Phones, Social Media, and Compulsion

"Not all addictions are rooted in abuse or trauma, but I do believe they can all be traced to painful experiences. Pain is at the centre of all addictive behaviours." —Gabor Maté

In an age where digital devices and social media are integral to daily life, especially for adolescents, understanding their impact on mental health is crucial. The surge in internet usage among adolescents worldwide is remarkable, with 79% of those aged between 15 and 24 being active users. This demographic spends an average of over six hours daily on screens, engaging in activities ranging from social media to gaming.

There is a mixed and contradictory picture emerging, however. Large-scale studies in the UK and the US have found the link between screen time and mental health to be minimal. Yet a comprehensive 2023 review of 50 articles highlighted significant associations between screen exposure and mental health issues in adolescents, especially regarding smartphone use on weekdays and its correlation with reduced mental well-being. The impact of social media is also complex, with certain users, particularly girls, showing a higher risk of depression linked to its use.

The addictive potential of smartphones and the internet has become a growing concern. Phone addiction is not a diagnosis in the DSM-5. Still, indicators of compulsive use include a preference for the virtual world over real-life interactions, negative reactions to being offline, and neglecting important responsibilities. The transformation from pleasure to compulsion in the digital realm is akin to substance abuse and neurochemical reactions. The release of dopamine plays a crucial role.

Compulsion often begins with the pleasure derived from online activities but can evolve into a harmful dependency, particularly when it begins to control behaviour and daily life. In the digital age, we find ourselves in a world where the internet reigns supreme. It's a realm where pleasure knows no bounds. Hours spent scrolling through social media, binge-watching TV, or simply clicking through cat videos may seem harmless at first. But for many, these activities can transform into compulsions, driven by the relentless pursuit of pleasure. Neuroscience seems to shed some light on the paradoxical relationship between pleasure and control; it demonstrates that when we try to restrain ourselves from these digital indulgences, it often intensifies the craving, creating what's known as the "forbidden fruit" phenomenon. Our brains are wired to seek pleasure, even when we know it might not be in our best interest.

The Power of Pleasure

Dr. Anna Lembke's dopamine theory in her book Dopamine Nation demonstrates that the pursuit of pleasure, mediated by the neurotransmitter dopamine, can lead to addiction when this pursuit disrupts the brain's natural balance between pleasure and pain. She explains that engaging in activities that release dopamine can result in a compensatory increase in pain sensitivity, creating a cycle where more dopamine-inducing activities are sought to offset this discomfort.

This theory highlights the delicate equilibrium between pleasure and pain in the brain's reward system and how its disturbance can underlie compulsive behaviours. Pleasure is an enigmatic force that we all experience, but do we truly understand how it influences our behaviours and decisions? Pleasure is a fundamental aspect of human existence, one that has captivated philosophers, psychologists, and neuroscientists for centuries.

From Use to Abuse

From the moment we're born, pleasure-seeking is hardwired into our DNA. Think back to your childhood—those endless hours of play, exploration, and laughter were central. Renowned psychologist Abraham Maslow said that once our basic needs like food and shelter are met, we embark on a quest for higher-level needs, including the pursuit of joy. Play, in all its forms, becomes our gateway to pleasure.

Ancient civilisations understood the importance of play in a person's life. Take ancient Greece, for example, where various forms of play were celebrated as essential to every citizen's well-being. Whether it was sports, theatre, or philosophical debates, they recognized that these activities provided not just pleasure but also a sense of purpose and belonging.

Pleasure doesn't just stop at play; it also acts as a soothing balm in times of distress. When life throws its curveballs, we turn to actions that bring us comfort and relief. Neuroscientists have explored the brain's reward system, unveiling the connection between pleasure and self-soothing. Even in the scenario of self-harming behaviours, such as cutting or scratching, these actions may have initially served as a way to alleviate psychological pain, yet over time, they can take a surprising turn, offering not just relief but intense pleasure. It's a perplexing phenomenon, one that reveals the complex interplay of our brain's circuits.

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Dependency

The transition from regular use to problematic use occurs when pleasurable experiences become compulsive, leading to a loss of control. At the heart of pleasure lies the brain's reward system, governed by neurotransmitters like dopamine and endorphins. Pleasure motivates essential behaviours such as eating and mating, and dopamine is released through the brain's reward pathways, which reinforces beneficial activities and influences learning and memory. Endorphins, another group of neurotransmitters, reduce pain and boost well-being, are often released during stress-relief activities. The interplay of these neurotransmitters in brain regions like the nucleus accumbens and prefrontal cortex underpins the multifaceted nature of pleasure.

Addiction arises when the absence of pleasurable experiences triggers withdrawal symptoms, only alleviated by resuming the behaviour. Anticipation of pleasure initiates a cascade of neurochemical events. Adrenaline intensifies excitement, leading to endorphin production, and makes challenging tasks seem easier. Addiction hinges on these neurochemical processes, and I believe highlights the profound role of pleasure in shaping everyday human behaviour. Understanding this relationship is crucial for addressing compulsion and developing effective intervention strategies.

The Individual Behind the Screen

The role of individual vulnerabilities and real-life social experiences in shaping one's relationship with social media is vital. Psychologist Lucy Foulkes emphasizes that those who are particularly anxious about likes on social media often have pre-existing concerns about appearance and social approval. Additionally, the vast majority of young people who experience cyberbullying may also face bullying in real life. Therefore, understanding the individual behind the screen is essential in comprehending the true impact of social media on mental health. Despite concerns about its impact, social media has undeniable benefits, especially highlighted during the pandemic as a crucial tool for communication and connection. It plays a fundamental role in modern socialising, particularly for young people, facilitating self-identity exploration and offering opportunities for positive interactions. The challenge lies in balancing these benefits against potential risks and understanding the nuances of individual user experiences with these platforms.

Combating Compulsion

Ultimately, successful recovery from compulsive online and smartphone use necessitates more than just behavioural change. It requires a profound transformation in the individual's relationship with their digital habits. Reducing screen time is insufficient; there must also be a shift in how individuals understand why they excessively use digital devices and how they relate to the digital world. In essence, when addressing compulsion, it becomes evident that this issue extends beyond the individual and is significantly influenced by various systems and factors in our 'digital era'. Just as a healthy relationship with the digital world depends not only on the individual but also on the societal, cultural, and technological environment, addressing online and smartphone compulsion requires a comprehensive approach.

Therapy has shown effectiveness in addressing online compulsions (Portelli and Papantuno, 2017) and effective therapy focuses on helping individuals recognise their compulsion and regain control over their usage. Techniques include interval training to delay responses to notifications and reducing app use to foster healthier habits. Effective therapy emphasizes the importance of understanding the individual's needs and motivations, guiding them towards reclaiming a life beyond the digital realm. The relationship between screen time, social media, and mental health in adolescents is a complex and evolving issue. It requires a nuanced understanding of individual experiences, vulnerabilities, and the socio-digital environment they navigate. While acknowledging the potential risks, it's equally important to recognize the benefits these digital platforms offer, especially in fostering connections and aiding in identity formation during crucial developmental stages.