Despite significant controversy, Gaming Addiction is now a mental health condition in IDC-11 (although not formally recognised in the UK’s DSM-V 2013; but listed as a condition for further study), characterised by:

· Impaired control over gaming
· Increasing priority of gaming over other life interests and daily activities
· Continuation despite negative consequences

This raises questions for parents and carers about what is ‘normal’ online use and time spent on gaming. The most recent Children’s Media Use and Attitudes Report 2017 shows that 61% of 12-15 year olds play online games[2] – and 2017 data shows young people aged 12-15 spend an average of 12.2 hours gaming a week[3]. These are averages and time spent gaming online needs to be balanced with a young person’s overall screen time and activities offline.  But when does a child’s online world now become a medical disease or illness? An interesting question I suspect medical professionals are now pondering with regards to assessment, purpose and treatment?

Equally there are also a number of campaigns about Pressing Pause in our online and offline worlds, with an interesting campaign from the not-for-profit JED Foundation in the US, which supports young people’s mental 

health. This campaign, in conjunction with MTV, helps young people to cope with stress, anxiety and relationship issues, by encouraging them to Press Pause, supported by 10 online short video clips[4].

What can Pressing Pause online – for ourselves and our young people – involve?

· Limiting screen time and being aware of the amount of time spent online, either gaming or using social media for example.
· Being aware of when time spent online is interfering with activities offline, especially sleep.
· Being aware of any differences in time spent in chat/interaction with others and time alone reading or viewing content but not interacting.
· Limiting smartphone notifications and pausing the desire to respond.
· Pausing before replying to a text message or email.
· Pausing before uploading content to social media, especially if it is about or contains images of other people.

Social media companies don’t make this easy and are fully aware of how our minds respond to keep us engaged with their sites; more time engaged online means more adverts are viewed and sponsored links clicked.  Our minds, thoughts and actions are controlled by our neurotransmitters, one of which is dopamine, the pleasure seeking stimulus. Dopamine controls our desire to seek pleasure and receive reward, especially with the instant gratification from a text or tweet. This is further fuelled by the unpredictability of the unknown; who is the message from? Who has liked or responded to our post/content? This creates a dopamine loop[5] of seeking pleasure, reward and gratification, from which it is hard to press pause.       

Yet training ourselves to press pause and resist these desires can be beneficial to help mind and body relax and switch focus. But it’s important to remember that it’s hard for us and even harder for our young people, whose teenage brains are firing much faster than ours, flooded with dopamine and a heightened sense and priority given to risk and reward[6].