Gaming Strategy

Help for kids who can't seem to shake video gaming

Over the years she's worked specifically with people addicted to digital technology, Cosette Rae, a social worker, has noticed a troubling pattern. In the hundreds of calls answered daily at reSTART, the technology addiction center near Seattle she helped start in 2009, the people seeking help keep getting younger.

"Instead of college-age students, we're getting calls from parents with kids as young as 8 and 6," Rae says. "When we had started, the problem was starting to emerge with late high school and college-age kids. Now we're introducing technology to younger and younger children. The problem is starting to emerge earlier in the psychological development of childhood."

Rae is CEO of reSTART, where a staff of mental health professionals works to meet the challenges of treating adolescents ages 13 to 17 who show signs of addiction to the internet, video games and other digital technology. In November, reSTART launched the first adolescent treatment program at its Serenity Mountain campus — 32 acres in Startup, Washington, with two residential care homes staffed with professionally trained clinicians.

The program was sought by parents for years, Rae says. They call with questions about children who, for example, have lost interest in all their usual activities, stopped eating dinner with the family and fallen behind and lost interest at school where they used to excel. Instead, parents battle outbursts at the slightest suggestion that it's time to set aside the gaming console or cellphone.

"I don't get calls from parents who are saying, 'He just spends too much time online.' It's a whole group of things," she says. "It becomes a big battle. They become policemen. It becomes kind of the meltdown of the family."

Known as "internet gaming disorder," this kind of addiction is not included in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, or DSM. But the APA has indicated it is a "condition for further study." Rae believes it will be officially recognized within the next couple of years.

The unofficial disorder is most common among males ages 12 to 20, according to the latest edition of the APA's manual. Under the definition, internet gaming becomes a disorder when use starts to impact basic human functions. Rae says that could mean it's affecting academics, health or relationships.

Daisy O'Dell, a marriage and family therapist in Spokane who has seen this disorder show up as a symptom in families experiencing other issues, says that gaming dependency looks and acts like other forms of addiction. She explains how it can develop.

"Because of the way gaming activates the reward center of the brain, anyone can be susceptible in creating a dependency when engaged in excessive amounts," O'Dell says. "Video gaming has the ability to release the 'feel good' chemicals, dopamine and serotonin, in the brain. Anytime we experience a release of these chemicals, we want more of whatever we experienced."

These chemicals are released all the time through exercise, learning and connecting with others.

"What is tricky about how video games release feel-good chemicals, is that they introduce an intermittent reward process while in play. Meaning that our brain doesn't know exactly when we will reach our goal or complete our task, therefore the pursuit and anticipation of reward becomes a part of the excitement," she continues. "This process mirrors that of gambling behaviors. The brain is engaged in a way that solicits more play, more risk, more investment in pursuit of the reward."

There are certain indicators of a problem: The person grows preoccupied or obsessed with gaming. They have withdrawal symptoms when they're not playing. They need to play more and more to get the same thrill, because they develop a tolerance. It's become the thing in their lives — more important than relationships or other obligations, even when they recognize its impact.

O'Dell says some people are at higher risk of developing dependency because of other mental health issues, including anxiety, depression or ADHD.

Rae says parents are made to believe the solution is as simple as unplugging the device.

"What many of us don't understand is that [gaming addictions] change the brain. They change the brain in a very powerful way," she says, referring to building tolerance and feeling withdrawal. "Parents don't see that that's what they're dealing with. It acts like a substance."

But it's a substance that everyone is using and few people are thinking critically about. Combine that with the place digital technology has come to occupy in society, and it's not really feasible to tell someone who overuses to just quit. That's why mental health professionals at reSTART focus on education to help patients develop the knowledge about themselves to better regulate their use of technology. Rae's aim is to see this kind of curriculum used to prevent overuse.

"We all face this," she says. "We need to find strategies and ways to understand what we're dealing with. A problem understood is half-solved."

Adolescent services include a short-term intensive assessment program and a long-term therapeutic program. During the first phase, clinicians use assessments to get to know the person and understand the problem. Treatment means being completely unplugged for a while to address health issues like poor sleep and eating habits. Education on addiction — including its biological and societal impacts, and lessons on big data and privacy issues — fill kids' days. They also work with a therapist to address other mental health issues, such as depression or aggression. Throughout the process, clients work toward building a plan to establish a healthier relationship with digital media.

"We're excited because we feel that the missing piece is this: As a society, tech has slowly been emerging over decades. We didn't see it and say, 'Let's analyze how this affects us.' We just fell in love with it and embraced it, and ran with it at the expense of many children with our family," Rae says. "Now we're seeing the effects of embracing tech without understanding the risks and the benefits." ♦

Getting Help

Worried that your child is overusing digital media? ReSTART lists a number of behaviors to look for to recognize computer or screen addiction. If a person exhibits three to four of these behaviors, that may suggest abuse. If five or more apply, it may suggest addiction.

• Spends increasing amounts of time on computer and internet activities

• Fails attempts to control behavior

• Experiences a heightened sense of euphoria while involved in computer and internet activities

• Craves more time on the computer and internet

• Neglects friends and family

• Feels restless when not engaged in the activity

• Is dishonest with others

• Computer use interferes with job or school performance

• Feels guilty, ashamed, anxious, or depressed as a result of behavior

• Sleep patterns change

• Experiences physical changes, such as weight gain or loss, backaches, headaches or carpal tunnel syndrome

• Withdraws from other pleasurable activities

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