Children and Screens cordially invites you, your friends and your network to join our series of three virtual workshops for parents featuring leading interdisciplinary experts on the topic of “Children and Screens During COVID-19” via Zoom. Parents can register through our website www.childrenandscreens.com. Hear from the country’s leading pediatricians, child psychiatrists, child psychologists, neuroscientists, educators, and parenting experts to learn:

The “Ask the Experts” series will focus on different developmental age groups, beginning with young children on April 28th at 12:00-1:30 EDT, moderated by Dimitri Christakis, pediatrician and editor in chief of the leading medical/science journal JAMA Pediatrics. Other panelists include: 

• John S. Hutton, Attending Pediatrician, Director of the Reading & Literacy Discovery Center at Cincinnati Children’s Hospital
• Brandon T. McDaniel, Research Scientist at Parkview Mirro Center for Research & Innovation
• Ellen Wartella, Professor of Communication Studies, Psychology, Human Development and Social Policy; and Medical Social Sciences at Northwestern University
• RSVP here

The second workshop for school-aged children (K-8) will take place on May 6th at 12:00-1:30 EDT, moderated by pediatrician Colleen Kraft, the immediate past president of the American Academy of Pediatrics. Experts include:

• Elizabeth Englander, Director of the Massachusetts Aggression Reduction Center at Bridgewater State University
• Catherine Steiner-Adair, Clinical Psychologist and Consultant, Author, and Speaker
• Moriah Thomason, Associate Professor of Child and Adolescent Psychiatry and  Associate Professor in the Department of Population Health at NYU Langone Health
• RSVP here

The final workshop on Adolescence is scheduled for May 12 from 12:00-1:30 EDT, moderated by child and adolescent psychiatrist Paul Weigle, chairman of the media committee of the American Academy of Child and Adolescent Psychiatrists. Speakers include:

• Tracy Asamoah, Child and Adolescent Psychiatrist 
• Jean Twenge, Professor of Psychology at San Diego State University and author of iGen
• Nicholas Kardaras, Author “Glow Kids”, Director of The National Institute for Digital Health & Wellness (NIDHW); Founder/CEO: Maui Recovery in Hawaii and Omega Recovery in Austin. 
• RSVP here

While we all learn to cope with living a digital life during this pandemic it brings up questions about the effects all the screen time will have on us and our futures. Screenagers explores the this in the article below:

Understandably most young people are on screens a ton right now. Thank goodness there are all sorts of great things made possible via screen time. 

But, what are the potential costs of loads of certain screen time activities on their brain health and mood? Are there ways to do changes in tech time that might help them feel better — even while keeping the same total amount of screen time?

Clifford Sussman, MD, is a psychiatrist for children and adolescents in Washington, DC, and he is well known for his work in treating those with problematic internet and video game use. He and I have presented together at the American Academy of Child and Adolescent Psychiatry Conference and have shared ideas over the years.  

Sussman and I were talking last week and I realized now would be a good time to share with you the brain model and action steps that he often teaches his clients. No matter if you put his suggestions into practice, this is a great science topic to discuss with youth in your life. 

Sussman talks about “digital binging” — many hours on end, without any real breaks doing things such as video games, social media, youtube, shows, etc.  This leads to what he calls the “residual effect” on the brain with prolonged use of such activities. 

The residual effect of the brain is caused by changes in the physiology of the brain. 

The brain has a reward center called the Nucleus Accumbens, where dopamine is the chemical released by one neuron to signal the adjacent neuron.  We can call the first neuron “Neuron A” and the second one, “Neuron B.” Neuron A will secrete dopamine in the small space between itself and Neuron B. Neuron B has specific receptors for dopamine. When dopamine attaches to the receptors, it causes feelings of pleasure and reward. Dopamine is what causes chocolate to taste good, etc. 

In instant gratification activities, such as social media, TV shows, and video games, dopamine is secreted non-stop. With ongoing dopamine release, the receiving neuron will eventually decrease its number of receptors for dopamine. This is because the body is always working to stay in homeostasis (balance).

If your brain gets bombarded continuously by dopamine, you start to develop a tolerance to it — meaning the intensity of good feelings decreases. The dopamine receptors have lessened, so even though there is dopamine present, the receiving neuron doesn’t fire off much of a signal because the receptors to the dopamine are less. 

Sussman says that this can lead to a higher sense of boredom. Boredom is not a pleasant state.

When the person stops doing social media or playing video games after several hours, they may feel cranky or just not very happy. They may think it is only because they want to be on screens more, but part of these lower feelings can be due to having fewer dopamine receptors.

Non-screen activities may just not be that appealing because the receptors are less (downgraded) so things, like reading a book or being with family, might not be as enjoyable as could be. 

The person may not be consciously aware of any lower feelings from normal daily activities, but they are experiencing this state. 

Solutions Dr. Sussman Suggests:

Know this key point

With time off of screens the dopamine receptors start to regenerate themselves. This is why Sussman does a lot of work with his clients to get them to take many breaks between engaging screen time activities to let the brain receptors get back to equilibrium. 

Change the conversation

Rather than parents talking about activities as “work vs. play,” consider talking about activities as high dopamine and low dopamine activities. High dopamine activities are ones where there is a constant, high flow of dopamine, such as video games, web surfing, and watching shows. Low dopamine activities are ones with delayed gratification — they can be enjoyable, or can lead to a sense of well being by eventually achieving things like completing a homework assignment. Some examples include exercising or playing board games, which are still fun but have a slower pace. Another good example is baking, which is enjoyable, and then there is a short high from the reward of eating the baked good. 

Alternate high and low dopamine activities

Dr. Sussmansays that the issue is not so much the total number of hours of high dopamine activities on screens, but instead, there need to be many breaks from those high dopamine activities so that dopamine receptors can return to more normal levels.

He suggests that for teens, only about one hour at a time of a high dopamine screen activity be done before taking a break. And for younger kids, it should be more like 30 minutes. And then whatever the time spent on a high dopamine activity should be followed by that same amount of time for low dopamine activity (on or off-screens — but ideally many times off screens). So if a teen girl played an hour of Fortnite, she would do a low dopamine activity for an hour before going back to do high dopamine screen activities. If a teen spends two hours on social media, they should then be off of high dopamine screen activities for two hours. 

More concrete suggestions from Sussman:

1. Make a list of high and low dopamine activities with the family.
2. Don’t abandon some routines now with COVID-19, such as having a certain time at night when screens are put away. He told me how this will help facilitate a “commuter instinct.” This is the instinct where the brain adapts to repeated habits. For example, if a person takes the bus home each afternoon and has a habit of falling asleep on the bus, they find that they naturally wake up a stop before their stop. Brains get in sync with our routines.
3. Work with kids to plan in advance how they will get off their screens when the allotted time is up. For example, if a kid enjoys playing Fortnite and they know one game takes at least 40 minutes, and they have an hour of allotted screen time, then they should be self aware that they should not start a second game. Instead they can do something else during the remaining 20 minutes of their high dopamine screen time.

Ideas for conversation starters:

1. What do you think about the concept of high and low dopamine activities?
2. Do you think taking more breaks between screen time fun activities could improve your mood?
3. Do you recall a time you binged on screen time and felt particularly low afterwards? Maybe sad, or angry or perhaps you had a headache?
4. You can visit Dr. Sussman’s website as a family and watch some videos he created that show animations of the science. 
5. I think it can be interesting to talk about how one feels during the day doing certain screen time activities vs. at night. Personally at some point in my early 20s, I realized that I could not watch TV or movies during the day, unless I was home sick, because afterwards I would just unexplainably feel blue. It was not from binging. I still have that to this day. I don’t see how Sussman’s ideas would explain this, but it has me wondering.

If you have a loved one struggling with the effects of screen time, please contact Tamara Ancona, MA, LPC at (678) 297-0708 for an evaluation, and to discuss the best treatment options available.

As adults we frequently discuss the things we’re stressed about. But what about our kids? Particularly teens and tweens? Screenagers tackles how to talk to this age group about their stress and ways to help them cope.

Teens and tweens often tell me how they talk with each other about their stress levels.

The other day I passed out an anonymous survey for reactions from teens to Screenagers NEXT CHAPTER, and one high schooler wrote: “It was really helpful to hear someone other than teens talk about teen stress.”

When people get asked to rank their level of perceived stress, teens on average report higher levels than adults. There are many reasons teens report stress, including academic-related stress and stress from relationships with peers and family. There is also the stress of trying to feel “good enough,” or trying to belong to a peer group, just to name a few.

Screen time and stress can be intertwined.  

Youth tell me many positive ways screen time helps them to cope with stress, such as contacting a good friend to get advice, or using it to make a song. Both of these uses help them relax and feel more competent. Many talk about YouTubers they turn to for insights on “How to cope on a bad day?” or “How to approach a friend who is ignoring them?” Others tell me that they achieve instant stress reduction from watching funny YouTube videos. 

On the flip side, there are many ways screen time can promote feelings of stress. 

One of the big ones is managing social media – both the relationship issues that emerge and the sheer volume of things that demand their attention. I interviewed a 15 year-old girl in Screenagers NEXT CHAPTER who talked about the stress she feels from social media and all the “Snaps” (i.e., messages) she gets.

“I’ll send Streaks. At eight o’clock I’ll put my phone down, I’ll go eat breakfast. I’d come back, and I’ll have like 17 different Snaps from people. I have to make sure I’m not ignoring them. And they know I’m not ignoring them. It’s just a lot.”

While adults talk a lot about their fear that cyberbullying is a significant issue on social media platforms, far more often tw/teens tell me other ways that screen time leads them to feel stress. Here are a few of the many other examples they give: 

• Seeing others out without them on a Snapchat story
• Seeing the guy they like in photos with his new girlfriend
• Seeing one image after another of the popular girls looking their best
• Having someone open their Snapchat, so they know their message has been seen but then they don’t respond
• Not being invited to be in a group video game or an ongoing chat group

• Having someone not respond to a text message
• Having someone post something snarky about a post they made
• Having a guy repeatedly ask them for a photo, or meet them somewhere
• Having a friend going through a hard time and they keep texting, and they feel bad saying they have to go to bed
• Arguing with family about screen time

So often, youth tell me that immediately turning to a screen for escape is their go-to when they are feeling stressed. One 12-year-old boy said, “When I’m feeling stressed, I go on my phone, Snapchat, YouTube.”

Teens are fully aware of how using screen time to cope with stress can help in the short run but often only makes things worse. For example, when they feel stress if they have to write a paper – how easy it is to escape the feeling by watching YouTube videos, only to feel greater stress as the night gets later. They have not done work on the paper and then it just spirals, with less sleep and so forth. 

Things parents can do to help youth develop skills for stress:

1. Help them stop and define “stress”
   We all know that “stress” is the word of the day. It gets thrown around all the time. It can be helpful to do the following when your child (or yourself) says they are feeling stressed. 
   Stop and ask:
   “Hey, I just said stress, or hey, you just said stress, what emotion is it really?”
   See what the person who said “stressed” comes up with. Maybe it is actually tired, or overscheduled, or angry about something, or perhaps even sad?
   Just doing this one step, like identifying the core emotion, gives us the ability to address it with more skill and forethought.
2. Help them identify Challenge Stress vs. Overwhelming Stress
   How we help them to see stress in new, more helpful ways. Some degree of stress is healthy and desirable – this is often called challenge stress. But feeling overwhelmed by stressful feelings is not desirable.
   Talking about “challenge stress” vs. “overwhelming stress” is key.
   You might start by asking, “What is happening in your life that is challenging?” And then say, “There is some good stress. For example, a cross country runner might be feeling stressed about a meet on Saturday, and that keeps her making sure to practice all week. And frankly, she is excited about Saturday’s race. So the stress is a good thing – motivating her to work hard, to step into a risky situation.”
   Overwhelming stress might look like this example, a student is in three clubs, two that meet on different days before school, one after. They have several challenging classes. Meanwhile, peer issues are happening. So now they find themselves having a hard time falling asleep.
   Once they have identified what type of stress they have, challenge vs. overwhelming, then problem-solving is warranted.
3. Let teens lead when it comes to problem-solving
   When it is overwhelming stress, ask them if they have any ideas to solve the problem. When we jump in and solve, science shows that for teens, this often can increase their level of stress. This is what I did so often with my teens, but I learned much more effective communication techniques along the way. I have learned to say these two things that have made all the difference:
   “Do you have any ideas for facing this stressful situation?”
   “I am here to brainstorm solutions whenever you want me to — just let me know.”
   If they do want your insights, still let them lead, and perhaps they will come up with answers themselves. For example, the situation above about the teen with the overwhelming stress, some solutions may include getting help in how to address the peer conflict, taking a break from one of the morning clubs, or seeing if they can swap one of the classes for one that is more enjoyable. 
4. Show them the ways you handle your stress
   Parents have told me how surprised they were when they stopped to think about it – that they realized they rarely share their coping strategies for stress with their kids.
   My teens know that exercise is my number one stress reliever. I am not an Iron Woman athlete, but I rely on my daily dose of movement of some kind. It makes all the difference in the world for my stress levels.
   Another example is that they know that other than for texts, I have no notifications that come to me on my phone. They know that I don’t bring screens into my bedroom when going to sleep because sleep is so important to me.
5. Ensure they have “stopping points”
   Gone are the days of “natural stopping points” because videos, online games, social platforms are all specifically designed to be an endless chain of events. That means as families, we need to create the stopping points. 
   If a 13-year-old knows that screens get put away at 9 pm, they have to learn to not keep postponing work. Having times when they need to be off social media and video games ensures they have time to recharge – such as playing with a younger sibling or helping chop vegetables at dinner time. 
6. Teach them about Growth Mindset of Personality
   Studies have shown that teens do better with stress when they learn about how personalities are not fixed but change over time. Researchers measure their stress response during social situations after getting lessons on a growth mindset, and their stress hormones are lower than teens who did not get the lessons.

If you have a loved one struggling with stress, please contact Tamara Ancona, MA, LPC at (678) 297-0708 for an evaluation, and to discuss the best treatment options available.