ADHD Brains on Screens: Decoding a Complicated Relationship
Screen time has increased dramatically for 84% of ADDitude readers in the last year. New efficiencies and important connections are undeniable — as are new risks of video game dependence, Zoom fatigue, and poor mental health. Read the results of ADDitude’s recent technology survey and its insights into screen dependency.
Zoom is not a hammer. Instagram is not a shovel. Your iPad is not a screwdriver. We call these technologies “tools,” but they don’t perform a discrete function and then hibernate in the shed. These screens — used 8.5 hours a day, on average, by ADDitude readers during the pandemic — exert a powerful and sometimes nefarious influence on the ADHD brain.
The wins and likes of video games and social media deliver the potent hits of dopamine that ADHD brains crave, a biological need also satisfied — albeit momentarily — by an impulsive Amazon purchase or a hilarious TikTok video. But the ADHD brain is never satisfied. Five hours of Fortnite today will not satiate; it will demand more tomorrow. Video game and screen time dependence are dominant concerns today, according to a new survey of 885 ADDitude readers regarding technology use during the pandemic.
Technology Is Not a Passive Force on ADHD Brains
Revealed in the January 2021 survey was a striking dichotomy: ADDitude readers praise technology for softening hard times, and they curse it for the toll it’s taken on their families members’ mental and physical health. The price of productivity, convenience, and safety — being able to learn, work, socialize, and shop while remaining socially distant — is high and still rising.
“Research suggests that use of screens can result in a bi-directional worsening of mental health symptoms,” said David Anderson, Ph.D., vice president of School and Community Programs at The Child Mind Institute, in the 2019 ADDitude webinar “How Screen Time Impacts the ADHD Brain”. “If a child is prone to anxiety, continued engagement in screen-related behaviors may worsen those symptoms in ways they wouldn’t otherwise worsen.”
“There is also evidence of a correlation between media use and the severity of ADHD symptoms. Screens may not cause ADHD, but they may play some role — depending on what limits are placed on them and how a child or teen is using them — in exacerbating the way that ADHD symptoms are expressed.”
Nearly 85% of caregivers surveyed reported behavioral changes in their children with ADHD during the pandemic — a period when screen time has increased for 90% of families. The ratio of negative to positive behavioral changes is 4 to 1, with parents reporting heightened emotional dysregulation, diminished motivation for school and non-screen activities, lethargy, and greater frustration and anger — particularly when forced to transition off of a screen to a less-desired activity.
Parents are not only feeling concerned; they are feeling guilty. Working from home alongside remote learners, they rely on screens not only to educate their children, but to occupy and entertain them during the business day. Cutting the cord is simply not an option for working parents, who are all too aware of technology’s double edge.
“We are seeing lots of anger and frustration with limits to screen time, plus there’s an internal conflict with upholding limits when the screen play is his primary source of connection to friends,” wrote one mother of a 14-year-old with ADHD in Ohio. “I feel like I don’t have a good enough reason for him to get off, as there is nothing specific — sports, clubs, etc. — he needs to do.”
How Technology Promotes Lethargy and Sleep Problems
Only a slim fraction of children with ADHD are able to participate in organized sports now. Most caregivers report that basketball, soccer, karate, and swimming have all been canceled for more than a year. In that time, nearly 40% of caregivers report that technology has had a negative impact on their child’s physical health; only 13% reported a positive impact.
“He used to love playing lacrosse, but his league is still not playing,” wrote the mother of an only child, age 11, in North Carolina. “His friends in the neighborhood only play inside on games, so he refuses to go outside even though he loves to play — just not by himself… He has become more belligerent, needs melatonin to sleep, and just overall struggles with his sensory processing.”
Some survey respondents said their kids are enjoying online yoga and dance classes, Outschool sports programs, or their “Ring Fit” on Nintendo Switch. But the majority of caregivers reported a daily battle to induce any physical activity whatsoever. “Why go outside when his friends’ faces are on a screen?” asked one mother of a 9-year-old with ADHD in Arizona.
“Exercise turns on the attention system, the so-called executive functions — sequencing, working memory, prioritizing, inhibiting, and sustaining attention,” says John Ratey, M.D., an associate clinical professor of psychiatry at Harvard Medical School and author of Spark: The Revolutionary New Science of Exercise and the Brain. “On a practical level, exercise causes kids to be less impulsive, which makes them more primed to learn.”
When children and adolescents with ADHD don’t move their bodies, the opposite is often true: Their self-control and inhibitions falter, leading to even more screen use — which quickly begins to steal time from school, homework, hobbies, and sleep. The unhealthy behaviors feed on one another and descend into a spiral.
“The major effect of screens — for adults, children, and adolescents – is that we sleep less because we don’t obey the rules for good sleep hygiene,” Anderson said. “This is particularly true for adolescents, for whom the prefrontal cortex is still developing and for whom executive functioning and planning is still under construction. They are still working on prioritizing tasks with long-term payoffs over and above ones they find rewarding in the moment. At that age, it can be really difficult to make the right decision about when to put down the phone, stop talking to your friends, and go to bed.”
Technology as a Vital Social Bridge
The social pull of technology, for teens as well as younger children, is huge. With in-person school, sports, and club activities on hiatus across large swaths of the country, most social interaction today is happening on screens. Platforms like Discord allow gamers to chat with friends they could not otherwise see, Instagram and TikTok allow teens to feel less isolated, and texting delivers instant gratification and consolation. The power to connect friends across town and across time zones is one of technology’s greatest assets, according to survey respondents.
Fifty-nine percent of caregivers said technology has been useful and helpful in connecting their children to friends and family members during the pandemic. Many cited FaceTime with grandparents, virtual holiday gatherings, and gaming with buddies as highlights for their kids — especially those with social anxiety or shyness.
“If it weren’t for video chatting, we would not be able to stay in touch with grandparents whom we haven’t seen now for well over a year,” wrote the mother of a 12-year-old girl with ADHD. “Being able to let my kids talk and play games with their friends online has also been a god-send — otherwise the isolation and mental health side of things would be even that much more difficult.”
Learning How to Learn – and Live Healthier – Online
Certainly, without technology, most students would be unable to attend school right now. That said, digital learning is useful or positive for less than half of ADDitude readers surveyed; 30% called it negative and 19% were neutral.
On the positive side, parents reported their remote learners using digital tools to become more organized, to turn in assignments more regularly, and to review materials more effectively. On the negative side, the temptation to click away from Zoom or Google Classroom to YouTube or Among Us is high and persistent. Many students with ADHD and learning disabilities benefit from the one-on-one instruction that is in short supply and sorely missed right now. And Zoom fatigue is real.
“My child is experiencing massive anxiety and exhaustion over using Zoom for class and doing all of his work on a Chromebook, plus distracting games and YouTube videos are only a click away,” wrote the mother of a 13-year-old with ADHD in Illinois.
More universally positive, for both children and adults with ADHD, is telehealth. Six times more parents called telemedicine helpful than called it harmful, and 56% of adults said technology has aided them in accessing medical care or addressing health concerns during the pandemic. Though some children, especially young ones, refuse to engage with counselors or therapists on video platforms, many parents say they plan to continue using telehealth services even after the pandemic.
“Telehealth and teletherapy appointments have been great,” wrote the mother of a 17-year-old with ADHD. “She has seen her general practitioner, pediatrician, psychologist, and two other medical specialists via telehealth with great success.”
Others find telehealth appointments convenient, but shallow. “My children prefer it, but I worry that the all-virtual meetings prevent actual conversations about issues of concern,” wrote the mother of 13- and 17-year-old with ADHD in Ohio.
Though some adults with ADHD complain of similarly ‘cursory’ telehealth appointments, most sing the praises of telemedicine, as well as online support groups, therapy sessions over Zoom, and seamless medication refills. In 2020, teletherapy and telehealth was new to 60% of survey respondents who are using it now.
“I was diagnosed with ADHD in June 2020,” wrote a mother from Seattle, Washington. “That was accomplished thanks to being able to message my primary care doc for recommendations for psychiatrists, and then accessing a psychiatrist for an assessment, diagnosis, and ongoing monthly appointments for prescriptions.”
How Technology Saved Our Work — and Play
Even more foreign before the pandemic were digital platforms for video calls and work meetings like Zoom, which 77% of ADDitude readers said they had never used before last year. Now, 63% of readers say technologies like these are useful for in helping them manage and complete their work. After overcoming the tech learning curve, they say technology has helped them achieve greater productivity, organization, and collaboration.
“The pandemic has forced me to find better ways of tracking my responsibilities and the actual time it takes to do things,” said a young professional with ADHD and anxiety in Washington, D.C. “At first, I was worried that I would fall so behind that I would get in trouble with work, but I was able to find organizing and time-management resources that work better than my old systems.”
The biggest downsides to working from home with ADHD? Digital distractions, video exhaustion, and burnout. “It’s harder to pull away from work since it’s right there on the computer when I’m doing online leisure things,” wrote the parent of an 11-year-old with ADHD who also has attention deficit.
Leisure is the domain where technology was rated most useful by both adults and caregivers. More than 79% of adults praised streaming, gaming, and audiobook platforms for keeping them entertained and occupied at home.
“Podcasts have become a mainstay of my life and streaming services had been a god-send for my family,” wrote a mother of two with ADHD. “But I have to regulate social media, or I can get sucked into a 9-hour wormhole and fail to get anything done.”
That time suck is a ubiquitous concern, and risk, for adults with ADHD who complain of doom scrolling their nights away. Many of those surveyed by ADDitude voiced concerns over becoming addicted to TV, video games, and/or social media while in quarantine.
“I fall into a sort of low-arousal, low-barrier-to-entry instant gratification loop where I don’t necessarily feel that I’ve been enjoying myself, per se, despite being entertained,” wrote one young adult with ADHD and anxiety who reported heavy Discord and Animal Crossing usage.
“Screens can be very addicting to me,” wrote the mother of two small children with ADHD. “My inattentiveness can give way to the instant gratification of the screen, and I end up feeling not as accomplished or feel shame/regret for not being able to stay on task.”
Technology is a Poor Motivator, But a Good Connector
Shame, regret, and frustration all bothered adults with ADHD using (or trying to use) technology for fitness as well. Though many felt they should have more time to exercise without commutes and errands, only 27% said technology actually aided their fitness. Though fitness apps are convenient and relatively inexpensive, they fail to deliver the accountability and social outlet of an in-person gym or recreation league. Motivation takes a hit as a result.
“Without my smart watch I would not be able to motivate myself to work out,” wrote a woman with ADHD, anxiety, and PTSD in Minnesota. “It displays my activity throughout the day, and if I’m close to hitting my goal I’m more likely to get up and do something to complete my rings.”
Though most ADDitude readers look forward to attending live yoga and Zumba classes after the pandemic, one technology habit will persist with enthusiasm: online shopping. Three-quarters of readers called grocery apps, Amazon, Target.com, and other digital shopping tools useful during the pandemic; for 40% of them, this technology was new.
“I never did much online shopping before the pandemic, but I think this is a habit I will keep,” wrote a woman with ADHD and anxiety in Canada. “Going shopping used to cause me so much anxiety — it is much easier to make shopping decisions from the comfort of my home and online shopping decreases impulse buys since I can verify if I actually need something before I buy it.”
And no one is complaining about fewer errands, less driving, or an end to frivolous purchases. In this way, technology is creating efficiencies and cost savings that many adults with ADHD say they may not have otherwise realized. Though this may be the most practical benefit of technology during the pandemic, it is not the most impactful or the most important. That is summed up beautifully by one mother from Virginia who answered our survey:
“My 99-year-old grandmother is in an assisted living facility, which has been closed for visitors,” she wrote. “My mom sent in an iPad (and headphones) set up with Zoom, and she now has regular Zoom meetings every day with several family members. Her 11 children all have scheduled days to make sure that someone connects, and grandchildren and other extended family and friends from all over the country often join as well. We all miss the hugs, of course, but this has been an amazing way to stay connected and keep her from being too lonely while we all stay safe and look forward to celebrating her 100th birthday in person!”
Screen Time Limits for ADHD Families in the Pandemic: Next Steps
- Read: My Kids Are on Screens All Day: Is That Okay?
- Learn: How to Enforce Screen Time Limits on Teens with ADHD
- Research: Parent Control Apps
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