When Coping Becomes Avoidance: Technology Use in Anxious Youth

Children and teenagers often turn to video games and smartphones to cope with anxiety, but what happens if that coping strategy turns into habitual avoidance?

In this interview ahead of his presentation,"Anxiety and Avoidance in the Digital Generation," at Psych Congress 2026, Paul Weigle, MD, Associate Medical Director of Ambulatory Programs, Natchaug Hospital, discusses how clinicians can identify problematic technology engagement, assess its effects on functioning, and understand the psychological needs driving screen use. He also explains when psychotherapy and pharmacologic treatment may enter the care plan, addresses common misconceptions about screen media, and offers strategies for helping young patients develop a healthier, more intentional relationship with technology without treating all screen use as inherently harmful.

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Key Clinical Summary

• Pediatric anxiety and problematic technology use can reinforce one another. Clinicians should assess loss of control, interpersonal conflict, sleep, socialization, school or work functioning, motivation for screen use, symptom chronology, and collateral information from families or teachers.
• Psychotherapy may be appropriate for mild anxiety, particularly cognitive behavioral therapy or motivational interviewing; pharmacologic treatment should be considered for moderate to severe symptoms or inadequate response after 2 to 3 months of psychotherapy.
• Screen use should not automatically be considered harmful. Clinicians can assess whether technology primarily provides healthy coping or reinforces avoidance and help patients develop additional strategies for connection, distress management, and meaningful activity.

Editor’s Note: This interview has been lightly edited for clarity.

Psych Congress Network (PCN): When anxiety and screen use rise together, how can clinicians determine whether technology is a contributing factor, a coping strategy, or both?

Paul Weigle, MD: It is important to recognize that screen use (eg, gaming, social media, smartphone use) can serve as a coping strategy for anxiety, contribute to anxiety, or, in many cases, do both. Clinicians should assess for signs of problematic technology use, including excessive engagement with video games or social media, loss of control over use, interpersonal conflict related to technology, and negative effects on sleep, in-person socialization, and work or school functioning.

Understanding the motivation for screen use can also be helpful. For example, playing video games primarily to socialize online is less likely to become problematic than playing primarily for achievement or as an escape from problems in daily life.

When problematic screen use and anxiety co-occur, they can reinforce one another and create a vicious cycle. Looking at the chronology of symptoms and behaviors can help clarify which problem emerged first, although in many cases it is most effective to address both simultaneously regardless.

PCN: Which clinical signs suggest that a young person’s technology use has shifted from a common habit to an avoidance behavior that warrants intervention?

Weigle: Clinicians should first assess the young person’s overall functioning in the family, at school or work, socially, and in self-care. The next step is to determine whether technology is helping to alleviate distress, or contributing to or maintaining the problem.

When anxiety leads to significant avoidance, some degree of functional impairment is often present—for example, a teenager avoiding school because of social anxiety. Technology becomes particularly concerning when it provides an increasingly consistent way to avoid anxiety-provoking situations or responsibilities.  Getting collateral information from family members, teachers, etc can be particularly helpful in getting a full picture.

Using technology as a coping strategy can be appropriate when it is done in moderation and alongside other coping skills. However, when screen media becomes a young person’s primary or only way of managing distress, it is more likely to be used excessively and to reinforce avoidance.

It is also useful to consider what psychological need the technology is fulfilling. A young person may be using gaming or social media to feel connected to others, competent, successful, or in control. Identifying that need can help clinicians and families develop healthier ways to meet it, such as in-person socialization, physical activity, creative pursuits, or other meaningful activities.

PCN: When should pharmacologic treatment enter the plan for a pediatric patient whose anxiety is closely intertwined with problematic media use and emotional dysregulation?

Weigle: For mild cases, a trial of psychotherapy—particularly cognitive behavioral therapy (CBT) or motivational interviewing—may be appropriate. For moderate to severe symptoms, or when a young person does not respond adequately after 2 to 3 months of psychotherapy, pharmacologic treatment should be considered.

Research suggests that treating co-occurring conditions such as depression and attention-deficit/hyperactivity disorder (ADHD) can also improve problematic technology use, including symptoms associated with gaming disorder. Because anxiety that co-occurs with problematic media use may be associated with a poorer prognosis, clinicians may want to have a lower threshold for considering evidence-based medication treatment, such as an antidepressant, than they would for problematic media use alone.

Medication should not be viewed as a treatment for problematic technology use itself, but rather as one component of treating the underlying psychiatric conditions that may be contributing to the problematic use.

PCN: What misconceptions about the relationship between technology use and anxiety in children and adolescents do clinicians most often encounter, and how can they address them with patients and families?

Weigle: One common misconception is that screen use is inherently harmful. When used in moderation and alongside other coping strategies, activities such as video games can be a healthy way to manage stress, relax, and connect with others. The problem arises when technology is used excessively or becomes the primary way a young person manages difficult emotions.

Another important misconception is that if a young person reports that technology helps them feel better, it must therefore be a healthy coping strategy. What begins as a coping strategy can gradually become a form of avoidance. Clinicians should help families look beyond whether technology provides immediate relief and consider its longer-term effects on anxiety, functioning, relationships, sleep, and the ability to tolerate distress.

Rather than simply telling young people to “use their screens less,” clinicians can ask what function the technology serves and help them develop additional, healthier ways to meet those same emotional needs.

PCN: What is one key takeaway from your session that you’d like to share with our audience of practicing clinicians?

Weigle: Screen media activities such as smartphone use and video games can provide a powerful distraction from anxiety and other difficult emotions. But when they become excessive, they can also become powerful enablers of avoidance, preventing young people from confronting anxiety-provoking situations and ultimately making anxiety worse.

Clinicians can help by identifying problematic media use and understanding the function it serves, while helping patients develop a healthier and more intentional relationship with technology. The goal is not necessarily to eliminate screen media, but to help young people use it mindfully, in moderation, and alongside a broader range of healthy coping strategies.

Paul Weigle, MD, is associate medical director at Natchaug Hospital and associate professor of psychiatry at UConn School of Medicine. For over 20 years he has studied and taught about the effects of screen media habits on youth mental health. Dr Weigle is a Distinguished Fellow of the American Academy of Child & Adolescent Psychiatry, and has served 20 years (including 8 years as chair) on the Media Committee as well as on the Public Resources committee. Dr Weigle also serves on the Institute of Digital Media and Child Development’s National Scientific Advisory Board for the over 10 years.

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