Reset Your Child's Brain. Victoria L. Dunckley, MD

individuals with ESS aren’t always or even usually addicted to screen-time. Furthermore, teens and young adults often find the term addiction off-putting, which can create roadblocks in treatment. Thus, I feel the most accurate and helpful term is “problematic,” since it includes the child who experiences screen-related symptoms but whose screen habits are not necessarily excessive or addictive in nature. Nevertheless, the terms “pathological,” “excessive,” “overuse,” and “addiction” are all used in the scientific literature, so for purposes of discussion here, they may be used interchangeably.

      In reality, if the average school-age child is consuming four to six hours and the average teen is consuming seven-plus hours daily,⁷¹ then the majority of children have screen habits that should be considered “excessive” — especially considering that we don’t yet know what the long-term effects will be. Terminology notwithstanding, the findings in screen addiction research dovetail nicely with those observed in ESS, including biological, psychological, and behavioral aspects. If ESS and screen addiction are part of the same spectrum, then addiction research highlights the need for aggressive screen management — to “head it off at the pass.”

      Screen addiction or dependence can be psychological (causing anxiety or distress with lack of screen access), physical (causing brain changes and a true “withdrawal syndrome” similar to drug withdrawal), or both. In developed countries worldwide, an estimated 5 to 15 percent of people have screen-time addictions, making it an epidemic.⁷² The silver lining behind the enormity of the problem is that because the problem is more widely recognized, a robust body of literature now exists that didn’t a decade ago.

      As I’ve said, electronics overuse bears a striking resemblance to stimulant abuse and addiction. Like amphetamine abuse, focus and mood may seem — and indeed may be — enhanced by the stimulation of screen-time. However, over time and as usage increases or accumulates, the “user” will begin to experience mood changes, sleep disturbances, shortened attention span, irritability, depression, defensiveness, an inability to tolerate stress, and a general worsening of functioning. Other similarities between screen addiction and stimulant addiction include decreased interest in other activities and feeling anxious if forced to be “without.” Also, as with drug abuse, electronics use or abuse “just on the weekends” can still produce significant issues.

      As with drugs, people are drawn to interactive electronic media for its ability to provide immediate gratification and intense stimulation. Marketers exploit these tendencies and thus “up the ante” with every new game, gadget, or application. Each new version becomes more stimulating, titillating, or rewarding — and thus more addicting — and the hijacking begins. Both physiological arousal and “feelings of presence” are factors known to promote and maintain engagement in video game play, and these factors are enhanced with newer games.⁷³

      Although there has been considerable media hype about the ways in which technology may be rewiring our brains, the bigger concern is that excessive video game and Internet use is causing actual brain damage. Numerous brain imaging studies have shown abnormalities in both brain structure and function similar to damage caused by drugs, such as in heroin, cocaine, and alcohol addiction. As discussed in chapter 2, research has demonstrated brain shrinkage in processing areas (gray matter), including the frontal lobe; loss of integrity in connection pathways (white matter); reduced cortical thickness (higher brain areas); and more impulsive but less accurate cognitive processing. When video game addicts are shown cues that induce “craving,” their brains light up in the same areas that drug-addicted brains do. Finally, dopamine receptors may become desensitized, effectively requiring larger amounts of dopamine to do the same job.⁷⁴

      Interestingly, one group of researchers summarized the literature on pathological Internet use in a way that described the mood, attention, and behavior traits seen with ESS: “Taken together, these findings indicate that internet addiction disorder is associated with structural and functional changes in brain regions involving emotional processing, executive attention, decision making and cognitive control.”⁷⁵