"I want my son back," Melanie told me. She had brought her 15-year-old son, Derek, to therapy because obsessive gaming had led this bright, once-loving boy to fail classes and turn venomous towards his parents. In this first meeting with Derek and his mom, the teen was cloaked in a hoodie and refused my efforts to engage in conversation.
Melanie's description of her son's symptoms revealed the signs of video game addiction: demands to add to already exorbitant time gaming, sneaking and lying about gadget use, rages when parents tried to limit electronics, and profound damage to family relationships and school success from overuse of video games.
In 2013, Internet Gaming Disorder was placed in U.S. psychiatry's chief guidebook, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), as a diagnosis that needs more research before it's fully accepted. However, the diagnosis is already recognized in China, South Korea, and Japan, and there is increasing concern it's afflicting many American children and teens.
I worked with Derek and his family for months, trying all that I have learned in working with tech-addicted kids. But, in the end, his resistance was too much to overcome and I failed to help this teen. Frustrated by Derek's case, I wrote this article to draw attention to the significant barriers health care providers are encountering when treating this emerging problem. I also wanted to encourage you to prevent your child from developing a game addiction, and will describe steps how to do so.
Addicted Kids May Not Want Help
"My mom's the one with the problem," Derek told me. Denial often run deep for the game-obsessed, just as it does with substance addictions. The result is that some kids insist that all is well--even when their world is crashing down around them. "Can't you convince him he's ruining his life?" Melanie implored. I explained that I had done my best to get through to Derek, but his mind had been hijacked by addiction. Brain imaging studies reveal that game addictions commandeer the cingulate gyrus (a key brain area involved in motivation) and the prefrontal cortex (the brain's judgment center). The result is that kids can become fixated on digital devices, cease to care about what once mattered to them most, and yet have no insight regarding their problems.
The Struggle to Find Real Life Rewarding
In my meetings with Derek, I encouraged him to look for alternatives to gaming that he could enjoy, such as discovering an interest in a school subject or playing a sport or instrument. "Tried that, don't like it," he would tersely reply. Why the resistance? Brain scans show that video gaming triggers the release of the reward-based neurotransmitter dopamine into the brain at the same level as an intravenous shot of amphetamine. In other words, gaming provides pleasures real-world activities may not be able to match. For example, in contrast to the profound and immediate rewards found in gaming, kids need to work all semester long in math or chemistry before they receive a grade stamped on a transcript.
Consequences That Can Last a Lifetime
"I'm not getting into college with my grades," Derek told me. He had a point. Even if he could turn things around, the F's on his high school transcript would remain, hurting his chances of college admission. Because he wasn't able to see a way out of his predicament, Derek struggled to find the motivation to change.
The Tough Choices Families Face
Derek attended therapy regularly with his mother and father--at least initially. But as time went on, he missed appointments, claiming he was sick. Near the end of our work together, he simply told his parents that he wouldn't attend counseling. Because of Derek's refusal to participate, I informed his parents that the treatment strategy would need to shift. I said that I could now meet with them to discuss steps that they could take at home to address their son's tech overuse.
Derek's parents were justifiably wary of moving ahead alone. Prior to coming to see me, they had experienced their son's fury in response to gaming limits. On more than one occasion, they had considered calling the police when their son threatened them or tore apart his room. Derek's parents therefore wanted me to assure them that limiting their boy's gaming wouldn't throw the family into chaos again.
I told Derek's parents that I wished I could make such assurances, but acknowledged that gaming addiction treatment carries risks. Kids may become violent or suicidal when parents attempt to restrain their gaming. Game-addicted kids also run the danger of being arrested or psychiatrically hospitalized. Understandably, not wanting to risk such problems with the son they loved, Melanie and her husband decided to withdraw from counseling.
The Power to Prevent
"If I had this to do over again, I would have made different choices," Melanie told me in our last meeting. This sentiment, in which parents--with hindsight--recognize that preventing game addiction is preferable to treating it, is common among the parents I treat. My hope is that you act to help your child before problems start.
How can we prevent youth video game addiction? Recognize that children, with their developing brains, are highly vulnerable to today's advanced gaming technologies which are designed to be difficult to put down. As noted in the New York Times' article "Steve Jobs Was a Low-Tech Parent," leading tech execs are wary of the dangers of tech addiction and therefore set strong limits on their own children's use of devices.
By limiting children's access to gaming, they are more likely to find joy in real-world activities--such as spending time with family, reading, creative and outdoor play, and school. Such limits also help children learn that technology is best used as a tool, not a toy.
Let's give our kids the help they need.