ELECTRONIC SCREEN SYNDROME

CHAPTER 1

ELECTRONIC SCREEN SYNDROME

An Unrecognized Disorder

In diagnosis, think of the easy first. -- Martin H. Fischer

Consider the following questions: ? Doesyourchildseemrevvedupalotofthetime? ? Doesyourchildhavemeltdownsoverminorfrustrations? ? Doesyourchildhavefull-blownrages? ? Hasyourchildbecomeincreasinglyoppositional,defiant,ordisor-

ganized? ? Doesyourchildbecomeirritablewhentoldit'stimetostopplaying

video games or to get off the computer? ? Doyouevernoticeyourchild'spupilsaredilatedafterusingelec-

tronics? ? Doesyourchildhaveahardtimemakingeyecontactafterscreen-

time or in general? ? Wouldyoudescribeyourchildasbeingattractedtoscreens"likea

moth to a flame"? ? Doyoueverfeelyourchildisnotashappyasheorsheshouldbe,or

that your child is not enjoying activities like he or she used to?

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14 | RESET YOUR CHILD'S BRAIN

? Doesyourchildhavetroublemakingorkeepingfriendsbecauseof immature behavior?

? Doyouworryyourchild'sinterestshavenarrowedrecently,orthat these interests mostly revolve around screens? Do you feel his or her thirst for knowledge and natural curiosity has been dampened?

? Areyourchild'sgradesfalling,orisheorshenotperformingacademically up to his or her potential -- and no one is certain why?

? Have teachers, pediatricians, or therapists suggested your child might have bipolar disorder, depression, ADHD, an anxiety disorder, or even psychosis, and there 's no family history of the disorder?

? Havemultiplepractitionersgivenyourchilddifferingorconflicting diagnoses? Have you been told your child needs medication, but this doesn't feel right to you?

? Doesyourchildhaveapreexistingcondition,likeautismorADHD, whose symptoms seem to be getting worse?

? Doesyourchildseem"wiredandtired,"likethey'reexhaustedbut can't sleep, or they sleep but don't feel rested?

? Doesyourchildseemlazyorunmotivatedandhavepoorattention to detail?

? Wouldyoudescribeyourchildasbeingstressed,despitefeworno stressors you can clearly point to?

? Is your child receiving services in school that don't seem to be helping?

If these questions strike a familiar chord, like many other parents you may be confronted with difficulties all too common in today's electronically saturated world. These days, parenting a child who is struggling with behavior, mood, or cognitive issues is fraught with confusion and frustration: What's causing the problem? Where do we focus our resources? Does my child need formal testing? Should we get a second opinion, and from whom -- a neurologist? A psychiatrist? A psychologist or educational specialist? And so on. Many parents feel lost; they are unsure of what's going on and often receive conflicting advice, leading them to feel pulled in different directions. They seek multiple opinions, scour the Internet for information, ask other parents what's worked for them, and agonize over whether to try medication. Parents often report that the process winds up feeling like they're simply going in circles. This paralysis of analysis is costly -- in terms of time, money, resources, and a child's self-esteem.

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You might notice that the quiz questions above cover a wide variety of dysfunction, but they all represent scenarios -- related to symptoms, functioning, or treatment effectiveness -- that can occur when a child starts operating from a more primitive part of the brain. During this state, two things tend to happen: 1) symptoms and functioning worsen, and 2) interventions don't work very well. Thus, the goal is to find out what's causing this state. Regardless of what your child's particular issues are, if they're not being managed adequately, it's safe to assume that something is being missed. Wouldn't it be nice if that something could be the same thing for each and all of these issues? If addressing one thing improved functioning across the board, whether your child carried multiple diagnoses or none at all?

To see how this might be possible, consider the following three cases: Diagnosed with autism, six-year-old Michael was receiving in-home behavioral services. When he suddenly developed severe obsessive-compulsive symptoms, his treatment team called me for a consult. Upon learning he was earning video game time daily as a reward, I convinced the family and treatment team to try the Reset Program before initiating any medication. Four weeks later his obsessive-compulsive symptoms had diminished substantially, and as an added bonus he made better eye contact and displayed a brighter mood. Calla was a high school junior who struggled with severe mood swings and insomnia. Calla's treatment providers suspected she was bipolar, and her defiant attitude and dramatic displays of emotion had recently landed her in a class reserved for kids with emotional problems, which only made things worse. Frustrated after a particular medication trial caused a rapid weight gain, Calla and her mother wound up in my office. After much discussion, they agreed to try the electronic fast as part of an overall treatment plan. Six weeks later, the sweet girl underneath all that turmoil resurfaced. Within six months, Calla was sleeping soundly, following the rules at home and school, and had lost ten pounds. By the end of the school year, she was back in mainstream classes. Eight-year-old Sam was a typical kid with no formal diagnosis who had always enjoyed learning. But in third grade, Sam's math and reading achievement scores dropped inexplicably, and he began to dread going to school. He was nearly constantly in trouble for being disruptive, and both his teacher and the school psychologist suggested to his mother that Sam might have ADHD. Yet within two months of completing the Reset Program, Sam was turning in

16 | RESET YOUR CHILD'S BRAIN

more assignments, getting glowing reports from his teacher about his "attitude change," and making steady progress in math and reading.

Though their individual presentations varied, each child was essentially in a state of dysregulation -- that is, they lacked the ability to modulate mood, attention, and/or level of arousal in a manner appropriate to the given environment or stimulus. Something was irritating these kids' nervous systems, making it difficult to handle everyday life. All three kids felt miserable and out of control, their families felt taken hostage by whatever had taken hold of their child, and their support teams struggled to identify what was being missed. Yet all three children responded to the same simple intervention. The fact that each child's nervous system renormalized with an electronic fast suggests that screen-time played a role in the development of each child's decline.

The Dawn of a New Disorder

Like many other aspects of our fast-paced but often sedentary lifestyle, screen-time is introducing new variables into the health equation. Screentime affects our brains and bodies at multiple levels, manifesting in various mental health symptoms related to mood, anxiety, cognition, and behavior. Because the effects of screen-time are complicated and diverse, I've found it helpful to conceptualize the constellation of common phenomena as a syndrome -- what I call Electronic Screen Syndrome (ESS). Importantly, ESS can occur in the absence of a psychiatric disorder and yet mimic one, or it can occur in the face of an underlying disorder and exacerbate it.

ESS is essentially a disorder of dysregulation. Because it's so stimulating, interactive screen-time shifts the nervous system into fight-or-flight mode, which leads to dysregulation and disorganization of various biological systems. Sometimes this stress response is immediate and obvious, such as while playing a video game. At other times the stress response is more subtle, taking place gradually from repetitive screen interaction, such as frequent texting or social media use. Or it may be delayed, brewing under the surface but managed well enough, then erupting once years of screen-time have accumulated. Regardless, over time, repeated fight-or-flight and overstimulation of the nervous system from electronics will often eventually culminate in a dysregulated child. The sidebar "Characteristics of Electronic Screen Syndrome in Children" (page 17) provides a good idea of what ESS looks like.

One way to think about the syndrome is to view electronics as a stimulant

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(in essence, not unlike caffeine, amphetamines, or cocaine): electronic screen device use puts the body into a state of high arousal and hyperfocus, followed by a "crash." This overstimulation of the nervous system is capable of causing a variety of chemical, hormonal, and sleep disturbances in the same way other stimulants can. And just as drug use can affect a user long after all traces of the drug are out of the body, electronic media use can affect the central nervous system long after the offending device is actually used. Furthermore, also like drug use, functioning may not be impaired immediately, and in some cases it may even improve initially, but then become worse. In fact, abuse and addiction of stimulant drugs such as cocaine and methamphetamine have a very similar presentation to that of ESS, including mood swings, concentration problems, and restricted interests outside of the substance or activity of choice.

Characteristics of Electronic Screen Syndrome in Children

1. The child exhibits symptoms related to mood, anxiety, cognition, behavior, or social interaction due to hyperarousal (an overly aroused nervous system) that cause significant dysfunction in school, at home, or with peers. Typical signs and symptoms mimic chronic stress or sleep deprivation and can include irritable, depressed, or rapidly changing moods, excessive or age-inappropriate tantrums, low frustration tolerance, poor self-regulation, disorganized behavior, oppositional-defiant behaviors, poor sportsmanship, social immaturity, poor eye contact, insomnia/non-restorative sleep, learning difficulties, and poor short-term memory. Tics, stuttering, hallucinations, and subtle or overt seizure activity may also occur. Irritability and poor executive functioning* occur in most cases and are hallmarks of the disorder.

* Executive functions include reasoning, judgment, task completion, planning, problem solving, and critical thinking; they take place primarily in the brain's frontal lobe.

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