The precipitous decline in the mental health of American children and adolescents has been meticulously cataloged in newspaper articles, books and documentaries. In our own pediatric clinic, the numbers have skyrocketed – a baseball player unable to get out of his car to practice, a teenager with aggressive behavior masking underlying depression and anxiety, and a 9-year-old unable to go to school due to daily panic attacks. Every day now we are faced with conventional somatic and behavioral presentations as well as less obvious somatic presentations of the underlying emotional struggle. In a 2021 CDC national survey of 7,700 teens, 4 in 10 said they felt “persistently sad or hopeless” and 1 in 5 contemplated suicide.
While having plenty of services is crucial to catching mental illness downstream after it’s onset, given the scarcity of such services, we might be better served if we stem the tide upstream. This means sufficient monitoring and intervention in homes and schools to combat incentive contributors. It also means thoughtfully shaping strong and resilient children to withstand the inevitable headwinds they will face in their lives. I am convinced, despite all its conveniences and advantages, that we should start by declaring a strategic war on devices.
A 2017 Atlantic article titled “Did Smartphones Destroy a Generation?” seems to answer his own question with a resounding yes. The article cites numerous studies evaluating the deleterious effects of devices on mental health. iGens, a term attributed to those born after 1995, are digital natives who grew up under the pervasive influence of technology.
While more time spent on the device has led to some positive trends like fewer teen pregnancies, less experimentation with alcohol, and fewer car accidents, there is nonetheless an opportunity cost for teens. who do less what they have always done since time immemorial – make an independent decision, however stupid, and learn from them. This is how self-confidence is built.
When I talk about screen time, I often explain to families that I worry more about a child’s missed growth opportunity when fascinated by a device than the content viewed on it. Children crave boredom because that slight discomfort turns into resilience. If you can consistently avoid and soothe small discomforts with a screen when you’re little, you’ll likely be ill-equipped to endure the desired and unwanted hardships when you’re big. Unfamiliar with the common discomfort that accompanies the growth of skills and abilities, children instead perceive these developmental challenges as alien and frightening.
Excessive screen time also wipes out sustained attention and deep thought, leading to diminished knowledge, intellect, and even sense of self. With a fractured attention span that only comes with practice, we impede the transfer of information from short-term memory to long-term memory where mental schemas, the conceptual scaffolding that supports intelligence and identity, are integrated.
Therefore, although we can search for anything on the net, we have limited basic knowledge to reach it and create new unique connections. Moreover, since the brain continues to digest and sublimate ideas long after they have been ingested, the persistent input of technology robs us of the solitude the brain needs to complete its organic work.
On a relational level, two 2017 studies published in the American Journals of Preventative Medicine and Epidemiology hypothesized that increased use of social media leads to increased feelings of social isolation and decreased feelings of well-being.
While social media creates the patina of sociability, it lacks the complexity and benefits conferred by high-level social processing. Interaction is more than verbal communication. Body language, facial treatment, tone of voice and physical touch induce real and beneficial biochemical changes that virtual encounters do not. Any mood boost from a Twitter “like” is far outweighed by the lasting physiological enrichment of offline communication.
So knowing all of this, why not just hang up our phones and begin the healing?
Georgetown professor Cal Newport explains in his 2019 book Digital Minimalism why it’s not that easy. Have you ever waited to pay at a grocery store or sat at a red light and felt pressured to check your phone? Dr. Newport explains that billions of dollars have been spent on addiction engineering. Concerted strategies of “intermittent reinforcement” and “social approval cues” intelligently tackle our most addictive and vulnerable tendencies and are especially effective for developing adolescent executive function. Ad hoc, cobbled-together resolutions don’t stand a chance against the power of biology. We must meet force with force, argues Newport. We need a “digital philosophy”.
Dr. Newport recommends that adopting a digital philosophy involves, first and foremost, abstaining from technology entirely. Catalog your life for a day, a week or a month. How much time do you spend on it and what are the functions of technology in your life? Next, ask yourself if technology supports or hinders the realization of your core values.
Being methodical both illuminates a fuller picture and grants due diligence due to a worthy, albeit unfeeling, adversary. Finally, choose carefully which digital tools you let back into your life and specify when you use them. Technology should only be an adjunct to the full realization of your values, as opposed to the primary means of expressing them.
Technology has attached itself to our children’s psyches, and loosening that grip will take more than regulatory policies limiting use. Children and teens won’t be deterred by a long list of warnings. The pull of the digital world is too strong and, as we now clearly understand, its negative impact can be wide and long-lasting. They need to be inspired more by the meaning and connections they experience in the analog world than by the fleeting dopaminergic gratification they get from escaping to the digital world. Nothing less than their mental health and well-being depend on it. Maybe a solid digital philosophy is a good place to start.
David Shafran is a pediatrician.
Image credit: Shutterstock.com
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