Video Games

YES, YOUR KID IS PLAYING TOO MANY VIDEO GAMES.

If you even have to ask yourself the question, you probably already know the answer. Video games are entering the world of addiction medicine and video game and internet addiction may actually become diagnosable conditions in the new addition of the Diagnostic and Statistical Manual for psychiatrists.

I see countless kids who are doing their brains a severe disservice by gaming too much. A recent study in the journal of pediatrics states that kids can definitely give themselves even worse ADHD by playing games and watching TV more than 2 hours average per day. But my thinking is that number is not low enough. For the most part, there is no socially redeeming reason to play video games, especially first-person shooters and massively multiplayer online games. My reasons are many, but my main complaints center around the damage that the games do to family togetherness. Humans are animals who are meant to be around each other, communally, enjoying each other, sharing, cooperating, and helping each other. The endless selfish hours of videogames that many children are allowed undermine the role of the family on human development. My other complaint about videogames is the false sense of self-esteem that develops in children. I see so many kids whose sole talent is that they can beat levels on the hottest XBox game. Who cares? When that kid is applying for college, is the Dean going to ask, "what level are you in World of Warcraft?"

Gaming is reaching the level of addiction for many kids. It impact sleep, worsens grades, and becomes an obsession just like drugs and alcohol. Kids play games for longer than intended, just like drugs and alcohol. They get withdrawals just like drugs and alcohol. They lie about their gaming, just like drugs and alcohol.

If your kid is addicted to video games, I suggest removing the system from your house or disabling the computer. Require your kids to play on the weekends only or play as a family for limited amounts of time. Video games are a huge privilege, but some kids act like they are entitled to play games every day. No they are not. Put your foot down. Your kids will throw a giant fit and be mad at you, and that's ok.

Diet Recommendations

A healthy diet is essential for brain functioning.

Many kids have the false idea that a low-fat diet is healthy for weight control. Fat is a major component of a healthy diet and is essential to keep our brains and many other organs running properly. Your brain is mostly made of fat, so don't skip out on one of your body's most essential building blocks. Carbohydrates are turned into glucose which is the only fuel that your brain can use for energy. Our neurotransmitters are made from amino-acids which are the breakdown products of protein we eat. Without the right amino-acids, we can make ourselves depressed, anxious and slower thinkers.

A balanced diet of an even proportion of fat, carbohydrates, and protein is probably the best diet for humans. We must also account for activity level when we eat. If you are a couch-potato, the calorie requirements are not the same as if you are an endurance runner.

Some helpful tips

1lb=3500 calories

-if you want to lose a pound or gain a pound, it’s all about the numbers. If you eat 500 calories more than you need, you’ll gain a pound per week (500x7=3500calories=1lb). If you eat less or exercise equivalent to 3500 calories less than your base calorie need, you will lose one pound.

Base calorie need:

-take your weight in lbs and multiply by 12 and that’s the minimum number of calories you need to stay your current weight. If you do lots of physical activity, you may need to multiply by 13 or 14 to get you basic needs. If you need to lose weight, then multiply your target weight by 12 and eat that many calories.

Food Diaries:

-keeping a food diary and using web resources to calculate you total calorie intake, fat/protein/carb balance is really helpful. “Lose It” is a great application if you have an iPhone. Caloriecount.com and livestrong.com are other great resources.

Life is not a Spectator Sport- by George Sheehan MD

We are constantly being warned to check with our physicians before beginning athletics. Play and games evidently can be risky business. What we are not told are the risks of not beginning athletics-that the most dangerous sport of all is watching it from the stands.
The weakest among us can become some kind of athlete, but only the strongest can survive as spectators. Only the hardiest can withstand the perils of inertia, inactivity, and immobility. Only the most resilient can cope with the squandering of time, the deterioration in fitness, the loss of creativity, the frustration of emotions, and the dulling of moral sense that can afflict the dedicated spectator.
Physiologists have suggested that only those who can pass the most rigorous physical examination can safely follow the sedentary life. Man was not made to remain at rest. Inactivity is completely unnatural to the body. And what follows is a breakdown of the body's equilibrium.
When the beneficial effects of activity on the heart and circulation and indeed on all the body's systems are absent, everything measurable begins to go awry.
Up goes the girth of the waist and the body weight. Up goes blood pressure and heart rate. Up goes cholesterol and triglycerides. Up goes everything you would like to go down and down everything you would like to go up. Down goes vital capacity and oxygen consumption. Down goes flexibility and efficiency, stamina and strength. Fitness fast becomes a memory.
The seated spectator is not a thinker, he is a knower. Unlike the athlete who is still seeking his own experience, who leaves himself open to truth, the spectator has closed the ring. His thinking has become rigid knowing. He has enclosed himself in bias and partisanship and prejudice. He has ceased to grow.
And it is growth he needs most to handle the emotions thrust upon him, emotions he cannot act out in any satisfactory way. He is , you see, an incurable distance from the athlete and participation in the effort is the athlete's release, the athlete's catharsis. He is watching people who have everything he wants and cannot get. They are having all the fun: the fun of playing, the fun of winning, even the fun of losing. They are having the physical exhaustion which is the quickest way to fraternity and equality, the exhaustion which permits you to be not only a good winner but a good loser.
Because the spectator cannot experience what the athlete is experiencing, the fan is seldom a good loser. The emphasis on winning is therefore much more of a problem for the spectator than the athlete. The losing fan, filled with emotions which have no healthy outlet, is likely to take it out on his neighbor, the nearest inanimate object, the umpires, the stadium or the game itself. It is easier to dry out a drunk, take someone off hard drugs or watch a three-pack-a-day smoker go cold turkey than live with a fan during a long losing streak.
Should a spectator pass all these physical and mental and emotional tests, he still has another supreme challenge to his integrity. He is part of a crowd, part of a mob. He is with those the coach in The Games called, "The nothingmen, those oafs in the stands filling their bellies." And when someone is in a crowd, out go his individual standards of conduct and morality. He acts in concert with his fellow spectators and descends two or three rungs on the evolutionary ladder. He slips backward down the development tree.
From the moment you become a spectator, everything is downhill.

Video Games and Attention

A new study highlights the dangers of excessive television and video games on attention. The study published in the Journal of the American Academy of Pediatrics is available for free download at www.pedatrics.org.

Self Injury

I see an alarming number of children that harm themselves, and this is one of the most difficult behaviors for parents to understand. Self injury can take many forms from overt physically violent behaviors like cutting, burning to less violent forms like overdoses and substance use. I like to give parents and kids a basic framework from which to think about self injury.

In non-technical terms, the 4 categories basically look like this:

1. "It feels good"

2. "It stops a negative feeling"

3. "It gets me attention"

4. "It gets me out of something"

"It feels Good"- some kids describe a rush of pleasure when they injure. I don't really see this description very often. Of course, this is the major motivator behind substance abuse and dependence.

"It stops a negative feeling"- Most of the kids I see identify this as their number one motivation. Many kids who self-injure are depressed, anxious, or they have experienced some type of trauma. They feel horrible or their thoughts are intolerable, and they have learned that the self-injurious behavior temporarily distracts them.

"It gets me attention"- This is another major motivator, but it's the one kids are least likely to admit. Whether conscious or not, self-injury is an attention-grabbing behavior. Parents need to be very aware of how their own reaction to self-injury could actually be rewarding self-injury. Kids also use self-injury and the threat of it to manipulate parents, friends, and their boy/girlfriends.

"It gets me out of something"- Many of the circumstances that lead up to self-injury involve a kid being in trouble, feeling overwhelmed, threatened or trapped. Many of the kids I see started out using self-injury in a moment of desperation and then continue to use it under less severe circumstances because it worked before. Self-injury takes away a parent's power, afraid to challenge the self-injuring child for fear they will repeat the behavior.

So those are the basic theories. I hope this helps some parents out there. With this knowledge, the next step is to get the kids working on alternative behaviors, understanding their own motivations behind the behavior, exploring their sources of stress, improving communication before they get into that overwhelmed place. For parents, we need to work on identifying the underlying issues that might be overwhelming a child, examining the ways in which a parent might actually be reinforcing the self-injury.

If you or your child are dealing with this problem, please seek help with a local mental health provider.

Child Fitness

Obesity in children and adolescents has nearly tripled since 1980. Obesity is theoretically the easiest medical problem to fix and it is up to parents to fix it. Obesity is the result of consuming more calories than we expend. Losing weight is simple- burn a few more calories than you consume and you will lose weight. We live in a world with too many calories that are too cheap.

Diet

I get lots of questions in my office about diet and nutrition for behavioral disorders. I try to keep my answer as simple as possible: DON'T GIVE YOUR KIDS JUNK. I also typically recommend more protein (especially fish), more fruit, more vegetables, less bread. Processed foods containing preservatives, artificial flavors, high fructose corn syrup, and artificial colors are probably the worst things to feed children. Whole foods such as fresh fruit, fresh vegetables, lean meats, nuts, fish are the kinds of foods nature intended us to eat. If I ever plug any supplement, it is Omega-3 fatty acids from fish oil.

If you want a longer explanation of my thoughts on diet, I suggest reading the book "The Paleo Diet" by Dr. Loren Cordain. The theory behind the paleolithic diet is that many of our modern ailments are attributable to our physical inactivity and modern diet. By modern, I mean the typical grain-based diet that began around 10 thousand years ago. Prior to the discovery of modern agriculture, humans ate what we could hunt and gather, and what we could prepare without much cooking. There was no bread, no chips, no potatoes, no pasta, no cookies, etc. The only sugar we ate came in the fruit and vegetables. Insulin levels remained very low eliminating the possibility of type II diabetes. Calories were low, exercise was plentiful, so obesity was virtually impossible. Artificial colors, flavors, and evil high fructose corn syrup weren't invented until the mid-20th century. All the vitamins and trace minerals we ever needed are contained within the basic foods of the paleolithic diet.