Screens are a drug, experts warn. Why is no one listening? What can parents do? | Opinion
I take the dog for walks at night. I call it exercise.
When I’m out, I often listen to podcasts on my phone, through small buds plugged into my ears.
In a world flush with gadgets and instant gratification, it’s normal, everyday behavior. There’s always a glowing screen offering distraction nearby.
The podcasts are like a treat — something I look forward to, a digital escape from the physical world.
According to Anna Lembke, a professor of psychiatry and behavioral sciences at Stanford University, the routine I’ve developed is no big deal — until it is. That’s the thing.
The proliferation of screens has put stimulation at our fingertips, she says, and like any other drug, technology has the potential to be habit-forming and life-changing.
“It was really the advent of the smartphone that kind of exploded this problem,” she said, noting that the risk of ubiquitous screens and endless content is profound, particularly during childhood development
Lembke specializes in the treatment of addiction and authored the 2022 book, “Dopamine Nation: Finding Balance in the Age of Indulgence.”
The fact that I stumbled on her while listening to one of those podcasts I’m hooked on is either ironic or telling.
“The sheer volume of content, the portability, the 24/7 access, the cultural emphasis on the technology’s advantages … incorporated now into every aspect of our lives, including schools, it just takes it to a whole different level,” Lembke said.
“All of it contributes to the levels of harm.”
Despite the urgency of Lembke’s words, two things remain unquestionably true:
Since the beginning of time, parents have fretted over the most recent cultural trends: Kevin Bacon’s hips, video games, and Marilyn Manson CDs. All of those fears were overblown and silly.
Meanwhile, sounding the alarm about the dangers of technology at this point almost feels quaint and naive. Two decades ago, experts might have been divided. Today, not so much.
The U.S. Surgeon General recently issued a warning about the dangers of social media among children. The health risks associated with excessive screen time have been documented and reported, time and time again. Few, if anyone, seems to care.
The amount of time we spend plugged in has been on the rise for roughly two decades.
The average American now spends roughly seven hours a day looking at a screen; for children ages 8 to 18, it’s slightly more, according to the Centers for Disease Control & Prevention.
Dr. Mary Ann Woodruff, who has practiced for more than three decades at Pediatrics Northwest in Tacoma, generally agrees with Lembke’s assessment.
Screens have their benefits, Woodruff told me. Virtual education has been a blessing for some families, and the ability to connect to a world beyond has provided many kids with meaningful and healthy social relationships, she said.
Still, there’s a youth mental health crisis across the nation. Anxiety and depression are up in kids. Young people are flooding local emergency rooms and asking for help.
It’s no coincidence, Woodruff said. In her mind, the connection is clear.
“It’s just pervasive. It’s now part of the childhood experience, and … the impact is enormous,” Woodruff told me, describing some of the common effects she sees in patients, including social withdrawal and significant sleep disorders.
Woodruff also encounters parents who succumb to the pressures of life and the prevalence of technology and “throw up their hands,” she said, giving small children cell phones or tablets.
“It’s about loss of connection with relationships in real time,” Woodruff explained of the danger and the challenges facing families.
“Screens are absolutely like a drug,” she told me.
Pleasure and pain
Outside of her work at Stanford, Lembke is a practicing psychiatrist in Silicon Valley, where she helps patients living in one of the wealthiest areas of the country overcome addiction.
Appearing on a 2023 episode of “Hidden Brain,” a podcast that attempts to demystify the intricacies of human behavior by delving into the science that drives it, Lembke described how the proliferation of screens and digital technology has rewired people’s brains, leading to unhealthy dependency — the same kind we associate with alcoholism or drug addiction.
The addictive potential of digital content is undeniable, Lembke said, highlighting the relationship in our brain between pleasure and pain.
Instant digital content tickles our pleasure receptors, just like caffeine, nicotine or cocaine, setting off a neurological chain reaction, she explained.
The problem? What goes up must come down.
Chemically, the human brain is wired to counteract the release of chemicals that make us happy or euphoric with ones that do the opposite.
Before long you have to be online and connected just to feel normal, Lembke said.
Your brain’s new baseline requires a flood of positive stimulation just to counteract the flood of downers it’s constantly swimming in.
“The same parts of the brain that process pleasure also process pain. And they work like opposite sides of a balance … like a seesaw or teeter-totter,” Lembke explained to host Shankar Vedantam, a former correspondent with NPR and Washington Post reporter.
“When we experience pleasure, it tips one way. And when we experience pain, it tips in the opposite direction,” Lembke continued. “Our brains will work very hard to restore a level balance after any deviation from neutrality.”
Evolutionarily, the system has its benefits — providing humans with the motivation to hunt, gather, reproduce and survive.
When we’re hungry, eating makes us feel better. Love burns hottest in the beginning. Tolerance builds up; it’s never as good as the first time.
With a smartphone in everyone’s pocket capable of delivering a constant drip of serotonin, dopamine, endorphins and oxytocin?
We’re overmatched.
The allure is too strong, and our brains try to keep up the only way they know how, Lembke said.
“When we’re not using, we’re walking around with the balance tilted to the side of pain, experiencing the universal symptoms of withdrawal, which are anxiety, irritability, insomnia, depression and craving,” Lembke said.
“This is essentially how continued consumption of any high intoxicant, highly reinforcing substance or behavior contributes to the inability to take joy in anything. … We lose the perspective of the fact that continued consumption actually contributes to the problem,” she added.
“All we can see is the way in which it brings us temporary relief.”
Advice for families
Even if the intricate brain chemistry Lembke draws on sounds foreign, her description tracks with things we know to be true — like the reality of hangovers and how it feels to be starving.
According to Woodruff, the dire scene Lembke paints also mirrors the challenges and health concerns being reported by local families at local pediatric clinics.
Woodruff arrived at Pediatrics Northwest in 1989. For the majority of her career, patient intakes involved questions about screen time — specifically, how many hours a day a child spends in front of the TV. For many children, the limit was always no more than two hours.
“Now, it’s not just the TV. It’s a phone, it’s a watch ... It’s just everywhere,” Woodruff said of the ways children are exposed to screens.
In some households, the old guidelines are being obliterated, Woodruff indicated.
Beyond the potential to harm a child’s development and mental health, she pointed to research documenting a link between the overuse of technology and issues related to eyesight and hearing.
Many parents worry online dangers like cyberbullying and sexual predators, Woodruff said, but they ignore the harm of tech addiction and excessive screen time.
“Over a lifetime, the impact of some of the decisions that are happening now, by default, are going to have an impact — and that impact will be a significant problem for people over their lifetime,” Woodruff said.
“I think it comes back to the intentionality. It’s not like being a Luddite and saying, ‘There’s no technology that’s good,’” she continued.
“For families, it starts with parents saying, ‘What, what do I hope for in our family life, and for our kids? What gives us joy?’”
Of course, recognizing the potential dangers of screens and technology — for children and adults – is one thing; limiting consumption is entirely another.
It’s everywhere, and it’s not going anywhere. Where do you even start?
As a parent, how do you respond to a challenge you never faced growing up?
How can you avoid being overwhelmed and discouraged knowing full well this is the world we’re leaving our children — and they’ll be adults one day soon anyway?
According to Lembke, an obvious place to start is in the classroom.
The COVID-19 pandemic might have created a temporary need for the increased use of screen time in our schools, but it’s a trend many districts have taken and run with, she said, in the face of everything we know — and the inherent risks of tech addiction.
Even if virtual learning has been a useful tool for some families, the across-the-board expansion of technology in general classrooms — including the use of district-provided laptops and often personal cell phones during school work — is like playing with fire, Lembke said.
“Schools are at fault. Schools have completely over-embraced the use of technology, to the detriment of kids, and learning and teachers and everybody,” Lembke said.
“We absolutely need to unwind the way that technology and devices have been integrated into the classroom,” she told me.
“We can start by mandating, from the top down, that kids should not have access to their smartphones and personal internet devices at school.”
Andrea Donalty is a general pediatrician and medical director of the Mary Bridge Children’s Primary Care Network.
The goal for parents, she said, should be striking a reasonable balance.
The limits parents set often depend on a child’s circumstances, Donalty said, like how old they are, where they live, and the other activities they have available to them.
Even guidelines issued by the American Academy of Pediatrics acknowledge the impracticality of hard-and-fast rules, she noted.
One thing that should be obvious:
Children mirror the behavior of their parents, so the key to getting your kids to spend less time on screens is often being willing to do the same, Donatly told me.
Setting a good example really does matter, she said.
“What is actually doable and tangible?” Donalty said, relaying the screen-time advice she typically gives families visiting Mary Bridge clinics. “As adults, we need to do this, too.”.
“I tie some of this into the discussion we usually have on overall good health, which includes sleep, movement, (and) nutrition,” Donalty said.
“Maybe you start with a small thing. We encourage having family meals together, and one of the rules — which is very common but not always enforced — is that nobody has their screens at the dinner table.”
It’s sound advice, similar to the guidance Woodruff doles out at Pediatrics Northwest, she said, the kind parents and families can put into action.
At the same time, practical guidelines that acknowledge the impossibility of avoiding screens altogether — and the reality of the technology-dependent society we’ve built — also risk understating the danger, Lembke said.
The real key, Lembke said, starts with understanding what happens in your brain every time you log on — and then treating the technology for what it is, a widely available, highly-addictive substance.
“In the mental health care field, people are coming in whose lives have been destroyed by compulsive over-consumption of digital media and digital drugs,” Lembke said.
“Respecting the powerfully potent, addictive nature of the medium and recognizing the actual physiologic phenomenon as the brain withdraws … is a useful frame in which to understand the impact,” she told me.
This story was originally published January 17, 2024 at 5:00 AM.
