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Tom Fluent

Hooked on Screens

What happens when video games and social media take over people's lives?

by Cynthia Furlong Reynolds

From the May, 2018 issue

A 1950 survey found that parents most feared two things: the atomic bomb and polio. In 2018, NBC News reported, "Overwhelmingly, parents fear screen addiction far beyond anything else."

We've all seen families sit silently in restaurants, each member focused on a device. And parents glued to phones or laptops while their small children beg them for attention. And solitary students "talking" to friends electronically while walking across the Diag alone, surrounded by hundreds of other solitary students.

Video games. Facebook. Twitter. Snapchat. They can enrich our lives, but they can upend them, too.

"Adam,"* twenty-seven, has returned to his parents' home and to community college classes after nearly a decade of doing "nothing much but gaming." He says he realizes that he should be "doing more with my life" but still games, sometimes through the night. His only "friends" are online gamers he knows only by their first names. His father is so angry that he avoids his son. His mother worries that Adam "shows all the signs of a deep depression."

"Kyle," twenty-one, spends all day and long into the night playing Call of Duty or War of the Worlds, often while smoking marijuana. He quit his part-time job and then his college classes because they interfered with his gaming. He avoids family interactions, including meals; refuses to take antidepressant medications; shouts and fist-pumps when he "achieves" a new level of gaming expertise; and complains about back and wrist problems.

"Linda," sixty, an occupational therapist and grandmother, plays Candy Crush and word games with online "friends" whenever she's alone. "I'll ignore housework and other obligations to play these games," she says. "I know I'm on dangerous ground, so I limit myself to four, maybe five, hours a day." She admits she has lied to her husband about how she spends her days.

"Madeline," fifty, an architect, started online gaming in graduate school, to relieve stress. Nowadays, she says, her compulsive game playing on her phone and iPad

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"comes and goes in spurts," between bouts of binge watching old television shows. "This is just like a gambling addiction," she says. "I know myself well enough to refuse to go to a casino--I'd play until I lost my socks and my cat."

"Riley," three, throws massive temper tantrums when her phone is taken away at bedtime. Her parents are consulting a therapist about ways to wean their daughter off cell phone games and television.

"Caitlyn," a beautiful sixteen-year-old with a 3.8 GPA, tried to commit suicide when "friends" repeatedly pranked her by refusing to "like" any of her social media posts. "No one cares about me anymore," she wrote in a note to her parents before swallowing pills. She is now in treatment at an out-of-state recovery center without access to the Internet.

"America is facing a social/technological crisis," says Tom Fluent, medical director for ambulatory psychiatric services at the U-M Depression Center and assistant professor in the U-M department of psychiatry. "I hesitate to use the term 'addiction' lightly, but this situation is starting to feel addictive."

---

A 2017 U-M study of kids and screen time concluded that the number of hours spent using a screen is less important than "whether screen use causes problems in other areas of life or has become an all-consuming activity." Lead author Sarah Domoff listed nine warning signs, including loss of interest in other activities, frustration when use is denied, sneaking time with screen media, and using screens to alter moods.

"I could have written that study," says Kyle's mother. Until eighth grade "he had been a great student, but suddenly he wouldn't study. He became a discipline problem in school and equally unresponsive and unmotivated at home. He'd never been particularly athletic, but eventually he wouldn't even go outdoors. He spent more and more time with his gaming system and showed aggressive behavior if I tried to curtail the hours."

"I have no doubt that it's an addiction," says Adam's mother flatly. "I don't know how to get my son away from the gaming."

Fluent says the capacity for compulsion is built into the product. "These games are incredibly complex and layered with all sorts of opportunities for achievement and status," he says. "They're brilliantly--and deviously--designed with the input of psychologists and neuropsychologists, to hook kids. Video games impact the center of the brain dealing with pleasure, excitement, interest, and compulsion."

"When I play games through the night, I get a sense of accomplishment and a huge rush of adrenalin," Adam confirms. "It feels so good I don't want to stop."

Fluent sees "a danger that a child's developmental journey will get hijacked for life ... Kids are spending so much time in an artificial, virtual world that their minds, bodies, and social development are stifled. Their executive functioning is impacted. They can't sustain attention on anything else. Their regulation of emotions and their ability to handle stress diminish. They equate the skills they develop in gaming with achieving a certain status in the world, and their behavior becomes narcissistic."

The damage isn't limited to the brain. "We call it a Gamer's Body," Fluent says. "I've worked with kids over a ten- or twelve-year span, and I've watched their bodies morph in the last two decades. Obsessive gamers have little to no muscle definition. Their shoulders are hunched, they move bent over, and they're often very, very thin.

"As part of the male's physical development, boys need intense physical and muscular activities to stimulate the production of testosterone and mature the body. Kids who play games for ten or twelve hours a day aren't getting that stimulation."

The obsessive gamers Fluent sees tend to belong to more affluent families who can support unemployed teenagers and young men. "Well-intentioned parents get caught up in a Catch-22 situation, where gaming becomes the individual's only social outlet and source of joy and self-esteem," he says. "I've found that many of them combine cannabis with gaming. It renders them apathetic, and they believe the real world doesn't compare favorably to what they achieve in their artificial worlds."

"That is completely true," Adam's mother says. "Adam finds such joy in winning a game or reaching another level--a level of success he finds only when he plays video games.

"Initially I thought the gaming would help him cope with depression. But I was wrong. I think it creates his depression."

---

"High school counselors are very concerned about our students' excessive screen time," reports Gerry Holmes, a thirty-year veteran at Dexter High School. "We counselors find that many of our students are 'unable' to be parted from their smartphones."

A 2014 Baylor University study found that college-age women average ten hours a day on their cell phones, males nearly eight hours, and roughly 60 percent of college students admit they may be addicted to their phones. Statistics for younger students are equally frightening. Between 2010 and 2015, the suicide rate for girls aged thirteen to eighteen rose by 65 percent. Those who spent five or more hours on phones were twice as likely to contemplate, plan, or attempt suicide as those who spent less than an hour.

Girls tend to focus more on social media than video games. "They're worried that they're going to miss out on what someone is saying about them or about someone close to them," Holmes says.

"Their self-esteem is based on how many likes their posts get or who wishes them happy birthday," Fluent says. Social media, Fluent says, "give the illusion of social interaction, but it's actually the opposite. They're reading what people post about their lives, descriptions that are not necessarily truthful."

Constant checking of social media can also be physically exhausting. "A primary concern of guidance counselors everywhere is that our students are becoming sleep-deprived as a result of sleeping with or near their phones," Holmes says. They do it "because they're worried that they're going to miss out on what someone is saying about them or about someone close to them."

Holmes thinks screen use also contributes to another worrisome trend. "Students today are having trouble with ordinary problems that students were able to successfully navigate twenty to thirty years ago on their own," she says. "More and more students are unable to calm themselves, regulate themselves emotionally, and get back to the task at hand ... We're seeing students who are experiencing heightened anxiety and panic attacks on a near-regular basis," she says.

"Although students are constantly drawn to their phones to connect socially, many are achieving just the opposite. They oftentimes lack the ability to read social cues correctly and to tap into others' feelings without becoming overemotional themselves."

The result? "A serious lack of trust, Holmes says. "They're terrified of being judged, which teenagers naturally have a propensity for anyway."

A January BBC report cited two studies involving more than 700 students that found that depressive symptoms (feelings of worthlessness and hopelessness) were linked to the quality of their online interactions. Children with higher levels of depression reported more negative interactions, "due to cyber-bulling ... a distorted view of other people's lives, and feeling like time spent on social media is a waste."

"Do people turn to technology because they're depressed and it makes them feel better?" Fluent asks. "Or does the overuse of technology result in depression? It's a chicken-or-the-egg dilemma."

---

The first efforts to regulate social media were bans on texting and driving--Michigan passed one in 2010. But the latest Root Insurance of Harris Poll survey revealed 80 percent of American drivers still admit to using a mobile device while driving--and teens are more than twice as likely as adults to talk or text while behind the wheel.

According to the National Highway Traffic Safety Administration, text messaging requires a driver to look away from the road for approximately five seconds--the distance of a football field for drivers going 55 mph. Car and Driver reports that a driver who is texting has a slower reaction time than one whose blood-alcohol level is at the legal maximum. My son was involved in an accident when another high school driver pulled out into traffic while texting without stopping at a stop sign; it was her third accident in the six months since getting her license. Roberta, a local mom of two teens, continues to suffer from a traumatic brain injury sustained when her car was hit by a texting teen.

"Technology advanced so quickly that we didn't have time to figure out the social mores for its use," Fluent suggests. "There is no etiquette in place for managing technology. If we grownups don't know how to manage it, how can we expect the kids to do it?"

Increasingly, divorcing couples cite screen addiction as an "irreconcilable difference." Madeline, the architect, admits her binge watching and gaming have caused "considerable difficulties" in her marriage.

And yet "detoxing" from social media is not only challenging, it can be dangerous. "It gets to the point where pulling a child--or young adult--back or cutting off the gaming can be catastrophic," Fluent says. That concern is echoed by the parents of three-year-old Riley. "How do I know that causing her to give up the cell phone games won't lead to other, more serious problems?" one asks.

Psychotherapist Nicholas Kardaras, author of Glow Kids: How Screen Addiction is Highjacking Our Kids and How to Break the Trance, writes, "I've worked with hundreds of heroin addicts and crystal meth addicts, and what I can say is that it's easier to treat a heroin addict than a true screen addict."

Desperate parents are turning for help to expensive wilderness camps, therapists, and screen-free private schools (average tuition: $68,000 a year). One local parent of a heavy gamer admits to spending "nearly $900,000" in desperate efforts to deal with what she is convinced is a serious addiction. "They'd work for the time he was away, but the minute he got back to 'civilization', he went right back to old habits," she says. "All I can do now is pray and hope that he outgrows it."

The American Academy of Pediatrics suggests that parents and caregivers develop a family media plan. The group considers less than one hour a day of gaming or phone use optimal, with two hours "the absolute maximum." The AAP also urges parents to prioritize creative unplugged playtime for infants and toddlers. Although it concedes that some media can have educational value for children older than eighteen months, the report urges, "It's critically important that this be high-quality programming" and that parents watch with their children.

My nieces, both mothers of three small children, set firm limits on screen time.

"I wish I could set the clock back and do that," Kyle's mother says tearfully.

In addition, the AAP urges parents to establish times and places that are media-free, especially bedrooms. "Have ongoing communication about online citizenship and safety, including treating others with respect online and offline," the report suggests.

"We all need discipline, structure, and platforms for creativity," Fluent says. "Without that, no one can develop fundamental social skills, regulate emotions, handle frustration, or feel empathy for others. All these qualities are critical to a successful life--and none of them will result from social media or video games."

Holmes agrees. "I have grave concerns when I see that the only time kids come alive is when they discuss their gaming success or the number of "likes" on Facebook or the number of Twitter followers."

"I talk to kids about gaming and social media the same way I talk about drug use," Fluent says. "I'm seeing parents held hostage and frustrated with their children's treatment providers, while the treatment providers are frustrated with the parents who have allowed their children unlimited use of electronics--and who themselves may suffer from the same problem."

Kyle's mother says, "Every day I hear the fast-paced clicking of a keyboard or the annoying sound of a control for hours on end ... not to mention the constant bickering, swearing, and berating of teammates and opponents regarding a certain shot or kill. Even the humming of the non-active screen with pictures of weapons, fighters, and lifelike scenery consumes my thoughts until the next 'war' begins, during which time my son is not to be bothered until the game is over."

"We must be aware of the encroachments of screen influences, and we must be willing to act," Holmes says.

"I think we're raising a lost generation," Adam's mother suggests. "That's tragic. Terribly, terribly tragic."     (end of article)

[Originally published in May, 2018.]

 

 
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