Monday, May 23, 2016

Be Low-Tech When You Can… Internet and Gaming Addiction






A New York Times article entitled “Steve Jobs Was a Low-Tech Parent” discusses how tech executives set tough limits for their own children regarding the use of technology.  The author concludes they must know something the general population does not.  They are the experts, aren’t they?  What both technology folks and pediatricians know is limiting access to video games allows children to find pleasure in everyday life activities—engaging with friends and family, reading, playing outside, and achieving in school.  They learn the true value of a hard day’s work.  Isn’t that what we all want for our children?



Internet companies are learning that addiction makes for a solid business strategy.  When a human being is suffering from addiction, they relentlessly search for situations associated with pleasure; video games and smartphone use can provide these instantaneous rewards for the incompletely developed adolescent mind.   Addiction is epitomized by complete denial of experiencing any negative consequences. Teenagers especially, insist they are fine despite evidence to the contrary their world is falling apart.  Addicted teens quit caring about friends, sports, schoolwork, and even their families.   



Brain imaging reveals video games and trigger release of dopamine, a neurotransmitter in the brain with similar effects on the body as methamphetamines.  Gaming provides immediate fulfillment and a sense of accomplishment unlike the delayed gratification experienced in real life. There is even something known as “phantom smartphone buzzing” where our brains are tricked into thinking our phone is buzzing when it is not actually happening.    

During puberty, the brain’s reward center (a.k.a limbic system) becomes highly activated, and then gradually settles down as they reach maturity.  The prefrontal cortex is in charge of executive function, including impulse control and support for planning and organizing behavior. Society considers children to be adults at the age of 18, yet their prefrontal cortex is not fully mature until age 25.  Imagine what constant immersion in rapid, flashing images and repetitive violence does for the immature connections in the not yet mature brain?

Addiction is a disorder of the brain’s incentive system (highly activated in adolescence) encompassing a strong desire to seek rewards despite adverse consequences.  Two things that characterize addiction are the activity is intrinsically pleasurable and the theory that “reinforcement” is present, meaning it is highly likely the person will habitually seek exposure. Signs of technology addiction include: sneaking and lying about time on the internet, demanding unreasonable amounts of time to surf the internet or play video games, or experiencing rage when access is restricted. 



“My son does not care about anything but using his phone or playing video games.”  Parents often pursue professional help when their previously loving, bright and engaging child becomes unrecognizable.  Their teen will not eat, sleep, or comply when asked to stop playing video games.  In 2013, a diagnosis known as Internet Gaming Disorder was added to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the encyclopedia of mental health disorders.  Internet Addiction Disorder (IAD) has not been formally characterized as a disorder according to the manual, however many pediatricians are concerned the number of afflicted children is increasing. 



“You must start him on a medication that will make him happier.” parents say.  If their child is happy, they mistakenly believe he or she will stop being addicted, but that methodology is terribly flawed.  Instead, parents must get rid of the gaming consoles or significantly curtail use of other technology in order for their children to find alternative activities they enjoy, like playing sports or musical instruments. 



Unfortunately, parents are terribly resistant to this approach for fear of upsetting the delicate balance in the volatile relationship with their teen.  Parental anxiety is frequently behind reluctance to remove video games from the home altogether.  They have already witnessed tremendous rage from their adolescent when barring video game use temporarily.  Teenagers can actually become violent or even suicidal; sometimes they have already been involved with law enforcement or the juvenile justice system prior to coming to my office for help.  Inevitably, teenagers show up at their first visit with me in wrinkled clothes always including a sweatshirt, and looking unkempt and exhausted.  The last place they want to be on earth is sitting in my office. 



The bottom line is no medications are available to “make someone happy” when they are suffering from a technology addiction.  It is nearly impossible to treat addiction for something easily accessible inside the home.  That is like treating an alcoholic by displaying liquor bottles on top of the refrigerator. In my experience, the grip of addiction can be nearly impossible to break once it has begun.  It is far better to prevent your child from developing an addiction in the first place. 



Experts are still compiling best recommendations to prevent addiction to technology in children and adolescents.   My thoughts raising my own children and treating addicted children are to focus early on using the internet mostly for school assignments, creative pursuits, or research.  A bedroom is not the proper location for a screen of any kind.   Keeping internet use restricted to specific high traffic areas of the home allows for close monitoring and establishing boundaries while they are young.  Limit time children spend playing video games or engaging in social interaction; emphasize producing content rather than mindless consuming. 

Steve Jobs had the right approach to limit access to technology while his children were being raised.  He knew of the dangers of internet addiction, but also the risks of cyberbullying and exposure to inappropriate content.  Technology can be a helpful adjunct for learning, but when your child becomes compulsive about internet use or playing video games and angry at the thought of doing something else, that is a red flag.   Adolescents are exceptionally vulnerable to activities associated with instant gratification and pleasurable experience.  Curtail those types of internet activities when possible.  Finally, if you observe symptoms of internet addiction disorder (IAD), internet gaming disorders, or see signs of anxiety or depression which may trigger internet addiction, please seek help from a physician or other profession experienced in this area.












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