Screened out: The Spanish teens hooked on technology

They call it non-substance addiction. For Adri¨¢n, a 14-year-old from the southern Spanish city of C¨¢diz, it started in the summer. Almost without realizing it, he began to spend his days holed up in his room, barely eating and refusing to shower. He hardly spoke with his family and spent all his time playing video games on PlayStation. ¡°My routine changed, I stayed up all night and slept for a few hours at noon. When I got hungry I went to the kitchen for more Red Bull ¨C the energy drink ¨C, made a couple of sandwiches and grabbed a bag of chips,¡± he says. When his parents began to worry about the change in behavior, they took the PlayStation console away from him and hid it in the car. Adri¨¢n was furious and desperately clung on to it, says his mother Isabel. ¡°Adri¨¢n was not Adri¨¢n. He had always been affectionate and then he started acting violently,¡± she explains.

In Spain, 21% of young people between the ages of 10 and 25 suffer from behavioral disorders caused by technology, according to survey of 4,000 youths which will be included in the new National Drugs Plan from the Health Ministry. Screen addiction, however, is not considered an illness and it is not included in The Diagnostic and Statistical Manual of Mental Disorders (DSM5), a volume and classification of behavioral disorders compiled by the American Psychiatric Association. Gambling is the only addictive behavior recognized by the association, which primarily relates addiction to substances like alcohol, tobacco, stimulants, marijuana and opiates.

Around 90% of teens between 14 and 16 have between two and five personal digital devices

¡°There is no protocol to act in these cases, the diagnosis of new illnesses always lags behind social changes. You have to know how to differentiate between excessive consumption and addiction, which is when the person loses control and suffers because even though they want to stop, they can¡¯t,¡± explains Celso Arango, vice president of the Spanish Society of Psychiatry (SEP). At the Gregorio Mara?¨®n Hospital, where Arango works, video game addiction is the most common behavioral disorder for adolescents after cannabis.

Adri¨¢n says he felt he had lost control during the two months he was addicted to his PlayStation. His parents decided to seek help shortly after his grades nosedived and he dropped six classes. ¡°He didn¡¯t reason, he would push us and punch the wall,¡± explains Adri¨¢n¡¯s mother. In an effort to address the problem, Adri¨¢n and his parents attended family therapy sessions organized by the Proyecto Hombre Association, a non-profit organization dedicated to the prevention and treatment of drug addiction. In 2013, they launched a program to help young people addicted to technology. The therapy worked.? Adri¨¢n sold his console and used the money to buy a mountain bike, a passion of his that he abandoned for video games.

¡°When we begin treatment, the kids have a large sense of emotional emptiness. They have filled their lives with [video] games, with the recognition from other people of their virtual exploits,¡± explains Pedro Pedrero, a psychiatrist from Proyecto Hombre who has already treated 200 young people, mostly 16-year-old teenage boys. Girls make up 20% of those treated. ¡°Unlike in real life, [in the video game] they feel competent and the failures they may have are not penalized. What can you offer them to make them feel a similar way? Addiction does not have to do with the number of hours, but with the consequences,¡± he says.

Around 90% of young people between 14 and 16 have between two and five personal digital devices, and 86% recognize that they ¡°frequently¡± use their cellphones, according to the study Information and Communications Technology (TIC) and its influence on adolescent socialization, which was published last January by the Help Foundation against Drug Addiction.

Addiction does not have to do with the number of hours, but with the consequences Pedro Pedrero, psychiatrist from Proyecto Hombre

In most cases, the addiction is covering up deeper personal issues and self-esteem problems. ¡°There is a reason why they seek refuge in technology. It¡¯s what we call the iceberg phenomenon: the addiction is what we see, but beneath it there may be family conflicts, bullying, pain over the death of a loved one dear or the stress of changing countries,¡± explains Jos¨¦ Moreno, director of Madrid region¡¯s Center of Technological Addictions, a public program dedicated exclusively to adolescents. Since it opened in April 2018, the pioneering program has already treated 124 youths between the ages of 12 and 16. In the first 11 months, 1,583 people had participated in its prevention programs.

Part of the problem stems from how technology is used by families. ¡°At three years of age, [parents] are giving kids a tablet so that they will eat or to calm them down from a tantrum. This teaches children to regulate their emotions through a device,¡± explains Moreno, who says that communication is the key to preventing addiction. ¡°Parents need to go with their child to therapy, the responsibility does not lie with just one person, everyone has to be open to change,¡± she says. Warning signs of technology addiction include irregular hours, bad sleeping habits and failure to fulfill responsibilities. But it can be difficult for parents to acknowledge their child has a problem, says Moreno.¡°They¡¯re scared, and there is stigma against accepting that their child is an addict.¡±

Warning signs of technology addiction include irregular hours, bad sleeping habits and failure to fulfill responsibilities

What do screens do on a neurological level? ¡°Unlike substance addiction, [technology addiction] does not psychologically scar them for the rest of their lives, it can be overcome more easily,¡± says Domingo Malmierca, the coauthor of three guides on living with technology, published by Madrid region, and a member of the Learning to Look Foundation, which works against abuse in the digital world. According to Moreno, children get excited by technology because it poses different challenges: be it winning a video game battle or making a witty remark in a WhatsApp conversation. ¡°Each success releases dopamine ¨C it¡¯s an immediate satisfaction,¡± says Malmierca.

Adolescents¡¯ brains are ¡°immature¡± and very vulnerable to stimulants which can quickly become addictive, explains Hilario Blasco, a psychiatrist from the Puerta de Hierro Hospital in Madrid. ¡°Adolescents have fewer controls, the frontal lobe ¨C the part of the brain responsible for regulating impulses ¨C is not developed yet. Not everyone becomes hooked, those who have good social skills or play sports are more resistant,¡± he says.

Families need to set an example for their children. ¡°Children repeat what they see, not what their parents tell them to do, which is why one solution is to set schedules and to designate technology-free areas around the house,¡± says Stephen Balkam, founder of the Family Online Safety Institute, a US organization which researches responsible practices in the digital world. ¡°We still don¡¯t know what the long-term consequences are, [but] you don¡¯t have to demonize technology, just apply common sense,¡° he says.

You don¡¯t have to demonize technology, just apply common sense Stephen Balkam, founder of the Family Online Safety Institute

Self-imposed isolation is another red flag for technology addition. Daniel, 13, has gone to class only three times since the school term started. He doesn¡¯t want to leave home or hang out with friends. His home is the couch, in front of the television connected to his Nintendo game consule. ¡°I don¡¯t have anything to hide, my son has a high risk screen addiction,¡± says Daniel¡¯s father ?ngel Guti¨¦rrez, who is going to weekly therapy sessions with his wife and son. Guti¨¦rrez is worried that social services will take Daniel away because he has been absent from school so many days.

¡°He lacks social skills and we are now looking at his self esteem, which appear to be very low,¡± explains Guti¨¦rrez. Daniel¡¯s parents have started to limit how much time he can play video games. Meanwhile, Daniel is meeting teens his own age with similar problems in group therapy sessions. ¡°Technology is the worst thing that has happened to us,¡± says Daniel¡¯s mother, who preferred not to give her name.

¡°Many of the families who come to therapy are very dysfunctional. They don¡¯t know how to express their emotions or say no with respect. Judgment and yelling is a form of violence, and education is fundamental. We teach them other ways to relate to each other,¡± explains Moreno.

WHO recognizes video game addiction as a mental illness

The World Health Organization (WHO) included? video game addiction as a mental illness in their International Classification of Illnesses (ICD-11) last June. The classification had not been updated since 1992. According to the WHO, video game addiction is considered a mental health problem if there is a "significant deterioration" in how a person performs in their personal, family, social and school life.

English version by Asia London Palomba.