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Dark Side of the Moon: The
Secret Addictions of Adolescents
Molly Stanton, MS
Clinical Trainer, Addictions
Therapist
www.linkedin.com/in/mollystantonms/

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Dark Side of the Moon: The
Secret Addictions of Adolescents
I would there were no age between ten and three
and twenty, or that youth would sleep out the
rest; for there is nothing in the between but
getting wenches with child, wronging the
ancientry, stealing, fighting.
- Shakespeare, The Winters Tale

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Learning Objectives
 A robust understanding of drug, video game, pornography,
self-injury, and food addictions are; how they originate; and
the incidence/prevalence in adolescents and society
 Awareness of the consequences on adolescent development
as well as impact on academic achievement and social
maturation
 Methods to assist with identification of problematic
behaviors within these domains
 Skills and strategies to deal constructively with these
addictions and related behaviors

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What Is Addiction?
 Addiction is a primary, chronic disease of brain
reward, motivation, memory, and related circuitry.
-American Society of Addictive Medicine
* In a chemical addiction or food addiction the reward centers of the brain are
stimulated to simply want more.
* In an arousal addiction like video games and pornography, the brain is
stimulated by “what’s next”. Escalating amounts of novelty and intensity drive
the problem.

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What Is Addiction?
Diagnostic Criteria for chemical type addictions:
Tolerance
Withdrawal
The substance is used in larger amounts than intended. (loss of control)
Persistent desire and inability to cut down.
A great deal of time spent procuring, using, and recovering from the
effects.
Previously loved activities are ceased to increase the amount of time
using.
Use continues despite adverse consequences.

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What Is Addiction?
Addiction disorders are complex involving interactions
between: family influence, peers, boredom, risk-taking
tendencies of teens, co-occurring emotional disorders,
and the sheer availability of drugs and alcohol in
schools and communities.

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Developmental Characteristics of Teens
 Teens are forming their sense of self.
- self-absorbed
- belief they are unique “no one understands”
- friends become their focus, not family
* Want parental support, but resent interference.
• Intense emotional reactions (hormones, brain changes)
• Communication skills developing.
• Prefrontal cortex growth completes in 20’s.
• RISK TAKING

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Behavioral Signs of Addictions
• Personality changes
• Moodiness and irritability
• Blaming negative events in their lives on everyone
else
• Declining school work
• Changes in friends
• Loss of interest in previous hobbies
• Wanting to cut back but can’t

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The Variety of Teen Addictions
 Drug and alcohol addiction
 Video game and social networking
 Pornography
 Food
 Self-harm
 Fame-seeking
All of these addictions affect the emotional, reward, and
motivational pathways in the brain.

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Dark Side of the Moon: The
Secret Addictions of Adolescents
Whatever landscape a child is exposed to
early on, that will be the sort of gauze
through which he or she will see all the
world afterwards. – Wallace Stegner

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The Tale of 3 Brain Areas
Three brain areas are undergoing dramatic changes from
puberty through mid-20s:
•The Limbic System
•The Nucleus Accumbens
•The Prefrontal Cortex
These are also areas dramatically affected by chemical and
arousal addictions.

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Prefrontal Cortex
Prefrontal cortex is responsible for:
* Decision Making
* Planning for short and long term future
* Inhibiting inappropriate behavior
* Social interaction, reading other people
* Self Awareness

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Prefrontal Cortex
The Prefrontal cortex primarily develops in adolescence via
synaptic pruning – or if you use it you keep it, if you don’t use
it, you lose it. This part of the brain is literally being sculpted
in adolescence.
•The environment is what is
shaping these connections and
forming the adult brain.

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Nucleus Accumbens and Motivation
The Nucleus
Accumbens is
responsible for
translating desire into
action. Without it a
person may want a
career, sex, education,
but will take no action
to achieve those goals.

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Nucleus Accumbens and Motivation
Underachievment:
William Carlezon, Harvard University exposed rats to
stimulants, namely Ritalin.
*over time those rats exposed lost their drive.
* the rats would not take action to escape electric
shock.
* Teens prescribed or taking stimulants in the short
term have greater focus. In the long term the
same loss of drive occurs.

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Nucleus Accumbens and Motivation
Brown and Tufts University researchers found a linear
correlation between the size of the nucleus accumbens
and motivation.
85% of all prescribed stimulants are given to boys.
For every girl who drops out of school, 3 boys do.

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The Limbic System
• Emotional regulation
• Memory
• Rewarding feelings
Hypersensitive during adolescence
which leads to risk taking.
Recall the prefrontal cortex has not
yet developed its task of inhibiting
risky behaviors.
Results in risk taking without thought
of consequences.

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The Limbic System
 Dopamine in the limbic system rewards certain
behaviors.
 Highest in healthy adults during eating and sexual
activity
 Drugs and alcohol force overproduction or mimic the
effects of dopamine creating tolerance and
dependence.
 Drug use alters the limbic system, makes normal
activities less rewarding – rec0very may create a
period of more intense risk taking.

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Scope of Chemical Addictions

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Food Addiction
 Obesity is defined as weighing 20% or more above
your ideal weight
 1 out of every 5 American teens is obese.
 Heredity accounts for 40-70% of the risk for obesity.
 Lack of physical activity contributes to the problem.
 Poor nutritional role models in the home.
 Income: low income families are more likely to be
obese. - US National Library of Medicine NIH

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Food Addiction: Sweet, Fatty, Salty
Sweet, Salty, and Fatty foods trigger the reward center of the
brain (limbic syteem), triggering compulsive eating habits.
SALTY
-Salt acts as an anti-depressant.
- Many people diagnosed with Chronic Fatigue
were on a low-salt diet.
- Rats on a low salt diet are not motivated to press a
bar for a reward of sugar. But when given free access to
salty foods compulsively ate them (Alan Johnson, U of
Iowa).

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Food Addiction: Sweet, Fatty, Salty
FATTY AND SWEET
-Sweet and high fat foods affect the brain in much the
same way as heroin and cocaine (dopamine release).
Continual and regular consumption
leads to building tolerance
and eventual overload of the
pleasure center = compulsive
eating.

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Food Addiction: Sweet, Fatty, Salty
FATTY AND SWEET
Paul Kenney, PH.D. Scripps Research Institute: Study
on compulsive eating in rats.
-Group 1: rat food (yuck)
-Group 2: 1 hour a day bacon, frosting, chips.
-Group 3: unlimited 24 hour access to
sweet/salty/fatty.
Group 3 rats ate constantly, developed a tolerance to the foods were 40%
over healthy weight, and would eat until they were in pain or had stomach
rupture.

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Addiction vs. Obesity
Not all obese children are addicted to food. And not all
teens addicted to food are highly obese.
Signs of a food addiction:
- Predominance of junk foods.
- Hiding food for later use.
- Eating to cope with stress or mental health issues
- Creating “drama” as an excuse to eat.

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Addiction vs. Obesity
Assessment:
-Food diary
- Ask family about eating habits/hiding food
- Nutritional education for clients and professionals:
Yale Rudd Center For Food Policy and Obesity
www.yaleruddcenter.org

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Self Harm: It’s About Coping
Self Injury consists mainly of lacerating the skin with
blades or burning the skin.
Estimates between 12-37% of teens have tried or are
currently engaged in self-injury.
2-3 times more girls than boys self-harm.

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Self Harm: It’s About Coping
Causing physical pain temporarily relieves psychological pain
from trauma, depression, stress, and anxiety.
Some teens who self injure say that it takes away numbness
and for a time they at least feel something.
Self harm triggers endorphin and dopamine release, triggering
an increase in pain tolerance and a need to escalate the
behavior.

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Self Harm: It’s About Coping
Risk Factors:
•Being a teen female
•Having friends who self-injure: pro-si.livejournal.com
•Trauma background/abusive home.
•Mental health issues
•Substance use.

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Self Harm: It’s About Coping
Warning signs:
•60% of inpatient psych admits report at least 1 self harm
incident.
•Poor coping skills
•Covering of wounds – long pants/sleeves in summer
•Presence of blades other means to cut in their room
•Visiting pro-self-injury websites.

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Video Game/Pornography/Social Networking
“I think the on-demand pleasure, gratification, control, and
stress release of pornography and video games reduces our
patience, makes us hold ourselves to unrealistic expectations,
and cripples us socially.”
-Teen respondant in a study by Philip Zimbardo.

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Video Game/Pornography/Social Networking
• 70% of American teens are using social networking (2011)
• 51% of these teens say they regularly see pictures of their
friends intoxicated or high.
• These teens are 5 times more likely to smoke
• 3 times more likely to drink
• 4 times as likely to use illicit substances.
-National Survey of American Attitudes on Substance Abuse
XVI (2011) Columbia University

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Video Game/Pornography/Social Networking
Video Games:
•Average youth spends 10,000 hours gaming by age 21.
- A Bachelor’s degree takes 4,800 hours.
Pornography:
•$100 billion worldwide. 89% of sales in US
- 13,500 porn flicks made vs. 600 movies.
- estimates between 60-70% of boys consume porn
- 1 in 3 boys is classified as a heavy porn user.

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Media and the Brain
AROUSAL:
•If there is lust, arousal heads toward a sexual direction and
the limbic system is the primary focus.
•If there is a need to win, arousal sends us goal setting and
achieving success, and the nucleus accumbens comes into
play.
Both create a release of dopamine in these brain areas similar
to chemical dependence.
- tolerance occurs
- seek ever increasing extreme examples.

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Media and Development
Why do teens prefer games and pornography?
Phillip Zimbardo interviewed thousands of adults and teens:
•85% instant gratification
•73% no risk of rejection
•72% fun and easily accessible
•67% a sense of control
•67% escape the monotony of real life.

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Consequences
Costs to development of online addictions:
•Increase in shyness and social awkwardness/deep fear of
rejection.
* 1980 – 40% report shyness. 2011- 60% report shyness
•Decrease in face to face contact leads to lower empathy and
inability to read social signals.
* A negative cycle: regular gamers and porn users report
poor physical health and depression, low social skill, which
leads to further use of these media.

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Consequences
• Inability to conduct a healthy relationship that builds gradually and
requires intimacy.
• Eventually the inability to become aroused at all as there is an end to
novelty and intensity.
• Instant gratification and total control aspect lead to a “get everything/do
no nothing attitude.”
• A total rewiring of the prefrontal cortex, limbic system, and nucleus
accumbens which may be a permanent problem.
• Poor achievement in career and family.

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Media and Guys
Philip Zimbardo: The Demise of Guys
http://www.ted.com/talks/zimchallenge.html

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Why Is This Happening

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Individual Factors
Addiction is hereditary, about 15-20% of people carry the genes.
60% of kids who use substances before 16 will meet the criteria for
substance dependence as adults.
Developmentally kids are primed to absorb addictive media and drugs
* Sensitivity of the limbic system coupled with prefrontal cortex
development drive risk taking and novelty seeking.
* Stresses on teens are increasing, their coping capacity is still
developing.
Learn to expect gratification for minimal effort. Nucleus accumbens is not
functioning, no motivation to get off the couch.

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Microsystem Factors: Family
• Changes in Family Structure:
* 1950 a family had 4 adults to 1 child (grandparents, uncles, etc)
* 2013 average family size is just above 3. Ratio of teachers to
students 30-1
* only 3 of every 5 kids have regular family dinners those that do
report much lower incidence of all kinds of addictions.
* 40% of households are headed by single moms who are under
increasing stress, yet are responsible to teach kids stress regulation.
* CDC reports kids of divorced families/single moms are 375% more
likely to need mental health or addiction treatment and more likely
to be on ADHD medications

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Microsystem Factors: Education
The education system differentially fails boys:
* boys are 30% more likely to drop out.
* boys verbal abilities develop later, energy levels high, learn by doing,
schools are eliminating recess, PE, teaching to a very verbally slanted
test. – Boys begin to feel like a failure and despise school.
* boys receive 70% of all Ds and Fs.
* 5x more likely to be labeled ADHD and be given ritalin (nucleus
accumbens burn out, anxiety as a side effect increases marijuana use)
* 2/3 of kids in special education are boys
* boys earn only 40% of bachelor’s degrees, 37% of Master’s and 46%
PhD’s by 2016

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Microsystem Factors: Education
• Schools teach to the test. Kids find this irrelevant to their needs and
tedious at best and not relevant to their real world needs.
• Zimbardo and Duncan (2013) – How would you change the school to
engage young men?
* 74% - teach more practical subjects (communication, critical
thinking, personal finance)
* 66% offer more advanced programs for kids who show interest or
ability.
* 60% - smaller class sizes
* 50% male and female teachers.
*64% felt pressure to perform to the test coupled with fear of failure
led them not to try

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Microsystem Factors: Education
• The elimination of play time and gym leads to negative consequences:
* in boys increased probability of ADHD diagnosis, nowhere for their
energy to go.
* decreased time to learn socialization skills
* decreased development in intellectual flexibility which develops
during free time and imaginative play.
* Parents are absent or too exhausted from their own time demands to
support healthy participation in school.

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Exosystem Factors: Perceptions of the Future
RELATIONSHIPS/FAMILY: Why bother?
* Divorce rate high and most divorces are vicious and result in pain and
stress for the kids.
* 45% of people born after 1970 feel marriage is archaic.
•No good role models for trust and intimacy.
•Marriage to Gen X and Y is seen more in terms of losing your
independence, sacrificing your own goals for a thing that will fail anyway
in 10 years
•Kids are still taught to pursue it, but are not taught how to handle it.

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Exosystem Factors: Perceptions of the Future
MEDIA AND FAME – OR – THE GREAT DISAPPOINTMENT
Robert Bly and Marion Woodman:
•Kids are told they can be anything they want to be.
•Young kids move through life feeling something wonderful is about to
happen.
•In our 20s somewhere we realize nothing wonderful is about to happen,
we will not be the next American Idol.
•We do an awful job of preparing our teens for the fact that 99.999% of
them will not be famous.
•Fame seeking is about unrealistic expectations.
•Only in the virtual world can you “rule the world”

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Exosystem Factors: Perceptions of the Future
COST OF LIVING
•Compared to their parents generation, the cost of living is out of
proportion with earning potential.
Peter Brokvar, economist: The cost of living is at a record high, but there
are 7 million fewer jobs.
1970 1990 2010
Median income $8370 $29,943 $49,445
Ave. Home $17,000 $79,100 $221,800
Public Tuition $480 $5,243 $15,014

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Exosystem Factors: Perceptions of the Future
• In the recession 3 men lost jobs for every woman.
• Young men are disinclined to feel optimistic about their ability to
successfully provide for a family or keep a marriage together.
• Many young people feel their hard work will not result in prosperity.
* again, fear of failure is high, stress level is high, control is low. It
becomes easier to retreat to online activities and substances to manage
the stress or be in a high control/high gratification environment.

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HOLY COW!

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Interventions?
• Screening for substance abuse, referral to treatment,
family involvement in treatment.
• DSM V despite mounting information about arousal
type addictions, will not be including them, creating
multiple barriers for prevention and treatment.
• Better and comprehensive sex education in schools.
• Mentoring for boys: Journeyman 2007 – movie
about mentoring.

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Interventions?
• Social skills training in schools.
• Close parental monitoring of online activities.
• Social media literacy programs?
• Family dinners
• Teaching coping skills in school
• Community development of places where boys can socialize
in pro-social ways.
• Health classes focused on nutrition and education
• Parental limitation on fast and snack foods.
• Harass your public representatives about a lot of things.

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FIN
We are the
people we
have been
waiting for.