2020 Parenting

Claudia Ma

When should I worry about screen time? Q&A with Dr. Claudia Ma

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When school is virtual and most peer interaction is happening on Minecraft and Fortnight, how do I know I know when the screen time has gone too far?

A lot of parents who had pretty strict screen time rules before the pandemic have changed their views or fully “given up” by now, but many are feeling guilty no matter how they’ve chosen to handle it. Too much technology is certainly a modern life concern, and it’s complicated. In some ways, technology can be incredibly helpful! When I talk to parents about screen time, I ask them two questions:

1. Do you think your child is addicted to technology?

The same thing that makes some adults prone to more common addictions can cause kids (and adults) to become addicted to “screens,” too. Interestingly, this has very little to do with a specific number of hours. Some kids can show signs of addiction in minutes whereas others could spend countless hours without any concerning signs. For those concerned about addiction, there are some telltale signs. What happens when you turn it off? Does behavior change before and after? Does your child talk incessantly about his/her videogames or shows and can’t put the topic aside? While the current diagnostic manual for mental health disorders (DSM-V) does not have a formal diagnosis for “screen time” addiction; it is currently being considered and it will soon be a diagnosable disorder in the near future. If your child is showing these concerns, there are treatment available in forms of CBT and behavioral therapy. Additionally, there is more research, and there are more resources coming out that will help parents and the kids with understanding “screen time addiction.”

2. What concerns you about your child’s screen time use?

Ask yourself: what is the most upsetting thing to me about my child’s screen time use? Am I most worried about my child losing interest in other activities? Am I worried about my child’s obsessions with video games and computers? Am I worried that they will not have enough physical activity or more diverse interests: e.g., reading, developing other hobbies? Or, am I worried about the impact on my child’s eyesight. Each parent has his or her particular concern. 

If you feel that screen time has simply gotten a bit “out of control,” think about balance. Just like you balance your diet, your family could likely benefit from a more defined screen time balance. And just like different families have varied views on what is considered a balanced diet, screen time balance is subjective as well. Do you want technology in your family to be a main course? A snack? Junk food? In most cases, it’s helpful to think of what your child is missing (what are the metaphorical “veggies” in your house – reading? Physical activity? Homework? Music?) and ensuring that your child gets those “veggies” before jumping into screen time. In other words, assuming addiction is not a problem, most screen time is okay if it isn’t taking away from your child’s other daily “ingredients.”

If you find that in trying to make those changes in your family, you’re getting a surprising amount of struggle or new behavioral challenges — think obsessive talk or meltdowns whenever it’s time to turn it off — you may be moving more toward addiction territory. If struggles don’t seem to be getting easier over time, a psychologist or therapist may be able to help. Just remember — many games are actually designed to create addiction. There is no shame in breaking that bond.

One related note — some people have mentioned that they are allowing endless Minecraft or Fortnite because it is through these games that their children are socializing with other kids. While this is a fun way to connect, these games do not replace face-to-face interaction and are not ideal for socialization. Without seeing facial cues, children are not learning critical social skills, and many adolescents will tell you that this can result in “drama” — from bullying to inappropriate behavior that people would be less likely to act on if they were looking each other in the eye.

What’s normal, and what’s anxiety/depression? Q&A with Dr. Claudia Ma

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What’s normal, and what’s anxiety/depression?
Q&A with Dr. Claudia Ma

This pandemic seems to have triggered some anxiety / depression in my child (and me too!). How much is expected because of the pandemic or lack of interaction with friends, and when should we get professional help?

This is the most common question I’ve been asked lately, and it’s an incredibly important one! I think it is great that parents are paying more attention to mental health during this really trying time. Humans are made to be adaptive and resilient. But what we’ve been experiencing these past several months is not normal – this unprecedented stressor is creating too much stress to our autonomic nervous system, and it’s taking a toll on us all. Even mental health pros are looking for guidance on what to say and how to help. Additionally, this pandemic exposes our limitations and can further exacerbate what we have already been struggling with.

The pandemic has caused a lot of heavy feelings for children, including anxiety and depression. - Photo by Brothers' Photo

As the parent, I would ask yourself this question: did my child have signs and symptoms of mental health concerns prior to the pandemic? Did he/she have difficulties with anxiety, depression, ADHD, or other childhood mental health concerns prior to the pandemic?  If the child is presenting with these signs and symptoms AFTER the pandemic, then we know more that these mental health concerns are due to an exposure to an identifiable stressor (e.g., pandemic).  In this case, we are looking at the child possibly meeting the criteria for an adjustment disorder (with mixed anxiety and depressed mood). This child’s responses must be occurring within 3 months of the onset of the identifiable stressor.  Adjustment disorders could be acute or chronic, but the root cause is identifiable, the duration is usually not that long, and once the identifiable stressor is removed, the child has an easier time bouncing back.  In the case where the child was experiencing noticeable mood and behavior concerns prior to the pandemic, and significant changes have been noted during the pandemic, then the parents should bring the child to get formally evaluated by a psychologist or qualifying mental health professionals.

One thing to note- an individual can fully meet criteria for Major Depressive Disorder or General Anxiety Disorder without needing to meet criteria for Adjustment DO first.  Parents, continue to pay attention to your child! Watch out for significant changes in these areas: sleep quality, interactions/interest with friends, appetite, concentration, irritability, motivation, somatic complaints, thoughts of self-harm, complaints of depressed mood, preoccupation in worries, development of phobias and extreme fears.  Are things getting better or worse? Is your child feeling “stuck” and can’t pull out of a behavior or mood? It’s helpful to understand the big picture of whether things are improving, staying the same, or getting worse. If your child is struggling, working with a psychologist or therapist can certainly help.

In my practice, I see a wide range of parents. Sometimes they themselves are feeling panicked or guilty, or even projecting their own anxiety on their child, even though the child’s behavior is well within the normal range. Other times I see a child whose parents have been in denial about clinical symptoms for longer than is healthy. The key is to realize that (A) it’s very normal for kids to be struggling right now, but (B) there is no harm in chatting with a professional if you want to clarify the extent of your child’s struggle or simply have some “tools” as a parent to help them cope. Just remember — this is new territory, and I have no doubt that by even thinking about these questions, you are on the right track as a parent!

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