Expert advocates early detection of online, gaming addiction in children

It is extremely important to safeguard children’s mental health in the digital age. Recognizing the signs of online and gaming addiction early and providing early assistance as well as a supportive environment are vital for children to become mentally resilient adults, says Dr Tee Bee Chin.

Tee, a consultant child and adolescent psychiatrist, pointed out the impact of social media on the mental health of children and adolescents in Malaysia has gathered significant attention in recent years. The National Health and Morbidity Survey (NHMS) findings in 2022 on students aged 13–17 found one-in-four adolescents reported feeling depressed, one-in-eight had suicidal thought, and one-in-10 had actually attempted suicide. [Available at: https://iku.gov.my/images/nhms-2022/1a_Infografic_AHS_BI_15062023.pdf. Accessed on 21 December 2023]

As young adults increasingly engage with social media, concerns about its impact on mental health have grown, with studies revealing that it can lead to cyberbullying, anxiety, and depression. Tee emphasized the importance of early recognition of online and gaming addiction signs that may signify underlying struggles.

She noted that online and gaming addiction is pervasive, often emerging as a secondary issue rooted in underlying primary challenges such as learning difficulties, social conflicts with peers, and familial disputes. It can manifest through signs such as withdrawal from real-life activities, increased tolerance for screen time, and a preoccupation with online activities. “We use standardized criteria to diagnose addiction, considering factors like the time spent online, its impact on daily life, and unsuccessful attempts to cut down usage,” she said.

The benefits of early recognition and appropriate treatment
Tee highlighted the benefits of early recognition of addiction for child development, emphasizing that timely identification and intervention reduced suicide risks and enhanced coping mechanisms, particularly for those struggling with depression, anxiety, and loneliness during treatment. She also encouraged parents to seek help from healthcare professionals.

“Parents must seek proper treatment and advice from healthcare professionals who understand the unique challenges of online and gaming addiction. Support groups can provide a vital lifeline for adolescents facing life’s challenges when they find solace in environments where adults and friends accept them without wanting to change them,” she said.

She added that specialized support groups by trained child psychologists with proper counselling techniques may be a beneficial addition to treatment for patients who may feel more comfortable among those also experiencing similar issues. Despite being one of the leading causes of mental health issues in adolescents, social media can also promote mental health awareness by educating the public about disorders and providing crisis support options. While it is alright for children to use the internet, it is essential for adults to provide guidance and encourage children to utilize its constructive side to share helpful ideas, indulge in arts and crafts, pursue hobbies, and develop valuable skills, she said.

“A range of treatments and therapies must be tailored to the individual needs and factors like age, availability of supportive networks, existing coping skills, personality traits, and the acceptance of diagnosis or treatment by both the child and their parents,” Tee said.

The range of treatments can include:

●        Counselling for venting stress

●        Cognitive-behavioral therapy to address erratic thinking linked to depressive and anxiety disorders

●        Grief therapy for emotional distress due to loss

●        Trauma work for those coping with childhood trauma or unhealthy escapism through internet addiction

●        Play therapy for young children to express their thoughts and feelings

●        Family therapy to address familial conflicts contributing to emotional distress

●        Medications such as antidepressants and antianxiety drugs for severe symptoms

The adverse impact of online and gaming addiction on children’s mental health
Highlighting the impact of online and gaming addiction among children in Malaysia, especially on their mental health, Tee said online and gaming addiction can have severe consequences. Prolonged usage can lead to anxiety, depression, and other mental health issues, and disrupts a child’s life both physically and mentally.

Tee said research indicated a significant association between increased social media use and symptoms of depressed mood, social anxiety, and physical symptoms of anxiety over time among adolescents, with stronger effects for girls. [Int Rev Psychiatry 2020;32(3):235–253] She has also seen a connection between violent video games and aggressive behavior in children. Games that involve seeking out enemies or completing aggressive quests can cause quick, violent reactions, she added. A study confirmed that adolescents exposed to increased video game violence exhibited higher hostility levels, more frequent arguments with teachers, increased involvement in physical fights, and poorer school performance. [J Adolesc 2004;27(1):5–22]

According to Tee, the underlying causes of mental health issues in young adults include:

●        Cyberbullying: Social media platforms can become breeding grounds for cyberbullying, leading to anxiety, depression, and low self-esteem.

●        Fear of missing out (FOMO): Continuous exposure to seemingly exciting activities of others induces FOMO, causing isolation and anxiety.

●        Addiction and compulsive behavior: The addictive nature of social media can lead to compulsive use and a constant need for validation, resulting in anxiety and depression when attention is not received.

●        Reduced face-to-face interactions: Over-reliance on social media for communication may decrease real-life social interactions, leading to loneliness and social isolation.

●        Information overload: Continuous exposure to distressing news, graphic content, or triggering posts on social media can increase stress levels and negatively affect mental wellbeing.

Patients often experience stigma when seeking mental health treatment, further exacerbating their pain. Tee said she has seen cases where adolescents initially progressing with therapies and medications, experience a relapse because they stopped treatment. While stigma is not a direct cause, it can be a potential problem for adolescents, especially those wanting to get help but are afraid of the stigma, she added.