With the recent marriages of Microsoft and Facebook to ‘metaverse’ (“virtual reality + digital second life”), we are now on the verge of always being online and enter the mind of a computer. With the existing toll on mental health due to our parallel digital lives, what would this lead to? A mental health catastrophe, as suggested by a coalition of global scholars to ‘Meta’ CEO Mark Zuckerberg.
Science and common sense can hardly disagree with that threat.
For long, studies have highlighted the impact of social media on poor mental wellbeing, depressive symptoms, feelings of isolation due to ‘rejection’ on digital platforms, and anxiety, among other mental health problems. Some recent studies have even highlighted the negative effects that occur over time by simultaneously tracking the user’s social media usage and mental health/behavior. For example, a 2021 study cites that addictive usage of social media predicts poor mental health, negative social comparisons and cyber-victimization, one year later.
Without science at our fingertips, we can safely say that the animal within social media promotes guilt, rivalry, hate, judgments, changing norms, consumerism and what have you. It plays with our self-esteem, moods, choices and aspirations on a continuous basis. So, the mental health effects, particularly in adolescents and teenagers, but perhaps across age groups, are not surprising.
It is an irony that … we know and realize the harm and keep publishing evidence on harmful social media usage, and find it difficult to detach ourselves from social media. At best, we can track our screen time and achieve the scientifically recommended cut-off of 30-minutes per day usage to reduce its mental health effects, but that’s also a tall order. And now metaverse would make it further challenging for us to self-discipline.
How do we reconcile the digital realities of today with the desperate need to protect mental health?
Answering this big question has two parts to it.
1. The conversation on social media ruining mental health disregards the developing world.
Social media, for that matter, the internet, is a social equalizer and that framing essentially applies to the developing world, which lives with persistent and long-standing systemic inequalities in access to services.
I work in the mental health intervention space, including the ‘digital mental health space’, which focuses on the design and delivery of mental health services through digital channels.
A ‘service’ here is not necessarily a medication. It could mean awareness, knowledge, breaking of myths around mental health, or, it could mean counseling, linking with the doctor, or supportive care of some form (particularly in pandemic times).
In developing countries, we do not have enough doctors. India (where I work) may well be on the path to achieve 1 doctor per 1000 people (WHO’s recommendation) by 2024, but this is far from a situation of having 1 psychiatrist per 1000 people having depression.
Sample this: We have more than 50 million people living with depression in India, out of the global 250 million, and 1 psychiatrist for every 333,000 people. So, it’s going to be impossible for India, and I am assuming a host of other developing countries, to produce graduates in psychiatry, psychology and other mental health disciplines at a pace that matches the growth in population and rise in mental health disorders. And, the smartphone penetration in India has paralleled the rise in mental health disorders.
Therefore, we need to take digital platforms, smartphones, social media channels and apps very seriously to provide mental health services — perhaps not direct treatments, but services that at least support on-the-ground clinic-based treatments.
If we do not do that, we would repeat the same mistakes of burdening mental health doctors with tons of patients, reducing per-patient time and quality of care. And this is assuming if the patients do visit — we also have to consider the widespread stigma in developing countries around mental health disorders (relative to physical illnesses).
2. We have failed to recognize that individuals with mental health conditions also use social media and there is a ‘demand’ for digital interventions.
In 2020, we wrote a paper in the Journal of Technology in Behavioral Science citing the benefits of social media interaction for individuals living with mental health disorders, all of which can be sourced to preceding scientific studies. The paper includes a table to summarize these benefits and their evidence.
Broadly, social media and digital platforms help users having mental health conditions in three ways:
1. Facilitate interaction:
Online interactions may be easier for individuals with difficulties in social functioning or symptoms of mental illness, than conversations in person. Anonymity is possible here, compared to in-person conversations, so individuals with mental illness can interact with their peers. Online conversations do not require immediate responses or non-verbal cues, which may work well with users having mental health conditions.
2. Access to peer support network:
Online peer support among those living with depression or anxiety for example, can help users to seek information, discuss symptoms and medication, share experiences, learn to cope and facilitate self-disclosure. Individuals can establish new relationships, feel less alone or reconnect with people. ‘Peers’ could mean other individuals with mental disorders or caregivers interacting with each other.
3. Increase the use of traditional mental health services
In a developing country, a mental health doctor could be far away or not always accessible due to the scarce numbers we saw earlier, relative to the demand for services. Therefore, digital platforms can help in the following ways –
- Maintain a connection between patients and doctors, beyond the clinic
- Digital tracking of symptoms or providing awareness/guidance on self-care
- Mobile apps (subject to quality and rigorous testing) can monitor symptoms and help users set realistic goals in routine life; they can also predict the occurrence of complications (mentally stressful events) based on tracking patient’s sleep pattern, step count, heart rate, etc.
- Fitness/weight loss goals in those with mental health conditions can be achieved through digital channels, which go a long way in improving mental health symptoms.
- Online networks can extend support to family members of those with mental disorders.
The way forward — What is our best bet?
You do not let a raging bull take over, especially when you know the damage it has already wrecked. You take the bull by the horns and tame it to suit your needs.
Our lives changed with the advent of the internet in 1983–1984 and with social media in early 2000s. It further transformed with the arrival of Artificial Intelligence and Machine Learning, dictating our choices, decisions, preferences and even moods, as social media users. And with metaverse, it’s taking our digital lives towards virtual realities.
While this is a recipe for the brain to get bombarded with stimuli, left, right and centre, and increasing mental stress, and completely cutting off our connections from the admittedly more real, beautiful, natural and challenging physical world, we are not playing any effective role in changing our digital habits. The digital world has constructive purposes, which we realize and enjoy (which includes this blog as but one example). Moreover, we are social animals who cannot stop digitally connecting, but at best, limit our usage patterns and reduce screen times.
The reconciliation between our unavoidable and dominating digital world and the urgency of protecting our mental health, apart from less screen time, is to tame the animal.
We have to keep taming this animal by leveraging its constructive side.
Just like we have to live with a new virus amidst us, we have to live with the evolving nature of this alternate world, than allow it to further ravage our mental health.
We have to include users with mental health conditions to gain from services that can be delivered via digital platforms.
We have to continuously spread the right information and break stigma on the very digital channels, which can otherwise breed guilt, stigma, rejection, negative social comparisons, loneliness, and hostile environments for all of us, and particularly those who are vulnerable to mentally distressing states, or living with mental disorders.
Finally, we do not have to (and we cannot) throw the baby out with the bathwater. We have to recognize that social media offers opportunities but we have to pick them, believe in them, test them, observe their effects, gauge their risks, and move forward.
We have to keep the conviction that a reconciliation between the ever-changing digital animal and our mind is possible, and perhaps the only viable option.
Dr. Ameya is a public health researcher, clinician and author. He writes on issues of mental health, disability, stigma and gender.
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