Duty of care
‘The internet is causing our children physical harm’
A10-year-old so addicted to gaming he had to be treated for a distended bowel and bladder that ballooned out of his pelvis after he stopped going to the toilet. A 13-year-old who gets heart palpitations and dizziness every time he stands up because he is so unaccustomed to moving around. A 14-year-old with a severe vitamin D deficiency because she never sees the sun. Not to mention the scores of children so sleep-deprived after gaming until the small hours that they can’t perform at school because they can barely stay awake in lessons.
This is the reality many families across the country are facing, and we have to do something about it.
I started really noticing what was happening five years ago. Slowly, more young people were brought to see me at my paediatric clinic at University College Hospital in London by worried parents, presenting complex physical issues such as breathlessness, exhaustion or persistent headaches, for which there seemed no immediate explanation.
Examination and questions about their home life and routine revealed that the debilitating constipation one 12-year-old was suffering from had one major cause – the inactivity caused by the amount of time they spent on the internet. It’s why I am in support of the World Health Organisation’s decision to class gaming addiction as a mental health disorder. It is also why I welcome the news that a London hospital will soon open the first Nhs-funded internet addiction centre. Initially, the Central And North West London Nhs Foundation Trust will focus on gaming disorders, but plans to expand to cover other internet-based addictions.
As an adolescent physician in a complex functional disorder service, I see the worst of the worst. Not every child with a smartphone or an Xbox is going to present the extreme symptoms I see coming through my door. But I am in no doubt that there is also a grade of physical damage being done to our children because of the internet, and I would be very keen for more research to help us understand the implications of this compelling issue properly.
As phenomenons in healthcare go, this is an unusual one. Unusual because technology is so fast-moving and unnatural in its progression, that it is incredibly difficult to hypothesise its effects on society. Unusual because the people it affects most (the young) are protected, treated, weaned off this thing that captivates them, by adults who don’t know the extreme social pressures of being in a “streak” on Snapchat or in a Fortnite match.
Because that’s what it is for some children, it’s an addiction. It isn’t just social media that has them hooked (though it is a major culprit), I’ve even seen kids hooked on Wikipedia. You can pick your poison with the internet, you see, but to your brain it’s all the same. You shoot someone on a game, someone likes a picture on Instagram, you get chatting on Facebook, you get into a game with someone on the other side of the world – in every case, small doses of dopamine are released in your brain, and that can quickly hook you in.
It’s the same effect as you might find with an addictive drug. From what I’ve witnessed, the physical symptoms can be as significant, and its burden on the health service is growing. Obesity, type two diabetes, sleep deprivation, behavioural problems (which in extreme cases could be caused by poor brain development) – they are all symptoms of modern life, but when presented in 10-year-olds, whose days should consist of running around and then a good night’s sleep, we need to think again.
A lot of parents do a great job, but as a doctor, I see the kind of pressure that they’re under. They are watching their children becoming more emotionally withdrawn, and less physically well, all because of the phone they were given for their birthday. Of course, some children will be more likely to spend too much time on the internet because of difficulties in their home lives. But for many parents, it can be difficult to know how best to cope with a child so addicted to a game that they become violent when it is taken away. I have known middle-class parents threatened with knives when they’ve tried to get their children offline.
Taking technology away at night is vital, but an addicted child can be pretty devious and make it incredibly hard for well-meaning parents to get it right, despite the best of intentions.
Do they need to go cold turkey? Do you need to be weaned off? Or is that so impossible that you need to find a way to make it a healthy part of your life?
The truth is that the internet is everywhere. We need it, that is how our lives are these days. We also have to hold on to its educational and social benefits. However, we don’t yet have a full picture of what its effects are on this generation, and what we’re seeing on the front line of treatment already is pretty thought provoking.
It would be too simplistic to just take it away – technology is woven through children’s lives – however, we can keep an open dialogue; we can empower them to use it well; to develop healthy relationships with it, like we do with food; we can try to give them enough resilience not to fall into its traps; and we can seek medical and psychological help when it becomes too much.
Parents alone cannot stop this phenomenon. As doctors, we have to treat the physical and emotional symptoms of what has become a major health concern, and like any other issue, Government, and the firms that manufacture this technology, must take some responsibility.
We have the FDA to check food quality, but right now the internet has no real mechanism for managing its effect on our health, even though the symptoms are there to see. The WHO says the decision to make gaming addiction a disorder is based on the fact that an addiction by definition is a pattern of persistent behaviour so severe it “takes precedence over other life interests”. This is what a small, but significant, number of our children are suffering from.
In many ways, the internet is like food. You can’t say we don’t need it, because we do. It has essential bits, and it has extremely bad bits. We understand how addictive sugar is, and the Government is taking steps to mitigate against that. Without a proper regulator, people are allowed to put as much sugar into the internet as possible. At some point, somebody needs to start taking the sugar out of the internet. Our children’s health may be at stake.
As told to Eleanor Steafel
‘I’ve known of middleclass parents threatened with knives when they try to get their children offline’