Heavy Gaming May Be a Sign of ADHD

Teens who spend more time on digital devices have a higher risk of developing attention deficit hyperactivity disorder. Should you be worried about them?

Is your child especially impulsive or restless, unable to focus on tasks or schoolwork? Lots of screen time — especially playing games — may make the situation worse.  

Teens who spend more time on digital devices are twice as likely as infrequent users to develop attention deficit hyperactivity disorder (ADHD), according to a report in the prestigious Journal of American Medicine.

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The study tracked nearly 2,600 public school teenagers who didn’t show any signs of ADHD at the time they signed up for the research. The researchers asked them how often they used any of 14 different media platforms — from texting to streaming music or movies or posting photos.

The more time teens spent video chatting, the more likely they were to develop ADHD symptoms over the two-year study. Playing games alone on a console, smartphone, or computer was also strongly linked to ADHD.

Adults who spend a great deal of time online, particularly on role-playing games, also seem to have more ADHD symptoms.

Heavy gamers are also more likely to have depression. 

Video chatting or video games don’t cause ADHD or depression, but people at risk may be more attracted to those activities.

In gaming, constant flickering of light and sound effects make it easier to stay focused. Because it rewards short bursts of attention, gaming can be comforting and give some kids their best chance of success. If you have trouble socializing offline, online activities may provide a needed outlet.

The big risk is you’ll give up offline activities. Some gamers develop signs of a behavioral addiction, like gambling. In fact, the World Health Organization includes “gaming disorder” in its list of ailments. The U.S. Diagnostic Statistical Manual on mental health disorders, however, lists online gaming only as worthy of more study.

Gaming may become addictive and aggravate inattention as teens enter their 20s. In a study of more than 5,000 Swiss men, researchers concluded that heavy gamers at age 20 were more likely to show symptoms of ADHD at age 25, compared to other men. If someone had ADHD at 20, they were more likely to be a compulsive gamer five years later.

In another study of some 3,000 children and teens from Singapore, the heaviest gamers become more impulsive and less attentive over time.

In Asia, tales of extreme compulsive gaming grabbed headlines. South Korea cracked down with a midnight curfew for online game-playing for anyone under the age of 16. In studies in Germany and Canada, more than a quarter of teens who gamble with play money at home move on to gambling with actual money, most often using scratch cards.

The classic danger signs of an activity that’s out of control include:

• Spending more and more time, trying and failing to cut back
• Withdrawing from other pleasures
• Feeling euphoric when you play
• Craving
• Neglecting family and friends
• Restlessness
• Lying about gaming
• Feeling guilt, shame, or anxiety about gaming

Physical symptoms like weight gain or loss, backaches, headaches, and strained wrists could show up.

To make the discussion with your child more concrete, you might invite him to consider this these symptoms of gaming addiction.

It’s possible that people with ADHD are self-medicating themselves through gaming, which supplies shots of the pleasure-chemical dopamine. ADHD is less common at higher altitudes, at which people naturally produce more dopamine. Ritalin, the ADHD medication, increases available dopamine levels.

Screen time amounts are rising

When schools closed during the COVID pandemic, students were forced to spend more time online both for education and socializing. There’s evidence that the habit stuck with many kids, who continue to spend more than an extra hour each day in non-school-related screen activities. Teachers and principals say the increase in screen time is linked to bad behavior.

American teen boys spend about nine hours a day entertaining themselves online, and girls about eight, according to one survey. Middle- and lower-income teens, both male and female, spend more than nine hours online, more than an hour of it on gaming.

Heavy gamers spend even more time. In earlier research among teens who said that gaming was their favorite technology use, two and a half hours a day was typical.

Gaming isn’t all bad. It may enhance spatial skills, which are linked to abstract thought. One meta-analysis concluded that playing shooter games improved spatial skills in ways that applied beyond the games. Another study backs up the idea that boosting a child’s spatial skills can improve achievement in math.

There’s no standard rule for how much game time is too much. The important factor is how well your child meets responsibilities, according to psychiatrist Kourosh Dini, MD, author of “Video Game Play and Addiction: A Guide for Parents.”

Just be aware that you probably are underestimating how much time your child spends on games and other online activities. Seeing your kids playing games for long amounts of time may be a clue to seek an evaluation.

If your child is depressed or has ADHD, treating either problem tends to unglue kids from their video games.

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