When John was admitted to treatment, he was 18 years old and was neither in school nor working. John was bullied from age 14 to 17 years, which led him to quit school. He lived at home, did not interact with others and developed symptoms of depression and social phobia: he did not interact with people other than his family and had a fear of going out alone, felt a lack of pleasure in doing things, was extremely tired and had low self-esteem.
These symptoms were not noticed by his family, which could be characterised as disorganised with little authority and minimising conflicts. During the first months of being at home, John played various games such as Legend Online, League of Legends, Aion, and Call of Duty for 12 hours a day. He would become irritated when he could not play, when he was prevented from playing by a family member or when the Internet connection was lost. He gave up his hobbies, he no longer wrote amateur stories nor read novels. At one point he stopped interacting with his friends, preferring to interact with people online.
When the treatment started, Steven was 16 years old. He was diagnosed with ADHD with oppositional and defiant behaviours at the age of 8. He suffered several traumatic events and periods during childhood. Firstly, because of his hyperactivity, he was isolated at school and excluded by his peers. Secondly, his parents had several businesses that financially collapsed, and they lost their family home because of the debt incurred.
After his uncle died, Steven took refuge in video games and he played them 8 hours per day, namely World of Warcraft, League of Legends and Call of Duty. His school performance worsened, and he started arguing with his parents because of his video game playing. He became very irritable when his parents would interrupt him while playing. He insulted other family members and shouted at them. A year passed, and his isolation increased, he stopped going out with friends, and he stopped playing sports. He asked for help himself, and he was (partially) aware of his problems. He said he lost control over his temper and his video game playing.
Problematic use of the Internet is often not the only psychological issue the persons with it experience. What we also notice in the presented scenarios is that problematic use of the Internet can be used as a mechanism of coping with difficult life circumstances/ other conditions. Similarly, it can be a way to deal with unmet basic psychological needs in real life (autonomy, relatedness and competence).
It is often hard to speculate what might be the primary issue. In Scenarios 1 and 2 it seems that persons have other primary issues (depression, anxiety and so on) and problematic gaming is a “by-product”. For example, John’s parents and teachers should have sought professional help for his issues regarding bullying and subsequent depression and social withdrawal even without the gaming. It is important to recognise these issues and changes in children’s behaviour, even if sometimes it is hard to notice. Both John and Steven needed the help from a mental health professional and they needed this help even before they started to play video games excessively.
Jane purchased a better computer when she was 16 and this allowed her to play online video games for the first time. She started to play League of Legends, she watched the streamers and wanted to become as good as them and perhaps earn money from playing professionally. However, according to her words, her competitive “drive” was too strong, combined with the fact that she could not control her gaming well and was drawn in too much by the rewards, victories and experiencing them with her teammates. She would come home from school, do a bit of homework, and play for the rest of the day. She would play for entire days during weekends as well. While playing, she would not pay attention to eating and would consume a lot of sugary drinks and “junk” food.
This additionally worsened when the COVID-19 imposed lockdowns started. She soon played so much that her grades worsened and she started to cancel appointments with friends so that she would not interrupt her play. A few things prompted her to change her behaviour.
Firstly, Jane was shocked as during a regular medical check-up she noticed that he gained an additional ten kilos. This was especially bad since she wanted to have a career in the army, and this would not be possible with the added weight. Secondly, she noticed she must improve his grades and her older siblings advised her constantly to reduce her gaming. She eventually managed to significantly reduce her gaming time, and today she still plays video games, but very casually. She stopped eating “junk” food and she trains regularly, hangs out with her friends, and is focused on her future career.
Liam was playing video games since he was a small child. He was always a passionate gamer, but he also had enough time for school, socialization, and other activities. However, because of his father’s new job, he moved from a small village to a big city in another country at the age of 12. Soon enough, he started to have a hard time adapting to the life in a big city and in a new culture. He could not find a group of friends to hang out with, he was lonely and withdrew himself into the virtual world, playing much more than before, mainly the game Football Manager.
This went on for some time, but, thankfully, his mother noticed it once his grades started to worsen. She banned him from playing until his grades improved. He was motivated and managed to improve his grades and, more importantly, he started to train football and found friends there. Today he still spends significant amounts of time playing video games and he socialises with friends he met online, but he also socialises with friends in real life, plays sports and he is doing good in school. Additionally, he manages a sports page on Instagram, and he is very proud of that.
Conversely to Scenarios 1 & 2, in Scenarios 3 and 4, Jane and Liam manage to successfully correct their excessive gaming patterns on their own and with the help of their family.
This shows that not every time professional help is needed and that it is often enough for parents/family/teachers/school (here, by realising the worsening of the grades) to show interest for their child and react if they sense that there is a change in their behaviour or if their child tells them that something is not right.
However, seeking professional help is never wrong since it is not always possible for children and adolescents to change the unhealthy patterns of interaction with the digital technology on their own and sometimes other previously not noticed mental health issues and other problems might be “lurking” in the background.
Alice started using Instagram when she was 12. Her family was travelling a lot, and she was the “chief-photographer”. She enjoyed taking photos of everything around her, and it seemed that she really had an eye for the camera. Soon she discovered various tools for editing photos. Both her parents were proud of her photos and started to share them on social networks. As she was entering teenage years, she discovered Instagram herself. At the beginning she mostly shared photos of landscapes and animals. However soon she discovered that no matter how beautiful the photo of nature was, she always got more likes when she posted selfies. She became an expert in taking and arranging selfies, and the number of people who followed her grew rapidly. She quickly realised that what would be stereotypically considered as “provocative” would receive more “likes” and she replied to every comment to get more visibility. Soon enough she would receive DM’s (direct messages) from other children and even adults, and while most of them were harmless compliments, some of the messages were very disturbing. Alice started to feel very bad about all this.
At first, she was ashamed to talk about this to anybody, but her teacher noticed that something was wrong with her and asked her about it. She was a bit reluctant, but eventually she did tell them, when they promised they would not judge her. Together with her, the teacher had an open discussion about the safe use of Instagram and about social media and the representation of the female body in general. They discussed and explained to her why this is happening (the disturbing DM’s), the way that social media functions and the consequences of our new era that is much based on creating images are issues that she can figure out and choose how to deal with as she grows up and there is no reason to rush. Also, her teacher made clear to her that harassment in any level, online, in real life, is never acceptable and that if she ever again feels the need to discuss anything, they will be the safe place for her to share such concerns and to find the safest solutions.
Sonya was a regular user of Youtube, TikTok and Instagram, where she would follow influencers, look at funny videos, post pictures and interact with friends. She enjoyed these social networks, and although her parents were sometimes concerned that she spent a bit too much time on them, this was not really the case since she was doing good at school, had friends and was generally a well-functioning and a happy child.
However, at the age of 15, she began to feel dissatisfied with her looks, thinking that she is “too fat”. She compared herself with the Instagram models who all looked picture perfect and she felt bad thinking that she will never look like them. Additionally, she got into a bad fight and stopped communicating with her best friend, with whom she was hanging out since kindergarten and they were really close. Soon enough she took refuge in the TikTok and Youtube videos, and she watched them more than usually to somehow feel better, but this did not work. She still looked at the pictures of those Instagram models and this made her feel even worse.
She began to feel despondent and started losing the motivation for school and her grades became worse.
Luckily, her teacher noticed that something was not right. She talked to Sonya after the class and Sonya did admit that she was feeling really bad lately. The teacher talked to the school psychologist about Sonya, and the psychologist arranged a meeting with her. After multiple meetings, Sonya began to feel better. She started to learn how to embrace her looks and not pay too much attention to the Instagram reality, and how to cope effectively with life’s challenges without overusing the social networks.
In Scenario 5 we see this: the teacher noticed that something was wrong with Alice and this prompted their discussion about the safe use of Instagram. In her case she neither had other issues in life nor did she overuse Instagram but she encountered problems related to cyberbullying. It was very important that her teacher did not judge her nor terrified her for the dangers of Instagram and social media.
Here are two pages that provide short and to-the-point information about the safe use of social media:
In Scenario 6, the teacher was good to notice that something was wrong with Sonya and referred her to the school psychologist who started helping her with her problems that she would have otherwise hardly resolved on her own or even with the help of her parents. Sonya had body image concerns and the social media in this case amplified them. She soon developed a non-adaptive pattern of using social media to cope with body image concerns and other problems in a life of an adolescent (e.g., broken friendships). The school psychologist helped her to address the body image concerns and to regain a healthy relationship with social media.