Is technostress hurting your child’s mental health?

The biggest change pediatrician Lori Zito, MD has seen since she began her career as a pediatrician in 1990 is the increase in mental illness. Today, she says that at least 25 percent of her patients are being treated for mental illness, and technostress is the biggest contributor.

“I’m fast to blame technology and social media for the overwhelming increase in mental illness that I’ve seen among my pediatric patients over the past two decades. I think organized sports, dance and gymnastics adds an element of stress as well,” Dr. Zito said. “Of all the illnesses we see, anxiety is the most prevalent, and that wasn’t the case two decades ago.”

Technostress is a modern disease of adaptation caused by an inability to cope with new technologies in a healthy manner, according to the most widely accepted definition. Look around the next time you’re in a restaurant and notice how many people are looking at their cell phones or tablets instead of at each other, Dr. Zito said. That’s technostress.

Recent high-profile studies about the alarming suicide rates among American youth stop short of firmly linking social media with mental health problems. For instance, JAMA Network Open reported that suicide rates around girls ages 10 to 14 tripled between 1999 and 2014. Despite this “unprecedented escalation in suicide,” the researchers said their 2019 study was not designed to investigate the sources of suicide among youth. However, they wrote:

“Increasing rates of suicidality may be the ‘canary in the coal mine’ signaling important health concerns arising from the increased and pervasive use of social media affecting child and adolescent development. Such a signal in general health would raise great alarm and calls to action, and it must not go unheeded in mental health.”

Dr. Zito sees no need to wait for the proverbial canary or one more young person to die needlessly. Suicide is the second leading cause of death among young people.

“Why wait to address the problem?” she said. “We need to talk with kids and teens, get this topic out in the open, and get them the help they need. We, as a society, need more counselors because the ones we have are overwhelmed. And we need to help kids and teens learn to cope with technology before it’s thrust on them. I see 2-year-olds with tablets. The American Academy of Pediatrics recommends no screen time for children under 2 years of age.”

Technology Has Changed

Every patient who comes in for an annual checkup at her practice, Bass River Pediatric Associates in South Yarmouth, MA, completes a Pediatric Symptom Checklist (PSC), a 37-question behavioral and mental health survey. Parents fill out questionnaires for patients ages four to 11. Everyone from 12 to 20 gets a teen version of the survey. The PSC is a standard among healthcare providers.

“The surveys are a launching point for conversation,” Dr. Zito said. For example, there are some kids who will check that they feel sad and unhappy, hopeless, down on themselves, or seem to be having less fun, and those are indicators of depression. Other questions deal with anxiety, stress, suicidal ideation, Attention Deficit Hyperactivity Disorder (ADHD) and Oppositional Defiant Disorder (ODD, which is very oppositional behavior; not listening to or following directions).

The surveys became necessary about 10 years ago, she said, when technology changed.

The increase in the number of kids and teens needing help for mental health problems is a national concern. Between 2011 and 2015, alone, there was a 28 percent jump in emergency room psychiatric visits among Americans between the ages of 6 and 24, according to the March 2019 journal Pediatrics. There was a 54 percent increase among adolescents as a whole.

A recent analysis published in JAMA Pediatrics said that as many as one in six U.S. children between the ages of 6 and 17 has a treatable mental health disorder such as depression, anxiety problems or attention deficit/hyperactivity disorder (ADHD).

Treatable is a key word in the mental health equation. Just as stress, depression, anxiety and ADHD are treatable, suicide is preventable, and Dr. Zito noted that almost half of children with at least one of these disorders do not receive treatment or counseling from a mental health professional.

She spends a great deal of time in the office talking with patients and parents.

“I always tell my patients that other kids post the best things on Instagram and Snap Chat. Funny and happy things. They aren’t going to post something bad about themselves, or say they are sad or depressed because they have nothing to do. So anyone who is feeling a little sad thinks they are missing out, or they are not good enough, or something is wrong with them. I remind people that is just not the case. We are all more alike in our emotions than we are different.”

What to Do

Dr. Zito recommends the following to parents and guardians:

• Keep children screen-free until they are at least 2 years old.
• Remove excess pressure on kids to perform in athletics, which, after social media, is the second biggest pressure she sees children facing. (“I see 8-year-old children practicing 20 hours a week, and that is just not healthy. Too many patients are stressed about athletic performance, and it’s a societal thing we need to ramp down. Consider taking one dance class a week and enjoying it instead of studying constantly for the next big, pressure-packed performance. The same with hockey, football, and other sports,” she said.)
• Remember that everyone needs downtime, especially children and teens. Playtime is important; that’s when kids learn important social skills and lifetime coping skills. Give them unstructured time and opportunities to interact with other kids—playing in the backyard, using their imaginations and learning negotiating skills.
• Take your children and teens to the doctor, and make sure they are given a mental health survey.
• If children need counseling or medication as treatment for mental illness, follow your doctor’s instructions without hesitation. Parents or guardians need to make sure medications are locked up and that they give any prescriptions to the children.
• Talk with your kids, even if you can only get them to talk when you’re driving. (Hint: It’s a common ‘thing’ that teens talk when riding since they have little else to do. Take advantage of the time alone with them!)
• When you talk with your kids, ask open-ended questions such as “What is something good that happened today?” or “Did anything funny happen during lunch? Tell me about it…” instead of “Did you have a good day?” That puts a positive spin on the conversation and will make it easier for your child to open up.

Adults need to understand that social media imposes new pressures on youth. “Imagine not being invited to a party or other big event. At one time, any disappointment went away in a few days, but today it lives forever on social media,” said Dr. Zito. “Today’s teens are living with a whole new set of pressures, and we have to find new ways to help them deal with the stress technology imposes.”