While we all have our vices and indulge in them to relax every now and then, doctors at NIMHANS hospital, who’ve already been doing work with de-addiction, were faced with a peculiar addiction. A 26-year-old man presented with being addicted to watching shows online. He would reportedly spend at least seven hours a day watching programs and movies on the online platform.
“The patient told us that initially it was a stress buster for him. He was facing immense pressure at work and was also dealing with some other personal issues and would end up logging onto to an online platform to watch some shows as a distraction,” said Dr Manoj Sharma, Professor of Clinical Psychology at NIMHANS to TNM, “But soon he found himself using this as an escape mechanism and spent far more time on it than he did doing any other tasks.”
Manoj further explained how often and how easily an escape mechanism could turn into a terrible coping mechanism. Constantly changing environments can lead to people experiencing stress which may be internalized if not handled appropriately. “In this man’s case, he first came in saying that he was playing too many video games, but through our examination we realized that he was quite in control of that. It was on deeper probing that we came to know that he used these shows and movies to de-stress. It did two things in his case, one was that he became completely cut off from his environment and the other was that it helped him become relaxed,” added Manoj.
Over time, the man’s coping mechanism became the only activity he took time to do, ignoring all other things in life.
When leisure activities become an addiction
“Everyone enjoys some form of entertainment, something which relaxes them. But there is a point at which is becomes something which may warrant professional intervention,” explains Manoj.
First it starts as a simple activity one wants to undertake to cope with stress. Over time, this becomes replaced with a desire or need to continuously partake in such an activity. In this man’s case, he derived a sense of relaxation from watching multiple programs online. Eventually, a person ends up ‘addicted’ to the same and ends up using it as an escape mechanism.
How is this treated?
“In this young man’s case, he was quite aware of the fact that he’d fallen into this bad pattern, so it was easier to work with him to break out of that. However, if someone is in denial of the fact that they are falling into certain patterns, then our best approach is to get them to become aware of the existing problem,” said Manoj.
Once a person is aware of the fact that they struggle with such an issue, they are then taught relaxation methods. In this patient’s case, they administered an aptitude test to help him determine what skills he possessed which he could tap into to get him out of his addictive patterns. Next, doctors work to help patients develop better stress management mechanisms and problem solving techniques.
“The last step is to bring in family members, so that the person is surrounded by a supportive environment. Family can definitely help someone achieve their goals of breaking addictive patterns by showing that sense of understanding itself,” explains Manoj.
Identifying good and bad coping mechanisms
While Dr Manoj explains that using an external agent or device to manage stressors may not necessarily be indicative of an addiction, however there is a point at which these coping mechanisms become addictions. Persistent and recurrent habits which one turns to for relief from stress may be considered an addiction, according to him.
“It comes down to how cognitively aware a person is of their habits,” explains Manoj, “When they are more pessimistic in nature and find that they are unable to focus on their daily work without being drawn back to their habits, it is potentially harmful to their well being.”
In contrast, someone who has good coping mechanisms in place is able to recognise symptoms of excess stress and is able to figure out how to actively tackle the same.
“Loss of touch with reality, other activities taking a hit and this one becoming the priority, and even withdrawal symptoms are all signs that someone is actively battling an addiction,” explains Dr Shwetha Raghavan, a psychiatric consultant from Chennai, “Many times the person becomes excessively aggressive if you try to actively pull them away from the addictive activity or habit.”
An in-built rewards system
The mind has an inbuilt system which leads to addictive behaviour when unchecked.
“There is a part of brain known as the orbitofrontal cortex or the OFC, this is the primary output of the rewards region. It is under inhibitory control by the prefrontal cortex (PFC). When there is a defect in the prefrontal cortex, it leaves the reward system susceptible to become more prone to developing addictions,” says Swetha.
Any alterations in the PFC and amygdala interactions can result in a defective OFC which can lead to the onset of addictive behavior.