“I hear voices at night, and sometimes I think someone’s outside my window,” the 19-year-old young man informed me. “I know no one’s really there, but it’s still scary.”
In my practice in the past six months, no less than five youths have reported psychotic symptoms that were attributed to, or exacerbated by, electronic screen devices.
As per my protocol, I always get a "screen-time" history:
- video games (including handheld)
- computer/internet use, especially using laptops and ipad
- cell phone/smartphone use (talking, texting, streaming, and internet
- television (especially cartoons/animated, 3-D, or watching on a laptop)
Not surprisingly, all five of these patients, ranging from 15-22 years old, were “plugged in” for six or more hours each day. Three were female and two male. After discussing electronic screens’ toxic influence on the brain, I recommended to each of these patients that they forego all interactive electronic media for at least four weeks.
The three females all decided to go “cold turkey ” and gave up their games, laptops, and phones. All three saw their symptoms resolve completely within a month. Of the two males, one cut down use significantly and his hallucinations disappeared; his paranoia remained but was less severe which in turn improved dysfunction. The other male turned out to be severely addicted to the internet and video games and flat out refused to change his habits at all. Needless to say the young man continues to suffer from psychotic symptoms.
Importantly, the therapeutic effects were achieved without using medication! This is a big deal, because medications used to treat psychotic symptoms are heavy duty, and have serious side effects--weight gain, hormone dysfunction, and movement disorders, which can be irreversible.
Electronic screens, particularly interactive ones (as opposed to passive ones, like television), increase dopamine in the reward center of the brain. This effect has been demonstrated by brain scan (Koepp, 1998: http://www.nrc-iol.org/cores/mialab/fijc/Files/2002/120402_Koepp_Nature_1998.pdf ) Dopamine is known as the brain's "feel good" chemical, but is also related to stress, addiction, anxiety, mood, and attention. Dopamine in excess can lead to psychotic symptoms--voices, delusions, paranoia, or confusion.
Psychosis is defined by abnormal thinking. This can involve thought content, such as hallucinations, delusions, or paranoia, or thought process (highly disorganized thinking, or feeling like thoughts are “blocked”). It is typically attributed to the severely mentally ill, like schizophrenics, but can also be seen in “normal” people under extreme stress. Children in particular are more likely to hallucinate when traumatized, sleep-deprived, or over-stimulated. Interactive electronic screen use cause or mimic all three of these states!
Take home point: Children, teens, and young adults who have unexplained hallucinations or delusions should have ALL electronic screendevices removed for at least 3 weeks, as part of the diagnostic work up. This includes cell phones, as texting, media viewing, and internet use can quickly rack up hours. Virtually all teens and many young adults do not yet have the impulse control to moderate their own usage, so parents should physically remove these devices. While this may seem extreme, drastic times cause for drastic measures. Psychosis–and treatment thereof–is serious and has long-lasting effects.
As psychiatric disorders in young people continue to explode, and evidence mounts about the toxic effects of electronin media on the developing brain, parents and clinicians would be prudent to remove this offending environmental trigger from the child’s life, as part of the diagnosis and as one “arm” of any mental health treatment plan.
When you start to feel conflicted about removing screens--they are so ingrained in our lives, after all--this is what I tell my patients and their parents: “You will never regret removing video games and computer use, but you may sorely regret letting them remain. “
For more information on how screen-time affects the brain, visit www.drdunckley.com/videogames.