by Dr Richard Graham, Leading child and adolescent psychiatrist
Too much of a good thing?
Leading child and adolescent psychiatrist Dr Richard Graham investigates how young people’s technology use can sometimes tip over into addiction.
One of the most difficult dilemmas that any parent faces today is knowing when the amount of time a young person spends online is becoming too much.
Other risks of the online world, such as cyberbullying or accessing inappropriate material, tend to be more easily understood and might present more immediately (the child might show signs of distress, for example). What is much more difficult to recognise is the gradual increase of online time until it reaches a level that many would consider not only a problem, but even an addiction.
My work in recent years has centred on the influence of social networking, social media and video games on adolescents, with a particular focus on technology addiction. In 2010, I founded the UK’s first dedicated Technology Addiction Service for Young People at Capio Nightingale Hospital, so I have seen first-hand the effect that excessive use of digital technologies has on families.
When being online becomes priority #1
There are many reasons why a child or teenager might increase their Web use. Homework often has to be completed on a computer now and smartphones, games consoles, tablets and other portable devices mean that the digital world is available to them 24/7.
Yet, as some parents discover rather late, there is a point where online activities become the dominant part of a young person’s life and even essential biological needs, such as sleeping and eating, take second place.
Clinical work with young people and their families – where their online activities are interfering with their school attendance, offline social activities and even their physical health – does suggest that internet addiction is a reality and can be compared with other behavioural addictions, such as gambling addiction.
Simply put, thinking about or getting access to the internet takes over, and a young person may spend more than half of their day online. Convergence of online activities makes it difficult to be clear what it is that pulls the young person back online and even compulsive gamers are often heavily involved socially with other gamers online.
I use the questions below to help determine whether someone is becoming addicted to technology:
Do you stay online longer than you expected?
Do you ignore and avoid other work or activities to spend more time online?
Do you frequently get annoyed ot irritable if someone bothers you when you are trying to do something online or on your phone?
Do you prefer to spend time with people online or through messaging to being with them without using technology
Do you think a lot about about when you can get back to being online when you are offline?
Do you often check messages or emails before doing something else you need to do?
Do you argue with or feel criticised by friends or family about the amount of time you spend online?
Do you get excited at the thought of when you can next get online and also about what you will do online?
Do you feel tense or bad if you can't get online (a feeling which goes away when you get back online?)
Do you hide or become defensive about what you do online?
These questions help to indicate technology addiction but it is often the intensity of the feelings or responses that identify the level of difficulty experienced. For example, many young people get angry when they are asked to switch off their laptop but some parents fear aggression, even violence, if they ask their child to do this. Similarly, a teenager’s online time might be rising to three or four hours a day but this is far more ordinary and less concerning than someone spending 14 hours a day gaming who cannot go to school or work because of the time they spend online. What is tricky is that, at some point, the gamer would have only spent a few hours a day online.
A range of motives
In a sense, the task is to establish how dependent the young person is on online activities in order to feel good – either about themselves or their lives. In other words, how much of a grip do their online activities have on them? As with other addictions, there is a slow realisation that the laptop or phone has become a dictator demanding attention to the point that the online activity takes over everything and is in control of the young person and their life.
The motives of going back online are many: to avoid feeling excluded, to placate peers who demand your return, to manage the reputation of the digital self, to obtain rewards in a game and so on. Understanding the range of these motives can help to inform any discussion of how much time is too much time spent online. I have found, for example, that a detailed description of what exactly a gamer might do in a role-playing game opens up the discussion and allows some recognition of what they may be forgetting.
A simple test of how far someone has gone down that road is to ask the young person to go for three days without their phone or laptop. At a time when most young people never switch off their phone, the response to this question can be disturbing. But then it can be just as disturbing for many adults.
It is perhaps too soon to have established guidelines as to how much time a young person should spend online each day, partly because it depends on the actual online activity – some activities, such as instant messaging or gaming, seem to exhaust the brain more quickly than others. Some young people also feel drained by the expectation to respond to others online and are relieved when their mobile or laptop is ‘put to bed’ at night.
Similarly, as recommended in the USA, a week away from technology from time to time can have a really positive effect on the young person’s mood; too much online time can lead to a very flat, depressed young person, who becomes livelier and more confident after a week offline.
If you’re planning on suggesting a time-out from technology for your son or daughter, make sure you are in a place where getting online will be difficult and plan lots of physical activities. Some of the ‘withdrawal symptoms’ of going offline are minimised by having something to do, especially if it involves all of their senses and their body. It’s fair to say, the eyes and the thumbs can really use a holiday.
1 KNOW Find out how long the young person spends online
2 MONITOR Ask yourself, is the time they spend online growing rapidly? Is it interfering with ordinary life?
3 BALANCE Organise offline activities and opportunities to balance out time in front of a screen – don't let online time mushroom
4 SUPPORT Get support from partners and other family members when trying to reduce online time
5 HOLIDAY Organise weekends and holidays to allow for more offline activities
Dr Richard Graham is a leading Consultant Child and Adolescent Psychiatrist and Clinical Director of the Adolescent Department at the Tavistock and Portman NHS Foundation Trust and the Technology Addiction Service at Capio Nightingale Hospital.Nightingale Hospital