Video Game Addiction

“My son does not care about anything but playing video games.” Parents often seek help when their previously loving, bright child becomes unrecognizable to them. They report their teen does not eat, sleep, and will fly into a rage when asked to stop playing.

Inevitably, teenagers show up on their first visit in an unwashed sweatshirt, looking tired and unkempt. The last place they want to be on earth is sitting in my office, yet that is where they need to be.

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. Many pediatricians are concerned the number of American children afflicted with this problem is increasing.

Addiction is a disorder of the brain’s incentive system (highly activated in adolescence) encompassing a strong desire to pursue rewarding input, despite adverse consequences. Two things that characterize addiction are the activity is intrinsically pleasurable by nature and the idea of “reinforcement”, meaning there is an increased chance a person will habitually seek repeated exposure. Signs of gaming addiction include: sneaking and lying about playing time, demanding unreasonable amount of time to play, or becoming furious when access to video games is restricted.

Denial of experiencing negative consequences is the epitome of a human being addicted to anything; insisting they are fine despite evidence to the contrary their world is falling apart. Addicted teens often quit caring about friends, sports, schoolwork, and even their families. “Can’t you start him on medication that will make him happier?” parents ask. If their child is happy, they mistakenly believe he or she will stop being addicted, but that approach is backwards.

There is no medication to treat addiction for something kept inside a home. That is like treating an alcoholic by keeping a dozen liquor bottles on top of the refrigerator. Brain imaging reveals video games trigger release of dopamine, a neurotransmitter in the brain with similar effects on the body as amphetamines. Gaming provides immediate fulfillment and a sense of accomplishment unlike the delayed gratification seen in real life when a child wins a basketball game after countless hours of practice.

Instead, I encourage parents to get rid of gaming consoles or other technology used to play video games in order for their children to find alternative activities they enjoy, like playing sports or musical instruments. Parents are very resistant to this approach. Why? Fear is often behind their reluctance to remove video games from the home. They have already experienced tremendous rage from their teenager when attempting to prohibit video game use. Teenagers can become violent or even suicidal; sometimes they have already been involved with law enforcement or the juvenile justice system prior to coming to me for help.

In my experience, the grip of addiction to video games can be nearly impossible to break. It is best to prevent your child from becoming addicted in the first place. Teenage years are an exceptional time for growth and development of the brain. Adolescents are particularly vulnerable to activities associated with instant gratification and pleasurable experience. During puberty, the brain’s reward center (aka limbic system) becomes highly activated, and then gradually settles down as they reach maturity. They are constantly searching for situations associated with immediate reward and video games provide a tangible benefit in their immature minds.

Despite the fact we consider them adults at age 18, their prefrontal cortex, which controls impulses and helps with planning and organizing behavior, is only halfway mature by that age. It is not fully developed until age 25. This area is in charge of executive function, which involves gauging actions to determine future consequences, working toward defined goals, and predicting certain outcomes based on our decisions. Imagine what constant immersion in rapidly flashing images and violence does for these immature connections in the still developing brain?

A New York Times article “Steve Jobs Was a Low-Tech Parent" describes tech executives setting tough limits for their own children’s use of technology. The author concludes they must know something the general population does not. Yes, pediatricians and technology folks know 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 want for our children?

Technology can be a helpful adjunct for education and learning however, when your child becomes compulsive about playing video games and angry at the thought of doing something else, please take notice and find help before it is too late.

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