I opened an e-mail from a stranger one afternoon in May 2012. The message was from a young man who had recently read about my work on the adolescent brain, and in the subject heading of his e-mail he wrote, simply, “Computer Addiction.” He began by telling me how at the age of fifteen he was lonely and introverted and spent most of his free time on his computer in teen chat rooms. It was easier to “meet” people this way and talk about his own interests anonymously, he said, and these chat rooms became a kind of obsession with him. The man writing to me said that he was now twenty-six and that over the years these online experiences had become more real—and more pleasurable—than his “off-line” experiences. “After that, my life went in a downward spiral,” he said. He became “addicted” to chat rooms and increasingly felt as though his life was divided between his cyberself and his real self. Eleven years later this man felt confused and tortured about his computer addiction. He wrote to me, he said, looking for some perspective from me, and I hope I was able to give that to him. I told him being addicted to the Internet involves the same reward center as drugs, and when he was a teenager, he was more susceptible to addiction in general, so it was understandable from a neurobiological perspective how he could get caught up in it. The digital world simply presented him with a means to interact with others at a time when that was enormously challenging for him, so it shouldn’t make him feel guilty. After all, he did this self-searching totally on his own, without any guidance. The adolescent propensity for addiction occurs at a time of exploration when you’re trying to make decisions but also, in the case of my correspondent, experimenting in a virtual world, so your perspective is skewed. He had no way of verifying what was real. Social isolation itself can be a stressor for teens who are roaming the digital world alone in their bedrooms.

Today’s teenagers and twenty-somethings make up the first generation of young people exposed to such a breathtaking number of electronic distractions, and they are therefore susceptible to a whole new host of influences. Technology is another opportunity for novelty-seeking, and because the brain of a teenager is so easy to stimulate, all it takes is the latest digital toy to tease it into distraction. The cascade of neuroprocesses that kicks off the brain’s reward circuitry and the rush of the pleasure chemical dopamine can be triggered just as easily by the release of the latest iPhone as by alcohol, pot, sex, or a fast car. In some ways, technology is a drug. Neither the American Psychological Association nor the American Psychiatric Association formally recognizes Internet addiction as a mental disorder, although the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, released in 2013, added Internet Gaming Disorder to its appendix and advised that additional study is needed. Both organizations, however, seem to be a bit behind the curve. There is increasing evidence of the effect of excessive Internet use on mood in adolescents, and several studies have shown a connection between depression, poor academic performance, and the inability to curb time spent online. In any case, increasing numbers of Internet “overusers” do, in fact, describe themselves as addicts and even seek professional help. In 2009, reSTART in rural Fall City, Washington, became the first residential treatment center in the United States specifically devoted to what has been termed “Internet addiction.”

Today’s teenagers are the world’s leading authorities on technology, and while adolescents are the savviest of users, they are also the most vulnerable. Witness these headlines:

An experiment began in the spring of 2010 when two hundred students in a basic media literacy course at the University of Maryland were asked by their professor to do something unusual: go without their digital tools and toys—all media, in fact—for twenty-four hours. The results of the experiment, picked up by news outlets all over the world, prompted the professor, Susan Moeller, to conduct a second, much wider experiment. Both began with a simple request:

If you lapse by mistake (i.e. you answer a phone call without realizing it), do not then “give up.” Note the mistake and go on to finish your 24 hours. If you do NOT make it the full 24 hours, be honest about it. How long did you make it? What happened? What do you think it means about you?

Although you may need to use your computer for homework or work, try to pick a time when you can go without using it—which may mean that you have to plan your work so that you can get it done before or after your 24-hour media-free period. You will not be judged on whether you went 24 hours, but we expect that you all will make it through the entire time without using any forms of media.

Moeller, who is a member of the International Center for Media and the Public Agenda (ICMPA) at the University of Maryland, partnered with the Salzburg Academy on Media and Global Change to conduct the second survey. They asked close to one thousand students in twelve countries, including the United States, to write about their experiences after their twenty-four-hour period of media abstinence was over, and when the students did, they poured out their angst:

Across the globe, the same feelings were expressed again and again:

        “Emptiness. Emptiness overwhelms me.”

        “Unplugging . . . felt like turning off a life-support system.”

        “I feel paralyzed.”

        “I sat in my bed and stared blankly. I had nothing to do.”

        “The feeling of nothing passed into my heart . . . I felt like I had lost something important.”

        “I felt like there was a problem with me.”

        “I counted down minute by minute and made sure I did not exceed even a single second more!”

        “I felt so lonely.”

        “The anxiety continued for the rest of the day. Various scenarios came to my head, from kidnapping to extraterrestrial invasions.”

        “I went into absolute panic mode.”

        “It felt as though I was being tortured.”

Many of these students borrowed the language of substance abuse when they likened their media habit to an addiction and their self-imposed abstinence to drug and alcohol withdrawal. One US student wrote, “I was itching, like a crackhead, because I could not use my phone.” A student in Mexico wrote, “It was quite late and the only thing going through my mind was: (voice of psychopath) ‘I want Facebook.’ ‘I want Twitter.’ ‘I want YouTube.’ ‘I want TV.’” A college student in the UK wrote, “It’s like some kind of disorder, an addiction. I became bulimic with my media; I starved myself for a full 15 hours and had a full on binge: Emails, texts, BBC iPlayer, 4oD, Facebook. I felt like there was no turning back now, it was pointless. I am addicted, I know it, I am not ashamed.” Amusingly, the online media outlets whose headlines screamed addiction and warned about the all-consuming “technobsession” of the young provided multiple links, platforms, and interactive choices to “Follow” or “Share” or “Like” it on Facebook; to tweet it, “Get Alerts,” and “Contribute to the story”; to send corrections, tips, photos, videos, or comments. No wonder that in trying to be media-free for a full day, many students also found themselves emotionally and psychologically distraught:

Moeller is neither a psychiatrist nor a neuroscientist, and her survey was more sociological than scientific. Still, it’s hard not to read the responses of the experiments’ subjects and wonder exactly what is going on inside the brains of young people who have been raised on digital technology. According to a 2011 study by the Pew Research Center’s Internet and American Life Project, 95 percent of all young people, ages twelve to seventeen, use the Internet, and 80 percent use social media. Ninety-three percent have Facebook accounts, and 41 percent have multiple accounts. In an article written for a weekly teen publication, two Chicago high school students reported on the popularity of smartphones and the degree to which students will go to hide them from teachers and administrators. One student interviewed said, “Back in my sophomore year, I snuck my phone in as a biscuit sandwich in the morning. I covered it in [a] brown napkin and put it in between the biscuit buns. I would simply come to school and put my lovely cup of orange juice and tasty ‘Bisquick biscuit’ sandwich on top of the metal detector and walk right through.” Another student said she would wrap her long hair into a bun before school and hide her phone inside. “Whenever the metal detectors beeped, they couldn’t find my phone,” she said. The level of attachment between teens and smartphones is so extreme, one high school senior told the authors of the teen publication article, “My phone has my whole life in it. If I ever lost it I think I would die.”

So embedded in our consciousness are our smartphones that two-thirds of cell phone users report that they feel their phones vibrate when in fact they don’t, a phenomenon researchers have taken to calling phantom-vibration syndrome. Judging from the above testimonials, it’s not surprising to find that many of the same behaviors that typify the closet drug addict are also seen in Internet addicts: concealing behavior, lying, neglect of normal activities, and social isolation.

The compulsive need to be digitally connected happens on two levels, behaviorally and biochemically. Every ring, ping, beep, and burst of song from a smartphone results in an “Oh, wow” moment in the brain. When the new text message or post is opened, the discovery is like a digital gift; it releases a pleasurable rush of dopamine in the brain. In fact, there is mounting evidence that Internet addiction has much in common with substance addiction. Recent functional MRI studies in adolescents have shown that addiction to cocaine and meth alters connectivity patterns between the brain’s two hemispheres as well as other important regions that use dopamine as a transmitter. What is interesting about the MRI studies of Internet addicts is that they are similar in pattern. Amazingly, unlike the effect on drug addicts, this neurobiological effect is not due to a chemical substance—it is purely a case of “mind over matter”! Hence, studies of Internet addiction may have revealed the purest circuits for addiction yet and may also prove to be good markers for rehabilitation in future treatment trials.

One of the most time-consuming Internet obsessions for young people is video gaming—electronic video games that involve human interaction with a user interface that generates visual and audio feedback. These games can be found everywhere—on computers, iPads, iPhones, Xboxes, Game Boys, you name it. Video games, of course, are more than half a century old. We can probably date the precise beginning to October 18, 1958, and, of all places, the Brookhaven National Laboratory on Long Island. The lab was holding its annual visitors’ day, and nuclear physicist William Higinbotham, head of the instrumentation division, had an idea about how to provide a bit of educational entertainment. The result was the first real interactive electronic game: Tennis for Two. The game featured a two-dimensional “tennis court” on an oscilloscope, similar to an old black-and-white TV. The court was basically a vertical line down the middle and a brightly lit dot that left a trail as it bounced back and forth horizontally over the “net.” Players served and volleyed from a console with buttons and rotating dials that controlled the angle of swing from an invisible tennis racquet. Would you be surprised to learn that even back in 1958 hundreds of people lined up to play the electronic game? No, I didn’t think so.

Unlike a lot of the science in this book, what we know about the effects of video gaming on the brain comes almost exclusively from humans. After all, it would be pretty hard to simulate gaming in an experimental animal. Imagine a rat working a controller, playing a round of Grand Theft Auto! Not likely. So the effects have been measured either with psychological testing or with functional MRI studies. In the latter, researchers look at brain regions that get turned on and off in gamers and nongamers and measure the comparative size of brain regions. A study published in China in 2012 looked at seventeen adolescents who met the definition of gaming addiction and compared their brain scans with those of twenty-four nongamers of similar gender, age, and educational level. First, the gamers group scored much higher on tests for risk-taking. Next, functional MRI showed less connectivity to the gamers’ frontal lobes, but more connectivity in areas that have been observed in nicotine addiction, for instance. These findings were also visible in a study aimed at measuring the actual thickness of the connections to the frontal lobe.

Another study, from Korea, corroborated the effect on brain structure in adolescents: fifteen adolescent males with the diagnosis of Internet addiction were compared with nongamers, and the finding showed the gamers had smaller orbitofrontal cortex regions, an area involved in modulation of risk-taking. This same pattern has been seen in people with obsessive-compulsive disorder.

Average young people, especially boys, will have played about ten thousand hours of video games by age twenty-one. This is a lot of time honing a skill that is not directly linked to any monetary or educational gain. In his book Outliers, Malcolm Gladwell says ten thousand hours is generally the amount of time required to become an expert in any field. This means that as a sideline, our youth are becoming experts in a skill set that has limited use outside itself, except of course for those who go into professions related to the gaming industry or whose job involves a lot of computer simulations. It also has been pointed out that ten thousand hours are more than it takes to get a bachelor’s degree!

So is video gaming at a normal rate good or bad for the brain? The answer is not 100 percent clear. In a nutshell, it seems that a modest amount of gaming, like any form of learning, can actually be good for the brain. There is a difference between the hard-core gamers and casual gamers. Similar to reading and all other forms of “balanced” brain stimulation, developing superior skills at a video game has its upside. A study from the Max Planck Institute in Germany showed that gaming was associated with some regions of the brain being larger, in particular the entorhinal cortex, hippocampus, and occipital and parietal lobes. These are areas that are important for working memory and visuospatial skills. This sort of information is likely to be heartwarming for the many educators who are increasingly using video simulations that look a lot like games to teach many experiential skills, from flight schools teaching piloting to medical and nursing schools that simulate patients having heart attacks or strokes.

But obsessive gaming in the adolescent, to the exclusion of most other activities, appears, like addiction, to have both immediate negative effects and long-term negative effects on the brain.

Chinese researchers have discovered changes in the brains of college students who spend approximately ten hours a day, six days a week, playing online games. In these online gamers, the Chinese scientists found changes in small regions of gray matter responsible for everything from speech, memory, motor control, and emotion to goal direction and inhibition of impulsive and inappropriate behavior. They also found that with increased time online the adolescent suffered increased shrinkage, sometimes as much as 20 percent. And there was more: when the researchers focused their scanners on white matter, they found abnormalities, specifically in white matter connectivity in the brain’s memory centers, especially in the right parahippocampal gyrus. They hypothesized that an increase in density in white matter in this area of compulsive online gamers’ brains could indicate problems in temporarily storing and retrieving information. A reduction of white matter in other nearby areas could impair the ability to make decisions, including the decision to turn off the computer or turn away from the online games! All these areas also have been implicated in alcohol, heroin, cocaine, and marijuana addictions in adolescents.

Perhaps the scariest digital temptations for teenagers are electronic games of chance and poker where they are suddenly vulnerable to a kind of double whammy addiction: gambling and technology. Various studies indicate that anywhere between 70 and 80 percent of all teenagers have tried online gambling at least once. Although you must be eighteen to place a bet in a casino, studies show kids as young as ten are logging on to Internet poker sites that offer free practice games. Subverting proof of age requirements on Internet gambling sites is made easier by the relative anonymity of, and 24-7 access to, these sites. There are online casinos located all over the world, and all who want to, including American teenagers, can play thousands of hands of poker every day as long as the sites they visit are based offshore where there are no age restrictions. Kids also can get started early on a path to addiction through free-to-play gambling apps available through iTunes.

The International Centre for Youth Gambling Problems reports that while 3 percent of adults are struggling with compulsive gambling problems, that number more than doubles to 8 percent when it comes to minors. And the temptations will only grow worse. According to a 2013 Forbes magazine article, Morgan Stanley predicts that by 2020 online gambling in the United States will produce the same amount of revenue as the Las Vegas and Atlantic City markets combined, or more than $9 billion.

Behavioral addictions are just as insidious as chemical addictions because they make use of the same brain circuits. This is why, whether it’s gambling, interacting on social media, or snorting coke, teenagers are particularly susceptible to the rush of good feelings that comes with stimulating the brain’s reward centers. CRC Health Group, the largest provider of specialized mental and behavioral health care services in the United States, believes there is such a thing as Internet addiction and on its website and in its literature lists both behavioral and physiological indicators:

        Falling asleep in school

        Falling behind with assignments

        Worsening grades

        Lying about computer or video game use

        Choosing to use the computer or play video games, rather than see friends

        Dropping out of other social groups (clubs or sports)

        Being irritable when not playing a video game or not being on the computer

        Carpal tunnel syndrome—joint pain in fingers, hands, and wrists—a consequence of repetitive motions that come with excessive keyboard use

        Insomnia

        Forgoing food in order to remain online

        Neglecting personal hygiene and grooming in order to remain online

        Headaches, back pain, and neck pain

        Dry eyes and vision problems

Addiction, of course, may not be the only hazard of Internet obsession. A 2006 study reported in the Annals of General Psychiatry looked at the link between video games and symptoms of ADHD in adolescents and found that more symptoms, and more severe symptoms, of ADHD and inattention were found in adolescents who played video games for just an hour or more a day.

Which brings us to the topic of multitasking. While there is increasing evidence that adolescents are more vulnerable to Internet addiction, there are mixed opinions as to whether the digital invasion of our environment impairs an adolescent’s ability to focus the way adults claim it does. Can teenagers really multitask better than adults? After all, we know adolescents have a heightened ability to learn during their teen years, so perhaps they can. Yes and no.

When asked about multitasking, most teens say they believe they are good at it and that it allows them to accomplish more. On the other hand, studies show that multitasking actually interferes with learning in adolescents and that it takes anywhere between 25 percent and 400 percent longer for a teenager to complete his or her homework if multitasking is involved. So why do teens profess that multitasking helps them? It may be because multitasking makes them feel emotionally satisfied. For example, in one survey researchers found that students who watch television while reading report feeling more satisfied than those who read without watching TV. Zheng Wang, the lead author of the study, explained it this way, saying, “They felt satisfied not because they were effective at studying, but because the addition of TV made the studying entertaining. The combination of the activities accounts for the good feelings obtained.”

Remember the Minnesota undergrads who showed that distractions during memorizing and test taking lowered their scores? Not only is multitasking an impediment to learning, say scientists, it also can prompt the release of stress hormones such as cortisol and adrenaline. Chronically high levels of cortisol have been associated with increased aggression and impulsivity, loss of short-term memory, and even cardiovascular disease. In other words, multitasking can wear us down, causing confusion, fatigue, and inflexibility. We continue to do it in large part because of habit, and habits for adolescents are particularly difficult to break; that is why as teens get used to multitasking, they are more likely to continue doing it. “This is worrisome,” Dr. Wang of Ohio State told the media, “because students begin to feel like they need to have the TV on or they need to continually check their text messages or computer while they do their homework. It’s not helping them, but they get an emotional reward that keeps them doing it. . . . If you multitask today, you’re likely to do so again tomorrow, further strengthening the behavior over time.”

Despite the emotional rewards teens seem to get from multitasking, some researchers have found a correlation between multitasking and symptoms of depression and anxiety. At this point, however, scientists don’t know if increased multitasking leads to those symptoms or whether those symptoms lead to an increase in multitasking. The best way to help teenagers avoid the temptation to multitask is to encourage prioritization and structure. Encourage your adolescents to make lists—such as what they need to take home from school in the afternoon in order to do homework, or what they need to accomplish before going to bed. Try to get them in the habit of crossing these things off a list, too, as they are achieved. When your children come home from school, make them clean out their book bags or knapsacks in front of you and organize their homework assignments, and then ask them which they need to do first. Your teenagers may do this kicking and screaming, but if you make it a priority—no TV, no computer time, no snack until certain things are done—then you’ll increase your chances of success. Normally the fewer distractions the better, which is why you want to make sure the TV is turned off in the background when your son or daughter is doing homework. Some teens, of course, might actually relax and concentrate better listening to music on headphones while they do their homework. And the only way to be sure is to observe them.

The ramifications of adolescent involvement, or overinvolvement, with technology can affect a person not only cognitively and emotionally but also legally. In January 2013 an eighteen-year-old Oregon man, Jacob Cox-Brown, posted the following status update on his Facebook page: “Drivin drunk . . . classsic ;) but to whoever’s vehicle i hit i am sorry. :P.” The confession wasn’t sufficient to warrant a charge of drunk driving, but when the local police became aware of the post, they showed up at Cox-Brown’s door and arrested him anyway, charging him with two counts of failing to perform the duties of a driver. Six months earlier, an eighteen-year-old Kentucky woman posted a message after being arrested for drunk driving and hitting another car. In her Facebook post about the incident she added the ubiquitous abbreviation “LOL” (for “Laugh Out Loud”). Not taking kindly to the seemingly flippant message, the judge jailed her for forty-eight hours. States have varying laws regarding texting and driving; some even prohibit teenagers from any use of a digital device while driving, including talking on a cell phone, even if it’s with a hands-free device.