Hooked on Social Media

Hello, it's All in the Mind on RN, I'm Lynne Malcolm. Today, are we hooked on social media? And does it matter?

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Olivia Willis: How often do you use social media?

Vox pop: Probably about three times a day I'll just check in to Facebook, see what's going on, put a couple of likes on things.

Vox pop: Probably quite frequently, sadly, maybe every couple of hours during the day.

Vox pop: One hour a day, maximum.

Vox pop: I usually check it in the morning, like just Facebook, Instagram, and then at night I'd say I'm probably on it a lot.

Vox pop: Every day, but not very intensely.

Vox pop: I think very frequently in a day, even 10 times or 20 times a day.

Vox pop: Never. I'd rather just talk to people in real life.

Vox pop: I would say every day, a few times a day actually.

Vox pop: 12 times in a day, based on how much time we are free.

Vox pop: I don't really use it that often, I only use it to call my grandparents and relatives and friends over in India.

Vox pop: Daily, probably about three or four hours a day, it's a big part of my life.

Lynne Malcolm: Olivia Willis getting the pulse of social media on the streets of Melbourne.

Andrew Fuller: Human beings have always had a great desire to connect with one another. And of course social media is designed exactly to do that. So it's one of those things that has beautifully tapped into the desires of human beings to check up on other people and what they're doing, to compare ideas, to look at trends. So it's captivating in an enormous way. And of course we see it captivating not only our young people but also our general population. So it's an enormous growth, isn't it.

Lynne Malcolm: Clinical psychologist Andrew Fuller.

Brian Primack is professor of medicine and paediatrics at the University of Pittsburgh in the US.

Brian Primack: There are about 2.2 billion users. These days in the United States if you are a young adult for example, more than 90% are social media users. And the group that is actually experiencing the most increase is those over age 65. So it is something that is in all age groups and many different demographic groups.

Lynne Malcolm: Brian Primack.

How many times a day do you check your timeline on Facebook, or catch up with the latest tweet or Instagram post?

Olivia Willis: Do you ever feel like you use it too much?

Vox pop: No. In the past yes, but the reason why I stopped is because I wanted to do things more productive, read books and make more of my life than I have by wasting this time.

Vox pop: I recently felt that when I noticed that I was checking it so often that my Instagram feed didn't have that many updates, and I was like, oh God, maybe I should do this a little less often.

Vox pop: No, not really, because I have control over it. If I feel like I'm using it too much I'll just stop.

Vox pop: Yes, at one point, maybe at the start of the year and then I cut down because it was too much, a bit detrimental, and it stopped me from doing things I wanted to do I guess.

Vox pop: No, I've never felt I've ever used it too much, I've always kept it at an arms length. I've used it for what I required out of it and stopped from there.

Vox pop: No, I feel like I have a lot of self-control, so I go on when I want to, and if I feel like I need to get work done then I'll just put my phone away.

Lynne Malcolm: You might have a love/hate relationship with social media, but aren't the benefits obvious? It allows us to connect with people and issues more easily than ever. But do we rely on it too much? Are we becoming overly dependent? And does it really matter?

Brian Primack: It may be that because people are using so much social media that they are losing real social relationships in some ways. There may also be an effect where they feel like social media is the real world but it is actually a very distilled world. It's a highly curated world where people are not necessarily themselves. And so those relationships, while valuable in some ways may not really be good replacements for true human social relationships.

Lynne Malcolm: But social media is compelling. So can we overdo it? So far little research has been done, and although it's not yet officially recognised in the DSM5 as a mental disorder, there's speculation about whether you can become addicted to social media use.

Brian Primack from the University of Pittsburgh heads their Centre for Research on Media Technology and Health.

Brian Primack: It's generally called problematic internet use as opposed to an actual addiction. If you think about it, internet portals are designed to be extremely compelling and sticky, to keep you there as long as possible so that you are exposed to as many advertisements as possible. And then of course at the extreme this stickiness could be what we called problematic internet use or even addiction. So what do we call something problematic? Well, if it leads to things like significant interpersonal conflict, decreased ability to function in school or work, or problematic symptoms if you are not able to use the internet for some reason.

Lynne Malcolm: Brian Primack.

Vox pop: If someone, like, sends me something I want to reply straight away, whereas I know that decades ago it's fine to go home and then give them an answer the next day. So I feel like we are really dependent on it.

Vox pop: Not so much dependency, like addiction. It means to us as a requirement sometimes to communicate with others.

Vox pop: When I am without it, sometimes it's good because you need to disconnect, but yeah, I think we do rely on it more and more these days.

Lynne Malcolm: As a clinical psychologist, Andrew Fuller specialises in the wellbeing of young people and their families.

Andrew Fuller: I mean, obviously there is a small group of people who are so preoccupied by this their lives become detrimental and negative as a result. But they are still the exception. So I think it's important to keep a bit of perspective about this, that most young people use social media and use it fairly constructively. And so they still do have lives in the non-virtual world as well. But at the same time there is a group of people for whom that idea is blurred. And so what we are seeing really is a reshaping not only of friendship for young people, we are also seeing a reshaping of identity.

We know that adolescence is a time of identity formation, when you really work out in life who you are, or at least you begin that process. And of course online lots of young people have multiple identities. They play, they have avatars, they have different identities that they play, under different names. And so what's happening is there is a diversification of who you are as a person. And that could be seen as freeing but it can also be seen as a bit confusing for some young people; who am I really? And so we do see in therapy…in my clinic we see a number of young people who have been playing games of, say, the opposite gender, or they've been playing at a different type of character, and they've kind of lost a bit of sight of who they are, their own sense of integrity.

I guess what also goes along with that loss of integrity is the preparedness sometimes when things are a bit fractious online to respond not so much as you normally would when somebody has upset you with the civility or the courtesy that you might but to be a bit more barbaric in the process.

Lynne Malcolm: Last year the Australian Psychological Society issued its Stress and Well-Being in Australia report, which included a section on social media FOMO, or fear of missing out. What is that psychologically and how much of a problem is it?

Andrew Fuller: FONK and FOMO, fear of not knowing, and fear of missing out, are two kind of characteristics that we see very much being generated by the modern age or at least being amplified by it. The idea of being in the know of course has always been important for teenagers and young people. But the idea of a fear of missing out also means basically that unless I'm online checking this kind of stuff out, then in some ways I'm going to be behind, I'm not going to know what my friends are up to and I may miss out on events. And so what that means is that young people often become quite anxious when we ask them to basically go on a digital diet. If a young people has to go on a holiday where there is not access to their online social media, some of these kids act basically with the level of grief that one might see if there is the loss of a family member, it's quite remarkable.

Lynne Malcolm: And is that a real concern, is that a real anxiety that we need to treat as an anxiety?

Andrew Fuller: I think it's something that we need to try to rebalance. One of the interesting areas with this is in the area of cyber bullying where we see young people who have been bullied online, and I guess the biggest parallel that I can give you is that it's a bit like having a sore tooth. It's almost like your tongue just wants to keep finding that sore tooth and hitting it. I don't know if you've ever had that experience. And it's a bit like that, because if someone said something negative about you online, there's a tendency to go back online and check who has commented, who has liked it, who has made some sort of response to it. And so in a way then that almost compulsive checking and rechecking of fairly negative information can be really quite distressing for young people and traumatising for them.

Lynne Malcolm: Are there biochemical responses involved? You know, how many times you feel that you need to check social media a day, you're getting a sort of reinforcement/reward pathway happening there?

Andrew Fuller: One of the things that's interesting on social media is that we are often more interested in broadcasting than being the recipient of news. So quite often people will pass on stories, pictures, comments that they haven't even really read because they are trying to be in some ways a news service themselves, they are the point of some new story. And so what happens then is they get a reward from that. So we have always known that human beings basically get a dopamine hit by gathering things and setting a reward or setting a target and achieving it. And so what it does, it gives a very powerful boost of dopamine when you are using social media to gather stories or pictures and then share them.

Lynne Malcolm: So in your clinical practice, are you seeing an increase in the number of young people needing to be treated for mental health problems associated with their social media and online behaviour?

Andrew Fuller: What we know is that sleep disturbance is enormous as an issue. So the two real…if you like the major gains in terms of mental health problems are anxiety and they are also sleep disturbance, and they are interlinked of course, whether it's basically anxiety because you are basically worrying rather than sleeping, or whether it's depression because you are often waking up and being regretful about life. And so we don't really know as psychologists which is the chicken and which is the egg. Does the sleep disturbance really promote the mental health problems, or is it the reverse? And so it's a fair statement to say that sleep disturbance is going to be a major issue.

Lynne Malcolm: Andrew Fuller.

You're with All in the Mind on RN, I'm Lynne Malcolm. Today we're hooked on social media.

You've probably seen those stories in the news lately about laws prohibiting cyber bullying and the posting of revenge porn because of the very damaging effects this online behaviour can have on people's mental health.

The largest study yet into the mental health of social media users was carried out at the University of Pittsburgh. It was published in the medical journal Depression and Anxiety in April 2016. 1,800 young adults between the ages of 19 and 32 were surveyed about their social media use. They found that people who checked their social media the most frequently were 2.7 times more likely to suffer from depression than their counterparts.

Professor Brian Primack led the study.

Brian Primack: We were very surprised with what we found. We had expected sort of a U-shaped curve with a higher risk of depression on the ends, a higher risk of depression being correlated with people who had no social media use or very excessive use, but that is not what we found. Instead what we found was basically a straight line. More social media use was associated with more depression in a linear fashion.

Lynne Malcolm: So the more social media use, the higher the risk of being depressed?

Brian Primack: Exactly. It's important to acknowledge immediately that because this is a cross sectional study, it doesn't tell us what came first. In other words, it doesn't disentangle cause and effect. It may be that people who are already depressed are going and using increased social media because they don't feel like socialising.

On the other hand, it may be that people who are exposed to highly idealised representations of their peers on social media start to get feelings of envy and this distorted belief that everyone else is leading a happier, more successful life than you are. And of course it may be a combination of these kinds of things.

Lynne Malcolm: So is there an implication from your research that it's the way that social media is used rather than the amount that it's used that leads to poor mental health outcomes?

Brian Primack: That is a very good question, and that is not something that we addressed sufficiently. And I completely agree with you, that's a very important area for future research because in our study we really just looked at social media in terms of the amount of time spent and the frequency of use, how many cheques per day, for example. But what you're getting at is, wait a second, not all social media use is the same. Sometimes you go on for an hour and you are just liking pictures of people's cute puppies and children. But on the other hand, some people will go on for that same hour but they will become involved in very violent controversial conflicts about politics and religion. And so these messages, if they are supportive versus if they are confrontational, that probably matters. That's something that we are going to have to analyse in future research.

Lynne Malcolm: Did you get a sense that the number of times that people check their social media influences their mental health?

Brian Primack: What we found was an association. We did find that if people check more they were more likely to be depressed. But again, it may be that people who are already depressed or anxious just tend to take out that anxiety to self-soothe by checking social media. So it may also be that people who check social media very frequently tend to later on become more anxious or depressed because of what they are seeing. So we did find that there was this overall association between these two, but we don't know what the specific direction is.

Lynne Malcolm: So just looking at depression and how social media can influence or determine depression, do you think that it's mostly about the fact that people are comparing themselves to others, like the fear of others having a better, more interesting life?

Brian Primack: That is certainly one of the theories that a lot of people bring up. This is the classic 'Facebook depression' that the American Academy of Paediatrics has been very concerned about, but I think that there are other possible mechanisms as well. It's very easy on social media, for example, to have misconceptions or other kinds of misinterpretations. People often report that they saw an image of their good friends all together having dinner and they wonder why they were left out. People will make some kind of a post and then they'll have a deep regret over posting that, and literally it can cause them a great deal of anguish and trigger depression. So I think that that is another possibility.

Another is sort of interesting because it's almost the opposite of this idea of seeing this idealised world. On social media it's a place where a lot of people share many mean, scary world messages. It's very, very easy to pick up threads about the most recent murders, the most recent bombings, the most recent terrorist threats et cetera. And that can give people the idea that everything is like that, that the terrorists are right outside your door.

So it's interesting that both extremes are potentially problematic. The truth is somewhere in the middle. The world is a very good place in many different ways, but it's not perfect. But those are not the kinds of messages that we see on social media. We tend to see a lot of those extremes because those are the things that sell, those are the things that are compelling to people.

Lynne Malcolm: So to what extent do you think that we can perhaps help people to filter their experience with social media and to take into account that they might be seeing only the rosy side too often or they might be seeing only the grim side too often? What sort of skills are required for us in the future to really manage and balance social media?

Brian Primack: I think that that's a great question and I really like your word 'filter'. In other words, how can people interpret and analyse and evaluate what they see? And a lot of those words are what we see when we hear about media literacy. Media literacy is an entire movement that I think is gaining traction in the United States. And interestingly many of its roots are in Australia. And I think that media literacy should be a cornerstone of how we look at various media messages in the future.

I think that there has been some analysis and evaluation that people have been teaching about, for example, how to look at an alcohol advertisement and how to recognise that the advertisers are using fonts and colours and logos and all kinds of misrepresentations to sell a product, and that that is not necessarily reality.

But I think that people still have this sense that what they see in social media is reality. And so I think that taking those same principles of media literacy, of critical thinking and applying it to the social media world will also give that person a little bit more of a realistic understanding of what is going on, and then maybe make them a little bit less potentially affected by those messages.

Lynne Malcolm: There is research that shows that social interaction online can increase feelings of self-esteem and social support and decrease loneliness and depression. Do you think that there is a case for the emotional benefits outweighing the possible harms?

Brian Primack: Absolutely. I think it's important to recognise that the study that we did was a large epidemiologic study that basically just says that these two things are associated, that overall people with more social media use tended to be more depressed. But that doesn't mean that every single person who is using social media is going to be depressed, and in fact it may actually be the opposite for specific individuals and specific groups of people. I've seen some really great social media groups that are very valuable and supportive for people, for example, with depression and anxiety.

And so the purpose of talking about this study is certainly not to advocate forgoing social media altogether. Like many other technologies, social media is a double edged sword, and there are many potential positive uses in addition to some of the potential threats. So what I hope to do ultimately is to help people use this medium for improving their life as much as possible, but not for inadvertently detracting from it.

Lynne Malcolm: Brian Primack from the University of Pittsburgh.

Olivia Willis: Does it make you feel more connected to the world, or is it in some ways a bit more isolating?

Vox pop: I think that the static social media, things like Facebook and Instagram probably aren't true reflections of what's going on and what is posted therein. I think Snapchat though I sometimes do feel more connected through that to people who I wouldn't regularly get the chance to see them and it's nice to see what's going on with them, little videos of their day.

Vox pop: If you limit it…so I have friends overseas, then it's keeping in connection. If I use it for more than that then it is detrimental, definitely, as in I can see ex-boyfriends or things that you don't like, so that's why I have limited it.

Vox pop: I feel overall more connected. I use it quite a bit for work, to keep in touch with colleagues, and obviously for catching up with friends, it's a great tool.

Vox pop: It can make you feel isolated because people use it to brag sometimes or use it as a form of, oh look, we're hanging out, what are you doing? In that case you can feel a bit isolated.

Lynne Malcolm: So putting aside how imperative social media is now for communication, is social media mostly a positive phenomenon? Has it done more good than bad for our mental health?

Andrew Fuller: It has certainly increased our intelligence. We know that basically young people are far brighter than they used to be, and part of that can be attributed really to the amount of information that they process. So it is estimated that we process about five times more information every day than we did in about 1985. And so really all of us in a way are using our brains much more extensively than we used to. So that's a good thing.

We are also probably interacting with a broader range of people than most of our grandparents did. So we have a diversity of interactions and we have a diversity of role models of different ways of living life, and so we are exposed to a larger range of ideas. The risk really is if you then start to make yourself…compare your life with the highlights package of somebody else. It's just making sure that there's not a distortion of perception, otherwise you can feel very badly about your own life.

Lynne Malcolm: Andrew Fuller led a recent survey of over 91,000 young Australians for Resilient Youth Australia. It asks young people a series of questions aimed to measure positivity, confidence and the ability to deal with life's challenges.

Andrew Fuller: My aim in terms of doing the Resilient Youth Australia survey was to really help communities to identify the strengths as well as the vulnerabilities of young people. So links to social media…because in terms of social media it's very easy to remove yourself from the world and somehow be a kind of passive recipient because you are really focusing more online. What our resilience survey tells us is that young people want to help other people. They almost across the board are interested in helping other people, and yet we don't really give young people the chance to do that. And so it's a very important opportunity for our country because of course we live in a time now where we need to think are people more important than machines or are machines more important than people? And if we don't allow them to have some sense of positivity, some connection, some sense of empowerment and a sense of connection and confidence in their face-to-face world, many of them will retreat to a virtual world.

Lynne Malcolm: So what advice would you give to parents who were concerned about their kid's over-dependence on social media, but also adults who feel that they may have a problem too? How do you get that balance right?

Andrew Fuller: It's going to be a tricky one because of course the sort of formal advice that has been traditionally given to parents as being sort of take away the technology or keep it in the centre of the house where is easily supervisable…well, that seems sensible but in my experience that lasts about three days really. So it's really about having a conversation about what creates a good life, and starting to put that slowly into place, and it's helping them to realise there's a balance.

We live in a time in the world where lots of young people are information rich but experience poor. And so one of the things that in many families we need to think about is how do we help young people to be information rich, that's fine, but also experience rich. It's not just sufficient to gain your life experiences virtually, and so you need to have some time away from the devices. And it doesn't have to be for lengthy periods but at the same time there are times when you do other things.

Lynne Malcolm: Andrew Fuller, clinical psychologist and Fellow of the Department of Psychiatry, Learning and Educational Development at the University of Melbourne.

Olivia Willis: Have you ever tried to do a digital detox were you've gone off it for a certain amount of time?

Vox pop: Yes, I have, but I don't too often.

Vox pop: You do, you feel like you want to get off the grid.

Vox pop: I've never had the feeling that I needed to stop using them because it never bothered and I don't check it, I don't feel bad or anything.

Vox pop: I definitely have installed some add-ons to my browsers that limit certain websites. So I've chosen Facebook, chosen YouTube, websites like that. And it will say I can have two hours today, and after I have used that two hours, it's completely blocked. That's the way I try to detox and limit myself when I do work.

Vox pop: I haven't, but maybe I should! I'm going to try it this week…oh no, not the weekend, maybe mid week!

Lynne Malcolm: Production today by Diane Dean with sound engineer Jen Parsonage.

Thanks to Olivia Willis for research and getting out there on the street for All in the Mind.

I'm Lynne Malcolm. Catch you next time.