We often discuss about the ill effects of smoking and drinking alcohol. We debate on how cocaine and cannabis can destroy families. But we turn a blind eye to this very close to home addictions – the behavioral ones !!
These include
Internet addiction
Mobile addiction
Social media addiction
Gaming addiction
Pornography addiction
( and also Pathological gambling ,Pathological working ,compulsive Shopping )
Behavioral scientists believe that any source which is capable of stimulating an individual, could become addictive.
A number of experts believe that behavioral addictions can be passive (e.g. television) or active (e.g. computer games), and usually contain inducing and reinforcing features which contribute to its development.
Even as psychiatrists, we find it difficult to categorize these addictions into diagnostic compartments. These problems are new and “great gifts of technology!!. Studies are actively still being conducted and new discoveries been made. Lot of thesis of postgraduate students nowadays are also on these behavioral addictions.
Let me try and explain the complex nature of these addictions with a clinical example. (P.s. Names are modified to preserve confidentiality)
Vikrant * 50 year old businessman was always busy on the phone. WhatsApp had become his prime source of happiness. He would spend hours scrolling messages. He found it very stimulating to read new information and forward to different people. He felt he was doing something useful. Normally socially anxious and recluse, he felt this was the best way he could communicate with his peers and be accepted. Also his wife Nidhi was always nagging him. Her issues with his mother were driving him crazy. When would they stop fighting!!Mobile use was an escape from reality for him.
Their son Varun was busy playing online games. He would not come out of his room for hours. He would not have food on time. He would hardly sleep. His grades were slipping. His teachers were warning them, he would fail his exams. Vikrant had spoken to him once and Varun back answered that father should first change his habits first.
Nidhi would spend hours scrolling on shopping websites. She would buy trendy small sized clothes that she would actually never wear. She would wonder how she had gained so much weight . Her husbands’ erectile issues were irritating her. She would binge on biscuits and sweets when she was stressed. Then feel guilty. She would order food home whenever she felt low. Stress eating and comfort food had become a way of life. This family was brought for therapy when Varun was refered from school for behavioral therapy and anger management. He had lashed out at a teacher and pushed a classmate in anger at school.
As histories unraveled,a mind boggling revelation was made. This family, on the outside is a typical middle class family. Husband works hard. But so hard that he has no actual time to spend with his wife or son. He is a perfectionist and people pleaser. His boss is happy with him as he is a good worker. But he has ignored his health. He has developed diabetes early. Stress and diabetes has destroyed his sex life. Instead of addressing these issues he had chosen to self medicate with social media. Wife is in her own make believe world. She had decided to take up only a part time job as son had to “brought up well”. But what she is left with, is only complaints. She blames her husband for clipping her wings and not develop her career. The son detests the restriction imposed by parents. He sits in his room playing games online rather than hear them bickering. He is a typical teenager – defiant , impulsive and not bound by rules.
In the beginning of therapy none of them were willing to change, even a bit. There was simple denial of problem. Blame game and finger pointing was the only thing evident. It took time to convince Vikrant to take medication for anxiety. It helped improve the erectile issue also. His mother had to be moved temporarily to his sisters home so that domestic issues were less complicated. Varun had to be admitted briefly as he flatly refused to give up his gaming console. He was prescribed some medication to reduce impulsivity and agression. Intensive in-patients therapy was done for him. He was discharged only when controlled screen time was negotiated and agreed upon.
Nidhis’ issues were deep rooted. She had lost her father early. Mother was very dominating and over religious. She had a serious relationship with an out of her caste boy before marriage. She reluctantly married Vikrant due to mothers emotional blackmail. For the last 2 years she was secretly texting her x. It was the one thing that gave her some peace of mind. She has now agreed to discontinue this secret online relationship and work on her marriage. She will enrol for yoga classes and take more challenging roles at her workplace. A small family holiday was also suggested.
The number of people struggling with behavioral addiction is much much more than we can imagine. As long as it does not cause visible socio-occupational dysfunction, people don’t want to deal with it at all. Everyone self medicates boredom anxiety and sadness with gadgets these days. But these methods only mask the problems. When I read a news item that a child committed suicide because the phone was snatched away , I wondered if the child was depressed and taking the phone away was the last straw to break the camels back. In desperation the child decided to end it all.
We live in a make believe world. Virtual relationships and valued more than real ones. Genuine love is replaced with frivolous relationships. Meeting up is replaced by senseless texting and chatting. Our social and family norms are under serious assault which we as individuals and society have to defend. Covid has made things worse and made us all slave to our gadgets.
I often share these few tips to young parents in order to promote good digital hygiene and primary prevention of behavioral addiction which might help them with their kids. These include –
1. Not to expose children to any screen time before 2 years
2. Eat atleast one meal together as a family
3. Keep a consistent routine for waking up ,sleep etc
4. Parents to be role models and avoid excess gadget use in front of children
5. Limit setting to be done before gadgets are purchased for children regarding time limit of use
6. To use gadgets in family room and avoid behind closed doors
7. To learn how to use parental controls in internet usage
All said and done, internet is here to stay and so are its perils of numerous behavioral addictions. As a mental health professional it opens up new frontiers of knowledge for me and new challenges that I have to accept in order to help persons overcome these addictions.
Prevention is better than cure. Good digital hygiene can nip these addictions in the bud and promote good mental health and familial harmony.
Dr Supriya Hegde Aroor
Professor and hod
Dept of psychiatry
Fmmc
Consultant psychiatrist
Arogya polyclinic
Mangalore
