All of us know that the abuse of drugs, alcohol and tobacco affect our health. Yet, a few of us know that addictive behaviours like compulsive gambling, smart phones and downloading pornography, can have as serious an impact on our health as excessive substance use. Whereas, the impact may not be so obvious physically, their mental effect can lead to more serious complications leading to depression and affecting our inter personnel relationships and ability to perform effectively.
As we move into a hi tech world, the Sumithrayo Drug Demand Reduction Program at Mel Medura has now expanded its scope of activities to reach out to this fast rising category of persons who like substance users are trapped in their addictive behaviours.
The Sunday Observer asked the Director, Mel Medura, Jomo Uduman how his organisation has set about its task.
Excerpts…
Q. The Sumithrayo Drug Demand Reduction Program at Mel Medura is well known for its work in rehabilitating persons affected by misuse and abuse of alcohol and other drugs. I understand you are widening your horizons and reaching out to persons with behavioural addictions. Does that mean you have changed your earlier objectives?
A. Our objectives remain the same but have now been broadened to encompass behavioural addictions too - which we realize is escalating rapidly, spiralling out of control without being addressed. People do not know where or how to seek help – for themselves or their family and friends. The interest this new service has generated among people in all walks of life, that include professionals and parents - makes all of us at Mel Medura motivated and happy that we made this move to reach out.
Q. What kind of addictions are we talking about here? Video games? Smart phones?
A. The compulsive use of Smart Phones (to a great extent) and Computer Gaming (to a lesser extent) together with compulsive Internet browsing, Pornography, and Gambling. Of these only Gambling has so far been included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
Q. What about porn addiction?
A. Similar to substance users feeling a strong urge to use drugs, porn addicts could also experience a strong urge to view porn. They may deny their porn viewing or be upset when loved ones request that they stop. They may become angry, hostile, or irritable when asked to stop using porn. A person addicted to porn may feel guilty or ashamed and work hard to hide his or her porn viewing. There is a 4 step process that occurs after exposure to Pornography. 1.Addiction. After discovering pornography, you may want to view it often. 2.Escalation. You may want more exciting or shocking images to view. 3.Desensitization.The once shocking material becomes normal.4.Acting out. Once you become desensitized to the material, you may seek to reproduce it in the real world.
Q. How do these addictions impact on the health of the users 1) physically 2) mentally 3) psychologically 4) emotionally?
A. Behavioural addictions can cause a collection of disorders, such as, restlessness, fatigue, deprivation and changes in sleep patterns, reduction in physical activity, impatience, attention deficit, sexual cravings, violence, isolationism, anxiety, loss of self-esteem, reduction of coping skills, obsessive thoughts, occupational and interpersonal difficulties, avoidance of family and personal responsibilities and priorities of eating disorders, and withdrawal symptoms ensue. ‘Digital Dementia’ is a term now used to describe how the overuse of digital technology is resulting in the breakdown of cognitive abilities. While most of us grew up remembering phone numbers and other key information for our livelihood simply by memorizing it, many of us today do not need to remember these because we have devices that do it for us. It may seem like an easy way out, but can lead to the over development of the rational fact finding skills of the left side of our brain at the expense of the right side which is said to be more imaginative, intuitive and emotional.
Q. Socially, is there an impact on interpersonal relationships even with their own family members? Are they likely to use these digital tools to escape from the real world whenever there is a problem in the family, their workplace, or school?
A. Technology is now used to escape from the real world whether or not there are problems. Our short attention span lifestyle is training us to seek new information every moment, so that phones with constant news updates are more engaging than face-to-face conversations, and could result in fractured relationships, problems at workplace and of course school. We have seen families at restaurants staring at their devices jabbing, prodding and swishing them, hardly looking up to exchange a thought or a smile. Obviously, this happens at home too. We see people in all walks of life walking along roads neck bent supposedly looking at some ‘important’ message on their device. Sometimes, earphones are plugged in to completely shut off the real world while placing them in extreme danger. There are others who are addicted to watching porn, gambling, internet browsing and gaming, isolating themselves from their loved ones, tearing their families apart and then suddenly realizing it, and feeling helpless and unable to break the cycle of addiction to save themselves and their lives from destruction. That’s the point where Mel Medura can help them to recover.
Q. Today, we see many people compulsively using social media. What are the negative impacts that such behaviour can have on their health?
A. People feel good each time that notification bubble pops up and tells them someone has liked their post, and are dejected when the likes are few, or they cannot live up to the posts of other ‘friends’. How we respond to that feedback may reveal something about our self-esteem and sense of purpose. The positive feedback we get on social media can also make us feel more supported and better. But, those with low self-esteem could feel especially bad if they didn’t get that positive feedback. It is necessary to also examine a new phenomenon referred to as ‘false Facebook-self’ where one’s FB image deviates from their true image, serving as a gateway to more problematic behaviours. Hence, vulnerable personalities may create online identities which are much more rewarding and appealing than their true identities. Then, there is a certain amount of radiation that emanates from a phone and needless to say has an impact on the user’s health, considering that it touches the ear. Screens on mobile devices tend to be smaller than computer screens, which means we are more likely to squint and strain our eyes while reading messages. But we remain in denial that we are indeed susceptible to digital eye strain and an early visit to the optician. Also, there is an ailment termed ‘text neck’ caused by hanging your head forward and looking down at your device for long periods of time. It is associated with chronic headaches and shoulder/neck pain and also doctors are beginning to see an increased curvature in the spine and an early onset of arthritis. The statistics are quite alarming but nobody is sounding any alarmbells.
Q. Can chronic social media use contribute to anxiety in users if they are unable to connect?
A. Yes. There is an increase of tension, restlessness or irritability when it is impossible to connect, indulge or use the device. These can be considered as withdrawal symptoms – although it is different to withdrawal symptoms experienced with substance use.
Q. Can it lead to other more serious health issues like autism?
A. Developing brains adapt to the environment they find themselves in. There is some evidence that among the risks of early screen exposure is the hastening of autism in the young and attention deficit hyperactivity disorder (ADHD) in older children. Parents must be aware of this as substantial evidence already exists that screens impede mental health in the young.
Q. What is your present action plan to help persons with behavioural addictions?.
A. We have begun advertising the inclusion of behavioural addiction into our (Free) services and are having a lot of feedback from the public. Our key workers have also received specialized training from our Honorary Consultant Dr. Shamil Wanigaratne. A Bio Psychosocial approach is what Mel Medura strives to focus on and implement. Emphasis is on respect, focus is on strengths, the importance of personal choice, and self-determination of goals, all of which are crucial for the person struggling with substance and behavioural addictions.
The service is delivered free of charge in a personal and engaging style where clients leave feeling hopeful and good about themselves while looking forward to coming back for future sessions.
Contact: Mel Medura – 60 Horton Place Colombo 7. Tel: 2694665, 2693460 mel [email protected]