is one of the end products of all these disturbed pathways and mechanisms, and it is nearly always present when a child is chronically hyperaroused. It occurs as the fight-or-flight response causes shifts in mechanical, chemical, and electrical systems (such as blood flow, brain chemistry and hormones, and overstimulated networks) and is compounded by poor sleep. Mood dysregulation is characterized by poor frustration tolerance, tearfulness, irritability, mood swings, and meltdowns or aggression. Aiden becomes extremely emotionally volatile immediately following video game play, and then he continues to feel irritable and anxious for days and weeks afterward. If you’ve ever felt like you “have to walk on eggshells” around your child, then it is likely you are all-too familiar with this phenomenon.
For a summary that pulls all the pathways, mechanisms, and potential consequences together, see the table in appendix A, “Table of Physiological Mechanisms and Effects of Interactive Screen-Time.” In fact, bookmark this page to remind yourself why your child’s brain needs a reset!
Chapter 2 Take-Home Points
• The brain does not discern between real or perceived threats, and artificially intense stimulation from electronic screen media produces a psychological and physiological fight-or-flight reaction, regardless of content.
• These reactions have both immediate and cumulative effects, which eventually cause damage.
• Screen devices interface with your child via the eyes, brain, and body, triggering changes in blood flow, brain chemistry, electrical excitability, and hormones.
• Since the eyes are a direct extension of the central nervous system, they provide a pathway for overstimulation of the sensory system as well as for unnaturally bright light to suppress melatonin (the sleep hormone) and desynchronize the body clock.
• Numerous mechanisms, including disturbed sleep, reward/addiction pathways, brain-blood flow shifts, intense sensory experiences, and engaging content precipitate and perpetuate an ongoing stress response.
• Electronics-related sleep disturbance, in and of itself, creates a vicious cycle of exhaustion, compromised mood and cognition, more stress because of dysfunction, more insomnia, and craving for more stimulation.
• Examining the known effects of chronic stress and hyperarousal can assist in envisioning how screen-time may affect your child’s behavior, mood, and social skills.
* This story is a dramatization based on true events.
* This graphic does not include all stress reactions, and some of these factors are interrelated.
How ESS Mimics a Wide variety of Psychiatric, Neurological, and Behavioral Disorders
The system of nature, of which man is a part, tends to be self-balancing, self-adjusting, self-cleansing. Not so with technology.
— E. F. Schumacher, Small Is Beautiful 1
For a list of all the ways technology has failed to improve the quality of life, please press 3.
— Alice Kahn
Historically, certain infectious “agents” have become infamous for their capacity to randomly invade a victim’s nervous system, lending them an uncanny ability to mimic various neurologic and psychiatric disorders. In fact, both syphilis and Lyme disease have been nicknamed “the Great Imitator.”2 Not surprisingly, both illnesses are also considered to be sources of misdiagnosis as well as misguided treatment.
Other classes of mental health offenders demonstrate a similar nature. Food intolerances, such as gluten or dairy sensitivity, are capable of inflaming the brain and body and causing symptoms ranging from irritability and hyperactivity to fatigue and brain fog. Abuse of street drugs, like cocaine and methamphetamine, can cause wildly variant presentations; symptoms range from mild anxiety or depression to personality changes and overt psychosis. All of the above offenders — infections, certain food proteins, and illicit drugs — are known to cause widespread dysfunction and wide-ranging symptoms in some, and more “classic” symptoms in others, creating challenges for diagnosis and appropriate treatment.
It is, therefore, not such a stretch to imagine that if screen-time is capable of irritating the nervous system in general, that its corresponding syndrome would be capable of imitating or secretly amplifying more specific conditions. ESS “shape-shifts,” such that clinicians and parents may think they are seeing one thing when in fact ESS is the real villain. To make matters even more confusing, the way ESS presents itself depends not only on a child’s underlying constitution but also on his or her current environment and stage of development, and thus it sometimes morphs into different entities even within the same child. In other words, regardless of the nature of your child’s issues, it pays to be on the lookout for ESS.
The Shape-Shifting Nature of Electronic Screen Syndrome
This chapter categorizes and describes the ways in which ESS can either exacerbate or imitate various mental and neurological health problems. This covers a lot of ground, and you may want to turn first to the sections covering the types of dysfunction that you know apply to your child, and then read the chapter more thoroughly later. I have based these findings on my own and others’ clinical experience with patients, on what we already know about the brain and body, and on relevant, emerging research about electronic media and these conditions. In other words, this chapter presents the sum of what we see, what we know, and what we’re finding out about screen-time’s effects. Note that for some conditions, such as tics or psychosis, there remains a paucity of formal research, but the findings described here are nevertheless supported by peripheral research (for example, by screen-time’s impact on dopamine), published case reports, surveys, therapeutic effects from the fast, and anecdotal reports from patients and parents. No doubt we will improve our understandings in time.
Although pediatric mental health disorders are notorious for symptom overlap across differing diagnoses, for organizational purposes I have grouped symptoms and conditions into six categories: moods, cognitive concerns, disruptive behaviors and social issues, addiction, anxiety, and neurological dysfunction (including tics and autism). Some children exhibit numerous symptoms from different categories, and some only a specific one or two. Some symptoms may be directly related to interacting with electronic screen devices, while others may be indirect as a result of poor sleep or stress reactions. For some symptoms or disorders, ESS may only exacerbate but not mimic; for instance, autistic symptoms would (theoretically) not be mimicked in a typically developing child. But for most disorders, ESS can either mimic or exacerbate them. For example, ESS might mimic the symptoms of ADHD in a child without ADHD, or ESS might exacerbate symptoms in a child who does indeed have ADHD. In spite of these variations, a common ESS combination of symptoms is irritability (mood), attention issues (cognition), and immature or defiant behavior (behavior/social). Hopefully this chapter provides both a “big picture” sense of ESS as well as ways to specifically identify how it may be presenting in your child. Think in themes rather than absolutes, and remember most psychiatric symptoms and diagnoses occur on a spectrum.
Luckily, despite its shape-shifting nature, ESS is relatively simple to diagnose. Like food intolerances, the gold standard is simply to remove the potential offender — in this case, screen devices — and observe the child for symptom and function improvement. While this chapter describes most of the ways screen-time might impact a child, the swiftest and most accurate way to figure out if or how ESS is affecting yours is to follow the Reset