SINGAPORE — Fourteen-year-old student Nadheeruddin Tajuddin spends about four to five hours a day on social media, sometimes till the wee hours of the morning, which leaves him waking up the next day feeling “not that great”.
Eventually, with her encouragement, Josiah sought professional help last year through a boxing and group therapy programme organised by youth-based non-profit organisation Impart, after being addicted for almost three years.
The three teenagers’ experiences echo the findings of studies around the world on the detrimental impact that social media could have on one’s mental health.
TODAY’s Big Read had previously reported about youths’ chase for “likes” on social media and the dangers it poses.
Last year, Singapore saw its highest number of suicide rates since 2000, with the greatest number of deaths being among young people aged 20 to 29, the Samaritans of Singapore (SOS) said in June.
For those aged 10 to 29, suicide remained the leading cause of death for the fourth consecutive year, constituting more than one third (33.6 per cent) of all deaths within this group. Suicide deaths also rose from 112 in 2021 to 125 in 2022, among this group.
While there are no local studies conclusively linking social media use with suicide, United States research psychologist Jean Twenge argues that there is an indisputable connection between the rise of smartphones and social media and a decline in teen mental health globally.
In May, the US’ top health official, Surgeon General Vivek Murthy, also issued a stark warning to parents, tech companies and regulators, saying that evidence is growing about how social media use could have a “profound risk of harm” on children and adolescents’ mental health and well-being.
While acknowledging the benefits of social media, Dr Murthy noted that it also contains “extreme, inappropriate, and harmful content” which could “normalise” self-harm and suicide.
It could also perpetuate body dissatisfaction, eating disorders and depression and expose children to online bullying while they are still undergoing a critical stage in brain development, Dr Murthy warned in his report.
WHY THE YOUNG ARE PARTICULARLY VULNERABLE
Children and adolescents are particularly vulnerable to the effects of social media addiction, experts told TODAY.
Ms Ranjini Veerappan, a certified addiction specialist at Holistic Psychotherapy Centre, said that a child’s brain is still maturing and rapidly developing until they are about 25 years old.
As their decision-making ability, impulse control, and judgement are still being developed, excessive social media use could impact their brain development and potentially lead to long-term cognitive and emotional consequences, she said.
Given their age, they may also have limited coping skills to manage difficult situations that may arise in the digital world, which could affect their mental health, Ms Veerappan added.
Ms Julianna Pang, an addictions therapist from Visions by Promises, the addictions treatment arm of Promises Healthcare, said research has shown that adolescent brains between the ages of 10 and 19 show an increased sensitivity to social cues and rewards.
“Pre-teens between 10 and 12 are particularly vulnerable to the need for the attention and admiration of others,” she added.
Ms Tham Yuen Han, the clinical director at addiction treatment centre We Care Community Services, added that because adolescent brains are more adaptable and flexible, what they learn in their growing up years can play an important part in shaping their lives and personalities in the future.
Ms Jeanette Houmayune, a professional counsellor and family therapist at Talk Your Heart Out, noted that children and youths’ constant comparison of their body image, lifestyle, and social life with those of their friends on social media platforms could impact their self-esteem.
Excessive social media browsing, also known as “doom-scrolling” through Instagram reels and YouTube shorts, may also lead to addiction issues, as adolescents’ developing brains are particularly vulnerable to impulsive, dopamine-driven feedback loops, said Ms Houmayune.
Beyond these, experts warn that the long-term effects of a social media addiction on children and youths’ mental health and development are far-reaching and should not be ignored, even after the addiction has been overcome.
Dr Adrian Loh, a senior consultant psychiatrist from Promises Healthcare, a psychiatric clinic and mental health centre, said: “Addictive behaviours at a young age are definitely a concern.
“Aside from the direct effects, we also find that people who struggle with one addictive behaviour may be vulnerable to other kinds of addictions in the course of growing up.”
This could include a transference of the addiction from one substance or habit to another, such as alcohol, substances, pornography or gambling, he added.
Agreeing, Ms Claire Leong, a counsellor at Sofia Wellness Clinic, said: “This is because addiction is usually a form of maladaptive coping. Until they find healthy coping skills, they are likely to fall into different types of addiction as they experience more stressors in life.”
Experts also warn of the long-term negative impact of such social media addiction.
Dr Ong Say How, a senior consultant and chief of the department of developmental psychiatry at the Institute of Mental Health (IMH), said that existing research findings suggest that a developing child or youth with excessive smartphone use and similar behavioural addiction would not have the opportunity to develop the “essential cognitive capability and emotional skills necessary” to function healthily as an adult later in life.
However, more research is needed to understand this relationship better, he added.
Alluding to the long-term effects of addiction, Mr Narasimman Tivasiha Mani, executive director of non-government organisation Impart where Josiah sought help, said that social media addiction can contribute to anxiety, depression, loneliness, and other mental health problems.
“If left unaddressed, these issues could become more prevalent and severe among the current generation of youths as they grow older,” he said.
“An entire generation struggling with mental health and well-being could place a significant burden on healthcare systems and society as a whole, affecting productivity and overall quality of life.”
‘LEFT OUT’ IF NOT ON SOCIAL MEDIA
Most of the nine teenagers, aged 13 to 18, whom TODAY spoke to acknowledged that being on social media has affected their mental health in varying ways — from skewing their perceptions of beauty, to reducing their attention span, self-esteem, and ability to process emotions.
Only one teenager, 16-year-old Natalie Tan, said that she does not have any social media presence to begin with — though it was not a personal choice, but one mandated by her parents.
“We’re all at the age where (with) our hormones and everything, we’re very prone to comparing ourselves to other people — in the sense that I already compare myself to others in real life, there’s no need for me to compare myself to other people whom I don’t even know online,” said Natalie.
She added that she had seen how her peers compared themselves to images of “women with perfect bodies” on social media.
While not being on social media has been healthy for her in a way, it does make her feel like she is missing out on some things at times.
Natalie said that a lot of conversation topics discussed by her friends tend to start from things they have seen online.
“Because of that, I don’t know what they are talking about, so sometimes I feel a bit left out. I can only sit there and nod, but I have no idea what’s going on.”
For Nadheeruddin, because he uses social media to “check on what’s happening”, he worries that he might become “clueless” if he stops using it completely.
While the youths told TODAY that they are aware of how social media has impacted their mental health, none of the other teenagers, apart from Natalie, have completely stopped using social media, opting instead to take breaks or create their own boundaries where necessary.
Josiah told TODAY that his internet addiction has “definitely decreased” his attention span.
“You just know that at the flick of a button, you can just find something that you may find entertainment in, for a couple of seconds.”
He added that doing his homework, or looking at a piece of paper which he could not scroll, had become “so boring and mindless”.
While Josiah said that going for therapy has helped him to manage his internet addiction — he now tries to limit his screen time, including not using his devices in the morning — he has not stopped using them completely.
He finds that social media could still be a good platform for keeping in touch with friends whom he does not see often, or who do not live in the same country.
Today, Josiah, who has completed his therapy sessions, also volunteers with Impart to help children build positive coping skills and mental resilience, through sports.
For 14-year-old Aqil Ahdan, a Secondary 2 student, spending six to seven hours on social media daily is not out of the norm. He uses TikTok the most, followed by Instagram and YouTube.
While Aqil admitted that six to seven hours is “quite a lot”, he is not concerned and does not actively limit his time on social media, as he feels it does not affect his school work or physical health.
Instead of looking at the amount of time he spends on the apps, Aqil said that he is more cautious about what he posts.
He recalled an instance when he had uploaded video clips of himself on his TikTok account, only to have people he knew comment on the posts to body-shame how he looked.
“It made me feel insecure about myself, like I wasn’t a good person to be with.”
Aqil added that he got over these negative thoughts by taking a break from social media to exercise and focus on activities outside of the platforms.
Still, he eventually returned to social media since it still has its benefits, such as allowing him to learn stuff and gain new knowledge through the content viewed.
NO FORMAL DIAGNOSIS, INSUFFICIENT RESEARCH
Despite the growing body of evidence, experts told TODAY that social media addiction is currently not recognised as a mental health disorder in the Diagnostic and Statistical Manual of Mental Disorders, which provides mental health professionals in countries like Singapore and the United States with a standard classification of mental disorders.
“Hence, we can only highlight the impact of excessive social media use but we won’t be able to talk about diagnosis since it’s not a recognised disorder,” said Dr Ong of IMH.
The World Health Organization, which produces the International Classification of Diseases (ICD), has also not initiated any formal working committee to look into social media use disorder, said Ms Pang of Visions by Promises.
Ms Pang added that for a condition to be included in the ICD, it requires the gathering of sufficient research data, with consistent outcomes from around the world, about the condition’s diagnostic criteria, severity assessment, and its treatment recommendations.
Not having a formal inclusion of the condition in the ICD may affect the consistency of its terminology, choice of diagnostic tools used, and recommendations on treatments, she said.
Furthermore, while existing studies have drawn correlations between excessive social media use and its resultant negative impact on children and youths’ mental health, experts said that more research is needed for a conclusive look at its effects, and to establish that social media is indeed having a detrimental impact on adolescents’ mental health.
Dr Jeremy Sng, a lecturer at Nanyang Technological University’s (NTU) School of Social Sciences, said: “Many studies have claimed to find links between social media use and mental health issues, but the causal direction of these studies is actually unclear.”
It is important to also consider the study’s methodology, as correlation does not always mean causation, he said.
“The effects of social media are very difficult to disentangle, because it’s not that we are only using social media.
“We are also doing a lot of other things — we are going to school, we’re dealing with family, relationships, and all that. So it’s difficult to pinpoint that something has happened solely because of social media.”
Dr Loh from Promises Healthcare added: “For social media, it has been around for barely past a decade, so we are still trying to understand downstream implications.”
SIGNS OF A SOCIAL MEDIA ADDICT
When does social media consumption morph into social media addiction?
To this, Ms Jane Goh, deputy director of creative and youth services at the Singapore Association for Mental Health, said: “As a simple rule of thumb, if you find yourself constantly refreshing your social media applications and chasing validation and likes online, or posting to garner attention, then it could be time to reevaluate your social media habits.”
Experts also say that the long hours spent on Instagram, TikTok and the like may not necessarily be a sign of such an addiction. Instead, a good gauge of whether one’s social media use has become problematic is when it starts to displace other activities.
“Healthy social media use may look different for each person,” said Ms Leong from Sofia Wellness Clinic.
“Before I would call any behaviour an ‘addiction’, I look at three different factors — tolerance, dependency, and dysfunction,” she said.
Dr Ong of IMH added that for symptoms to be pathological, it must affect the person’s daily functioning, which could include avoiding school, giving up social gatherings, or experiencing mood swings.
“When all these things break down, that is when it’s a sign that it’s more than just a hobby. It’s a sign of an addiction.
“If a young person spends many hours on social media but still makes time to meet friends and have perfect relationships, including doing well in school, eating well and sleeping well, then in the eyes of the person and the clinician, it might not be considered a problem,” he said.
Mr Mark Rozario, a clinical psychologist at Mind What Matters, added that while the disruption of one’s daily routine or schedule can be a clear sign of risk, another signal is if one is also spending more time on social media than initially planned.
“Youths may not identify it themselves, so it could also be their peers, siblings, (or) close ones who point it out,” he added.
Regardless, addiction is a progressive illness with increasing severity of symptoms, said Ms Pang of Visions by Promises.
“Instead of focusing on whether or not there is an addiction before seeking help, early intervention is encouraged. In this regard, it would be helpful to look for signs of mood changes, changes in self-care habits, or difficulty in self-regulation when there is an interruption to use,” she added.
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‘EMPOWERING’ YOUTHS TO ESTABLISH BOUNDARIES
Since there is no escaping from a rapidly digitalising world, parents, professionals, policymakers and social media companies alike will have to navigate the myriad challenges, alongside children and youths’ exposure to, and use of, the various platforms, experts told TODAY.
To protect Singaporeans from harmful online content, Parliament passed a law in November which empowers the authorities to issue directions to online communication services to ensure local users are protected from content such as sexual violence and terrorism.
Providers who fail to comply with these directions could be subjected to fines of up to S$1 million.
To minimise the damage that social media could do to young people, Dr Murthy, the US Surgeon General, said in his report that parents and caregivers can create a family media plan which sets technology boundaries at home, create tech-free zones and report problematic content and activity.
Ms Jane Goh, deputy director of creative and youth services at the Singapore Association for Mental Health (SAMH), said that educating the young on social media use would be the way to go.
“While preventing the use of social media would seem like a simple solution, it would also create a feeling of isolation from their peers, creating a feeling of Fear Of Missing Out (Fomo),” said Ms Goh, echoing the sentiments of youths like Nadheeruddin and Natalie.
Agreeing, Ms Nicole Pang, who is head of mental health care at Impart, said that managing social media use is not solely about limiting the amount of time spent, but in empowering youths to establish their boundaries and make active decisions on the kind of content they would like to engage in or not interact with.
Ms Tham of We Care Community Services said that to prevent an over-dependence on digital use, parents may also prioritise introducing non-digital-based activities in their child’s formative years.
This includes encouraging outdoor activities and sports, especially those that involve group and in-person social interaction, teamwork and collaboration.
Rebecca’s father, Mr Kui Tuck Meng, 62, said: “We are at the age where we need to allow our children to use all these social media for their social interactions, which have their good side, as long as they are able to control its usage and are discerning to access and avoid bad social media postings.”
In turn, Rebecca said that teens like herself are still forming their world view and will require some form of guidance.
“Hence, although I think we’re capable of managing our social media usage, parents should still check in and remind their children to strike a balance between social media and their offline lives.”
Mr Brucely Christopher Edison, who has two sons aged 18 and 20, noted that with mobile phones becoming a necessity, it is hard to control what children use them for.
“For me, I think it’s almost virtually impossible to control them, because the moment you give them a phone, it’s an open channel and they are able to set up (social media) accounts,” said the 49-year-old business-owner.
He added that if parents were aware of what their children did on social media, they would be able to pick up on instances when their children were influenced and “bring them back”.
Ultimately, the ability to navigate social media in a healthy way requires not only tech savviness and knowledge of risks online, but also self-understanding and emotional and behavioural regulation, said Dr Andrew Yee, an assistant professor of media and communication at the Singapore University of Technology and Design.
“We can help young people develop that by having conversations about how and what they feel, including when they encounter things they see on social media.”
Ms Leong of Sofia Wellness Clinic added that it is also important to understand that those who are addicted to social media today are not doomed to a life of addiction and dysfunction.
“It is possible to get better. It has to begin with the awareness that the current behaviour is unhealthy, and there has to be an intention to do something about it,” she added.
This is what Mr Khairul Azri, a 28-year-old graduate student, has done.
He used to be active on his Instagram account in junior college and during his early years in university.
“Year 2 of university was a very bad year for me,” said Mr Azri, adding that he wasn’t doing as well as he wanted to academically.
He found himself frequently doom-scrolling on Instagram, looking at his connections’ updates about their grades and exchange or summer programmes, which made him feel worse about himself.
“It really creeps up on you, how it affects you mentally. Next thing you know, you’re just looking through post after post, and making yourself feel worse and worse.”
He stopped using Instagram, Facebook and Twitter entirely from his second year of university.
Echoing his sentiments is 27-year-old software engineer Caleb Lee, who has deactivated his Instagram account for about a year now, the longest he has stayed off the app.
He told TODAY that spending too much time on Instagram could skew his perception of a “normal day”.
“Right now, there’s way more content on social media … (and) let’s say you spend three hours on average everyday scrolling your phone,” he said.
“Instagram needs to find the best content among this growing mass of content to tailor to your three hours. Naturally the content will become more and more attention grabbing, so you’ll start to see the worst of the scandals and you’ll see the best of other people’s lives.”
Still, he acknowledges that social media is not all bad.
“At this point, we wouldn’t really know what are the good parts about it and what are the bad parts about it, until you actually learn it the hard way — by maybe staying in it for too long, or in my case, removing myself from the situation,” he said.
“Now that I’m away for one year, I can see there are actually many good things about it if I know how to control it instead of letting it control me.”