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Question: This is regarding my son. He is 17 years old. He is our only child and I admit, quite pampered. Our problem is that he is addicted to PUBG. The addiction is so bad that he is not attending college. He used to be a topper in his class...now he is not even writing his tests. Recently, we have noticed that he is becoming violent...he attacked his mother when she took the phone away from him. He does not come out of the room and is always playing PUBG. We are desperate Please help!

Answer: Hello! For us to understand this behaviour, it is important to know what the game represents or what the world of gaming is. Player Unknown's Battle Ground or PUBG is a mobile/device game where the user can play against any player from anywhere in the world. The anonymity that the name offers gives a lot of freedom in terms of losses and wins. The world of gaming is a fantasy and gives an opportunity to vent out the hidden aggression, frustration, or to create a sense of adventure in a person. Gaming is more in the news these days, for the wrong reasons, such as the unfortunate incident of a 21-year-old killing his father, over not giving money for recharge of mobile to play this game.

It is important for all parents to know that addiction to gaming is official. We are not imagining! The International Classification of Diseases (ICD 11) reckons that a person, who is addictively 'into gaming' will have personal, family, social, educational and occupational and other functional areas affected.

When does gaming world become an addiction? When initially it seems like entertainment, then slowly starts becoming an important aspect of the life that is overtaking other things.

There may not be things in the life that are holding the same fascination and interest, and essentially boredom is felt.

Another factor is that your son is the only child, being the centre of attention, and as you yourself said 'Pampered'. This often leads to a situation where the parents would not have enforced any rule-bound behaviour. This also happens many times as a compensatory behaviour from the parents, i.e., when they are not able to give time to the children correctly. Before any realisation comes, the child has been taken over by the digital world.

Why does the digital world hold so much appeal? It is quite far away from reality though everything is beautifully simulated like reality. The main difference is that one starts feeling the sense of power and control. "I can win in a battle against opponents and do things that otherwise are not so doable. I can stop and start as per my wish." Then begins the process of choosing digital world to the real world.

The immediate positive consequences of winning in the gaming world, as against working hard for over a year to finish an academic year makes them believe that the outside world is a waste of time. The feeling of winning becomes addictive, giving pleasure when it happens and frustration when it doesn't. Also, more often than not, players develop a 'Hero complex' only based on the gaming world. Just like gambling, if one place they lose they spend more and more time waiting for that elusive win. They are actually shutting out the world. Aggression is part of this kind of game and is becoming a part of reacting to restrictions also.

My advice:

Step 1: Seek professional help.

Step 2: While doing that also: Make the real world more interesting even If it is for a short while, plan events around his interest, and remember his favourites.

Step 3: Do convey to your child that you are standing your ground, but really are interested in reaching out to him.

Step 4: Enroll his friends in this process. They would have drifted away because of his behaviour, but peer group has the ability to make connection faster.

Step 5: Reflect on your own behaviour to check for the pushing away and pulling closer patterns. Make changes and form a deeper connection, especially emotionally.

- Vasuprada Kartic, Anthroposophic Counsellor and Psychotherapist.

Question: Hello! My brother is 19 years old. I feel he is doing drugs. He is always in his room. Never lets us in even to clean. He steals money, lies, bullies my mother, and is irritable. Sometimes he is extremely dull...stares into space and doesn't respond. Recently, he has started threatening my mother by cutting himself if refused money. He doesn't bathe, eat properly, doesn't attend college (he is in B.Tech 1st year). I came on vacation from the US and noticed this. He also has very shady friends. Please tell me what to do. My mother is a single parent and is at her wits' end!

Answer: Hello! Sorry...but it does seem like your brother is into something, and it might be substance abuse. The hallmark of an unpleasant habit is stealing, lies, subterfuge, manipulative behaviour, withdrawal from basic routines like personal hygiene, social behaviour, etc.

At 19, and in a professional college, many girls and boys do get into experimenting with drugs, alcohol, smoking, etc. Call it peer pressure, or curiosity or even an outlet to deal with issues, one may get 'hooked' on and find it hard to stop.

Some even become 'handlers' or peddlers, who work with the dealers to sell drugs for monetary reasons to buy more drugs.

Let me run you through a few commonly used drugs

1. Marijuana also known as weed, pot, dope and grass. The commonest addiction. Smoked in a cigarette with or without tobacco or in a pipe called a chillum. Also smoked in shots. Many argue that it isn't a drug at all. People get addicted because

2. You feel chilled out

3. Some become talkative, giggly

4. Initially, reduces anxiety colour looks more intense, or music sounds better

5. Hunger pangs.

After a few weeks of use

1. Makes you nauseous

2. Makes you anxious or confused and paranoid

3. Some experience panic attacks and hallucinations

4. It interferes with ability to drive, etc

5. Affects memory

6. Makes you sleepy and lethargic

7. Makes a person demotivated, and disinterested in work, studies, life, etc

8. Tolerance develops over time and people need more and more to keep themselves in a calm state.

9. If one stops using it, one is likely to experience withdrawal symptoms such as cravings, mood swings, irritability and restlessness.

Opium, hashish or hash also make a person drowsy, and gives a sense of calm.

Cocaine: Also called coke. This is a stimulant and keeps people awake causing an increase in heart rate and blood pressure. Cocaine is either snorted or injected in a powder form...or a rock form called crack!

Symptoms (called a trip) include: Dilated pupils, excitability, runny sometimes bleeding nose, weight loss, deterioration in hygiene, financial difficulties, syringes, blades, needles in possession of the person, mood swings and social isolation amongst many more.

Cocaine is a highly addictive drug that can make it challenging to quit.

Ecstasy or MDMA; LSD or Acid; Shrooms or Magic Mushrooms. All contain hallucinogens and are all highly addictive. The symptoms are almost like cocaine. By giving you a few of the symptoms of addiction of a few of these drugs I hope to increase the knowledge base of family members who will be able to recognise signs of misuse or addiction.

This is not an exhaustive list...I have just listed very few but commonly abused drugs.

There is also alcohol, nicotine, tobacco products like gutkha, etc which are also addictive.

What to do?

1. Talk to your brother. Maybe confronting him may not be a great idea immediately

2. Reason with him

3. Take professional help

4. Doctors usually conduct a few blood tests and check for blood levels of the drugs.

5. Treatment depends on the level of abuse, number of drugs abused, and several other factors.

6. Family support is extremely important at this stage

7. Don't treat him like a wayward person...treat him just like someone who needs help

8. Psychotherapy both for your brother and for the family is important as you all need to learn coping skills too

9. Sometimes, rehabilitation and admission may benefit.

10. But be there for him during these tough times and help him by raising his self-esteem, understanding his triggers and dealing with his withdrawal symptoms and other issues

11. Understand that this is long drawn, relapses are common, and support systems are needed throughout

12. Depression is a very common outcome of most addictions as is psychosis.

Be aware of such symptoms too.

Having said all this. Sometimes youngsters may not be into drugs...See if your brother has symptoms of depression or anxiety. Is he going through some trauma? Don't be judgmental...gentle understanding can make him open up. Youngsters dabble with drugs for many reasons…peer pressure or curiosity are not the only reasons. Sometimes, psychological stress can also cause one to walk that path.

Take him out for a walk and talk to him. Don't be stern or angry…but practice 'firm love', which means..."what you are doing is probably not ok but my love for you isn't diminished! Let me help you!"

Good luck and hope your brother, is able to confront and deal with his problems over time. I wish you all fortitude to deal with this and help him through.

Note: The list of symptoms and names of the substances are not exhaustive. Please seek professional help to learn more.

- Dr Purnima Nagaraja, Consultant Psychiatrist and Psychotherapist.

- Do you have any relationship related queries or issues with your friends, loved ones or family? For informed advice by professionals, send in your questions to features.thehansindia@gmail.com.