The word addiction is derived from a Latin term for "enslaved by" or "bound to." Anyone who has struggled to overcome an addiction -- or has attempted to help someone else to do so -- certainly understands what these terms really mean.
Addiction, unfortunately exerts a long and powerful influence on the brain that manifests in three ways: craving for the object of addiction, loss of control over its use, and continuing engagement with it despsite significant negative consequences.
For decades, medical experts believed that only alcohol and certain drugs could cause addiction. Neuroimaging technologies and more recent research, however, have clearly shown that certain pleasurable activities or behavioral processes, such as gambling, shopping, and sex, can also co-opt the brain.
The brain registers all pleasures in the same way, whether they originate with a drug, a monetary reward, a sexual encounter, or even a satisfying meal. In the brain, pleasure has a distinct neurochemical signature: the release of the neurotransmitter dopamine in the nucleus accubens, a cluster of nerve cells lying underneath the cerebral cortex.
Dopamine release in this nucleus is so consistently tied with pleasure that neuroscientists refer to this region as the brain's pleasure center. All drugs associated with abuse, from nicotine to heroin, cause a particularly powerful surge of dopamine. The likelihood that the use of the drug or participation in a rewarding activity will lead to addiction is directly linked to the speed with which it promotes dopamine release, the intensity of that release, and the reliability of that release.
As it turns out, interaction with the Internet and video gaming quickly stimulates the pleasure center in the brain, causing a release of dopamine that is both intense and reliable. This new information helps us understand why the Internet and gaming are so difficult to control and why children, teens, and adults experience intense cravings, tolerance, and ongoing engagement despite negative consequences.
Once the dopamine hook is in place it is extraordinarily difficult to modify behavior and it is crucially important that the person who is experiencing addiction to the Internet or video gaming go through a sustained period of being unplugged or detoxing. Without a sustained break from the dopamine surges there is no way to learn new behaviors that can produce pleasure. In my next blog. I will discuss how it is possible to retrain the pleasure center in the brain to release dopamine when it is stimulated by healthy, life-affirming, off-line activities.
Tuesday, May 6, 2014
Sunday, April 27, 2014
Teen Internet Addiction
I was invited to speak on teen internet addiction by The Asian and Pacific Islander Children, Youth and Family Council in Chinatown. My presentation focused comparing and contrasting the terms "process addiction" and "substance addiction." My discussion described the neurobiology of process addictions in teens and then highlighted at risk populations:" ADHD, Autism, Depression, and Social Anxiety Disorder. If you would like a copy of my power point, please email me at cyberrecovery@gmail.com. I will also post a copy of my power point on my website: www.teenvideogameaddiction.com.
Monday, March 24, 2014
Early Screening and Early Intervention for Technology Overuse
In my last blog I discussed the need to conduct early technology screenings and the need for early intervention - by "early" I am referring to preschool and elementary school. Due to the proliferation of tech devices young children are saturated with digital media which creates change resistant patterns of technology consumption.
The key is for parents to carefully regulate technology use in order to prevent change resistant patterns from emerging. How much time should children be using technology?
0 to 2 years NONE
3 to 5 years 1 hour per day of non violent TV/DVD (no handheld devices or video games!)
6 to 9 years 2 hours per day of total screen time (non violent TV/DVD and non violent video games such as Wii Sports or Resorts - no handheld devices of any kind!).
9 to 12 years 2 hours per day of total screen time (non violent TV/DVD 60 minutes, non violent video games 30 minutes, handheld devices 30 minutes).
13 to 18 years 2 hour per day of total screen time (non violent TV/DVD 30 minutes, non-violent video game, violent video games 30 minutes, hand devices 30 minutes).
No technology in bedrooms!
Rule of screen time use: for every one hour of screen time your child/teen must engage in 2 hours of physical activity.
In my next blog I will discuss 5 ways to successfully unplug children and teens from technology with the aim of maintaining a balance between offline life on cyber life.
The key is for parents to carefully regulate technology use in order to prevent change resistant patterns from emerging. How much time should children be using technology?
0 to 2 years NONE
3 to 5 years 1 hour per day of non violent TV/DVD (no handheld devices or video games!)
6 to 9 years 2 hours per day of total screen time (non violent TV/DVD and non violent video games such as Wii Sports or Resorts - no handheld devices of any kind!).
9 to 12 years 2 hours per day of total screen time (non violent TV/DVD 60 minutes, non violent video games 30 minutes, handheld devices 30 minutes).
13 to 18 years 2 hour per day of total screen time (non violent TV/DVD 30 minutes, non-violent video game, violent video games 30 minutes, hand devices 30 minutes).
No technology in bedrooms!
Rule of screen time use: for every one hour of screen time your child/teen must engage in 2 hours of physical activity.
In my next blog I will discuss 5 ways to successfully unplug children and teens from technology with the aim of maintaining a balance between offline life on cyber life.
Monday, March 3, 2014
The Importance of Early Screening for Technology Overuse
It is a common place occurrence in my practice to receive a phone call from a parent describing a teen -- usually a son -- who is in a video game addiction free fall: failing grades, social withdrawal, weight gain or weight loss, sleep deprivation, depression and anger when unplugged from gaming, and ever increasing preoccupation with gaming.
The first question I ask is "What have you tried to decrease you son's gaming?" In many cases the parent has tried many different strategies, including removing computers and tablets, gaming consoles and even unplugging wifi. Many parents have imposed restrictions on the amount of time and many have tied their son's grade point average to access to gaming. In short, most parents have made a good faith effort and, yet, their son's gaming only seems to increase over time.
When I ask how long their son has had a problem regulating gaming, the answer is typically 3 to 5 years. Parents often explain that their son was able to figure out a way to continue gaming, no matter what steps they took and no matter what barriers they put in place.
I explain that all is not lost - that we can work together to figure out a new way to decrease gaming and thereby restore balance between technology use and engagement in 3D reality. I also explain that changing gaming habits/patterns is a difficult process and requires time and focus and energy -- especially when the teen is fully opposed to change.
Parents often express frustration with the fact that no one gave them any warning or raised the issue of technology overuse or addiction. I then explain that in an ideal world there would have been some form of technology use screening early in their son's life so that they, as parents, could have put in place a structure or system that would have addressed the need for balance.
Unfortunately, with the possible exception of a pediatrician asking about screen time, very young children are consuming vast quantities of digital media and are developing what looks very much like a form of addiction to technology.
The key piece that is missing is early screening and early intervention. We need to treat digital media or "screen time" as a public health problem and put in place routine screenings - as we do with food and physical activity in order to prevent childhood obesity. As a society we need to understand that children are now growing up in a media saturated world that badly needs limits and structure in order to help prevent all forms of technology overuse and addiction.
If we can screen and intervene with a child rather than a teen, we stand a far greater chance of preventing the negative impact of technology overuse on development and mental health. Who would be responsible for this screening process: parents, pediatricians, mental health professionals, and educators.What is currently missing is information on the screening process. In my next blog I will review how to screen and intervene with children. In the meantime, go to my website and complete my technology screening test. This test will give a clear picture.of your son's current use and the need to intervene.
The first question I ask is "What have you tried to decrease you son's gaming?" In many cases the parent has tried many different strategies, including removing computers and tablets, gaming consoles and even unplugging wifi. Many parents have imposed restrictions on the amount of time and many have tied their son's grade point average to access to gaming. In short, most parents have made a good faith effort and, yet, their son's gaming only seems to increase over time.
When I ask how long their son has had a problem regulating gaming, the answer is typically 3 to 5 years. Parents often explain that their son was able to figure out a way to continue gaming, no matter what steps they took and no matter what barriers they put in place.
I explain that all is not lost - that we can work together to figure out a new way to decrease gaming and thereby restore balance between technology use and engagement in 3D reality. I also explain that changing gaming habits/patterns is a difficult process and requires time and focus and energy -- especially when the teen is fully opposed to change.
Parents often express frustration with the fact that no one gave them any warning or raised the issue of technology overuse or addiction. I then explain that in an ideal world there would have been some form of technology use screening early in their son's life so that they, as parents, could have put in place a structure or system that would have addressed the need for balance.
Unfortunately, with the possible exception of a pediatrician asking about screen time, very young children are consuming vast quantities of digital media and are developing what looks very much like a form of addiction to technology.
The key piece that is missing is early screening and early intervention. We need to treat digital media or "screen time" as a public health problem and put in place routine screenings - as we do with food and physical activity in order to prevent childhood obesity. As a society we need to understand that children are now growing up in a media saturated world that badly needs limits and structure in order to help prevent all forms of technology overuse and addiction.
If we can screen and intervene with a child rather than a teen, we stand a far greater chance of preventing the negative impact of technology overuse on development and mental health. Who would be responsible for this screening process: parents, pediatricians, mental health professionals, and educators.What is currently missing is information on the screening process. In my next blog I will review how to screen and intervene with children. In the meantime, go to my website and complete my technology screening test. This test will give a clear picture.of your son's current use and the need to intervene.
Wednesday, February 12, 2014
American Academy of Pediatrics: Pediatricians weigh in on screen time!
Media and Children
Media is everywhere. TV, Internet, computer and video games all vie for our children's attention. Information on this page can help parents understand the impact media has in our children's lives, while offering tips on managing time spent with various media. The AAP has recommendations for parents and pediatricians.
Today's children are spending an average of seven hours a day on entertainment media, including televisions, computers, phones and other electronic devices. To help kids make wise media choices, parents should monitor their media diet. Parents can make use of established ratings systems for shows, movies and games to avoid inappropriate content, such as violence, explicit sexual content or glorified tobacco and alcohol use.
Studies have shown that excessive media use can lead to attention problems, school difficulties, sleep and eating disorders, and obesity. In addition, the Internet and cell phones can provide platforms for illicit and risky behaviors.
By limiting screen time and offering educational media and non-electronic formats such as books, newspapers and board games, and watching television with their children, parents can help guide their children's media experience. Putting questionable content into context and teaching kids about advertising contributes to their media literacy.
The AAP recommends that parents establish "screen-free" zones at home by making sure there are no televisions, computers or video games in children's bedrooms, and by turning off the TV during dinner. Children and teens should engage with entertainment media for no more than one or two hours per day, and that should be high-quality content. It is important for kids to spend time on outdoor play, reading, hobbies, and using their imaginations in free play.
Television and other entertainment media should be avoided for infants and children under age 2. A child's brain develops rapidly during these first years, and young children learn best by interacting with people, not screens.
Additional Resources
Monday, February 10, 2014
Teen Depression and Internet and Video Game Use
The article below was written by John Grohol PSY.D for PsychCentral.
When you show a correlation between two things, you can’t say which way the relationship goes. Do people carrying umbrellas on a city street cause it to rain? Or does the rain cause people to carry their umbrellas?
We know the answer to this question, only because we know the relationship between rain and umbrellas — the rain came first, and then someone invented the umbrella.
So it is surprising to read that an NPR news story recently noted, “More Time Online Raise Risk For Teen Depression.” The only problem with that headline?
It’s not true.
The research they quote is from the journal World Psychiatry, and the European researchers examined 12,395 teenagers from eleven different European countries. They measured a bunch of at-risk behaviors, such as excessive alcohol use, illegal drug use, heavy smoking and being overweight.
They also measured behaviors we don’t typically associate with being “at-risk” for anything — sedentary behavior, reduced sleep and high media use. Media use included all use of a TV, the Internet and playing video games.
How researchers define the problem often pre-determines their result. In this case, the researchers defined “high media use” as anything over 5 hours per day. And they found that there’s a group of teens — an “invisible” group — that meet this definition of high media use and report increased psychiatric symptoms.
The problem with that arbitrary1 number? It doesn’t reflect the reality of teenage media use today. For instance, this study from 2010 found that, in the U.S. anyway, teens are now spending on average 7.5 hours/day on media.
If something is average or the norm, it can’t also be defined as “high” media use. And the 2010 study was from 4 years ago — I can imagine it’s only higher now.2 So the cutoff is both arbitrary and just plain wrong.
But the researchers didn’t measure whether the teens were depressed before they spent more time online, so the researchers had no way of telling which came first. Is a teen depressed and then turns more to the online world for support, friends, distraction, and emotional engagement? Or do people who spend enormous amounts of time online get more depressed?
The act of spending more time online doesn’t raise the risk of depression in a teenager. That’s not what the study found or said. Instead, it merely showed that if your teen is spending a lot of time online, playing video games, or watching TV, these may be signs that teen is suffering from some depressive symptoms. I know those two things sound very similar, but they’re not the same.
Going back to the umbrella example, if you see people outside walking down the street with an umbrella, you don’t think, “Oh wow, they must be trying to make it rain.” Instead, you just know that the umbrella is associated with rain, and yes, it may be raining outside. Or it may not be — carrying an umbrella has no impact on the weather.
These are subtle but important distinctions, and I certainly hope the news team at NPR understand them if they’re going to write about this kind of psychological research.
Otherwise, parents who just scan the headlines will just nod their head and say, “Oh, look, another study shows the more time a teen spends online, the more depressed they become.”
Reference
Carli, V. et al. (2014) . A newly identified group of adolescents at “invisible” risk for psychopathology and suicidal behavior: findings from the SEYLE study. World Psychiatry.
Footnotes:- I say “arbitrary” because no rationale was given for it in the study [↩]
- It’s hypothetically possible that European teen media use is significantly lower than the U.S.’s, but I couldn’t find any data to support that contention. [↩]
Friday, February 7, 2014
The Impact of The Internet on Adolescent Mental Health
Dear Readers,
Yesterday I had the great pleasure of presenting at conference in Los Angeles entitled "Navigating the Teenage Brain" where Dr. Daniel Siegel was the keynote speaker. My presentation focused on the impact of the internet on adolescent mental health. My presentation covered current research on how the internet is influencing both developmental and psychiatric disorders in teens. I have uploaded my power point to my www.teenvideogameaddiction website. Go to the "Products" page and you will see my power point under the title: The Impact of the Internet on Adolescent Mental Health.
Yesterday I had the great pleasure of presenting at conference in Los Angeles entitled "Navigating the Teenage Brain" where Dr. Daniel Siegel was the keynote speaker. My presentation focused on the impact of the internet on adolescent mental health. My presentation covered current research on how the internet is influencing both developmental and psychiatric disorders in teens. I have uploaded my power point to my www.teenvideogameaddiction website. Go to the "Products" page and you will see my power point under the title: The Impact of the Internet on Adolescent Mental Health.
Subscribe to:
Posts (Atom)