The Harms of Social Media

 Social media is a miraculous invention:  a way to stay in touch with friends and family, to share thoughts and pictures and videos and common interests, at any moment with perfect convenience, literally with the push of a button (actually, even the force of pushing a button is not actually required, it's just touching a piece of glass!).  

It is an electronic extension of ancient modes of human communication: instead of sharing stories and starting conversations around a campfire with a group of fellow hunter-gatherers or villagers, we have an electronic campfire, which allows 24/7 contact with almost everyone in the whole world.  

Human interaction and communication is a need, and our brains are designed to be very sensitive to social stimuli.  

There are many benefits of using social media, but it is in my opinion very harmful, both on an individual level and as a national or worldwide community.  

Social media companies of course want you to spend more time on their apps.  The algorithms are designed to feed you information that would interest you more, and keep you looking for longer.  But this isn't necessarily good or healthy!  It's the same mechanism that feeds addiction or any unhealthy habit.  It's like candy for the brain.  The algorithms are not designed to give balanced information, or to help people avoid getting sucked into rabbit holes of misinformation, or to stay healthy, or to foster harmony in communities, they are simply designed to optimize time spent on the apps.  

So people are spending huge amounts of time surfing on social media or other scrolling information sites.  "Doomscrolling" is a very common activity.  For children, there are clear psychological harms--Jonathan Haidt's latest book "The Anxious Generation" is a good place to start reviewing the data on this.  Especially for children, the social comparison that is fed by social media is almost guaranteed to at once absorb attention, but also make people feel bad about themselves.  This could result in an increased rate in mental illnesses such as depression and anxiety disorders.  

And there are secondary costs, as Haidt has also shown:  every hour spent on an app means one less hour doing some other healthy or meaningful human activity, such as playing outside, going for a walk, doing a hobby, studying, conversing with friends in person, or reading a book.  App use fosters both psychological harm and damage to physical health as well, by reducing the amount of exercise we're getting, sometimes interfering with sleep (people are often up late at night looking at their phones; aside from the psychological component driving this, the bright light from the screens further interferes with normal sleep).   

I spent a few years using Twitter.  I am thankful that I stopped using it by the time it had changed names a few years ago.  There were many positives of Twitter for me, professionally:  it was a way to stay informed about the ideas and research of numerous experts in various fields of interest, and to hear their ideas instantaneously, rather than waiting for journal articles to come out (sometimes years later).  At times one could interact directly with the experts.  And one could add on other peripheral or hobby interests, and just feel better informed every day.  During the pandemic I felt Twitter was a good way both to follow news of critical matters daily, but also to contribute a public message as a professional.  

But I ended up spending more and more time on Twitter.  Even during a hike outside, I would find myself pulling out my phone and checking.  Hours were spent on the app that could have been spent reading a book or a journal or a newspaper, or doing some fun activity.  And as I discovered over time, many of the interactions on Twitter were frustrating -- often you couldn't really have a conversation with people.  It was rare for an expert to actually interact with you.   The app created an illusion of connectivity, while very little was actually there.  The one advantage it did have was convenience, and efficiency in terms of cultivating a community of like-minded peers.  Such a community can sometimes be useful, but at worst this feeds the worst tendencies in society, of polarization and division.  

From a psychiatric point of view, I believe it is important to assess internet and social media use.  It should be an essential component of any psychiatric history.  

Consideration should always be given to weaning from social media, to try a few months entirely without it.  You may experience "withdrawal" from it, but after this passes you may feel more free.  If you fear that you'll become less informed, remind yourself that you can just read magazines or newspapers once a week, or once a month, and most likely remain as informed, or even more, compared to doomscrolling.  

On a societal level, I understand that one of the principles at play here is freedom of speech.  If governments were to regulate social media companies this would be seen as interfering with freedoms.  But if we consider that social media and many other internet sites are analogous to addictive products, such as cigarettes or alcohol, maybe we could increase the amount of regulation about how these products are marketed or accessed, especially to children.  

One of Haidt's ideas is to insist that children in school should not be allowed to have their phones during school hours.  I think this is very good idea.  Of course, modern education often makes use of electronic media, but this could be provided in schools using other devices that would not allow kids to be surfing social media during their classroom hours.  

This idea could be extended into adult life, to invite people to set their phones aside much more often.  

Grocery Shopping & Mental Health

 Good nutrition is essential for physical and mental health.  

But changing one's diet is probably not going to cure depression or make your anxiety go away.  In fact, I'm concerned about various trends in health care which exaggerate the effect of dietary change.  For example, there are programs run by professionals with titles such as "food as medicine" in which patients are taught about healthy dietary practices.  But the therapeutic value here is very modest, especially if compared to a well-controlled placebo condition.  It may be beneficial to have nutritional education, dietary change, and regular supportive meetings supervised by a professional, but there would be a lot of nonspecific factors involved here, including a benevolent structure, group support, empathy, and focus on general healthy lifestyle habits other than nutrition, which contribute to clinical improvements.  And sometimes these programs end up recommending various supplements or "alternative" nutritional habits which have a very questionable evidence base.  

The basics of healthy nutrition, however, are simple.  There is a lot of room for individual differences in preferences or restrictions, but the foundation of a healthy diet is vegetables (especially fresh green vegetables); fruit; nuts; whole grains and other complex carbs with high fiber; beans, lentils, and other legumes; lean protein; healthy fats such as olive oil; fish; and much less red meat than the average North American consumes.   High-sugar and simple-carb foods such as pastries, cookies, cakes, candy, etc. should be greatly reduced--often if you've reduced these a lot, you can enjoy the occasional sweet treat even more, without needing to have as much.  One should cut back on the amount of salt.  Ultraprocessed foods, such as chips, processed breakfast cereals,  instant noodles, soft drinks, and fast foods, should be avoided.  

These basics do not lead to some kind of unpleasant, spartan lifestyle, these are the foundations for a wonderful, sensually pleasing diet in which every meal can be a joy of life, with no end of variety possible, from simple snacks to daily meals to gourmet adventures.  The enjoyment of this type of diet involves not only the nutritional benefits, but also the process of shopping (for example at farmers' markets, produce shops, or berry picking) and meal preparation (in the kitchen).  These activities touch upon basic joys and skills of life that have been part of human ancestral history for thousands of years.    

When wandering through a major grocery store the other day, I was struck by how hard it can be to make healthy choices.  These stores have incredible variety.  It's easy to find all the perfect, healthy foods listed above.  But the problem is that junk food, ultraprocessed foods, candy, etc. are all marketed aggressively.  Whole rows of the grocery store are dedicated to junk food.  Shelf after shelf of chips, cookies, soft drinks, or even "fake health foods" such as sugary cereals or "vitamin water."  At the cashier, there is yet another opportunity to buy chocolate bars and other candy.  Even in the areas with healthier foods, such as the produce section or the aisles with baking products, there is often a display of some kind of ultraprocessed food or junk food on special.  Even health-oriented grocery stores such as Whole Foods feature similar marketing.   It's the same even at pharmacies which sell food products.  And even in a hospital, whether it be at the cafeteria or at vending machines, there is an endless supply of junk food.  Lunches served at schools, or food provided after sports events, often consist of pizza, burgers, and cake.  

Junk food is designed to be enjoyable to eat, so that people will buy more of it.  In this way it is comparable to addictive products such as cigarettes.  Unlike cigarettes, there are no restrictions about how they are marketed.  And the companies manufacturing these products, and the grocery stores selling them, are earning billions.   So we have a whole generation of people, including young children, who are basically addicted to junk food.  The health consequences of this include much higher rates of obesity, as well as a likely lifelong, chronic decline in physical and mental health.  Another consequence is a decline in culinary culture--many people just aren't interested in the artistry of food, if they are addicted to processed products.  

One of my interests this past year has been learning Chinese, and as part of this I like to watch Mandarin language movies and TV series -- the Chinese culinary culture has probably been the healthiest one in the world, and likely is a factor contributing to better health and longevity in this population.  But even in China it appears that ultraprocessed foods are disturbingly common.  In modern Chinese movies, we often see the characters eating pizza (it seems a common North American chain restaurant is popular there) or visiting a grocery store, the shelves stocked floor to ceiling with bags of chips and instant noodles etc.  So even in the healthiest culinary culture in the world, the bad nutritional habits of the West have crept in.  

What can be done about this?  Aside from individual education on this matter, and striving to make healthier choices, I think that public measures can help.  Other countries in the world are experimenting with having taxes on sugary foods, ultraprocessed foods, etc., and restricting marketing, especially to children.  It's a similar approach as we used to help reduce cigarette smoking in the population--it didn't require banning anything (and taking away anyone's freedom), it just required restrictions on advertising, display, marketing, and introducing a tax on the product.  Another public measure that I would love to see is a subsidy on healthy foods such as vegetables, so that everyone could afford them more easily.  This would have benefits not only for individual health and nutrition, it would also be beneficial for the environment, for farmers, and would be economically more efficient.