6 Signs of Internet Gaming or Gambling Addiction

i'd like to welcome everybody to  today's presentation on internet and gaming addiction and we're also going  to touch a little bit on gambling addiction specifically as it relates to  online gambling and day trading we're going to define internet and gaming  addiction explore the metamorphosis of internet use and video games into  addictive behaviors and discuss day trading and some of the online gambling and  how that may lead to gambling issues as well the internet provides an immense amount

of  information although not all of it is credible the constant novelty of the internet  can serve as an escape for people and that's not necessarily you know if they  are gambling or if they are gaming some people log on to facebook or log on to twitter and before  they know it four or five hours have passed i've worked with more clients than i would would care  to recount who have lamented that social media is a problem in their relationships because  their significant other spends too much ti

me on it they their significant other gets home in the  evening pretty much just plops down on the sofa gets on facebook and you know that's all she wrote  so it is important to recognize that internet um addiction and and there's you know  that it's not really actually a diagnosis but compulsive internet use or problematic  internet use is related to a lot of different behaviors and we really want to look at  the characteristics of the behavior is it causing the person to forego important activ

ities  that they used to enjoy is it causing the person problems in one or more areas of their life is  it taking more time are they spending more time engaging in that behavior thinking about that  behavior or recovering from that behavior than they anticipated have they been unable to  quit if they've tried now the caveat here is if they've tried not everybody who is developing a  problem with certain behaviors recognizes it yet as a problem so we do want to to recognize  that there are going

to be some people that are in denial but those are the things that  we really look for to decide whether a person has crossed the line so to speak from recreational  use to compulsive or problematic use video games online gambling online shopping and pornography  all have the potential to become problematic as does in some cases social media social media also  has an addictive quality that can cause withdrawal and exacerbate mood disorders and or addictions  i've done several videos on social me

dia and how it can be helpful you know if people are  plugged into supportive groups but it can also be contribute to depression and anxiety because  people go on and they see all of their friends posting all these wonderful things and it seems  like everybody else has a perfect life well you know most people are not going to  post pictures of themselves from the worst day of their life so it's important to help  people get perspective that they are seeing a very um cherry-picked selection of  e

xperiences from a person's life um so it is important to recognize that social  media can be helpful and people can find a lot of support there but it also can be very toxic  and very harmful to relationships it's all about how it's used and the extent to which it's used  going back again to what we were talking about with the criteria for addictive  or problematic behaviors if it starts causing problems in one or more  areas of their life and they continue to do it anyway then we are probably t

alking  about some level of compulsive behavior what do we see when we are  interacting with someone who may have problematic internet use they often  downplay and are defensive about how much time they spend playing games on the  computer or spending time on the computer they often have a sense of a lack of  control they spend more time uh on in the games or in the virtual reality um in  order to get the same enjoyment or they just get lost in it and completely you know forego  other aspects of

life they may withdraw from friends family or their significant others to  the point of disrupting those relationships they may experience feelings of anger depression  moodiness anxiety or restlessness when they are not engaging in that behavior whether it's gaming  or any of those other escape related internet behaviors they often find they're spending  significant sums of money for online services computer upgrades or gaming systems now this isn't  so much true when we're talking about socia

l media but when we're talking about gaming or we're  talking about online gambling or day trading people can spend a crap ton of money really  quickly and then there's preoccupation the person thinks obsessively about being on the computer  and engaging in that behavior they have a sense of incompleteness when they are not engaging  in it they feel very anxious very restless and in the case of gambling or um multiplayer  computer games they may even have a sense of fomo uh fear of missing out f

omo so what are the  consequences of internet gaming and potentially gambling addiction well physically there are some  you know basic things that we find carpal tunnel syndrome and actual problems with the joints in  the hands because of the way people are using their mobile devices or their joysticks or their  or their mice i find people actually do develop problems with their thumbs if they are typing  too much they can develop overuse injuries so we do need to recognize that our bodies  real

ly haven't evolved to deal with some of the pressures that we're putting them under  some people develop migraines when they are in doing a lot on the computer because of the  glare from the screen because of the blue light um because of you know they may be sitting in  a room that's dark and the screens are really bright so there's contrast issues they may have  vision problems they may have dry eyes they can that can happen when when they're having more  difficulty when they're using their eye

s a lot there's also sleep disturbances people who engage  in these behaviors often because the computer is there computers are everywhere if it's not  your mobile device or your tablet it's your desktop and we have them and computers somebody is  awake somewhere in the world at all times of day um and when you're engaging with  things that aren't even human like online gambling or single-person gaming  then you know obviously it doesn't even matter if people are awake so you may spend too much

time  engaging in that and that you um in that you um forgo sleep you know you look up and all of a  sudden it's four in the morning and you've got to be up at five to start getting ready for work so  sleep is really important to make sure that you're getting quality sleep but also to make it make  sure you're actually going to bed and it can cause circadian rhythm direct disruption we've talked  in other classes before about how blue light triggers our brain to be awake when we have um too  muc

h blue light coming in when we have blue light at night which is why they say don't sleep with  your tv on it can keep you awake and disrupt your circadian rhythms impairing your sleep quality  your circadian rhythms are involved in just about every system in your body so when those  circadian rhythms get disrupted it can cause a lot of physical health problems as well as mental  health problems so yes making sure that blue light is minimized one to two hours before bed they  have apps on mobile

devices that are blue light filters those are so important you can get blue  light filters for your desktop you can get blue light filters for your television for that matter  but blue light filters are very important and if you know somebody doesn't believe that that's  important uh you can get blue light filtering like sunglasses uh and encourage them to wear those for  a week at night or when they're the last couple hours that they're on the computer and see if it  reduces eye strain and hel

ps them sleep better being on the computer all the time can and  engaging in internet type behaviors can increase depression and neurotransmitter imbalances and  just basic ergonomic aches and pains from not moving around enough from having poor posture  from sitting in a chair that's not supportive all of those things can contribute to increases  in inflammation which can contribute to depression contribute to poor sleep so we see that  there are um physical consequences of compulsive internet

behavior compulsive online  behavior that can contribute to physical as well as mental health issues and remember when  you don't get good quality sleep when you don't get that deep restorative restful sleep your  brain isn't able to clear out the adenosine which is what causes the foggy headedness the  sleep pressure as they call it that makes you want to go to sleep so when you wake up the next  day you are often if you haven't gotten those that good restorative sleep you're often going to fee

l  foggy headed have difficulty making decisions have difficulty concentrating all of those cognitive  symptoms that we see with depression sometimes 50 percent of people who have difficulty or  problematic internet use report a strain in their relationships as a result of their behaviors they  also if they engage in these behaviors early in life may fail to develop effective face-to-face  in interpersonal skills there are a lot of youth today who have a lot more social anxiety  because they hav

en't had to talk to people face to face and they haven't developed some of those  interpersonal niceties so to speak because even when they're texting back and forth if they're  trying to be nice they're still abbreviating everything so there are a lot of nuances  that occur in face-to-face interactions that don't occur as much online and people may have  agitation and difficulty sitting still and difficulty being at peace with themselves  there's also challenges because online you literally hav

e the world at your fingertips  people tend to not devote as much energy than um to their relationships now than maybe they would  have back then because it's so easy to to use the expression swipe left uh when things get a little  bit difficult so compulsive internet use can apply and ripple out to a lot of different areas so  let's go back to video games though because that's you know one of those things that the dsm does  recognize as a problem uh what makes a video game addictive you know i

remember back in the day and  i will age myself again kind of like with wkrp uh pac-man and that was when tetris and we had this  game called pong and we thought that was the stuff so the high score is one thing that makes a video  game addictive if you are constantly trying to beat your own high score or beat someone else's  high score if you're trying to beat the game you're trying to learn the game and both of  those um i remember even with pac-man would keep me playing over and over and over

again i'm  like oh i i was almost there i can get there again if there's no end to the game and this  is especially true in massive multiplayer online role playing games or or mmorpgs it's an  ongoing saga so to speak so there is no final resolution it's not like you want to get not  like survivor where you want to get across well i don't maybe survivor's not it um what's  the one where they travel all over the world um the amazing race there you go it's not like the  amazing race where there's

an ultimate destination um in mmorpgs it is it can go on for indefinitely  and that can make it addictive because people feel like it almost becomes a second life for them and  they feel detached when they're not engaging in it role playing can make video games addictive  because like the sagas in mmorpgs when people take on a fictional role and they really embrace it  which a lot of people do when they embrace their um when they embrace their characters it can feel  like a part of you is being

left online if you you may feel actually disconnected with a part of  you when you're not playing that game when you're not engaging with that um with that role novelty  and discovery also makes a video game addictive um a good portion of world of warcraft which you  know that's not as popular anymore but it's spent exploring imaginary worlds minecraft is spent  designing new worlds and my son i always forget the one he's in right now um but there's one  that my son's in that he is regularly ex

ploring new worlds and now he has a vr headset so  he can explore it in all of its 3d reality which can be kind of cool i mean i've put on  his little headset before and i've been able to explore the towns and there's a lot of beautiful  graphics that you can explore but you can also get caught up in the in the escape of  being in that world they are becoming so incredibly realistic in their graphics that it it  can start causing problems people sometimes have difficulty separating um relationsh

ips are also  forged in some video games and in some online activities these relationships are generally  forged around a similar goal if it is uh day trading you know obviously it's playing the  stock market if it is uh gambling with um you know sport betting against sports teams or uh betting  on um esports you know a lot of times you start to talk with one another and you engage with  each other it's not like something like online poker where you're  playing against a machine but you join tog

ether or you unite with  this similar goal with these similar interests and it produces a sense of acceptance  that's not necessarily bad but if that is the only place the person is getting acceptance um it  can be much more problematic and online especially in games where you know mmorpgs role-playing  where people can try on different personas it gives them the opportunity and this can be very  cathartic don't get me wrong it can be great for people to try on different personas  especially if

they've got social anxiety so there are times when these characteristics  can actually be useful and therapeutic but again if it crosses over that line and it  becomes all-encompassing consuming the person prefers to live in that virtual world than in the  real world then we start having um more problems and and that's very true when  people put their whole identity into something whether it's social media  or whether it is a role-playing video game they may start feeling like they are not worth

y  because they've created this grand persona that's not who they are and that persona has gotten  acceptance whereas they may not feel like they've gotten acceptance so it's important  to process these things because that can as jennifer points out that can contribute to  low self-esteem we need to understand remember all behavior has meaning so we want to ask the  person you know why are you engaging in this game you know there is nothing wrong with having the  occasion you know even if it's e

very day for a p a brief a constricted period of time where  they are escaping you know when i go to the gym for an hour i am in my little la la land and i am  i've cleared my mind and i am in my happy place okay there's nothing wrong  with that uh because it is confined it's not ongoing it's an hour  every day uh but if it starts to become something that encroaches into you know time  that normally should be spent with other hobbies people you enjoy or heaven forbid hygiene  then we start to ha

ve problems with it researchers at hammersmith hospital in london  conducted a study all the way back in 2005 which found that dopamine levels in players brains  doubled when they're playing now remember dopamine is not your pleasure chemical dopamine is your  motivation and perseverance chemical it keeps you playing that game it keeps you hitting that button  so yes i want to play again i want to try it again and and the dopamine when we release that high levels of dopamine also increase levels

  of serotonin and oftentimes if there's rewards associated with the game even you know going  back to pac-man even if it's just getting those chomping those little fruits uh there are  there are endorphins that are released so there is brain chemistry that supports the rewarding  behavior of video games as well as as gambling jeffrey points out that one of the  more insidious video game innovations has been mobile video gaming and the use of  gambling to attain characters cards or items these a

re gotcha games or loot boxes  the dopamine dopaminergic activation is quite intoxicating because they receive that  reward for progress so we want those endorphins which means we've got to persevere  in order to get those rewards so let's you know talk a little bit about gambling  as we're talking about rewards you know in video games sometimes it's getting  you know imaginary loot or tokens or something in gambling a lot of times it's  actual actual money um gambling problems can co-occur with

other behavioral health conditions  unfortunately only about 10 percent of people with a gambling problem seek treatment  and a lot of this i did an interview with a man who specializes in gambling problems and he  pointed out that a lot of people don't recognize that what they're doing actually qualifies as a  gambling problem if they're spending half of their allotment their food food budget on lottery  tickets every week you know that's a problem a variety of other problems can be related to

  gambling including victimization criminalization social problems health issues and higher risk  for contracting sexually transmitted diseases and hiv and aids when gambling gets out of hand  and people are trying to figure out how to fund it it can cause put them at risk for other types  of you know health problems it can put them at risk for victimization and it can also just even  before that point it can cause social problems because their loved ones get scared for  them get frustrated with

their behaviors gambling is defined as risk risking something  of value usually money on the outcome of an event decided at least partially by  chance action gamblers are typically men and gamble because it's stimulating  they enjoy the rush they enjoy the power that they they feel when they when they win action  gamblers require some type of skill or knowledge like poker or sports they need to feel  like they have some level of control in what's going on relief gamblers on the  other hand are

often female gamble for escape and often gamble using games of chance like bingo  the lottery slot machines games that don't require any particular skill now why this occurs i i don't  know but the research has indicated that there is definitely um a different set of activities that  the different genders tend to gravitate toward in the dsm-5 pathological gambling was re  named gambling disorder and is categorized under substance-related and addictive disorders  problem gambling does not meet th

e criteria for pathological gambling and it's important  to remember that with any addictive behavior the addictive the behavior  itself is not the problem it is when people start using it and it  causes the neurochemical changes that result in the development of tolerance the  development of withdrawal the challenges and the after effects from what's going on alcohol for  example people can drink alcohol and not develop alcoholism people can gamble and not develop  pathological gambling there w

hich is why i talked earlier about that fine line between recreational  use and pathological or con compulsive use problematic gambling behavior uh lead is  defined as leading to clinically significant impairment or distress as indicated by four  or more of the following in 12 month period now you can generalize these you know  they they just kind of change the word gambling when they apply this as opposed  to applying it to other addictive behaviors but they gamble with increasing amounts of mo

ney  to achieve the desired excitement they're restless or irritable when attempting to cut down or stop  gambling they've made repeated efforts to cut back or stop gambling but have been unsuccessful  they're often preoccupied with gambling and gamble when they feel distressed after losing money  they often return another day to get even they may lie to conceal the extent  of their involvement with gambling gambling itself has jeopardized or caused  them to lose a significant relationship job o

r career and they often rely on others to  provide money to relieve financial problems now again like with all addictive behaviors  the behavior is not better accounted for by a manic episode or a hypomanic  episode so we do want to recognize that but thinking about each one of these  when we're thinking about somebody who gambles um online poker or online slot machines or  i i don't know a whole lot about gambling but um but then you've also got all of the the robin  hood craze and all of the p

eople who are now day trading and day trading the way it's  being done right now is essentially gambling people are using increasing amounts of  money to try to get the desired excitement or outcome a lot of times when the market's  closed they get restless or irritable you can go into any of these forums and you know  24 hours a day and there's somebody that is doing stock research there's somebody  that's talking about what the next big big wall street bets robin hood craze is going to  be and

what they're going to try to push up i mean it has become an um almost an obsession with  a lot of people so it's interesting to apply these criteria to day trading and just like gambling you  know my daddy used to go every year he would go to um las vegas he and my stepmother would go to  las vegas and they had a certain amount of money that they set aside and they would go gamble  and if they won great and if they lost okay but they had a very defined amount of time  and money they were going

to spend doing it so for them for example gambling wasn't a problem  because it was an activity that they enjoyed that did provide relief and escape but it didn't  meet these criteria it didn't cause them problems in their daily life it did not cause them problems  in psychosocial functioning so we do want to recognize that the same thing is true for day  traders i mean there are people who actually go to school to learn how to be traitors um and you know  i think that's a degree in finance or

something but their whole goal is to be able to work on wall  street so there is you know there's a fine line there uh between you know whether it is something  that's productive and helpful and healthy or it is something that is used as as an escape  or uh starts causing problems in your life casino gambling versus day trading versus online  gambling you know i think it's interesting to kind of consider some of the nuances in casino  gambling you know we've all heard that you you can't win agai

nst the house uh in in  casino gambling because there are often um they set the odds in in the favor of the  house that way you know they can keep the casino opening that totally makes sense so  casino gambling has its own little nuances day trading is almost like betting against the  house because a lot of the retail day traders are betting against or gambling against  if you will the hedge funds and the big money movers and then online gambling can be  just completely computer driven and compl

etely available 24 7. all of these provide one well  they provide escape they provide excitement and they also provide the lure of freedom  and a lot of people when they hate their life when they hate their job when they are struggling  financially which we know a lot of people are the allure of these activities  can be very intoxicating so we do need to examine again what is the  meaning behind what this person is doing and are there other ways that we can help them  achieve that goal are they

trying to get that rush of endorphins because they're depressed  are they trying to escape because their life is just you know crumbling with stress right  now are they trying to find an out because you know financially they feel that they're struggling  all the time and and they're hoping that they can achieve more money um and and  sometimes people are doing it to gain more wealth because they see  the influencers going back to online they see the influencers online that have you  know 20 000

square foot homes and 14 cars and whatever um and instead of focusing and noticing  what they do have and recognizing when appropriate that all of their basic needs are being met they  focus instead of on all the things that they don't have and they hope they think that oh when i get  that bigger house or when i get that nicer car then i'll be happy so they're living in the  future instead of in the present now obviously people need to get their basic needs met and  if they're not getting their

basic needs met that's a big issue but we can help them with that  that there are a lot of services out there call united way information and referral if you're not  familiar with some of the services in your area to help people with their electric bill with their  food with their you know whatever those needs are risk factors for gambling a need to escape well  you know when you've got stress sometimes and this is also a risk factor for  for internet and gaming addiction you want to get out of

your life so you may go to  social media and live vicariously through others you may get into a role-playing game  and live vicariously through that avatar you may get go online and engage in gambling  or day trading in order to focus your attention on something that increases  dopamine and increases endorphins poor interpersonal relationships have  also been found to be a risk factor for online problematic behaviors well that makes sense  if you have poor interpersonal relationships you may fee

l like you need to escape more when  we have when we have positive interpersonal relationships they serve as a great buffer against  stress people who are easily bored and in today's society somebody uh meg was mentioning  earlier our need for instant gratification and contributes i think a lot to  this and the sense of restlessness these days my i'll put something in the microwave  you know i'll put my coffee water in the microwave to heat it up and i get impatient because it's  taking too long

and i know that makes no sense but uh back in the day we used to have to put it in a  kettle um but we have become much more impatient and much more restless because we've been sort of  programmed that way we watched during the pandemic we watched several old movies uh with our kids and  you know when i say old movies i mean movies from the 80s when my husband and i were in high school  and those movies just seemed to drag on so slowly we have our brains have been reprogrammed  throughout the l

ast 20 30 years to expect more action more movement more of everything  so those movies that we used to think were you know terminator for example were just the  bomb back in you know the 80s now we watch them and we're like eh you know uh i'm getting  bored gotta do something else so we we can um identify the fact that our culture has  created a sense of restlessness and people do get easily bored and sensation  seeking or quote adrenaline junkies and marie points out and you know a very good 

point that there's often a lot of overlap with other compulsive behaviors or problematic  behaviors and this is one of those things that i harp on when i teach the addiction  counselor certification track because it's really important to explore the meaning behind the  behaviors i worked in residential treatment for 14 years and i would so often see people who  weren't able to access their drug of choice whatever that was but they were able to access  all kinds of pastries and donuts and coffee

and cigarettes oh and sex it was a co-educational  facility and let me tell you it's amazing how sturdy dropped ceilings can be i had  no idea you could crawl through them but anyhow i digress people would in order  to get that dopamine in order to get that serotonin and those endorphins that  their body had developed a tolerance to they need they needed the rush so they  would find another way to get them so we do need to look for substitute addictions  or concurrent addictions even if they're

not you know substances or behaviors you see you often  see both of them co-occurring or multi-occurring warning signs that somebody may be having  a problem with gaming or gambling financial problems exist despite adequate income money's  gone missing from a bank account wallet or valuables have disappeared there's a lot of  borrowing cash advances living off credit cards retirement or insurance policies have been cashed  in or allowed to lapse the person avoids family functions or other social

events they neglect  responsibilities or make excuses they may drop other leisure activities to focus on gambling they  disappear for large blocks of time and arrive late to work or for other commitments they may  appear deceptive or secretive particularly as it involves money or their use of the internet  they may seem edgy reactive or defensive and often have changes in their sleeping eating  and sexual behaviors so these are things that we can use as sort of a checklist for  people have you

experienced any of these signs and you know if so okay let's talk  about that let's talk about what that means um maybe they did a lot of borrowing and cash  advances because they just had a run of bad luck they got really sick they ended up in the  hospital and then their car died and then their computer died and their kid needed new shoes i  mean it happens to people who have no problem with gambling so we don't want to assume  that just because there's one or two signs that the person has a g

ambling problem but we  do we may want to explore what brought about that symptom or that sign to you know  figure out if it's a problem or not in treatment our goals are abstinence from the  problematic applications or sites which can be uh challenging sometimes because no matter how good  you put your um firewalls and restrictions on your home internet even on the purses persons mobile  devices they have what i call nanny apps that will prevent them from going to certain sites it will  report

to a a guardian or sponsor if they go to certain sites but there are also computers that  people can go to that aren't theirs they can use somebody else's phone they can use somebody  else's computer they can go to the library and use the computer so where there's a will  there's a way when it comes to computers so that is important to recognize  that complete abstinence can be challenging for people especially  people who are not super motivated think about again the person who has alcoholism y

ou  know there is alcohol out there there's alcohol at walmart there's alcohol at the 7-eleven there's  alcohol out there so they need to have tools to be able to deal with the cravings and urges when  they arise unfortunately a lot of our life is online now especially since the pandemic and  people working from home a lot of our life is conducted online whether it's talking with friends  or doing our work paying our bills balancing our bank accounts so sometimes it is not realistic  to expect s

omeone to just not use a computer and we may need to strive for what i call  balanced internet usage where they identify what they need to do they set time limits for how long  they're going to be on there and again they have blocks set up so they can't go to certain websites  some people in the early phases of recovery opt to unplug when they are not at work so they leave  their computer they leave their mobile device they leave all that stuff at work so they are plugged  in during the work day

when they have to be but during the evening they are not so they can  focus on mindfulness and their relationships and those sorts of things now that for  a lot of people that's overwhelming the thought of being without their mobile device for  8 or 12 hours is more than they can even fathom so it's it's going to be an  independent or an individualized goal interventions we want to help them prevent  use of the sites that are problematic for them you can have parental controls set on your home 

router that turns the internet off for the entire house at a certain period um of time firewalls  like i've talked about timers and this is not online timers this is getting an egg  timer or something and putting it across the room so just like getting out of  bed the person has to get up and go across the room to turn it off which can help them  recognize that okay my time online is done and look for and accentuate exceptions what are  you doing when you're not on the internet you know taking

a bath reading a book talking to  a friend playing with the dog what is it that you're doing when you're not engaging  in that behavior that helps make you happy remember when we're talking about preventing use that it's important not to forget tablets  smartphones any kind of mobile device those they also need to have firewalls and  parental controls of some sort installed we can also encourage people to  use decisional balance exercises identifying the benefits to use whether it's going  on fa

cebook or playing their role-playing game or day trading gambling whatever it is what are their  benefits what benefit do they do they get from from using from using and with people who gamble  it's really important that they keep a accurate diary or log of their wins and losses because a  lot of times they'll say well i'm making money i can make two thousand dollars a day or something  and it's important to be able to say well okay you know last tuesday yeah you made two thousand  dollars but t

hen the rest of the week you lost nine thousand so you know it's important to be  able to focus on the big picture not just the wins but helping them identify what they see as the  benefits to use can help you identify issues that they have which may need attention whether  it is self-esteem acceptance interpersonal skills dealing with social anxiety meeting basic  biopsychosocial needs we need to understand why are you engaging in this or addressing  depression and neurochemical imbalances and

then we can also identify areas where we  target alternate rewards so when you're not online you know what other things do you enjoy doing what  other things do you find enjoyable and rewarding we want to try to magnify those rewards so if  they enjoy spending time with their best friend well what what do you really enjoy doing with  that person is maybe going rock climbing or going hiking or something encouraging them to engage in  real life activities that will similarly stimulate dopamine and

endorphins because they're enjoying  what they're doing we want to talk about their drawbacks to use you know what is what are the  downsides to engaging in this behavior and this is the one that people have always lectured them  about so they probably will have a litany of these what are the benefits to stopping and  there are some overlaps in these quadrants the drawbacks to use and the benefits to stopping  there are some overlaps but we want to help them um identify you know why might i wan

t to stop  and using all of the dimensions of motivation physical how will how will it make you feel  physically better reduce your pain improve your energy improve your immunity um affectively how  will it make you feel emotionally less stressed cognitively how will it help you focus  on the things that are important to you environmentally it may or may not change  the environment and relationally how will it improve your relationships when you  are no longer engaging in that behavior and then

talking about drawbacks to abstinence  which will overlap a little bit with benefits to use that's fine but this is where we start  identifying people's fears about stopping using what are the drawbacks what are the things that  you dread about changing this behavior and then we can start addressing those and mitigating  that uh that fear or that dread whether it's you know not knowing what to do with  their time or you know whatever it is cognitive behavioral therapy has been found to  be super

helpful with addressing a lot of these issues from interpersonal skills to coping  skills to stress tolerance problem solving likewise dialectical behavior therapy  has been shown to be really effective to help people develop distress tolerance  instead of feeling like they need to escape with the by engaging in the online behavior  they can develop alternate skills to help them tolerate distress in the  moment and control their impulses motivational enhancement therapy is really helpful  and i

f you have done any addictions counseling you're familiar with the stages of readiness for  change pre-contemplation i don't have a problem contemplation yeah i might have a problem but it  it's all good preparation okay i got a problem i might think about doing something about it  and um action is when the person says okay i've got a problem i need help and then  maintenance but knowing those stages there are different techniques that can be really helpful  in each of those stages in developing

rapport and helping advance a person forward towards a greater  level of readiness for change and along with cbt and dbt i would be remiss if i didn't mention uh  cbt or a.c.t acceptance and commitment therapy and this is another um cognitive behavioral  approach that some people find very effective i have videos on all of these approaches on the  youtube channel not going to go into depth with them right now psycho education as we've talked  about a lot of people who engage in these online gam

ing compulsive behaviors often have dif  problems with their self-esteem either that led to this problem or as a result of this  problem so we do need to help people examine and enhance their self-esteem interpersonal skills  including communication skills assertiveness mindfulness and basic relationship skills may be  important because they may have never developed those skills because they spent their their  formative years engaging in virtual worlds coping skills training and goal  setting ca

n also be really helpful adulting can be daunting even for people who are  fully adults and when people learn how to set smart effective goals then they often start  to feel a lot less overwhelmed and they see a path to coping with life on life terms  medications are available that temp temporarily can help rebalance neurotransmitters ssris like  lexapro and wellbutrin are the ones that have been most studied in relation to internet and gaming  addiction now trexone which is an opioid agonist ha

s also been studied as has interestingly enough  dexmethylphenidate which is an adhd medication so we want to examine and each of these would be  a little bit different you know think about it ssris what are we doing we're increasing serotonin  levels now you're also slightly increasing norepinephrine and dopamine but mainly serotonin  so somebody whose serotonin is low who tends to have depression or even high levels of anxiety may  respond with better to ssris for addressing their behavioral i

ssues people who respond better  with naltrexone may have a dopamine imbalance because what we're doing is we are altering the  receptors that are engaged when someone activates their dopamine and their endogenous opioids so  when we get give them medications then we are helping them alter that system now this should  say antagonist naltrexone is an opioid antagonist not an agonist um but what naltrexone does is  basically it blocks the pleasurable feeling from the gaming and then dexmethylpheni

date  if somebody is engaging in online behaviors as a coping  mechanism to deal with their adhd that can be helpful and dexmethylphenidate is  more involved in increasing norepinephrine levels so you see that there are three primary  medications that they've studied each one of those alters a different neurotransmitter so what  causes the compulsive behavior differs between people and i think that's a really important  point to remember and the same thing is true when we talk about depression o

r anxiety as well you  know it is not one size fits all for medications exercise has been found to be helpful  with online compulsive behaviors exercise increases serotonin and dopamine and the  sunlight also can help regulate neurotransmitters including melatonin and which can improve sleep  and mood and help regulate those circadian rhythms nutrition water is important a lot of people who  engage in on a lot of online gaming uh don't drink enough water they don't drink enough period  and somet

imes they don't drink intentionally because if they drink they've got to get up  and pee and that means they're going to miss something so water is really important because  dehydration can cause symptoms of depression oats bananas chicken dairy products green  leafy vegetables and nuts are all chock-full of the vitamins minerals and amino  acids that are necessary for the development of neurotransmitters  particularly dopamine and serotonin like other addictions internet addiction can  have phy

sical social financial and emotional consequences in our digital age it is highly  unlikely that people can can completely unplug similar to other behavioral addictions like eating  and sex it's necessary to identify the motivations behind the person's use of the internet  sites additionally by its very rewarding nature internet addiction will cause neurochemical  imbalances which can lead to depression and apathy remember we've talked about addictive behaviors  before in when the brain when the

tissues are regularly exposed to high levels of dopamine  they start becoming less reactive to that dopamine so the person develops a tolerance  to those dopamine surges so in order to feel normal you know basically the tissues  have have adjusted to 10 times normal level levels of dopamine and i'm just pulling out  random numbers for the example um but when the body gets used to having 10 times  normal level of dopamine and then it's not getting that anymore then the person starts  to experien

ce withdrawal and agitation so even the dopamine surges that are caused by gambling  and gaming and those sorts of things can alter the responsiveness of the receptors  can alter the dopamine and serotonin systems so we do need to recognize this is not just  a willpower sort of thing just because it's behavioral and not chemical doesn't mean that  there's not an underlying neurochemical imbalance recovery involves in addressing underlying  mood self-esteem and coping issues identifying triggers

for use and ways to deal  with them and creating a relapse prevention plan there are a lot of resources that are online o l g anon which is online gamers anonymous is  an interesting site if you've got someone who is uh struggling with online gaming the challenge  with it is it's mainly online so for someone who is struggles with choosing healthy behaviors  online that can be a problem a lot of the online gamers anonymous chapters actually  don't have in-person meetings so that might be somethin

g if you see a demand in your area  to consider you know talking with your clients maybe about starting a olga non chapter that  actually has face-to-face meetings in your area and it is important to recognize that there are  a lot of people who especially people who are not auditory learners who get antsy when they are  having to sit still whether it's a zoom meeting or a sermon in church or a lecture at school  some people have a really hard time sitting still for that length of time so we don

't want  to necessarily pathologize that right away but we do want to recognize that there are  some people that do need um additional tools to help them deal with their restlessness  whether that's fidget spinners or whatever it is they do whenever i go somewhere  and i'm going to have to sit for a while i always bring my crochet with me because at  least i'm able to do something with my hands marie um has identified the social  dilemma which is a documentary on netflix is a uh movie about addi

ction to social media so  that might be something to explore a little bit and i'm with you on that one mark i i i don't  like losing money either i don't like messing with with monies but i do need to have something  generally i mean you see even when i teach i uh i move around a lot um i'm not one of those  people that that that can sit still very well so it is important to help people figure out  tools um that they can use to help them cope when they're in a setting that they have to sit  stil

l for a little while alright everybody have a wonderful day and i will see you on thursday when  we were talking something about eating disorders have a great day this podcast helps you help  your clients or yourself please support us by purchasing your ceus at all ceus.com or  getting your agency to sponsor an episode a direct link to the on-demand ceus for  this podcast is at allce dot com slash podcast ceus that's all ceus.com podcast  ceus to sponsor an episode of counselor toolbox and reach

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