Are video games, screens another addiction?

In an increasingly digital world, most people own multiple electronic devices with screens. However, many parents worry about the effects of screen use on themselves and their children.

With screens virtually everywhere, controlling a child's screen time can be challenging. How can you manage your children's screen time? How will you know if you or your children are addicted to screens or video games?

Is screen time damaging?

It's difficult to avoid screens completely, especially with their importance at work and school. However, excessive screen time can affect a persons mental, social and physical health.

Too much screen time has been linked to:

• Obesity
• Poor sleep or insomnia
• Behavioral problems, including impulsive actions
• Loss of social skills
• Violence
• Less time for play
• Eye strain
• Neck and back problems
• Anxiety
• Depression
• Difficulties with work or school

Screen time can be engaging for people of all ages. This is because their brains process and react to the sensory input as if it were happening to them. For example, many people have cried, laughed or been startled while watching a movie. This same type of engagement is possible when a person plays a video game.

While playing a video game, the person's brain processes the scenario as if it were real. If the game depicts a dangerous or violent situation, the gamer's body reacts accordingly. This "fight-or-flight response" to that perceived danger is triggered by exposure to intense stimulation and violence in the game. Excessive video game use can lead to the brain being revved up in a constant state of hyperarousal.

Hyperarousal looks different for each person. It can include difficulties with paying attention, managing emotions, controlling impulses, following directions and tolerating frustration. Some adults or children struggle with expressing compassion and creativity, and have a decreased interest in learning. This can lead to a lack of empathy for others, which can lead to violence. Also, kids who rely on screens and social media to interact with others typically feel lonelier than kids who interact in person.

Chronic hyperarousal can have physical symptoms, as well, such as decreased immune function, irritability, jittery feelings, depression and unstable blood sugar levels. In children, some can develop cravings for sweets while playing video games. Combined with the sedentary nature of gaming, children's diet and weight can be negatively affected, as well. Sometimes children will even avoid stopping the game to go to the restroom, which can lead to hygiene issues.

How can gaming become an addiction?

An addiction is defined as a person's inability to control use of a substance or behavior, despite negative consequences. Some people who are engrossed in screen time or video games while ignoring other normal activities could be close to meeting this definition.

So why does this happen? The reward center in the brain releases dopamine in response to a pleasurable experience or hyperarousal. If a person experiences hyperarousal while playing video games, the brain associates the activity with dopamine. The person develops a strong drive to seek out that same pleasure again and again.

Dopamine is a powerful neurotransmitter in the brain. It helps sustain people's interest and attention, which is why it can hard for people to tear themselves away from a situation or behavior. It's also self-reinforcing. The more times people experience the behavior, the more dopamine is released, and the more driven they are to return to the behavior.

Symptoms of screen time or video game addiction

Similar to tobacco, alcohol or drugs, screen time or video games can become an addiction if it damages your health and relationships, and you are unable to control it.

Some symptoms could include:

• Having intense urges for screen time or to play video games, and these urges block out other thoughts
• Spending money on video games or screens, even though you can't afford it
• Cutting back on social or recreational activities because of preference for screen time or video games
• Continuing to play video games or participate in screen time, even though you know it's causing problems in your life, such as poor performance at school or work, or letting household responsibilities go
• Displaying signs of irritability, anxiety or anger when forced to stop playing, even for brief periods of time
• Lying to others about the extent of your use
• Needing more screen time over time to get the same level of enjoyment
• Neglecting your appearance, including lack of interest in grooming or clothing

Continued excessive use of screens can result in long-term or permanent changes in the brain that require extensive behavioral and medical treatment to reverse.

What can you do?

As your child grows, a one-size-fits-all approach doesn't work as well. Not all kids are the same when it comes to screens and technology. Some children can self-regulate and might even put the screens down to go outside without you prompting them. Other kids become noticeably more anxious and quicker to lose their tempers when they spend a lot of time on screens. You'll need to decide how much media to let your child use each day and what's appropriate.

Consider applying the same rules to your child's real and virtual environments. In both, play with your child, teach kindness, be involved, and know who your child's friends and what your child does with them. Also, keep in mind that the quality of the media your child is exposed to is more important than the type of technology or amount of time spent. Encourage active screen time over passive screen time.

Active screen time is when you are interacting with other people that you know or when you are cognitively or physically engaged. For example, play educational games, or games that require players to build something together. Other options are fitness-type games that require movement while playing. Passive screen time includes watching screens with minimal cognitive engagement, such as scrolling through social media, watching online videos or playing simple games.

Set reasonable limits for your child's screen time and video game types, especially if your child's use of screens hinders involvement in other activities.

Consider these tips:

• Follow guidelines for screen time, such as those suggested by the American Academy of Pediatrics.
• Model healthy use of screens and video games. Consider unplugging when you first get home from work, at dinner and when driving. Model other methods of relaxation and entertainment, such as taking a walk, playing a game, having a dance party or reading a book.
• Encourage a balance between screen time and activities that require in-person social interactions, such as family activities or extracurricular activities.
• Create structured, screen-free times, such as during mealtimes, in the mornings and before bedtime.
• Consider using apps that control the length of time your child can use a device.
• Keep screens out of bedrooms.
• Require that all devices be charged outside of bedrooms at night.
• Learn about the game rating categories and only allow your children to play video games suitable for their ages.

If you're concerned about a child or loved one's use of screen time, consulting a behavioral or addictions specialist can help determine treatment options.

Edward Luker is a counselor in Psychiatry & Psychology in La Crosse, Wisconsin.