The smell hit Drew Horo­witz before he even opened the door.

Inside this Maryland bedroom, a 19-year-old woman had isolated herself for months, barely eating, refusing to leave the room to shower, brush her teeth or even urinate.

The scene had all the marks of a serious addiction intervention for Horowitz, a drug and alcohol assessment counselor. But this time was different: The drugs that had kept her awake and alone were her computer and social media.

“So much of this mimicked a traditional addiction,” said Horowitz, who practices in St. Paul and conducts interventions nationwide. “She was almost in a state of psychosis, just completely detached from reality.”

Clearly, this is not the norm. But as new platforms crop up and social media continue to swell in popularity, we’ve become increasingly dependent on cellphones. We use them to lock our cars and pay our bills, to keep tabs on our kids, check our heart rates and wake us up in the morning. Last summer, a study by Informate Mobile Intelligence showed Americans check social media sites 17 times a day and spend a staggering 4.7 hours per day on their smartphones.

Can that dependence lead to addiction? Some health professionals want to pump the brakes on such language, saying extreme use is likely a side effect of a more serious condition. Others, like Horo­witz, believe it’s already evolving into a crisis.

“I think it’s big and it’s going to get more serious,” he said. “Young kids now are even more dependent on technology. They have fewer social skills. Advertisements are flashing in front of them all the time. ... I think we’re in trouble.”

The most recent revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), updated in 2013, didn’t recognize cyber addiction as a diagnosable disease but labeled “internet gaming disorder” as a condition for further study.

Still, addiction experts across the country are beginning to treat people. Restart House in Redmond, Wash., markets treatment for problematic or addictive behavior involving the internet, gaming or phone use. Bradford Regional Medical Center in Pennsylvania opened a rehab program for internet addiction in 2013. TalkSpace, a New York-based online therapy company, treats social media dependency, among other things. Several doctors and counselors in the Twin Cities also have treated people for cyber addictions in the past few years.

Your brain on the internet

Ryan Wohlman, a psychologist at Life Development Resources in Lake­ville, made cyber addiction an area of focus after dealing with his own addiction to video games more than a decade ago.

Wohlman had just gotten his undergraduate degree when an obsession with video games began inspiring eight-hour sessions and kept him from finding steady work for three years.

“At some point,” he said, “I had to break free.”

Wohlman now helps others with what he calls “unhealthy relationships” with technology, creating unorthodox solutions — that involve a “harm reduction” model rather than abstinence — for an unorthodox problem. He also speaks at schools, before groups and at summits to help raise awareness about an addiction that researchers say affects a part of the brain the same way illicit drugs do.

In a landmark 2013 study, German researchers found that activity in the nucleus accumbens — the reward center of the brain — increases after receiving positive feedback on social media, similar to what happens when a drug addict receives a dose.

“You’re getting that same dopamine release,” Wohlman said. “So when people like it and it feels good, part of it may be because they’re getting that same rush.”

Trend or threat?

Not everyone, though, is ready to make the connection from perpetual use to addiction.

Shannon J. Lowell, who owns a private practice counseling office in Coon Rapids, believes focusing on excessive social media use is superficial, calling it a “trendy issue.” She’s found that some patients she treats overuse the internet to avoid intimacy and other interactions, or to hide a sexual addiction. Others latch onto the outlets as a result of anxiety, depression, social phobias, fears of failure or problems with boundaries.

While Lowell agrees that obsessive social media use is a concern — noting that as a society “we are literally losing our relational skills” — she treats it as a side effect.

“It’s like going to the doctor,” she said. “Maybe my arm is covered in pus. But the core issue is not the pus, it’s something happening underneath. The social media thing, from my perspective, is a symptom of a deeper issue, of the wound within.”

Wohlman, however, says research suggests that while social media overuse may be a side effect of some mental health conditions, it can also be the cause, leading to conditions like anxiety or depression.

Kelly Volkmann, a clinical social worker and alcohol and drug counselor in Woodbury, agrees that cyber dependency, like chemical dependency, can be serious, but says there’s a key difference:

“It doesn’t have the same immediate risk factors that someone with a drug or alcohol problem would have,” she said, “putting themselves and others in danger and the physiological effects of it in regards to withdrawal.”

Given the relative newness and ever-changing nature of social media, it’s unlikely that there will be a consensus on how to address social media dependency any time soon. But many agree on one thing: In some way and at some level, it needs to be addressed.

Horowitz, who has treated several extreme cases, is convinced that social media addiction poses a threat. In fact, he calls social media a “gateway drug” to more serious internet use.

“Until I saw it myself and I talked to those families, I didn’t believe the seriousness of it,” he said. “But this is real.”