Ryder was eleven when he was diagnosed with attention deficit hyperactivity disorder (ADHD).
“One way he was coping with his busy mind was playing games,” his mother, Charlie, told Healthline. Ryder would run to the computer the moment he came home and even enjoyed watching videos of other people gaming.
But Charlie noticed that as Ryder began spending more time playing video games, he was becoming more impulsive, withdrawn, and irritable. Ryder soon found everyone annoying, including his two sisters, who responded in kind.
“Our home became a battlefield of short-tempered children,” she said. “We began speaking openly to all three of our children about screen addictions, [asking], ‘Are you in control of the screen, or is the screen in control of you?’”
It’s a question a growing number of parents are contemplating as excessive screen time is becoming a bigger health concern for kids.
In fact, the American Academy of Pediatrics cites research that up to 8.5 percent of U.S. youth, ages 8 to 18, meet criteria for internet gaming disorder (IGD), which includes symptoms like the ones Charlie noticed Ryder had begun to exhibit.
Psychiatrist Dr. Perry Renshaw of the University of Utah has been studying heavy gaming for 15 years. Heavy gamers are more likely to have ADHD or depression, and treating either condition tends to make them cut back, he told Healthline. But why?
Does Playing Video Games Cause ADHD?
There’s no evidence that playing video games causes ADHD, but kids who game more often are more likely to develop symptoms later.
However, if your child doesn’t have a diagnosis of ADHD, frequent gaming combined with other worrisome signs is a reason to ask for an evaluation.
More than 9 percent of kids living in the United States, ages 2 to 17, have been diagnosed with ADHD, according to a 2016 Centers for Disease Control study. Among these children, 6 out of 10 are taking medication for their ADHD, and about the same portion have other diagnosed emotional problems.
In July, a California team reported in the Journal of the American Medical Association (JAMA) that teens who are heavy users of digital devices are twice as likely as infrequent users to show ADHD symptoms in the future.
The team tracked nearly 2,600 teenagers in public schools in Los Angeles County for two years, after first eliminating any students who already showed symptoms of ADHD when the study began. The participants reported how often they used any of 14 different media platforms—including games.
“This study raises concern whether the proliferation of high-performance digital media technologies may be putting a new generation of youth at risk for ADHD,” said study co-author Adam Leventhal, PhD, professor of preventive medicine and psychology at the University of Southern California.
Of all the possibilities, from texting to streaming music or movies, or posting photos, video chatting was most linked to future ADHD symptoms, followed by playing games on a console, smartphone, or computer.
How Much Gaming Is Too Much?
With kids spending so much time on their phones, it’s hard to know what they’re doing or how much is too much.
Research has linked conduct problems to spending any more than nine hours a week of gaming. But that’s much less than today’s norm.
Research from the nonprofit Common Sense Media divided U.S. teens into groups based on their favorite kind of technology. “Gamers,” the group reported, devote about two and a half hours per day.
About 10 percent of American eighth-graders said they spent at least 40 hours a week gaming, in an analysis of 2016 data by Jean Twenge, PhD, a psychology professor at San Diego State University. That weekly total comes to nearly six hours a day.
Parents are typically in the dark. Even concerned parents might guess “two hours a day,” said Lisa Strohman, PhD, a clinical psychologist in Scottsdale, Arizona, “and if you talk to the child, it’s often seven hours a day.”
However, psychiatrist Dr. Kourosh Dini, author of Video Game Play and Addiction: A Guide for Parents, claims the biggest indicator of an issue isn’t how much time kids are spending gaming, but how well they are functioning.
“I don’t have a set number of hours, if they’re on top of everything,” he said.
Additionally, gaming can be a special solace and source of esteem for children with ADHD, so parents may be reluctant to restrict game time.
“I’ve had numerous parents come up to me and tell me that their child has ADHD and the only thing they could focus on for two hours at a time is video games,” said Douglas Gentile, PhD, who runs the Media Research Lab at Iowa State.
Why Are People With ADHD More Attracted to Video Games?
Video games reward short bursts of attention and are designed to prevent your mind from wandering.
For people with ADHD, their attention tends to extremes — scattered or “hyperfocused” when they’re extra-stimulated.
In a three-year study of some 3,000 children and teens from Singapore, Gentile and his colleagues concluded that gaming wasn’t helping inattentive kids. In fact, the heaviest gamers become more impulsive and less attentive.
The game’s constant flickering of light and sound effects work as “crutches for attention—they support your attention so you don’t have to work hard to attend,” Gentile said. “That’s very different than being in the classroom where the teacher doesn’t have sound effects, lighting, special effects, music, and camera angles.”
He added, “Our data suggest that the children who already are most at risk for attention problems play the most games, which becomes a vicious cycle.”
Once you begin winning, “It feels like you’re invincible,” Strohman said, and kids feel “flat” without the boosts, especially if they tend to be unsuccessful socializing or in class.
The game is a respite and refuge some people don’t want to leave. Also, if they have ADHD, you tend to have trouble organizing time.
As with many psychological questions, there are evolution-based answers and biochemical ones. ADHD may arise from genes that were once an advantage. Being quick-moving and alert to signs of danger from different directions—as you need to be able to win a video game—could make you a good watchman.
Another theory is that people with ADHD are “self-medicating” themselves through gaming, giving themselves shots of the pleasure chemical dopamine.
Ritalin, the ADHD medication, raises dopamine levels, and other research has found that it can reduce gaming.
Also, ADHD is less common at higher altitudes, where air contains less oxygen and people naturally produce more dopamine. In fact, one study found that in Utah, ADHD is about half as common as in states at sea level.
Do Video Games Have Benefits?
Some research has shown that games can enhance spatial skills, especially the more violent “shooter” games. In fact, one meta-analysis concluded that playing shooter games enhanced these skills as much as high school and university-level courses designed for that purpose, and those skills applied beyond the games.
So, gaming might help a child succeed later in science and technology fields.
Some of the most popular games today involve teams of people playing online, so they may enhance the ability to work with others as well.
Strohman, however, noted that the online chatter is “quite abusive,” with players flying into rages in their excitement. “I don’t think any parent would sign up a child to spend time with kids who tell them they’re losers.”
Is Gaming Really Addictive?
“There is a big difference of opinion about whether [heavy gaming] is an addiction, impulse control disorder, a variant of ADHD and depression, or just a behavior that’s extreme in some individuals,” Renshaw told Heathline.
Nevertheless, the World Health Organization recently added “gaming disorder” to an updated version of its lists of ailments.
The idea that an activity can be addictive—like alcohol and nicotine—is recognized in the current manual of official psychiatric disorders (DSM-5), which includes gambling.
However, in an appendix to the DSM-5, the authors identified “Internet Gaming Disorder” as worthy of more study.
In Asia, one gruesome tale of out-of-control gaming fed fears of a serious public health problem.
A couple in South Korea pleaded guilty to negligent homicide after their infant girl died of malnutrition while the parents played 10-hour sessions of a game at an internet café. (The couple was playing Prius Online, a fantasy game that allowed them to raise an online girl with magic powers.)
Since 2011, South Koreans under the age of 16 can’t play online games between midnight and 6:00 am, unless their parents make a special request to lift the restriction.
While the topic of video games and addiction continues to be debated, the evidence that gaming can lead to gambling is clearer.
In 2011, a brain scan study of 14-year-olds found that frequent gamers had more gray matter in a particular brain area, a change seen in addicted gamblers.
Additionally, studies in Germany and Canada found that more than a quarter of teens who gamble with play money at home move on to gambling with actual money, most often using scratch cards.
What Can You Do If You Suspect Your Child Has a Tech or Gaming Addiction?
You might ask your child to answer the questions in a diagnostic tool from the team at reSTART Life, which runs a camp for teens on Serenity Mountain, in Washington.
Observe and be aware of the following danger signs of tech addiction: spending more and more time online or gaming, trying and failing to cut back, withdrawing from other pleasures, feeling more euphoric when they play, craving games, neglecting family and friends, restlessness, lying about time spent gaming.
Also, feeling guilt, shame, or anxiety about gaming are all indications of an activity gone out of control. Physical symptoms like weight gain or loss, backaches, headaches, and strained wrists could show up as well.
In speaking to your child, Dini said, “I’d ask two questions. ‘Are you able to disengage when you need to?’ ‘And is it a refuge from everything else?’”
If the answer is “No,” and “Yes,” your child may need more help for ADHD or depression and a gaming reduction program, usually based on cognitive behavioral therapy. Parents need to supervise.
However, reaching that decision can be tough for parents. “When the kid is quiet, isn’t jumping around, parents tend to feel relief. It’s an exhausting proposition to create healthy alternatives when it’s so easy to let them game,” Strohman said.
You may see a lot of “anger and aggression,” when you take your child’s games away, she added.
The Bottom Line
While video games do not cause ADHD, they can exacerbate symptoms. Those with ADHD may be more susceptible to developing a gaming addiction as a coping mechanism to better deal with their disorder.
However, parents working together with their children to address the issue can lead to positive results.
Strohman, who founded the Digital Citizen Academy, which brings programs on technology use to classrooms and parents, works with families to set up realistic goals and teach children to see the problem.
“It’s no different than teaching them about nutrition,” she said.
As for Ryder, he is now 13-years old and has reduced his gaming time together with the help of his family. He’s also begun playing team sports, which is giving him more confidence.
“We have also found that it is up to us to set the example,” Charlie said. “We enjoy unplugged days together as a family. This is challenging, but beyond worth it!”
Temma Ehrenfeld is an award-winning journalist who covers psychology, healt, and personal finance. This article was originally published on Healthline.com.