Six hours a day, 2 years: How an innocent tap on YouTube turned a six-year-old into a digital addict, drew her into a world of horror shows

It was in early 2022 that Anamika was referred to PGIMER by her pediatrician, who spotted the red flags – falling grades in school, making frequent mistakes in her academic work, losing concentration in class, not sleeping enough, crying in the middle of the night, losing interest in games and muttering to herself. Leave aside communicating, she avoided eye contact with anybody and completely withdrew into a shell. She would only talk to her dolls. The Department of Pediatric Neurology referred her to the Department of Psychiatry after an MRI and other tests ruled out any organic cause for her behaviour.

Dr Nidhi Chauhan, Assistant Professor, Department of Psychiatry, studied her genetic vulnerability, bio-psycho-social patterns and interviewed both parents. “We found that the child was spending close to six waking hours, unmonitored, watching YouTube videos. A treatment and therapy plan was chalked out by psychiatrists, psychologists, play therapists. We put her on low-dose anti-psychotic medicines, involved parents in the treatment plan, and asked them to address the emotional neglect which has a deep impact on impressionable children. After six weeks of intensive treatment and therapy, the child showed a marked improvement and began talking to other children in the ward, sat down for studies and games, began responding to others and started taking interest in daily activities. The parents were counselled on how to monitor content and restrict screen time, spend quality time and engage with her. Anamika has now started going to school and has reduced her screen time drastically, spending more time with her peer group. From the initial follow-up every two weeks, her visits to the institute are monthly. And the smile is back on her face,” she says.

Dr Chauhan notes that the number of children seeking help for gaming and social media addictions has increased substantially after the pandemic. “Our OPD walk-in numbers have gone up from an annual 1,000 new cases to more than 1,500 and this is just one institute in the country. The maximum percentage of children is between 11 and 15 years but the number of under-10 patients has also increased, with more males than females coming to the OPD. They all have the same symptoms — psychosis, behavioural problems, anxiety and depression. One positive sign is that 60 per cent who seek consultation are self-referrals, which means that awareness about mental health is increasing,” she adds.

Dr Chauhan, along with Dr Suravi Patra, has authored a paper, “Exposure to Smartphone and Screen media in Children and Adolescents and COVID-19 pandemic”, on behalf of the Indian Association for Child and Adolescent Mental Health (IACAM). “All locked up, we turned to digital media as a coping mechanism, except that it has turned out to be a maladaptive one. The impetus now should be to conceive a balance regarding exposure to digital media with this ‘new normal’ in mind,” adds Dr Chauhan. The paper reveals how early exposure to digital media narrows the children’s area of interest, limits their imagination, discourages exploratory learning and decreases their outdoor time with peers. All of this impairs their cognitive and social skills as well as their physical health. “We have treated teenagers with gaming addictions, who have been only preoccupied with the ‘likes’ of their followers, slipping into depression when they don’t get the validation, and ignoring their studies, family and friends. Cases of virtual friendships going wrong and affecting their mental equilibrium are far too many. Digital dependence happens because of instant gratification of a child’s desires, again born out of an attention gap within existing family structures. If parents recognise and accept that their child needs psychological and psychiatric help, with regular therapy, counselling and medication, the child will be on the road to recovery,” says Dr Chauhan.

How much is too much?

Under 2 years: This group should not be exposed to any type of screen media (smartphones, tablets, television). Minimal screen time may be allowed for social interaction with close family members staying at distant places.

2 to 5 years: Limit screen time to a maximum of one hour per day with each session supervised and not more than 20-30 minutes.

5-10 years: Limit screen time to less than two hours per day. The device used by the child should belong to one of the parents, and the child should not get an independent phone/tablet/laptop.

10-18 years: Balance screen time with one hour of outdoor physical activity (playtime), 8-9 hours of sleep, and adequate time for schoolwork, meals, hobbies, peer interaction and family time. Parents should keep tabs on their virtual activity. They should have passwords and the ability to access all online accounts at any time to protect and teach youngsters about their digital footprint.

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