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Your Brain on Smartphones: How Overuse Could be Hazardous to Your Health

Your Brain on Smartphones:  The Neuroscience of Smartphone Addiction.

 

Our smartphones have become a trusted “companion” for accessing vast information, keeping up with our friends and family who live away from us, and passing time. However, it is hard to realize how those minutes of checking social media could amount to hours a day. And it is hard to imagine what we could do with that time in minutes, while it accumulates to become hours each day.

Recently I watched the documentary “The Social Dilemma” on Netflix.  The documentary was well-done, essentially raising questions about how smartphones are a window into an individual’s brain, and how companies are exploiting this information for the sake of revenue generation while furthering a smartphone addiction. Other behavioral experiments are being conducted surreptitiously as well, including the fine-tuning of information toward what a person’s previous reading habits were, with the potential to polarize viewpoints.

For some time, this has been a concern of mine as well. I decided to dig deeper into this topic, not only for Your Health Forum but as a way to work toward a behavior change that I would benefit from as well.

It is incredible to imagine that more than 5 billion people have mobile devices, and more than half of these are smartphones. Just walking in a store, coffee shop, airport, one sees a common behavior:  people glaring at their smartphones, checking social media, reading articles, and in their own worlds, while gaps of time are allowed to pass. Many of us can also admit that the time spent swiping through cell phone social media and curated articles has increased over the last several months, since the pandemic.

When you add up these little checks on the phone, you might be startled about how much time you are spending on them.  Add up those 3-5 hours spent on the phone each day and, in one year, you have spent between 46 and 72 days on the phone! If you had that time back, is there something that you would prefer to have done with it?

We don’t always think about how the time in each day adds up. If we could have 2 free months delivered on a platter – let’s say a long sabbatical – wouldn’t we spend it on things that are truly important to us? Yet 2-3 hours are spent each day, time that could have been spent more present with loved ones, hikes, art, reading, volunteering, or developing new skills.

 

When a phone became more than just a phone: the dawn of the Information Age.

Let’s start this with the message that smartphones are here to stay. This article is intended to provide instruction for those who may be wondering if their smartphone use could be adversely affecting them. What is appropriate use and overuse varies from person to person: when it causes some for of harm, it may require attention. It mainly relates to how social media affects our brains.

Smartphones have become tremendous resource for information. It was common in medical school and residency to refer to my personal desktop assistant (PDA) as the “peripheral brain.” In the late nineties, I often referred to it for a review of medical or pharmaceutical information, before writing my orders or attending morning report.  I would carry the flip phone, beeper, and PDA in my whitecoat pockets.  I remember when I purchased my first smartphone 2007, how incredible it was to have all of the functions combined, including a camera. I just needed to carry one thing around with me. That was the beginning of my love affair with the smartphone.

In Nicholas Carr’s provoking book The Shallows, What the Internet Is Doing to Our Brains, he writes of how the brain maps out tools, such as the smartphone, as if they were appendages of our bodies. Neuroplasticity explains how the things that we spend time on literally shape our brains. This is not necessarily a bad thing. What follows is when it can become a problem.

 

A Modern Day Narcissus Story?

It got me to thinking about several motifs that illustrate how an object of our affection demands time and the story of Narcissus and Echo. It is based on Greek mythology, and where the terms “narcissist” and “echo” are derived.

Echo was a beautiful nymph that enjoyed talking.  Echo tried to stop Hera to prevent her from finding Zeus by occupying her with chatter.  Hera cursed Echo to say the last thing others said. She fell in love with the handsome Narcissus, but she could not express her love to him. Narcissus rejected Echo; he was punished by Nemesis as a result.

While near a lake, Narcissus looked at his reflection and fell in love with it.  As he continued to be enthralled by his reflection, he neglected to care for himself, withered, and died. Echo became despondent and withdrew into a cave in the mountains. Even now, if you are near mountains, and you speak, Echo might say your last word. But this is Narcissus’ story.

 

 

 

The Neuroscience of smartphones addiction

We didn’t completely realize when cellphones, and later smartphones, became available to the public, that we were subjecting ourselves to a mass experiment that would forever change the way we spend our days and, additively, our lives. Unlike a medication that undergoes rigorous testing by the FDA before it is approved, the smartphone was launched into the market for consumers without any knowledge of the ramifications of its overuse.

From phone to smartphone, a device changed from a method to communicate with others long-distance verbally, to a form of information dissemination and social media sharing. How did these changes come about? How can we balance out the importance of having these devices, while limiting the time consumption that these devices are increasingly getting from us?

 

What happens in our brains with heavy use of these devices?

The coding that occurs in the brains relates to the rewards system in the amygdala and prefrontal cortex, and the neurotransmitters that reinforce the action and make it more likely to be repeated (a behavior). There are strong forces regulated by dopamine, a neurotransmitter that pulls a person towards completing an action that had previously provided a reward, creating a craving that triggers a response.  Additionally, smartphones and internet addiction increase the neurotransmitter Gamma-Amino Butyric Acid (GABA) in the anterior cingulate gyrus (ACG). It is an inhibitory neurotransmitter, associated with anxiety.

 

Here are a few studies that help to localize the areas of the brains and resultant behaviors from heavy smartphone use:

  • Through recent developments in MRI technology, scientists have a tool to assess how smartphones affect certain areas of the brain preferentially and associate these with various neural pathways and neurotransmitters. This tool is referred to as “functional MRI.” In one study of nineteen youth compared with controls, twelve of whom received cognitive behavioral therapy (CBT) for internet and smartphone addiction.  The study showed the original GABA to creatine and GABA to Glx (Glutamate + Glutamine) ratios were increased in these addictions.  After the CBT, the volume of brain tissue ratios GABA to Glx or GABA to creatinine was decreased significantly (Seo, 2017).  The study not only showed a characteristic location of the brain present in addiction but also how therapy may substantially benefit.
  • Another study the behaviors and other parameters of heavy users compared with never users.  Heavy users showed a greater likelihood of impulsivity, decreased attention, and antisocial characteristics. These behaviors correlated with decreased brain signaling (from transcranial magnetic stimulation (TMS)) over the right prefrontal cortex (Hadar, 2017)
  • What’s concerning is that these grey matter changes in the brain from problem smartphone use (PSU) are also found in drug addicts. Another study evaluated MRI to determine the brain structure and function in 48 smartphone users. They completed an inventory on smartphone addiction, a depression inventory (Beck Depression Inventory), and an Impulsiveness Scale (Barratt Impulsiveness Scale). In those with smartphone addiction, the MRI showed decreased size and activity in the grey matter of the insula, the temporal cortex, as well as in the anterior cingulate cortex (ACC).  The insula has been associated with other addictive behavior (Horvath, 2020).

 

Smartphones and (Anti-)Socialization

Have you ever asked someone a question regarding something that you were concerned about, and the person stared at their phone while providing you a brief, vague answer?  This act is known as “phubbing,” or snubbing someone while paying attention to the smartphone. This behavior can have negative effects on relationship satisfaction and perceived communication quality (Chotpitayasunondh, 2018). If you are having any relationship strains with a friend or partner, you might want to check each other’s smartphone use to see if it could be a contributing factor. Some studies have raised the concern that smartphone overuse contributes to less sensitivity to read nonverbal cues, interpret facial expressions, or even show empathy.

 

Photo by Andrea Piacquadio on Pexels.com

 

Smartphone addiction and your health

Smartphone use is not only a silent stealer of your free time, but it can also be associated with physical and mental health issues, such as an increased risk for stress, depression, anxiety, and sleep disturbances. One study in university students (688 randomly sampled) found a correlation in daytime tiredness, decreased sleep quality, and duration with smartphone use. Depression and anxiety scores predicted smartphone addiction (Boumosleh, 2017).

The finding of younger adults comes up in several other articles. The development of the brain’s pathways is more impacted at an earlier age.  In one study that used questionnaires to assess smartphone addiction and depression determined a strong correlation between the two, the highest scores being seen in the younger age users (Alhassan, 2018). A large study of 41,871 children and young people found that 1 in 5 (23.3%) had problematic smartphone use.  Along with this was associated with an increased risk of depression, anxiety, stress, and decreased sleep quality. In a 2019 study of 346 older adolescents (18-20), smartphone dependence predicted depressive symptoms and loneliness.

In this way, measures to limit smartphone overuse and address addiction may be instrumental in reducing depression and other health impacts. For a more detailed summary of consequences associated with smartphone overuse, refer to the article Smartphone Use During Quarantine on Your Health Forum.

 

Behaviors associated with heavy smartphone use.

In a recent study by Pew Research Center, 50 percent of adults responded that they couldn’t live without their phones. Because many of us have become attached to our smartphones, there is even a new word in the Merriam-Webster dictionary for “fear of not having a mobile phone” nomophobiaA Time Mobility Poll (2012) of almost 5,000 people around the world, showed an especially attached connection in younger adults: three-quarters of the respondents between 25 to 29 years of age slept with their phones. What about checking the phone for updates? 1 in 4 people check it every 30 minutes, 1 in 5 every 10 minutes. With the surge of social media apps that followed, likely the average usage times have increased substantially.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) (2013) categorizes the behavior addictions gambling disorder and internet gaming disorder, as “substance-related and addictive disorders,” but smartphones weren’t included.  They have evolved very much since the time of its publication. The method of screen use is the key factor, as social media programs stimulate our brains differently than, for instance, taking an online course. Smartphone addiction resembles internet addiction. Factors that contribute to problematic smartphone use include compulsive behaviors, the development of tolerance, withdrawal symptoms, and functional impairment.

Let’s go a little deeper exploring these signs:

Compulsive behavior relates to keeping a smartphone available all day, being preoccupied with it, and not being able to regulate the time spent; included is an urge to use the phone or difficulty resisting the impulse to use. Safety may be called into question: walking or driving while using your phone.

Tolerance is marked by an increase in the duration of smartphone use.

Withdrawal symptoms include thoughts about using the phone, a feeling of boredom, displeasure, irritability, or anxiety after some time without the smartphone.

Finally, functional impairment relates to a loss of previous interests or hobbies, disruption of responsibilities and duties, and physical injuries or psychological problems resulting from excessive smartphone use.

For a detailed description of these proposed diagnostic criteria, refer to the article by Lin et al. published in 2016.

 

A wake-up call

Major depression rates in adolescents and young adults increased 52% and 63%, respectively, from 2005-2009 to 2017 (8.7% to 13.2%; 8.1% to 13.2%). Suicide rates among teenagers have also risen. The greatest increase was noted around 2011, a time when smartphone ownership and smartphone apps were achieving greater penetration to the general public, implicating some association with smartphones with these trends.

Dr. Jean Twenge, a professor, and researcher at San Diego State University wrote in the Atlantic of her research on the iGen, including teenagers who are going out, dating, and driving less, while they are more likely to feel lonely, get enough sleep, and feel depressed.

A teenager who uses their smartphone or other electronic devices more than three hours a day is more likely to experience depression or have a risk factor for suicide (e.g. a plan). The trend of loneliness, depression, and suicide has increased especially in girls.

 

“My precious” smartphone?

Fear of missing out, or FOMO, is a force for children and adults alike to stay-tuned and scroll through their social media feeds: something that is going on around the world at this moment in someone else’s life that might add value or inspiration to their own. As we grapple with how we must adapt to smartphones, one thing can be sure: the “fear of missing out” and staying plugged in actually causes you to miss out on life.

The Hobbit and The Lord of the Rings stories by J.R.R.Tolkein capture a poignant message of the downward spiral of obsessive dependence, similar to the myth of Narcissus.  The ring became the object of Smeagol’s affection, literally transforming him into the sinister, ring-obsessed Gollum.

The ring imparted the power of invisibility. Could smartphones be diminishing our “presence,” entrapping us under their spell while our present becomes the past? The allure of the smartphone can drive one to search within it for answers, acceptance, and connection, only to chase an illusion that disperses like a ring of smoke.

 

Recommendations

1. Set a daily time limit on the phone.

Time use can add up throughout the day.  A check every 12 minutes could be a set-up for checking sites, responding to other’s texts.  Most smartphones have a program that does a daily assessment of your use and calculates an average usage during a week.

Another way around counting your time is simply to change a behavior that you normally do.  For example, if you check your phone immediately when you wake up, use the bathroom, or fall asleep you could avoid that behavior.  This will likely cut down on the total time.  While it is hard to say an exact time of healthy smartphone use, it likely a “less is more” thing.

 

2.  Set aside the smartphone and other electronics for one day each week and set that as an example for all family members.

One important point is that children’s screen-time use is influenced by their parent’s use.  Techniques such as selecting one day a week without electronic devices, including smart phones, may be a good strategy for keeping overuse in check.  I have encouraged our family to do this once a week – I call it, somewhat ironically, “Sunday Funday.”  It is interesting to see how often topics of electronics and smartphones come up during the day.

 

3. Set up some daily time-out routines with phone use.

During this quarantine for COVID-19, there is much more time to fall into the use of a smartphone.  Setting up a routine, such as all the phones are switched off or to airplane mode by 8:00pm may prevent the time creep of evening use and sleep issues.

 

4. Practice Mindfulness. Know when you might need to limit.

One thing about human behavior is that it occurs below the level of conscious detection.  Yes your brain makes you do things that you don’t realize that you are doing. Although smartphone doesn’t seem to overlap with mindfulness, the use of this practice may help you by slowing down reflex decision-making to use or staying aware of the passing of time.

 

5.  Get outside and power down.

Aside from the (peculiar) behavior of using an outdoor smartphone app (e.g. Pokémon go), getting outside may provide a chance to power off your phone and connect to the present moment.  Smell the flowers, hear the birds chirp, and hear the wind.  Nature doesn’t know that there is a pandemic.

 

5. Refer to a number of applications that are designed to curb phone addiction.

There are a number of Apps available on Android and IPhone that can help regulate time and curb smartphone overuse.  Some of these include AppDetox  (free/android), Flipd (free/android/ios), Offtime (ios/android), ClearLock (paid/android), and QualityTime (free/android).

It’s a slippery slope when using an app on your smartphone to modify your smartphone overuse.  It is always possible to turn off the alarm and just continue to use it.  Nevertheless, they may be beneficial in creating mindfulness of the behavior.

6.  Consider getting help if the above efforts don’t work.

Cognitive behavioral therapy (CBT) has a role in the treatment of forms of dependence, including smartphone addiction.  The idea of CBT is to increase one’s awareness of how emotions and thoughts shape an action that leads to the dependence and how to break that arc.  There are several online conferencing CBT sites available as well.

Concluding Remarks

 If you feel like this article speaks to you and would like more information of recommendations, refer to the links provided below. I offer additional information on “keeping smartphone use in check” and the stages of behavior change.

I appreciate any comments. I realize there may be some irony with posting this online. Once again, the message is that technology comes with it an understanding of its use but also an understanding of how it can affect us negatively.

Bibliography

Alhassan A, Alqadhib E, Taha N, Alahmari R, Salam M, Almutairi A. The relationship between addiction to smartphone usage and depression among adults: a cross-sectional study. BMC Psychiatry. 2018. 18:148.

Boumosleh J, Jaalouk D. Depression, anxiety, and smartphone addiction in university students – A cross-sectional study. 2017. PLoS One. Aug 4; 12(8):e0182239.

Chotpitayasunondh V, Douglas K. The effects of “phubbing” on social interaction. Journ App Soc Psych. 2018.

Hadar A, Hadas I, Lazarovits A, Alyagon U, Eliraz D, Zangen A. Answering the missed call: an initial exploration of cognitive and electrophysiological changes associated with smartphone use and abuse. 2017. PLoS ONE 12(7): e0180094.

Harwood J, Dooley J, Scott A, Joiner R. Constantly connected – the effects of smart-devices on mental health.

Horvath J, Mindinger C, Schmitgen M, Wolf N, Sambataro F, Hirjak D, Kubera K, Koenig J, Wolf R. Structural and functional correlates of smartphone addiction. 2020. Vol 105,

Jeong E, Choi S, Kwon Y, Park H, Kim, I. Neurotransmitters in Young People with Internet and Smartphone Addiction: A Comparison with Normal Controls and Changes after Cognitive Behavioral Therapy.  ScienceDaily, 30 Nov 2017.

Lin Yu-Hsuan, Chiang Chih-Lin, Lin, Po-Hsien, Chang Li-Ren, Ko Chih-Hung, Lee Yang-Han, and Lin Sheng-Hsuan. Proposed Diagnostic Criteria for Smartphone addiction. PLoS One. 2016; 11(11): e0163010.

 

 

Are smartphones the new opiate of the masses?

Digiprove sealCopyright secured by Digiprove © 2020 Christopher Cirino

By Christopher Cirino

I am a board certified physician trained in infectious diseases and internal medicine. This site will feature health issues as they relate to infectious diseases, behavior and finding wellness.

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