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. Sussman says 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…

We NOW have a way for people to host online events during this time. We still strongly believe in the coming together as a group model for showing both movies, so these temporary online events will be here only while the social distancing is in place.

Click here if you are interested in hosting an online screening for your community.

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April 21, 2020

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Here is a video from the Screenagers YouTube Channel that talks more about this subject