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Emergency Medicine News

First Person

It's Time to Ask Patients to Quit Social Media

Lentz, Jacob MD

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doi: 10.1097/01.EEM.0000853944.77917.38

    I have been tracking research for several years as our mental health crisis rages, always operating with a solid amount of confirmation bias, in search of evidence to support what I have been telling patients and friends alike for a long time (including a recent patient having a panic attack): Get off social media.

    The data just keep coming to suggest that social media is destructive to mental health. Studies have connected it to a decrease in psychological well-being among adolescents, and others have tied it to the development of anxiety disorders and depression. Heavy use of social media has also been linked to loneliness and inattention, and the likelihood of having an eating disorder among adolescents has been correlated with the number of social media accounts someone has. Worst of all, suicides among young people skyrocketed by 56 percent from 2007 through 2017. I can print out a stack of new studies to bolster my case every time I advise a patient experiencing depression or anxiety to delete his social media accounts.

    Patients seem to get it immediately. They intuitively understand that social media is an anxiety machine. Most users are naturally inclined to share good news rather than failure, heartache, disappointment, relapse, or weight gain. Using social media as the lens through which you perceive the world too often causes those struggling with their mental health to conclude that everyone besides them is doing great. And then they think something is wrong with them if they aren't doing great.

    Convincing people that social media is making them feel worse than they would feel otherwise is not heavy lifting. It helps that it is no longer a secret that much of Silicon Valley's wealth is built on priming our worst impulses. Last year's Facebook whistleblower only confirmed what anyone with the tiniest amount of common sense already knew: These tech companies know full well what they are doing. It is a business model that runs on envy, pride, lust, and rage, with a dollop of moral silos and mob rage for good measure. It gets a lot of clicks and sucks up a lot of time, turning us all into the product these companies sell to advertisers.

    A professor friend sarcastically said to me, “Hard to believe that giving all our personal information to a few giant corporations didn't work out so well.” But we did, and the way they make money is by making sure we freebase the empty calories of a dopamine hit by screaming into the Twitter void and surfing other people's always-amazing lives on Instagram.

    Save Our Social Fabric

    We must face the reality that social media's pernicious effects go well beyond suicide and loss of productivity. The social fabric of the United States is under threat at a time when we can least afford it. The ways social media is designed to drive us nuts was captured by historian and media scholar Siva Vaidhyanathan, PhD, in his book Antisocial Media: How Facebook Disconnects Us and Undermines Democracy. He showed how it uses algorithms to promote stories and posts that get the biggest reactions. Social media makes more money when it can “amplify the crazy,” as he put it. This in turn allows it to function as a tool for elites to keep people angry, depressed, divided, and distracted. It works out for them while normal people are driven to the brink.

    Physicians need to start saying that these products are literally killing people. The way to do this is simple: Recommend the documentary “The Social Dilemma.” It features executives and engineers from Twitter, Facebook, Instagram, Google, and other platforms struggling with regret over the monsters they created, the algorithms that ensure steady streams of self-reinforcing and often untrue information that fuel individual and collective madness.

    It is impossible to unsee this film, and it has caused dozens of my friends to leave social media. Getting people to watch it may be the fastest way to begin addressing this new public health crisis. I told another patient recently that her homework after she left the ED was to watch it. (Her mother was very much in favor of this plan.)

    I used to have a Facebook account. I deleted it seven years ago after I realized it wasn't helping me with anything. I can report a decrease in stress and anxiety and a rise in productivity afterward. The harm of social media is real no matter its positives, and we are better off without it. It is time for physicians to start saying so and to lead by example by logging off—permanently. Our country needs it.

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