mechanism has potential long-term implications for brain development. When under stress, blood flow in the brain is repeatedly shunted away from areas of higher thinking (the cortex, or “new” brain, at the outermost layer) and toward more primitive areas (the limbic, or “old” brain, seated deep within). In other words, blood is directed to the areas involved in survival. Similarly, when addiction of any kind occurs during adolescence, it tends to stunt development of the brain’s frontal lobe, which is responsible for decision making, organization, attention, impulse control, task completion, and emotional regulation (to name a few!). If interactive screen-time induces a stress response and activates reward and addiction pathways, might it affect brain development by decreasing blood flow to the cortex and frontal lobe? Indeed, it very well might. Interestingly, when I’ve treated patients with the Reset Program and they continue to be screen-free afterward, they seem to mature developmentally in leaps and bounds — in a matter of months. This suggests that liberation from screens redirects robust blood flow back to the frontal lobe, thereby supporting healthy brain development.
Elevated Cortisol
Research suggests electronic screen activity is associated with altered cortisol regulation.43 While adrenaline is the dominant hormone released in an acute stress reaction, the hormone typically associated with chronic stress is cortisol. Cortisol actually serves to protect the body from stress reactions, but high cortisol levels over time cause harm. In fact, chronically high cortisol is correlated with obesity, high blood pressure, diabetes, metabolic syndrome, and hormone imbalance.44 During times of stress, when the body needs ready access to fuel, cortisol “loosens the reins” of blood sugar control by counteracting insulin. In the short term, this translates into unstable blood sugar levels, but in the long term it can lead to weight gain concentrated in the abdominal area and problems with insulin regulation. Recall how Aiden craves sweets after his episode; children under stress often crave sweets or other carbohydrates because of blood sugar fluctuations. As mentioned, research shows screen-time is a risk factor for metabolic syndrome regardless of activity level, and it is likely that high cortisol is one of the reasons why.
Additionally, elevated cortisol throws off the production of other hormones, such as thyroid and reproductive hormones, and over time excess cortisol damages the brain.45 Chronically elevated cortisol wreaks havoc on the nervous, cardiovascular, metabolic, and hormonal systems.
Oxidative Stress
Chronic stress — electronic or otherwise — puts stress on the very system that fights stress! At a molecular level, all cellular reactions in the body produce free radicals, which are unstable, unpaired electrons that must quickly grab another electron in order to stabilize. When a cell is healthy, free radicals are “scavenged” by adequate amounts of antioxidants — which are both ingested as nutrients and produced by the cell itself — and balance is maintained. But when the cell’s defenses are overwhelmed by too many stressors, antioxidants become depleted, and oxidative stress (excessive free radicals) ensues. As free radicals build unchecked, the unstable molecules containing them are forced to “grab” electrons from our own tissue. Nearby fats, proteins, and DNA are typically the elements vulnerable to being attacked. Eventually, this process creates inflammation, tissue damage, and inefficiency, further compromising the cell’s ability to contend with acute and ongoing stress.
Unfortunately, the brain is highly susceptible to oxidative stress for several reasons. First, oxidative stress can cause disruption of the blood-brain barrier, making it more vulnerable to toxins it should be protected from. Second, it’s also relatively hard to get antioxidant nutrients into the brain that could potentially provide the brain protection, so there’s never much of a buffer. And third, oxidative stress tends to attack the fatty sheaths that insulate brain cells, which can cause aberrant firing of networks. Meanwhile, a developing brain — because it is highly dynamic with increased energy needs — is more vulnerable to oxidative stress than a fully formed adult brain. This means that a child’s brain — especially if it is already compromised by a mental disorder — will develop damage from oxidative stress relatively quickly. The eyes are also vulnerable to oxidative stress; the retinal damage studies mentioned above also found markers associated with oxidative stress.46
Disturbed Sleep
The far-reaching effects of poor quality sleep have already been mentioned, and they can occur in children after just one night of not getting enough rest. Poor sleep goes hand in hand with both acute and chronic stress. In Aiden’s case, video game playing (and subsequent fight-or-flight rage) results in non-restorative sleep, which doesn’t allow his brain adequate recovery. After a night of poor sleep, the body produces adrenaline to get through the day, which can then cause difficulty falling or staying asleep the following night. Non-restorative sleep compounds hyperarousal and leaves a child feeling “wired and tired.”
Sleep hygiene is a set of practices sleep experts recommend to obtain quality rest on a daily basis. Recommendations include low levels of stimulation in the evening, exercise and exposure to lots of natural light during the day, banning electronics from the bedroom, and sticking to a regular sleep-wake schedule. Children and teens who are stressed tend to have poor sleep hygiene if left to their own devices.
Cognitive Dysfunction
If you’ve ever described your child as seemingly “out of it,” you may be witnessing the cognitive dysfunction that occurs when the brain has just been exposed to something it considers stressful. When Aiden tries to get ready for bed after his episode, he can’t quite get himself together and has trouble following sequential steps. After a poor night’s sleep, he continues to struggle with focus, long after the game has been turned off. Stress affects the ability to assimilate new facts, retain new information, and execute tasks. Short-term memory suffers. Cognitive dysfunction then translates into forgetting to complete or turn in homework assignments, falling grades, and a tendency to lose things. Chronic or repeated stress causes even more alarming effects, including loss of neurons, or brain cells, particularly in the hippocampus — an area important for forming and storing memories.47
Poor Sense of Time
Both sense of time and time management can be affected by stress. If we were to ask Aiden in the moment how long he has been playing his game, in all likelihood he will underestimate the time spent — even if he is being honest and not trying to minimize in order to avoid getting into trouble. In fact, video gaming has been found to cause time distortion in players, nearly universally.48 Both video games and Internet use cause problems with managing time as well: being late, underestimating how much time a task will take, procrastinating, forgetting appointments and activities, and so on. Interestingly, children with extensive traumatic histories have great difficulty with time perception. They appear to be forever stuck in the moment, unable to look forward or backward — an advantage if you’re trying to survive. Focusing on the “here and now” serves self-preservation in extreme situations. But in everyday life, it translates into impulsive actions, repeating mistakes by failing to reflect on their consequences, and an inability to focus on future goals.
Impaired Social Interactions
The very essence of survival mode centers around defensiveness. While in this state, being open and intimate creates vulnerability and therefore poses a threat. During Aiden’s episode, direct eye contact with his aunt provokes him. This is a primitive reaction, and it is why we don’t stare unfamiliar dogs directly in the eye — they’ll see it as a challenge. Try making sustained eye contact with your child after video game play — he or she will likely become uncomfortable and look away.
Chronically hyperaroused children get defensive easily when playing games and are often “sore losers.” They may feel wronged when something happens by chance, and they may be more prone to cheating. These behaviors can happen online and in other settings, like the playground. As this defensiveness rises, the child’s relationships can become affected. Interestingly, while both children and adults claim that social media helps them feel connected to others, it appears that, in fact, time spent online actually increases depression and a sense of social isolation.49
Mood Dysregulation