psychiatrists at the Be'er Ya'acov Mental Health Center and Tel Aviv University. Writing in the latest issue of Harefuah, the Hebrew-langauge journal of the Israel Medical Association, Drs. Pinhas Dannon and Iulian Iancu note that Internet addiction is very similar to other addictions, such as pathological gambling, kleptomania (the uncontrollable urge to steal objects), trichotillomania (pulling out one's one hair), sex addiction and pyromania (the urge to set and watch fires). Although criteria to diagnose Internet addiction have been proposed, it remains difficult to accurately identify when an Internet user has crossed the line from normal use to addiction, the authors write. They recommend early diagnosis of the condition to help the computer addict prior to the development of additional psychiatric problems - such as depression - and urge further research into the subject. Dannon and Iancu state that the Internet has many positive uses, but like with most things, its use can become exaggerated and cause harm, including family problems, isolation, anxiety, and dependency, and it can induce an inability to control urges in other areas. Some people create virtual identities through the Internet that are very different from their real psyches, living in online virtual worlds. Being in contact with others only via the Internet, the authors suggest, can give the Web addict a false feeling of commitment and intimacy with others, and may blur the line between reality and fantasy. When they are unable to use the Internet, addicts may suffer from withdrawal symptoms similar to those of smokers or alcoholics, like cravings and depression. Researchers have found that overuse of the Internet activates specific parts of the brain, such as the ventricular tegmental area and the prefrontal lobe, which have been connected with other addictions, and have identified correlations between Internet overuse and aberrant levels of neurotransmitters such as seratonin and dopamine. Pathological obsession about the Internet, the article continues, is a syndrome that can lead to refusal to cut down on surfing, a feeling of loss of control, irritability, aggression, and the need to surf more, because the same amount of hours provide a declining amount of pleasure. Addicts also tend to develop a diminished sense of self-esteem and impoverished social skills, as well as sleep problems and, sometimes, financial problems - if they invest money in superfluous gadgets or online gambling. The authors say that "Internet addiction disorder" can be treated by talk therapy with a mental health professional and with certain medications that also work against depression or obsession. Serotonin blockers and Naltrexone, which is also used to treat kleptomania, pathological gambling and trichotillomania, can be effective as well. But the disorder is very difficult for doctors to diagnose, as the activity is carried out in private, the authors write, advising "alertness to the possibility that most people avoid seeking help." Mental health clinics and psychological advisers in educational institutions and places of employment should be aware of the problem, and workshops should be held in schools and workplaces about the risks of excessive Internet use.