Digital Addiction and ADHD: a Toxic Combination
Do screens make ADHD symptoms worse?
Honest Definition of Our Parental Fear
- Impulsivity, short attention span, and inability to delay gratification are the symptoms of ADHD;
- They are re-enforced in the child’s brain by too much screen time, AND
- It will ruin their lives, compromising education, career and relationships.
I have a child with ADHD. He is obsessed with screens. The pain is personal.
Children today are spending increasing amounts of time glued to their screens. Parents all over the world are concerned, and some of us have started calling this phenomenon by what it is: addiction. According to research by Common Sense Media, 50% of teens feel addicted to mobile devices, and 78% check their phones at least every hour. It’s no secret that most of us adults are becoming addicted to technology as well: 48% of adults feel the need to respond to texts and other notifications from their phones immediately.
Common Sense Census indicated that between all their devices, U.S. teens consume a staggering nine hours of digital media per day! The key conclusion of 2016 study titled “New Report Finds Teens Feel Addicted to Their Phones, Causing Tension at Home” is that “even if children are not addicted, we should be cautious of the ways that problematic media use could affect their ability to stay focused or negatively impact their social and emotional well-being”. It’s getting worse: a 2019 study found that two-thirds of both teens and adults feel addicted to their mobile devices. The title of the report sounds almost hopeless: “The New Normal: Parents, Teens, and Devices Around the World”.
Research shows that digital media overuse leads to all kinds of negative consequences for children: from compromised academic performance to the destruction of social skills, from sleep deprivation to anxiety and depression.
But there is one particular group of children that is particularly vulnerable to digital addiction: children with ADD/ADHD (Attention Deficit/Attention Deficit Hyperactivity Disorder).
ADHD and Screens: Daily Parenting Reality
For parents of children with ADHD, screen time management is a daily struggle — your child cannot sit still for the 15 minutes of homework, but if you let him, will be hyper-focused for 12 hours straight playing video games!
And when you tell him time is up, all hell breaks loose. A child with ADHD will adamantly resist your efforts to impose limits on screen-time use. They fight back with a formidable weapon: Oppositional Defiant Disorder (ODD), which is another condition that often accompanies ADHD diagnosis. According to DSM (Diagnostic and Statistical Manual of Mental Disorders), what you get from this child is a pattern of defiant, angry, antagonistic, hostile, irritable, or vindictive behavior. For an unfortunate parent that experienced this, life becomes a battlefield.
The worst behavior is unleashed on the parent, and a good relationship with your child becomes collateral damage in the line of fire.
Peace and harmony is road kill.
How much easier it is to just hand over the iPad and experience hours of parental peace, instead of constant power struggles and exhausting negotiations over screen time? Many a parent has been there. Parenting is difficult, and parenting a child with ADHD is plain exhausting.
This child will not let you rest for a moment, demanding entertainment, breaking all kinds or rules and boundaries — unless their need for stimulation is fulfilled by the screen.
And — let’s face it — we are busy, and tired, and overwhelmed with a thousand obligations of our own (including more and more digital ones). Talking about temptation to give in! And maybe sometimes we have no choice but to engage in “electronic babysitting” for a while to give ourselves some breathing room. We just need to understand that if we stretch that breathing room for too long, experts have warned us about the consequences.
Your child with ADHD had been quiet for hours playing on his iPad, and he is not interested in anything else — not playing outside, not reading, not spending time with real people. When your child becomes addicted to digital media, you intervene — but they do not cooperate. Imagine what happens if an adult addict faces an intervention from a loving family and loses access to their drug/drink/behavior of choice?
You can expect resistance. Even violence.
A child with the neurological diagnosis that comes with lack of self-control as a symptom is ready to use anything — even physical force — against the parent. He would pry the devices out of parent’s hands to get their screen time fix. And sometimes the child in question is a teenager, bigger and stronger than a parent. This can get ugly, and it happens more often than we think.
Tech tantrums of a 3-year old can be cute, 13-year old — not so much.
When a child with ADHD becomes addicted to technology, all they care about is instant gratification of that next computer game or YouTube video, here and now, easy and fun, an instant dopamine hit that both ADHD and addiction demand from them; homework and health and sleep and relationships and their whole future be damned! Only a functional prefrontal cortex can put a stop to this toxic loop, but guess what? That part of the brain is not there yet! Scientists tell us that this essential human hardware is not fully formed until age 25, and for children with ADHD, there is about a 30% delay in its development.
According to Dr. Russell A. Barkley, Ph.D., one of the leading scientists studying the disorder, ADHD is a misnomer. It should have been called an executive functioning disorder, because a person’s prefrontal cortex does not do what it’s supposed to do — namely, self-control, responsibility, planning for the future, calculating the consequences of their actions, finishing important tasks — everything that they need to be a functional human being.
Your ADHD child of 12 is really 8, biologically speaking, says Dr. Barkley. And if they manage to get admission to college at 18, you are really sending a 12-year old to live in the dorm by themselves, manage their study schedule, and resist the temptations of college binge-drinking and promiscuous sexual behavior. Without some sort of external help and medication it could be a recipe for disaster. Now throw unlimited computer gaming into the mix without the parent to remind them to switch their attention back to schoolwork… and you just wasted tens of thousands of dollars in tuition because your kid dropped out of college and moved back home into your basement.
What is ADHD?
ADHD is a biological brain disorder, often genetic — a child is more likely to be diagnosed if one or both parents also has ADHD. Children with ADHD have trouble concentrating, finishing what they started, staying organized, managing emotions (particularly anger), thinking before they speak or act. While the causes of ADHD can be quite complex, it is generally believed that deficiency of the neurotransmitter dopamine in the brain is the main contributor. The dopamine loop is the reward system of the brain — when dopamine hits our neurons, it brings with it feelings of enjoyment and motivates us to repeat the behavior.
In a healthy brain, this can be a wonderful thing, designed by nature to bring happiness and satisfaction. But for children with ADHD the same dopamine loop could trap them in a cycle of pursuing instant gratification — which in their world is easily achieved by playing fast-paced computer games and engaging in online activities that provide an endless stream of perceived rewards. This digital obsession can and does often become a full-blown addiction. How does it happen?
What is Addiction?
The biological mechanism of addiction involves the same chemical as the biological mechanism of ADHD — dopamine, which generates feelings of pleasure and satisfaction in the brain. Certain drugs, alcohol or behaviors stimulate dopamine production, the person experiences the sensation of pleasure, consumes more and more of the substance or repeats the behavior to get the same feeling, and eventually becomes addicted. The brain suffers long-term damage and is no longer capable of producing the same levels of dopamine from normal human activities. The brain is hijacked - to be happy, the person now depends on the substance or behavior they got addicted to.
So, the kid who started playing Fortnite after school for fun is now losing sleep, missing developmental milestones, destroying his academic performance and social relationships. The very ability to control his life is sacrificed to the new kind of addiction — gaming. The World Health Organization has included Gaming disorder in their official International Classification of Diseases. Internet Gaming Disorder is on its way to be included in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM). Internet addiction disorder is defined by the National Institutes of Health as any online-related, compulsive behavior which interferes with normal living.
Digital media is officially on the list of addictions.
Playing Fortnite or taking meth is perceived by the brain as essentially the same. And like with any drug, with time the person needs larger and larger doses in order to get the same high. Computer games of today are faster, brighter, louder than computer games from a decade ago. Geared for the ever-decreasing attention span, and ever-increasing desire for stimulation and excitement. For some young adults, gaming addiction becomes such a big problem, that their families have to send them to a digital rehab center — a new and growing segment of rehab business.
Young people get hooked on gaming because the series of “small wins” built into computer games are intentionally designed to exploit the brain’s reward system by delivering a shot of dopamine to the pleasure centers of the brain, forming a habit. There is a disturbing ABC News report about the addictive nature of Fortnite, the most popular online multiplayer game. Parents in Quebec, Canada, actually filed a lawsuit against Epic Games Inc., the company behind the game, stating that it is as addictive as cocaine and ruins their children’s lives.
What happens when ADHD meets addiction?
One does not need to be a cognitive scientist to see that digital addiction for ADHD brain is like putting gasoline on the fire.
Research shows that people with ADHD are predisposed to addiction because ADHD by definition impairs impulse control. In the past it meant smoking, drinking, drug use, gambling and other forms of “traditional” addictions. In the present, internet gaming and digital media overuse hijack the same brain passages as drugs and alcohol. The areas of the brain that get the most stimulation are getting stronger — like the muscles with training.
Constant stimulation of the dopamine loop that is already malfunctioning because of ADHD enforces the very behavior that a child — and later adult with ADHD — needs to overcome in order to have a normal life.
Another fact is that exposure to digital media happens a lot earlier than a first chance to smoke and drink, usually before the age of two — and that’s a big problem.
The earlier in life the person becomes addicted to anything, the harder it is to break that addiction later in life.
A kid who started smoking, drinking, or taking drugs as a teenager would have a much harder time trying to break the addiction as an adult. The brain passages that formed in a developing brain associate pleasure with the drug or behavior, and it’s difficult to change this biology once the person grows up. Their brain was formed under the influence of addictive substance or behavior before it had the chance to fully grow and mature.
Addiction becomes biologically hardwired in the brain — and it’s not something that can be surgically cut off, like a tumor.
Do Screens Make ADHD Symptoms Worse?
The question that keep parents awake at night — does screen time make ADHD symptoms worse? The rapid-fire action of fast-paced shows and video games seems to synchronize perfectly with the ADHD brain that craves overstimulation. Although the child seems to be focused, it’s not the same kind of attention they need to function and succeed in real life. A video game requires short bursts of attention rapidly switching from task to task, with no time to stop and think. It rewards them with points, tokens, prizes, monsters killed — every few seconds, providing instant gratification and the illusion of progress.
Dopamine hits are constant, and happen within the shortened attention span of ADHD.
No wonder kids with ADHD find video games so appealing. With games being so pleasurable and stimulating, it is hard to concentrate on tasks that require sustained attention, long time to accomplish, might be boring, and do not bring rewards until much later.
According to the 2012 study by Iowa State University, children who are already more impulsive tend to spend more time playing video games, which may make their attention problems worse. What is interesting is that it was not the content of the video games (such as violence) that had the most negative effect on attention, but the overall time children spent gaming. According to this study, playing computer games does not cause ADHD. The causes are genetic and biological. However, there is enough evidence to suggest that excessive amounts of screen time make ADHD symptoms worse.
Parents may not be scientists, but we notice that after a long time on the screen our kid’s behavior goes downhill. And now the science is catching up with parental common sense: a study out of the University of Alberta has found that by the age of 5, children who spent two hours or more looking at a screen each day were “five times more likely to exhibit clinically significant behavioral problems such as inattention, acting out, hyperactivity and being oppositional; and over seven times more likely to meet the criteria for attention deficit hyperactivity disorder” than preschoolers who spent less than 30 minutes per day.
Another study published in the Journal of the American Medical Association looked at 2,500 high-school students in California, who were 15 to 16 years of age and had high amounts of screen time - especially social media. Researchers found that teens who used digital media many times per day and already had an ADHD diagnosis, experienced an increase in symptoms, while kids without ADHD developed ADHD-like symptoms after two years of frequent digital media use. On the last point the connection was controversial, but significant enough to cause concern — can children somehow acquire this environmental form of ADHD even if they did not have it biologically? According to the study, “Mid-adolescence is a period of high neural plasticity during which brain circuitry underlying attention and behavioral control mature rapidly and may be vulnerable to exposures that disrupt neurodevelopment”.
Researchers seem to suggest here that young people’s brains are being biologically rewired by high frequency digital media.
These growing humans are effectively reprogrammed for shorter attention spans, lack of self control, difficulty sustaining attention, hyperactivity, and impulsivity — all the classic markers of ADHD.
The symptoms of ADD patients and people with smartphones are “absolutely the same”, noticed John Ratey, professor of psychiatry at Harvard Medical School and an expert on ADD. “We’re not developing the attention muscles in our brain nearly as much as we used to,” he said.
It seems, our whole society displays ADHD symptoms driven by overuse of technology. Our lives are taken over by digital media, and it has us frazzled, overwhelmed, rapidly switching from task to task and not committing to anything in a deep meaningful way. As author Steven Pressfield said, we are all “a river a mile wide and an inch deep”.
Read a full version of the article here.
Her research on the relationship between technology and psychology seeks to reveal how digital behavior manipulation affects human wellbeing.