EDITOR'S NOTE: The following story deals with sexually themed subject matter that may not be appropriate for some readers. Discretion is advised.

A few weeks into his senior year, Matthew was sitting in his room staring at an AP statistics book. The test was tomorrow, but he had no motivation to study. He pushed it aside and went to get a snack.

An hour later Matthew trudged up the stairs, vowing to study. He got sidetracked texting a friend and listening to music and an hour later he still hadn’t cracked the book.

After dinner he watched some television, loaded the dishwasher and texted a few more friends. In the back of his head, the stress was building, throbbing like a toothache. Finally around midnight, the stress was unbearable.

But instead of studying, he flopped onto his bed, grabbed his phone and typed in an X-rated porn site. That night, instead of the usual 2 or 3 hours of viewing, he watched video after video.

For seven hours.

Matthew — who is now 20 and has allowed the Deseret News to follow him through his struggle with pornography for the last several years under the condition he not be identified by his real name — is part of a group that many therapists believe is growing: adolescents who see themselves as addicted to pornography, often unable to function normally due to an obsession with sexual images on the Internet.

Yet, there’s increasing concern among these same therapists, mental health and medical experts that labeling teens as porn addicts could become more problematic than the porn use itself as it creates an added burden of shame and self-loathing over something that began from and is intertwined with normal biological curiosity.

A 16-year-old given in to self-stimulation from viewing too much to porn, "statistically the odds are much in his favor to find out that this is a maladaptive coping strategy," says Adi Jaffe, executive director of Alternatives Behavioral Health LLC. in California. "And once that's resolved, (porn) doesn't need to be that much of an issue anymore — it may even be a non-issue."

Jaffe knows it's much tougher for teens today, with their immediate access to images through multiple devices unavailable 10 or 15 years ago, yet he and other experts believe that helping teens identify underlying stressors, learn healthier coping mechanisms and recognize healthy relationships may curb porn use faster than attacking the porn itself.

Matthew says that approach could have backfired when he first sought help. He knows now, thanks to several years of ongoing therapy, that self-introspection into underlying issues is the best long-term approach. But at first, he needed help dealing with the porn itself, and wants therapists to acknowledge the extent to which many teens grapple with these images.

“If anyone had tried to call (my struggle) anything other than addiction, it would have irritated me,” Matthew said. “Honestly, it’s like downplaying the issue. A person who’s trying to fight it is doing better than a person who doesn’t consider himself addicted. I feel like there’s a line crossed when someone stops considering it an addiction and is OK with it being a part of their life.”

The silent struggle

Over the last two years, Fight the New Drug, a nonprofit anti-pornography group, has received nearly 20,000 essays from teens and young adults, male and female, pleading for help in combating their pornography problems.

“I feel alone, and when I feel alone, I decide to watch porn to help me deal with it,” wrote one 18-year-old girl. “I have tried to stop by myself, but obviously it's not helping. I don't have any money, and I'm too embarrassed to tell my parents. So now, I feel stuck. I'm getting depressed, to the point I want to end my life.”

A 19-year-old young man, acknowleding his daily — and sometimes multiple times a day — involvement with pornography and self-stimulation, wrote: "I think of myself as a good guy, who generally shows a lot of respect towards women, but porn seems to be the exception, and it's starting to creep into my other interactions. I start looking at women as objects, and that terrifies me.”

And this simple plea from a 13-year-old boy: “I want to enjoy my life as a kid. Not have to look at it before I do my homework or go see my friends.”

There are no solid data about the number of teens who struggle with porn, though there are studies about its pervasiveness and increasing acceptability.

One study found that 72 percent of college students — 93 percent of males and 62 percent of females — had seen porn before they turned 18, and another study found that 87 percent of college-aged men and 31 percent of college-aged women reported using pornography.

Yet not everyone who sees it will develop a problem with it, and even those who do may struggle on a spectrum. Some are quick to call it an addiction, while experts might refer to it more as a compulsion or obsession.

“With our … teen clients, we don’t call them ‘addicts,’” says Alexandra Martin, a certified counselor and sex addiction therapist at Healing Solutions Counseling Center PLLC., in Charlotte, North Carolina. “We call them someone who’s dealing with sexually compulsive behavior. It’s not labeling them, but still addressing the problem.”

There’s an ongoing debate in the medical world about whether pornography can be an addiction like alcohol or drugs. While a growing number of studies show similarities in the effects of pornography and drugs on the brain, it’s still a disputed and often contentious question.

What's hard about behavioral or process addictions — like pornography, shopping, eating, etc., is determining when a normal condition becomes pathological, says Dr. Stuart Gitlow, the immediate past president of the American Society of Addiction Medicine and a general, forensic and addiction psychiatrist.

Take a boy who loves baseball. He follows all the major league games, memorizes stats, talks baseball, plays Little League and practices every day after school, Gitlow explains. This starts to take away from his other activities, he spends less time with his family and his homework starts to suffer. But most people wouldn’t see his baseball obsession as a problem.

Addiction, Gitlow says, isn’t defined by how much or how frequently someone uses the drug of choice. Instead, it’s about “resulting functional impairment.”

And currently, Gitlow believes there’s not enough data about whether pornography is impairing everyone who uses it — unlike marijuana, where experts can safely say that around 15 percent of kids who try it will eventually become addicted and of those, a significant percentage will experience psychosis and IQ loss.

“We can’t say that for porn,” Gitlow says, “We don’t have those data.”

Problems with labels

Jaffe is open and honest about his former drug dealing, meth addiction and numerous arrests. But that’s who he was — not who he is now.

And that is one of the big problems with the way addiction is currently defined, says Jaffe, who cleaned up and got a Ph.D. from UCLA.

He’s sure there are people who find themselves compulsively watching and acting out to porn, but the problem is Americans believe addictions are permanent disorders and "once you’ve got it, you’ve got it for life.”

Add that to the fact that today’s society is quick to jump to the addiction conclusion even if it doesn’t accurately represent what’s going on, and there's a big potential for incorrect diagnoses, he says.

"'I’m an addict' for most people means '(I'm) doing something more than I want to,' and that’s not really the definition of addiction,” Jaffe said. “It’s much more complex than that.”

With pornography, a young man may suffer from social anxiety and a paralyzing fear of talking to girls, thus preferring to get sexual satisfaction from online porn, Jaffe said. But that’s a complicated and clunky explanation, and “porn addict” is just easier to say.

More than being inaccurate, today’s hyperfocus on the idea of pornography addiction ignores deeper issues, which clinical psychologist David Ley believes are always at the root of problematic pornography behavior.

“Diagnosing porn addiction is diagnosing sneezing disorder,” Ley says. Sneezing is not the real problem, a virus or allergies are to blame. With pornography use, he says, “stress and negative emotions come first, then increase in porn use comes later.”

Ley argues that believing in a porn addiction is causing people iatrogenic, or unintended, harm — like going to the hospital for an appendectomy and getting a staph infection while there.

He cites studies that found religious individuals are more likely to believe they’re addicted to pornography and that a belief in a porn addiction — not the porn use itself — is the cause of mental distress.

“I will acknowledge that porn can affect people, but I don’t think it has any more effect than anything else,” said Ley, whose controversial book “The Myth of Sex Addiction” continues to fuel debate. “I don’t think porn has some magical grand disproportionate impact, compared to other issues.”

Treating sexual issues is complicated, particularly when it involves teens, which is why therapist Jackie Pack, owner and clinical director of Healing Paths Inc., in Bountiful, Utah, sought out training and certification from counselor Patrick Carnes, a leading proponent of the idea of sex addiction and founder of the International Institute for Trauma and Addiction Professionals (IITAP).

She’s comfortable with the idea of adults being addicted to porn, but is hesitant to label teens.

“Teens tend toward compulsive behavior and tend to make poor decisions,” she said. “That’s part of being a teen.”

When she treats a teen who struggles with porn, she’ll use words like “out-of-control” or “compulsive” that validate the struggle, but don’t apply a permanent label of addict. Then she’ll work with teens to figure out what’s driving them to porn in the first place.

“Pornography is serving a purpose or people wouldn’t keep doing it, especially when it’s causing them stress and anxiety,” she said. “Until we can identify that and get something else in place that serves the real purpose … the likelihood they will eventually go back to it … is high.”

Underlying issues

When sunlight finally streamed into Matthew's bedroom following his night-long porn binge, he put down his phone, feeling hollow. He raced to school, skipped his first and second period classes to study and barely passed the test.

A self-described perfectionist, this less-than-perfect behavior was killing him. But he couldn’t stop it.

Matthew had discovered years ago that porn temporarily relieved his stress, so any time he procrastinated homework and became stressed, he turned to porn.

He calls himself an addict — a label he believes he earned after the first time he tried to stop watching porn and couldn't. His senior year porn binge came while he was in treatment. He went to his weekly group sessions, completed his workbook pages, and continually worked to stay away from triggers. But it hadn't stopped the relapses.

His porn use, which began as a copying strategy, had also become a habit.

What scares people, Jaffe says, is when they can't explain why they're doing it — even though it's hurting them. Yet breaking even a simple habit like nail biting can be quite difficult, so imagine trying to stop doing something that "consistently provides pleasure and masks negative feelings," says Jaffe.

Stopping such a cycle takes a long time, and first requires that a person sort through emotional issues, sources of stress and other life-shaping events. Jaffe said his clients often need several months to peel back the layers of their past and identify issues that propelled them to seek out porn in the first place.

Without that introspection, many teens may say they're using porn not just to become aroused, but also because they're bored, curious or because it's fun, according to a recent survey.

For Matthew, porn was never fun, and it took almost a year of therapy and introspection before he fully identified why he was turning to it. He spent another year “hashing out the details of his emotional profile.”

His problem was stress and anxiety over school, and then deeper still, a perfectionist attitude created out of an erroneous belief that his dad was perfect, so he should be too.

“After I found them out … dealing with those things was far more effective and gutted my motivation to even watch porn in the first place,” Matthew said. “Then when I did go watch porn, it wasn’t nearly as attractive to me and it became easier to shut it down a little more.

“I still have occasional slip-ups,” he continued, “but because I’ve kind of taken care of those underlying issues, it doesn’t blow up into huge binges that last for a week.”

Regardless of what anyone wants to call his struggle, Matthew says it's an addiction he'll deal with the rest of his life.

"Porn is a weird addiction to say you've broken, because you'll never not be attracted to sex," he says.

But his goal is longer and longer periods of sobriety, which require continued introspection and new ways to cope that don't involve pornography.

"Porn-specific therapy was very important in the beginning,” Matthew said. “But (now my therapist and I) don’t even talk about porn anymore, we just talk about life and anxiety in general. If (a) person progresses correctly, you don’t need porn-specific treatment anymore, what you need is life treatment.”

Where to find help for a porn problem

No matter the level of struggle, here are four free or low-cost support options designed for teens and young adults who struggle with pornography:

Fortify, from Fight the New Drug, is an online program free for youth (a one-time fee for anyone over 21) that offers 52 video-based lessons about the harms of pornography and tools to help quit, as well as personal inventories, calendar behavior trackers and inventive badges as users work through the program.

RTribe A free app based on the belief that recovery happens in a tribe. Offers tribers the ability to track their sobriety and/or acting act thus helping to identify negative trends or bad habits that lead to problematic behavior. Tribers can also see the status of friends and give and receive real-time support.

NoFap.org A free emergency app (and website) provides quickly accessible inspiring quotes or humorous memes designed to distract someone from turning to porn or masturbation.

RebootNation.org An online forum for those who struggle with pornography where they can write about their successes and set backs and get support from others along the way.