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The Dose Transcript for December 19, 2024

Host: Dr. Brian Goldman

BRIAN GOLDMAN: Hi, I'm Dr. Brian Goldman. Welcome to The Dose. Your kids are back at home for the holidays, and you might be noticing just how much time they spend refreshing their social media feeds. A Pew Research Center report says close to 60% of teens use TikTok every day, and roughly half are daily users of Snapchat and Instagram. Experts say that frequent use of social media is harming teens. And last month, the Australian Parliament did something about it, passing a law that would ban social media for kids under the age of 16. So this week we're asking: How can we reduce the negative effects of social media on kids' health? Hi, Shimi. Welcome back to The Dose.

SHIMI KANG: Thank you, Brian. Very excited to be here.

BRIAN GOLDMAN: Me too. So what was your reaction to the social media ban that was announced in Australia?

SHIMI KANG: Wow. I was happy to see something versus nothing. But it is a really complex topic, and an all-out ban probably doesn't solve the whole problem and there's big holes. But I do think we owe it to our kids to have this conversation. We do need more attention on this issue. We need much deeper understanding. So all of that I think is great, um, kind of outcome of this news story.

BRIAN GOLDMAN: And that's why we want to talk to you. But before we begin, can you give us a hi, my name is? Tell me what you do and where you do it.

SHIMI KANG: Sure. Yeah. So, hi, my name is Dr. Shimi Kang, and I am a addiction psychiatrist practicing for over 23 years, and an author of a book called ‘The Tech Solution: Creating Healthy Habits for a Digital World’ and a book called ‘The Dolphin Parent: Raising Healthy, Happy, and Self-Motivated Kids.’ I'm a clinical associate professor at the University of British Columbia and founder of a leadership program called Future Ready Minds.

BRIAN GOLDMAN: Well, that's why we've come to you, because of your expertise. So let's get started. How much of an issue is social media use among kids in this country at the present time?

SHIMI KANG: I believe it's the issue of our time. In the Tech Solution book, I actually opened it up with this idea that technology is the fire of our time. And I was referring to, we've never had a human innovation since we learned to harness the power of fire that was so powerful as current technology. And young people and adults who use it well will go further and farther than ever before. Those that don't will get burnt and burn down the village. We're seeing both. And I believe the biggest existential threat facing humanity, in fact, is the well-being, mental health, creativity, problem solving of this current generation, which technology is making a huge impact.

BRIAN GOLDMAN: So let's drill down to some of the science. What's the latest research about how social media affects developing brains?

SHIMI KANG: Well, there's many different aspects to that. If we look at just things like blue light, we know that there's some studies that show a disruption of myelin, which is that fatty layer in the brain's cortex. And we don't even see that on MRI scans in major illness like autism or schizophrenia even. So, so it's really concerning. We don't know if it's the blue lights. There's also sedentary behaviour: prolonged sitting, lack of activity, posture issues. That's just the tip of the iceberg from a physical health point of view. There's also links now to technology in general and diabetes and heart disease. From a mental health point of view, there is links -- so not direct cause, but links -- to things like anxiety, depression, addiction. Addiction to the internet and gaming are medical disorders now in Europe, in the ICD-10. We know that there is proven deficits in attention, reduction in social skills, including the most basic social skill of empathy. We're seeing sleep disruptions. On a societal level, polarization, misinformation and bullying, which is still on the rise in many forms. So, the impacts of social media is affecting our physical health, our mental health, our societal health. But also, like I said, it's really powerful. It's the fire. You know, there's huge ability for innovation, creativity. So we don't want to vilify it, but we do have to address the problems.

BRIAN GOLDMAN: My reading of the scientific literature suggests that social media activates the brain's prefrontal cortex. Can you tell us a little bit about that?

SHIMI KANG: You know, I think what's really interesting in the research for the Tech Solution book, I realized the first iteration of AI, which was social media, the industry used the term 'a race to the bottom of the brain stem.' And the brain stem is that amygdala area that gets triggered with a fear response or stress response and moves into a freeze, fight or flight. So that's what the industry was doing, and they actually knew how to do it because it was very sophisticated neuroscience that was applied for the algorithms, devices and platforms. And I'm an addiction specialist and the currency is dopamine. So really it was the manipulation of that. And what they were hoping for was to keep the eyeballs on the screen. It became that race to the bottom of the brain stem, meaning who could trigger the response so that individuals would go to social media to soothe themselves when-- and would come back again and again with those hits of dopamine. So that's really the first iteration of social media. The second came with ChatGBT. And the industry is calling it a race to intimacy, meaning that's more the frontal lobe now, where they realize people understand the addictive quality, but they're wanting to keep people's attention by forming relationships, let's say, with AI bots. Snapchat has an AI bot, and, you know, my 14-year-old might be more comfortable talking to, let's say, you know, her bot's name is Nelly, because Nelly speaks her language, knows what she likes, can ask her about volleyball and is much more pleasant and easy to talk to than, let's say, a real-life person. So that's what I mean by that race to intimacy.

BRIAN GOLDMAN: So, you know, how many hours of social media use does it take to start to get these adverse mental health effects?

SHIMI KANG: Yeah, I think the best way to look at it is really the consumption as opposed to the time. Because five minutes of pornography or five minutes of bullying or five minutes of livestream footage of war, you know, could have significant traumatizing effects versus, let's say, you know, an hour of reading up on Greta and climate change, let's say. So really the conversation we want to look at [is] the quality versus the time.

BRIAN GOLDMAN: You mentioned briefly mental health issues like depression and anxiety. What are the statistics? How bad is the risk to the mental health of teens who use social media a lot?

SHIMI KANG: We know that it's definitely linked. And when we go back and think about mental health, it's multifactorial. So, you know, a vulnerable youth, let's say, that has a family history of mental health, may have had head injuries or have other risk factors, that child now is more at risk because they may not have the support or have the coping skills to manage all of the stresses and addictive aspects of tech. So. And on the other hand, another child that has less risk factors might be able to navigate the world, you know, with -- and this is where parental control and support, guidance, as well as digital literacy in the school comes in. Because I say it's like handing kids the keys to a car. You know, we don't just give them a car. We teach them how to drive, we give them lessons, we sit with them. There's a whole process before they're allowed in that driver's seat. And really, that is the same kind of idea we need to take when we're looking at social media and young people.

BRIAN GOLDMAN: I want to ask you a question about focus, which is, of course, very important for learning. And being on social media requires a lot of multitasking. What impact does that social media experience have on a young person's ability to learn how to focus?

SHIMI KANG: Right. Yeah. So we are seeing rates of attention deficit going up. Some people say that's, you know, better diagnostic picking it up. That is true. But also, there's no doubt that scrolling and having YouTube open, trying to do your homework, having music playing, the more we divide or fragment our attention, our brain is neuroplastic, meaning it's adaptable, the less we'll be able to sustain focus and attention on singular tasks. That leads to this attention deficit. People think they can multitask, but the brain can't. It's just switching attention very quickly. And our nervous system will then ask us, why can't you focus? Is there a hurricane? Is there a predator? And it'll fire a stress response -- cortisol, adrenaline -- just from the lack of focus. So young people could be consuming great content, but just their switching of browsers and the way they're doing it could be quite harmful to their brain and mental health.

BRIAN GOLDMAN: So Australia has passed a law that will result in a ban. I gather that won't take place until next year. Quebec is debating whether to follow suit, though a committee is hearing mixed messages. So how effective might a social media ban be in protecting young people's health?

SHIMI KANG: You know, when I first heard about it, you know, my thoughts were that it gives the social media companies a message that we know what's going on, we love our brains and the young people in our life, and things need to change. I believe Australia said the companies have to figure out how to make sure the young people aren't working on it, so it'll be interesting to see what they do. But in the past there's been a lot of, I would say, half-hearted attempts, and, you know, big openings that will allow young people to bypass regulations. That's pretty much how a lot of the age-restricted apps are right now. But on the other hand, we know that, first of all, young people -- and nobody likes the word ban. We have autonomy and free will. And in general, that's the best way to work with people, is to create healthy choices. Second, we know that digital literacy in the schools and in the homes is absolutely essential to make those healthy choices when the time comes, whether it's at age 12 or 17 plus one day, which will happen in Australia even. And there's big holes that also need to be addressed that are harmful. Like gambling is on the rise, and that's part of video gaming. There's this new thing that is very clearly marketed to young kids, and these are structured just like slot machines, these FIFA packs. They're highly problematic. So I really hope we don't miss the other aspects that are harmful in this debate.

BRIAN GOLDMAN: You know teenagers. Any idea how teens might react to a ban? Like, what would their response be to a ban on social media?

SHIMI KANG: You know, I think it's really interesting. I worked with teens, and like I said, I have three teenagers of my own. Like, I look at the recent ban on cell phones in schools. Many really welcomed it, in fact. But if it's imposed in an authoritarian way, now you'll get the pushback. We don't want to be like sharks or tigers or helicopters or snowplow-- whatever that metaphor is of overbearing micromanaging. But we also don't want to be jellyfish where we're not putting limits, expectations, rules. We want to be with them in a collaborative way, shoulder to shoulder. The dolphin metaphor is firm, yet flexible. So we're going to talk about restrictions, maybe even a ban, but there's flexibility, you know, in how we want to approach this. That's the approach that works for all humans, and definitely teenagers, who do feel they want to assert their autonomy.

BRIAN GOLDMAN: Do you think that teens would find ways of working around the ban?

SHIMI KANG: I think a lot would. I think the big issue is parental education, because even in the schools, a lot of parents were the ones who were pushing back against the limitations because of their own anxieties or, in my opinion, their own addictions. And even I understand. I have two kids with life-threatening allergies, and that impulse, like, oh my God, what if I need to reach them? But that's where parent support and education comes in.

BRIAN GOLDMAN: I think a lot of parents are listening to us talking about this. Are you saying that the first step that parents should take is to look at their own use of social media?

SHIMI KANG: Yeah. Really stop and reflect on how are you consuming tech. Just, and again, it's a complex issue. And I say, simplify it. We all know how to eat, in general, right? We all know that there's healthy food, there's junk food, there's toxic food. Apply that same paradigm to tech and ask yourself, am I consuming healthy tech? How much junk tech am I consuming? Like that bag of chips, just mindlessly scrolling through social media. What about the toxic stuff? And maybe start that conversation with your child and say, hey, I did a self-evaluation and this is what I realized about myself. And then, you know, maybe do it as an entire family. Well, we're going to clean up our tech diet, our food diet, you know, after the holidays. Less sugar, what have you. But it's really important. We don't want to make it all bad or all good. It really is very much like the food we consume impacts our body, the tech we consume impacts our brain.

BRIAN GOLDMAN: So parents starting a family conversation with their kids might point out their own use of social media. Now they're going to talk to their kids about their use of social media. What are the kinds of sites that are more addictive to kids, that are more likely to end up having an adverse effect on their mental health?

SHIMI KANG: Yeah, good question. A great resource for that is Common Sense Media, and they have a lot of different games and platforms assessed and categorized according to addictive potential, violent potential, potential for polarization, misinformation. So I think that's a great resource.

BRIAN GOLDMAN: Assuming you're going to have that conversation with a teen, how do you approach them?

SHIMI KANG: Yeah, there's a wonderful tool that I put together from my research in addiction and motivation, and it's called the KEYS, K-E-Y-S. And it starts with first K, like kill the jellyfish, kill the shark. Take a deep breath. Ground yourself first. Be that dolphin parent, that calm, collaborative. That's how you want to start the conversation. So that's the K. The E is make a statement of empathy. So start with something like, I know you love your phone, I know, you know, it's hard to be without it. I know gaming is a place you find, you know, you can talk to people or have community. You know, whatever the topic is, put yourself in their shoes and make a statement of empathy. The Y is your goal. State their goals to them because it's about autonomy. So say, I know your goal is to be healthier this year or to get, you know, better grades in school or to, you know, play soccer better or connect with your friends better. Find a goal that's what's in it for them. And then end with a statement of success -- that's the S in the K-E-Y-S. And that's really about, I'm sure we can work this out. I'm sure we can find a way to help you. I'm here for you. Optimism really pulls that individual out of their brain stem into that frontal lobe where they can see problem solving and solutions. So, you know, the combination of empathy, autonomy and optimism are wonderful aspects to any conversation, especially with young people.

BRIAN GOLDMAN: And from what you were saying about empathy, Shimi, it's clear that part of having that conversation is acknowledging some of the positive effects of social media. So what are some of the good things that are worth keeping, in the same way that, you know, fire is a good thing when it's used properly?

SHIMI KANG: Yeah. So the three areas of healthy tech are any tech that leads to self-care. So I call it the ingredients of the tech diet [which] are endorphin, oxytocin and serotonin. And tech can give us these. So endorphin -- any tech that leads to self-care. So, helps you with your sleep. Any aspect of tech that helps you be more healthy. The second one is community. So any tech that helps you build positive community, that's oxytocin. And then the third healthy tech aspect is serotonin or creativity and learning. So in the end, any tech that leads to self-care, community, and creativity would be healthy choices for a tech diet.

BRIAN GOLDMAN: And finally, what signs should parents look out for to see if their child has a problem with social media?

SHIMI KANG: Right. Yeah. So, you know, addiction is a real thing. You know, any parent, physician, pediatrician, teacher out there will tell you. I think, you know, when we look at the signs of addiction, it is out-of-control use. Negative consequences to that use, so impact on physical health, maybe not sleeping well, maybe gaining weight. Impact on social health, isolation. Obviously addiction, anxiety, depression. Out-of-control use, negative consequences, cravings, and that's a hard one. But if you're sitting with that young person in that moment, you can ask them, do you ever crave to use your video game or your social media? Does the thought pop into your mind in the middle of math class or dinner with grandma? They'll tell you in those moments. So those are the three C's of addiction. The fourth is compulsive use, which kind of ties it all together. But I would really encourage people to start before that, before the addiction, and just look at overconsumption. Check the screen times on your phone, on your young people phone. Have these conversations.

BRIAN GOLDMAN: And what kind of professional would you consult if you're concerned that your child might be addicted to social media?

SHIMI KANG: You know, I wish we had a robust system, but I'm not going to pretend that it's there. Find a mental health professional. If you can, go to your family doctor if you have one. School counsellors, some schools do have counsellors embedded. So if you don't have that mental health professional, having a strong community and reaching out even to older siblings, cousins, aunts, uncles, anyone who has a connection to your child can be really helpful in this situation.

BRIAN GOLDMAN: Well, Dr. Shimi Kang, thank you so much for enlightening us on this important subject and being on The Dose.

SHIMI KANG: Thank you. I really appreciate the opportunity.

BRIAN GOLDMAN: Dr. Shimi Kang is a psychiatrist and associate professor of medicine at UBC and the author of The Tech Solution: Creating Healthy Habits for Kids Growing Up in a Digital World. Here's your dose of smart advice. Recent studies suggest that up to 95% of young people ages 13 to 17 report using a social media platform. And nearly two-thirds of teenagers report using social media every day, and one-third report using social media almost constantly. Social media activates various parts of the brain. When activated over and over again in children with developing brains, that can cause emotional dysregulation, increasing the risk of depression, anxiety disorders and ADHD. It can affect memory and attention span. Children and adolescents who spend more than three hours a day on social media have double the risk of mental health problems, including experiencing symptoms of depression and anxiety. Social media does have some benefits. It can create a sense of community among kids and can provide a safe space to talk about uncomfortable subjects. But the risk is real. It's uncertain what impact an outright ban on social media might have on teens. Some might test the ban and find ways to work around it. Teens are more likely to reduce their social media use if they believe it's their choice. One way to do that is to engage directly with teens by giving them educational tools on how to navigate social media safely. At home, try creating a family media plan to set limits on social media use. At school, you can work with teachers to establish healthier patterns of social media use in the classroom. Advise your teens to be selective about what they post online. Remind them that what's posted online is hard to remove completely. See your health-care provider if your teen seems anxious or depressed, and you think their use of social media is a factor. If you have topics you'd like discussed or questions answered, our email address is thedose@cbc.ca. If you liked this episode, please give us a rating and review wherever you get your podcasts. This edition of The Dose was produced by Prapti Bamaniya. Our senior producer is Colleen Ross. The Dose wants you to be better informed about your health. If you're looking for medical advice, see your health-care provider. I'm Dr. Brian Goldman. Until your next dose.

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How can we reduce the negative effects of social media on kids' health? - Transcript

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