Mental Health is Self-Care, too
Stuck indoors while sheltering in place for so long surely increased awareness of being and feeling alone. It may have been the isolation of not being able to see smiles when we walked by in masks. Or the anxieties that gripped us from having to juggle school and/or work along with increasingly difficult family and business needs. And perhaps while on lockdown—even more so than usual, many of us resorted to using more of the very screens that can exacerbate loneliness—cell phones, computers, zoom, televisions. Or maybe it was just that all of a sudden we had time to consider our mental health, which perhaps we had been taking for granted and can be easy to overlook. Mark Zuckerberg is fond of saying Facebook brings us “together,” but he mentions less often the disruptions to human bonds rooted in empirical experiences. When the Centers for Disease Control & Prevention (CDC) urged us to stay home when possible to help slow the pandemic’s spread, “#together alone” became a slogan to help people feel better. The slogan, however, became ironic, given that it reversed the title of Sherry Turkle’s book and her research showing that social media increases feelings of being alone, despite being together. In her book Alone Together: Why We Expect More from Technology and Less from Each Other. Turkle showed that, tethered to our devices, we can feel lonely while immersed in numerous online contacts and crowd activities.1 We do not yet fully understand all the implications of technology and social media, in particular the isolation it creates despite seeming to do just the opposite. In an ad for Facebook—(now the Metaverse)–Mark Zuckerberg declares he just wants to “connect” the whole world. But we seem to have become increasingly isolated in our mental silos of technology that shield us, with its sometimes intrusive “connecting,” from more immediate and more meaningful human experiences. Thus, the innovation that has brought us to a state of tethered togetherness, also has a downside–disruption to personal and human connections that we compensate for with still more devices–cell phones, i-pads, and personal assistants or chatbots eager to “assist” us in navigating the domains of an impersonal, virtual imperialism.
Launched between 2004 and 2006, the pervasiveness of social media has left little-to-no space—especially for the young–simply to learn about and be themselves. Students often report they feel the lives of others on Facebook are more interesting when compared to their own. Sara Frier adds to comments made about Instagram, which boosts posts that get the most interactions: “‘Like everything else on Instagram, I’m selling something.’ No Filter. Constantly curating our own brand changes the way we act, or, as one Silicon Valley tech woman put it, ‘Faking it til you make it.’”2 Young people sometimes recognize these ploys more easily than do older adults and will remark, “They’re not being who they are.” Apps like Instagram (also owned by Meta), Snap Chat, and now Tik Tok consume much of their time and fill their social lives with pressures to compete with what they see on their screens and/or to isolate themselves with increasingly manipulative companions–those mechanical voices of algorithmic wizardry operating “behind the screens” of technology. Except…this “yellow brick road,” making gold for tech imperialists, seems to lead us…down rabbit holes…to more and more mental health issues. As far back as 2017, participants shared their responses to the use of more social media. A “5,000 person study found higher social media use correlated with self-reported declines in mental and physical health and life satisfaction.”3 Norah O’Donnell, asked Apple CEO Tim Cook if using the iPhone is “changing the way we interact?” Cook responded: “Users…started telling us, hey, my kids are using it too much. But we also learned something else–parents are also spending too much time. And so, the screen time is really focused on both kids and parents.”4 College students affirm their parents are on cell phones at least as much as they are, and too often parents are not even aware younger siblings are on cell phones. Students in my classes were emphatic that they would never let their children have cell phones until after high school. I don’t know if all of them stuck with that decision, but their attempt to break free from what we now know to be addictive was admirable. They see positive uses for social media, but also that we need tech free zones, such as dinner tables, time for walking in parks and other outdoor activities, space to remain anonymous, and in bedrooms when sleeping.
Early in the pandemic we began to hear a trend that would continue: “The pandemic has researchers worried about teen suicide.”5 A report from the Centers for Disease Control and Prevention (CDC) tracked emergency room visits from suspected suicide attempts before and during the pandemic: In early 2021, “suicide rates … were 50 percent higher among girls ages 12 to 17 than during the same period in 2019.”6 In October, 2021, three prominent children’s health organizations declared child and adolescent mental health a national emergency.7 Around the same time, whistleblower Frances Haugen disclosed thousands of internal documents that she collected while working for Facebook–renamed Meta. The leaked documents show Facebook’s public claims on mental health, hate speech, and freedom of speech–often contradicted the company’s own internal research. Haugen claims Facebook does not make apps and platforms safer for users when doing so would impact their profits.8 Some of the most striking facts backed by the leaked documents include how use of Instagram is damaging teenagers’ mental health, particularly when it comes to fostering eating and body image disorders. Scott Pelley asked “how Instagram harms teenage girls, including a study that 13.5% of teen girls say Instagram makes thoughts of suicide worse.”9 In her testimony to Congress and again on CBS 60 Minutes, Frances Haugen explained Facebook policies and algorithms contribute to teens’ low self-esteem and eating disorders: “Facebook’s own research says it is not just that Instagram…is distinctly worse than other forms of social media….As these young women begin to consume this eating disorder content, they get more and more depressed. And it actually makes them use the app more. And so, they end up in this feedback cycle where they hate their bodies more and more.”9 In 2022, the rate of suicide for 15-24 year-olds had doubled since 2015.10 The CDC issued a press release that “teen girls are experiencing record high levels of violence, sadness, and suicide risk, double that of boys. “Nearly 1 in 3 (30%) seriously considered attempting suicide—up nearly 60% from a decade ago, and 18% experienced some kind of sexual violence.”11 In 2023, the group Everytown for Gun Safety found suicide the third leading cause of death for 15-24 year olds, and now the leading cause of death for 13-and 14-year old girls.12 Christopher Booker examined the crisis for the PBS series “Early Warnings: America’s Youth Mental Health Crisis.”
Nuala Mullen, now 18, started social media at age ten, followed by Instagram and Tik Tok. “It’s just an addiction,” she says. “Once you know what it feels like to get likes and validation, you just crave it all of the time.”13 She gained thousands of followers, but Mullen says she knew she was hurting herself: I “needed that validation so badly that I was willing to do anything to get it…that’s really how I fell down the rabbit hole…I couldn’t get skinny enough. I couldn’t receive enough likes.”14 The pandemic heightened anxieties that many were already feeling from pressures to keep up with social media friends and also from expectations to succeed at school and in other activities like sports, all of which increased stress, already a daily consideration. Experts note some of the other negative effects a dependency on social media is having on the young– cyber-bullying, being cat-fished, sextortion, as well as the crudeness of many exchanges. Along with fears of a warming planet, our young people face some less than honest politicians, conspiracy theories, a worsening opioid epidemic, and fear of constant mass shootings–all factors contributing to trauma. US Surgeon General Vivek Murthy calls rebuilding our “social fabric, our connections with one another” urgent: “Children are now dealing with so much and often feel they are alone.”15 He warns, “Issues causing trauma are changeable and if we don’t address this, we won’t get ahead of it.”16 Stress, confusion, fear, and doubt are all factors that may influence how a teen solves problems and makes decisions.17 The CDC reported three-fourths of high school students do not get enough sleep, which is a minimum of 8 hours per night and cannot be “made up for” on weekends. With insufficient sleep, one is “less likely to handle stress productively.”18 If, however, we know young people are more susceptible to mounting pressures in a technological society and if we know increased expectations heighten anxieties and insecurities among those who are still in the process of maturing, then it would seem the adult world might take steps to limit exposure to the pressures young people face at certain periods in their lives. Another strategy is for adults to let the young know the adults “have their backs”–they are there to provide resources and support for them when they run into difficulties because some, though not all, of these factors can be anticipated.
Most adolescent brains—if not all brains–are susceptible to being overloaded, and when overload is reached, we adapt with various “coping mechanisms” (see 2b). It is up to the adult world—some of whom may be themselves overly stressed—to monitor the rate at which the young are exposed to overload before the young have developed enough positive coping mechanisms. Tia Dole, chief clinical operations officer at the Trevor Project a suicide prevention and crisis intervention for LGBTQ young people, states, “If you are a person who is in a community that is marginalized, you’re going to experience more stressors than other people. The research shows that young Black boys, for instance, are much more likely to complete suicide than other populations.”19 NY Times reporter Matt Rictal agrees with Dole’s analysis and finds “young kids of color who do not have access to care” are often misdiagnosed by being stereotyped as hostile and aggressive, “when in fact they may be “suffering trauma, depression, anxiety.”20 Rictal attributes earlier onset of puberty to the adolescent brain awakening to “all kinds of social information,” but those “parts of the brain that help make sense of all that information” develop at a slower pace, which can result in mental stress overwhelming a “hyperaware brain that is very sensitive at an earlier age,” but lacks coping mechanisms that are not yet fully developed.21 Pope Francis addresses the lack of coping mechanisms, or resilience, with reference to a “loss of spiritual meaning in the lives of many young people”22 being “replaced by an undue focus on material goods. Young people especially suffer from this lack of meaning. When encountering pain and uncertainties in life, “they often find their souls depleted of the spiritual resources needed to process suffering, frustration, disappointment, and grief.”23 Rictal downplays social media and attributes the problem, rather, to pressure coming from all kinds of places: the influence of “the larger, technologically-driven sense of competition, of a global economy, of the competitive nature of school, of athletics, of the world.24 “The shift in lifestyle driven by technology,” Rictal continues, has “shifted” how young people spend time “and in turn the kinds of risks they’re experiencing.”25 Those brains “susceptible to being overloaded,” he says, “begin to adapt through coping mechanisms: anxiety, depression, and weirdly enough, self-harm.”26 I agree with Rictal’s pinpointing of the overload to “technologically driven” competition that comes at young people from all directions (see 2b.)—a hyper-competitiveness. But, and as he acknowledges, the dominant way young people have access to that “information overload” is via time on social media.27
Furthermore, feelings of vulnerability, low self-worth, and craving approval are all in relationship to the lives of others they compare themselves with—or compete with–on social media. Much the way older generations once worked to “keep up with the Jones,” our youth often engage in intense competition with “friends” and influencers who show them different and seemingly ideal lives. The drive to perfect one’s image and lifestyle on the internet is intense enough to cause many of the young and vulnerable who feel they cannot live up to “perfection” to self-destruct. Behind that drive is the assumption that computer screens can help us develop self-images that match or even exceed what we find in the online appearances that, to many, may seem “perfection.” Then, too, and as with developments in artificial intelligence (AI), Rictal finds “current systems have not kept up with the problems young people are grappling with and the systems that we have in place to take care of it (sic.).”28 In an age in which “lifestyles are “driven by technology,” failure to keep pace with information overload that changes rapidly is common—not only with parents, in schools, in our government and court systems, but also even with the programmers who work with AI! One cause of a failure to keep pace with change is the snake-oil sales pitch that technology “saves” time. Another and major cause of the overload is that digital connections are not as intuitive or natural to human growth as are empirical experiences. Rather, they are sold to us using the non-stop drumbeat of persuasion– propaganda, advertisements, influencers, etc. This is not evolutionary adaptation so much as trying to impose or force increasingly rapid change to replace normal growth. Virtual assistants and other influencers prompt us to invest time and energy into whatever is trending. Conversations across the Internet favor “showmanship over exchange…The Internet is always on. And it’s always judging you, watching you, goading you.”29 Influencers themselves vie for attention 24/7 and are therefore in cutthroat competition with all others around the globe who are doing likewise. Rictal’s identification of the crux of the problem with overload being a “technologically-driven sense of competition” is accurate, I think, because it gets at this ruthless nature of much “competition” in today’s world. Seldom is competition simply fun or even team-spirited anymore. Most often its goal is rewarded with celebrity-status, money, and/or power. Too bad about the “losers.” Nuala Mullen, the eighteen-year-old interviewed for PBS, said, “It was competitive for me. I thought, oh, if I shared that I had anorexia with one of my friends, they might get a notion and they might become skinnier than me and they might get more likes.
So I wouldn’t tell anyone what was going on.”30 Technology also shields us from human connections the way cars shield drivers from looking out for people biking or walking or, conversely, the ways people walking and looking at cell phones can be oblivious to those driving. Except for people sharing grief with each other online or when setting up Go Fund Me accounts so that others hurting do not have to grieve alone, the Golden Rule seems largely absent from the internet. With so much technologically-driven and intense competition, the depreciation of simple human friendship and kindness that accompanies more ordinary activities has stressed many of our other relationships beyond capacities to function simply as neighbor to each other. That absence has found its way into our institutions. It shows in the impersonalized responses of machines mechanically transmitting information to humans and the subsequent lack of civility throughout much of government. Adults deride and often label others as “bad people” rather than merely ordinary people who, like everyone else, sometimes make “bad” mistakes. A similar attitude of ruthless competition shows in the 24/7 news cycle of in our politics. Liz Cheney was cautioned to downplay the violence on January 6 as a kind of litmus test. As many told her, “It’s all about survival.”31 So yes, technology brings with it extremely intense competition. Consider titles of some of the reality television shows— American Idol, Big Brother, Survivor, and dating shows in which partners you “loved passionately” last night are eliminated today. Even a fairly innocuous show like The Voice quickly becomes formulaic, with singers chosen from predictable categories—and often very young teens–and then listening to showers of hyperbolic praise again and again. The effect of so much praise on young contestants is telling. It is not that young, aspiring singers do not need praise because they do, and the reinforcement of confidence that the show offers can be very positive. But are more teenage stars needed with constant hype trying to outdo previous hype that is so familiar to the already super-hyped-up fan bases? Few others who might watch the show or know people from their home towns being treated like media stars achieve similar recognition.
This at a time in their lives when many struggle to seek approval, and are also trying to understand and come to terms simply with their own—and sometimes more fragile–identities. We may be teaching teens and now even pre-teens to idolize fame and compete for celebrity status, which will reward you with the envy of others and, oh yes, more money. These are the fairy tales of our age. You don’t get to marry the prince. But as long as you keep entertaining–drawing fans and making money–you get to be idolized “happily” ever after. If you do not become a star, you can participate vicariously as part of the energetic fan bases that support other idols. Not surprisingly, a goal for some young people today is to become influencers or You-Tubers.32 For those left out, some will seek notoriety. In contrast to reinforcing idolization, however, music can provide healing. Music therapy is a growing and promising field to help with mental health issues. Folk-singer Pete Seeger was blacklisted throughout much of his career, but recently honored on a 2024 U.S. stamp that included this tribute: “Seeger promoted the unifying power of voices joined in song to address social issues. His adaptation of “We Shall Overcome” became a civil rights anthem.”33 Folk music speaks plainly to the common person, and Seeger recognized that when we celebrate our best achievements or share in each other’s troubles, the “unifying power of voices” resonates with much of humanity—in positive ways to connect with others. When music combines with social purpose—King’s civil rights movement, anti-Vietnam war activists, Johnny Cash and prisoners, Cesar Chavez and the United Farm Workers (UFW) movements, and today’s search by many young people for their identities–working together to help others for a purpose larger than ourselves creates positive and shared synergy. During the pandemic, Global Citizen and other groups held free concerts to calm frayed nerves and cheer on people’s efforts not to feel alone while sheltering in place. Also, and often in support of human needs, marches bring together people of all ages, ethnicities, genders and religious backgrounds to bypass the insularity of today’s tribal politics and demonstrate that “unifying power of voices.” Students often mentioned they enjoy walking, jogging, and/or bike rides for various social causes. Those who participate in such experiences– particularly when they have become traditions shared with family members and friends–agree these times of joining together to make something better for humanity have meaning and are remembered as “good times” they will continue and pass on.
One of today’s rappers, Common, is an activist who reminds us of the value he finds in love in a way that speaks to many looking for meaning in their lives: “Life has no purpose without love, real love” or “There is nothing of value that is not in love, true love.”34 A recent airing of a new documentary produced in the middle of the pandemic was called “The Greatest Night in Pop.” Directed by Bao Nguyen and produced by Julia Nottingham, it recounts a night of solidarity among 44 pop musicians joining in singing “We are the World,” written by Lionel Ritchi and Michael Jackson, to raise aid for famine in Africa:
“We are the world. There’s a choice we’re making. We’re saving our own lives, until we make a better world just you and me. We are the world, we are the children.”35
Bao Nguyen, son of Vietnamese refugees, thinks of the film as “a bridge to my American side and my parents’ sort of immigrant side.36 Bao says all of the big-name artists coming together to focus on a moment of helping famine in Africa is “really unique.”37 He adds, “But I do hope the film is a way to inspire a generation of artists to realize … their own power, within their own talents, that they can make a difference.37a We need that now– perhaps to address climate change? To fight drug addictions? To protest wars? To raise aide for famine in Gaza? To help refugees? Every segment of society can be part of rebuilding the human bonds that help to heal and sustain our society. Yes, we will need more counselors and yes, more resources. But the surgeon general is also telling us our relationships themselves “are a source of healing and well-being hiding in plain sight.” 38 Stretching our relationships—going out to interact with and/or to help others is also “a way to help us live healthier, more fulfilled, and more productive lives.’”38a Some feel the pandemic simply called attention to problems long simmering within the culture. But it makes sense that a period of forced isolation such as sheltering in place would exacerbate feelings of self-doubt and being overwhelmed by the rapidly increasing and competitive pressures technology adds to what writer Jamie Ducharme calls that “vast ocean of need.”39