Intro: It's Your Health Radio, a special podcast series presented by Henry Mayo Newhall Hospital. Here's Melanie Cole.

Melanie Cole, MS (Host): In today's digital world, our kids are so immersed in politics, world events, personal drama. It all seems so much and yet it can be making them smarter, more worldly. But does the good outweigh the bad? Is it taking a toll on their mental health? Welcome to It's Your Health Radio with Henry Mayo Newhall Hospital. I'm Melanie Cole. And today, we are joined by fan favorite, Dr. Neela Sethi. She's a pediatrician on staff at Henry Mayo Newhall Hospital and her daughter, Malika Young. She's a teenage daughter. She is-- how old are you, Malika?

Malika Young: I'm 14. I just started my freshman year of high school.

Melanie Cole, MS: Oh, rock on. So, we're joined by 14-year-old Malika. Thank you, ladies, for joining us today. And Malika, I'm going to start with you. So, you just told us you're 14. On average, how much time do you think you, and you can guess about your friends, spend on social media? And since you can track the hours, my 22-year-old daughter shows me how you track the hours. Do you look at that and go, "Whoa"?

Malika Young: For sure, I mean, I'm typically a pretty busy person. I'm involved in my school's freshman volleyball team as well as ASB. So, it doesn't give for too much time to constantly be doomscrolling. However, I would say I spend an hour or two a day on social media. I think my friends probably spend around the same amount, maybe two to three hours. It definitely depends on the day and whether I have a lot going on or not. I think the weekends are definitely a time where the screen time can be a lot higher because there's not as much going on.

Melanie Cole, MS: So first of all, cheers to you for being on sports because that does help. My daughter was on volleyball and badminton as well, and it kept her off of social media. But those weekends lying in your bed on TikTok, especially at night, the hours can really drain away. Do you feel, Malika, that teens, young people can become addicted? Do you have some friends that maybe don't play sports, that you see they're just sitting there staring at their phone during lunch, during school breaks, during in between passing periods while they're walking the halls?

Malika Young: For sure. It's so easy to become addicted to and it's so easy to just let yourself doomscroll. I think I see it especially common in kids who've had it for such a long time because, you know, when they've had it for two or three years now, like, that's their reality and they don't know a world outside of it. And I think something that helps with getting addicted to it is just pushing back the downloading because I feel that having gotten it from an older age has helped me to put the phone down when I know that I'm doomscrolling and becoming addicted to it. And, yeah, I would say, like, being older has definitely helped regulate my time spent on it and the addiction to it.

Melanie Cole, MS: So, Malika, you mentioned doomscrolling a couple times. Now, I am certainly guilty of going on Twitter and going, "Oh my God, the world is going to heck. I don't know what's going to happen." I mean, I am so guilty of that myself. But I also love TikTok for recipes and funny old show clips and movie clips and all these things that I love it for. As we mentioned the word doomscrolling, do you feel that it can be a positive influence as well? Do you feel more informed, more active? Do you look at political posts and get involved or make comments? Are you involved in some positive social activism, or any of your friends?

Malika Young: Yeah, I totally get tons of updates about the community, about climate change, politics, sports. It's all on there and it definitely helps me get more involved in what's happening around me in the community or in the country. I also run the ASB Freshman Account. And on the account, we encourage students to get involved and to go to rallies and homecomings so there's definitely some positive to it to help people get involved in the world around them.

Melanie Cole, MS: Yeah. Dr. Sethi, up to you now. Do you worry? Should I worry? Do we worry about the effects of technology use on our children, on their mental health? But yet Malika is talking about the positive use for the social activism. We know more now. We can see things like terrible tragedies that are turned into positive activism. You know, like the kids in Florida did and Parkland kids, they turned it into a very positive way to get kids involved in gun control. Tell us about you. Do you worry? What do you think?

Neela Sethi, MD: I worry. I worry. You know, we know as pediatricians, and we've done several studies, that the effects of social media are widely negative. And while there are positive aspects, and I think we can encourage our kids to be involved in the positive aspects of social media, the overwhelming majority, unfortunately, they're not using it for good. They're not using it to get involved. And I think just as like how poignantly Molly said it, the younger that they get it, you know, when they're 10, 11, 12, they're not able to even understand global politics or understand activism. They're merely using it to connect with friends. And unfortunately. The comparison, the filters, the sort of creating this world that's false around them really decreases their self-esteem. It's more likely to make them depressed and anxious, and it's more likely to contribute to not getting involved and not being in sports, because as we know, it just has such an addictive nature that they're less likely to say, you know, at 10 or 12, "Okay, I got to put this down. I've spent too much time doing that." You know, we followed as best we could guidelines and gave Molly her phone. We followed the Wait Until Eighth campaign, which Melanie, you and I have talked about, which was phone at eighth grade. And she just got social media before starting high school, and that was difficult for her. You know, she really was the only person in her eighth grade class that didn't have it. And that was difficult. But I will say that giving it to her later does make her more likely to put it down.

On the flip, yeah, there are some positive aspects of it. And we've talked about this in the past as well, where this next generation is figuring out how to have balance and they are getting more involved. And a lot of the hope that I have for our country moving forward in such a divisive state really lies in this younger generation with, yeah, just getting involved in an activism and understanding what's happening in the world. So, it does allow us to connect, and there is a really beautiful social aspect of things. I think it's just up to parents to really figure out what that balance looks like and how to create that balance in their children.

Melanie Cole, MS: See, and that's the thing you and I have discussed that before. And I did the same, I made my kids wait till freshman year in high school and it wasn't easy. But look at how awesome our kids are, right? They're nice, they're kind, they're involved, they're involved in fitness and sports and things, and I think that that made a difference, right? Now, the algorithm that you were alluding to is what can bring in that negative content, that propaganda, boy, we're seeing a lot of that, can bring in all of these things that the kids don't know what to make of. It's very hard, and now adding AI into the whole picture. So, Dr. Sethi, as we look at our kids seeing all these things, and it's even confusing for those of us that are pretty knowledgeable about these things, what are some signs from a pediatrician, as we look at our kids, of the unhealthy digital addiction? What are we looking for?

Neela Sethi, MD: Absolutely. So, we know for a fact that social media usage, just the amount of time that you're on it can really 100% lead to more depression and more anxiety in teens. And so, I think it's really important to delve into those. What are symptoms of depression, anxiety that your teen may be showing you that is confusing? Because as we've talked about in the past, when you're a teenager, it's hard when they're in their room a lot and they don't seem as interested in things. And some of that is just normal average teenage development.

I think the first and foremost is to trust your maternal or paternal instinct. And I want to repeat that, trust your maternal and paternal instinct, because so many times mothers and fathers have said, "Gosh, I knew something was wrong and I just didn't follow it." And I think that's really a very powerful place to start is to say, if you think something's wrong, lean in on that, don't ignore it. So if you notice your teen, all of a sudden is spending way more time in their room and not coming down for dinner; if you're noticing that the things that normally would bring them joy don't; if you notice that they're getting really not involved in activities that they used to be, or just really kind of falling out of friend groups, or social situations, or their sports or their academics, those are red flags. If you're noticing that they're sleeping way more or that their sleep schedule is very off, or if you're noticing that they're sleeping very little, those are really concerning red flags. If you're noticing that their eating habits are very, very different, like their favorite restaurant, they don't want to go to. And when they do go, they're kind of pushing their food around. Or if you're making their favorite food at home or baking their favorite thing and they're not having it over and over, those are red flags. Or on the flip, if you're noticing, wow, they're just eating and eating and eating, and it doesn't even feel like they're tasting their food, those are all red flags to really just start the conversation to say, "Hey, how's your mental health? Hey, are you all right? Hey, I want to go for a walk with you and I want to talk." And just bringing up the conversation and destigmatizing that sort of aspect of "I'm here and I'm an advocate for your mental health. And having concerns is not worrisome. It's actually fairly normal," instead of coming in and just taking the phone away or saying, "I'm deleting all the apps" or "I'm hiding your phone." That just is punishment and makes them already feel bad when they're just feeling bad about themselves anyway. It's more important to converse and to communicate and say, "Hey, honey. I'm actually worried about your mental health. How are you? What is going on?"

And then finally, and I think one of the most important things is use me in this situation. Do you know how many times a day I have parents coming in that are bringing their teens and saying, "Hey, Dr. Sethi, I'm worried. I'm just worried. Can you talk to them? Is this something for me to be concerned about?" And a lot of times I'll say, "You know what? They're doing fine. I think that there's probably some boundaries, but they're doing fine" versus the flip of, "You know what? You need to see a psychiatrist or you need to start with therapy. And I'm actually very concerned." So, involve the professionals as well. That's what we're here for. We're trained in this.

Melanie Cole, MS: Boy, do we love our pediatricians, and I love how you said use me. Because I mean, you are the gold standard, and that is exactly what you all help us to do, is to raise our kids. It's so important. Gosh, I just have so much admiration for pediatricians. I can't even tell you.

Now, Molly, digital drama is common. Do you see a lot of it? And what have you seen? Your mother mentioned that you have an interest in the mental health toll of social media. What have you seen as far as the digital drama, the self-esteem, the bad talking, things that people put about other people? What have you seen?

Malika Young: It definitely happens very often, especially when people are pretending to be somebody that they're not. There's just so many filters and so many ways to make yourself--

Melanie Cole, MS: Isn't that called catfishing?

Malika Young: Yes, catfishing. There's so many ways that people can catfish on these apps. And average girls like me will look at that and think, "Why don't I look like that?" or "Why am I not on a cool vacation that she's on?" And it can take a toll on your mental health so greatly. I've seen friends of mine who have tried hurting themselves because they think they're not living up to these standards that people are on these apps. So, I think it's important like going into this, knowing that you're downloading this app, is to know that like everything you're looking at is fake to some level and nothing you see is real.

Melanie Cole, MS: Wow. What a statement. And cyberbullying is really just such a huge issue. And I mean, even with adults these days, right? We're seeing it in all these political campaigns. And it's just really out of control. Now, Molly, if I'm going to ask you and your mother the same question here, but I want to start with you, how can you have a healthy relationship with social media? How can you, as a 14-year-old active, busy, but also on these apps have this healthy relationship? And if you were to give your friends advice, so switch places here, what would you say?

Malika Young: I think, first of all, it's important to have private accounts and to only be talking to people that are confirmed in real life and you know them, because if you're talking to strangers, you don't know their identity, you don't know who they are. They could be capable of really bad things.

And I think another thing is to just setting like mental or even physical timers to regulate your screen time, to tell yourself that you're going to get off in an hour or get off in 30 minutes, whatever. I think that's really important to regulate the amount that you're on these apps, because it can get very addicting, and you find yourself scrolling, scrolling and scrolling if you're not regulating yourself.

And I think another thing that's really important is for parents to constantly be involved. As much as teens, you know, like their independence and want their parents to trust them and leave them alone in their room, it's really important for parents to stay involved and to never give up on their teen. I think, my mom's constantly asking me, "How was your day? How are your friends? Are you hungry? Have you eaten today?" It is annoying at times, but it truly helps because I would so much rather have a parent who's constantly nagging me than a parent who doesn't care at all. And it's so important in teens to have somebody constantly checking up on them and asking how they are.

Melanie Cole, MS: What a lovely thing to say. Dr. Sethi, you must be so proud. Now, I'm going to ask you the same question. First of all, before you answer the question, you can comment on what your daughter just said, but also I'd like your advice, if it's any different than Molly's, on how to wean our kids off a little for detox as a self-care strategy and things that parents can do, which Molly just so beautifully said.

Neela Sethi, MD: She really did. I know she makes me so proud. And I think she hits on an amazing point, which is, you know, it's really hard to be a teen parent. And it's difficult because it feels like they don't want you and they feels like they don't need you. And they really are expressing their independence. But, you know, all the studies suggest that this is your time to lean in even more. This is your time to get more involved and to be involved in their life. Because on the 20th try that you ask how they're doing, they may give you an answer. And if you didn't try those 19 times, you're not going to get to the 20 times.

So yes, am I that annoying teen mom? Absolutely. I am. And I ask, and I ask, and I ask. But guess what? That's what I know helps because that's what helps me know who she's hanging out with and who's being kind and who's being unkind and what friend groups she's sort of interacting with. So, the more energy that you put into your teen and the more time that you commit to them, the better the outcome is going to be. I can guarantee you that. And I've seen that in, you know, over 20 years of me doing this.

In terms of digital detox, it doesn't have to be complicated. I think a lot of parents come in hot. And I think they're like, "Johnny, we're taking your phone away and we're going to lock it in this box." And it's like, well, then you've gone from everything to nothing. And I don't think that, in any cases with mental health or in Medicine, all or nothing techniques work. I think it's more "Hey, we're going to have a digital-free dinner," or "We're going to have a digital-free Saturday. And we're going to pick family time," or "We're going to go for a hike, or we're going to walk, stroll the mall, or we're going to walk the dog, or we're just going to have an ice cream date. We're just going to go be out in nature. We're going to go to our lake house or a lake, and we're going to be active outside." And give your kids time to experience this beautiful grand world that offers so much joy and happiness. And teens actually love being outside. They may say they don't, but all the studies have suggested that being outside and experiencing nature's beauty and having all that vitamin D that hits their skin really does elevate their mood.

And so, it's thinking to yourself, "What are some natural dopamine sort of raisers out there? What increases dopamine and how can I do that for my child?" So, I think it's slow and steady steps and sort of changing the mindset of, "I'm not going to punish you. This is hard. You have something in your hand that is extremely addictive." And it's like, you know, having a plateful of doughnuts following you around all day every day and say, "Nope. Don't take a bite. Don't do it." The best thing to do is really just, you know, say, "Hey, you can have one and maybe even two, but you don't need 10." So, middle-ground parenting, and then really knowing your child.

I know with mine, with Mol, she really is an active person and she loves being in nature. So, it's the beach, it's the lake, it's outside, it's walking the dog. She gets this from me, but she loves fashion. And she expresses herself that way. So, a lot of times we'll just have mommy-daughter dates, and we'll, you know, stroll the mall or go through Sephora or sometimes we'll even just do Target dates together, to be honest. And we're not on our phone and we're testing products and we're laughing and we're, you know, looking at fun decorations for her room or fun nail ideas.

And so, I just think that there is something about human connection that is in-person that's being lost in this next generation. And I think we can kind of look to our parents to say, "What did they do with us and what made us feel good?" And I honestly believe that it's that one-on-one, it's that time together, it's that undivided attention that's true of them at one, and the same thing is true of them at 14 and 15.

Melanie Cole, MS: I love that you said it's not the time to look away, it's the time to dig in, because that is absolutely true. Those teenage years are so formative. And now, with the addition of what we did not have and I'm a lot older than you are, Dr. Sethi, but you know, we didn't have that stuff. So, it wasn't something we had to deal with, but now we certainly do. And with my kids, 22 and 24, I know, because I'm a bit in the thick of it, but I'm also on the other end of the hill now, because they are really young adults now. So, you're right in the middle of it.

And what a wonderful job, Malika. I would love to give you the last word of this enlightening discussion we're having for other parents. What would you like them to know? Speak to the parents now. As the daughter of this wonderful mother and pediatrician, and such a smart, engaged, involved girl that you are, speak to parents. What do you want them to know about the best ways to go about helping their children with the mental health tolls of social media?

Malika Young: I think, again, like just constantly nagging them and asking how they are, may not seem like it helps, but it really, really does. Knowing that parents are involved with their teens is really important. I think, also, to sign your kids up for sports or to get them involved in theatre, giving them stuff to do so that it doesn't give for time to be on their phone. You know what I mean? If they're constantly at their sports practice, or their theater rehearsal, it's hard to have time to even be on your phone, and it helps with the addiction aspect of it.

And I would say bonding time's really important, too. As my mom mentioned, Constantly being out of the house and together, the one on one time really helps you connect. And it helps teens to know that you're there for them and that, you know, they're involved in your life and they care about you. This is a time of our lives where self-hatred is so common in our generation and knowing that I have a parent that constantly cares for me and knows that I'm worthy is really important in teens.

Melanie Cole, MS: I'm choked up.

Neela Sethi, MD: I'm choked up too.

Melanie Cole, MS: Wow, how lucky are you? And Molly, how beautiful are you? Really. Thank you so much for joining us today-- and I'll get through this-- and for filling us in because maybe we're not as hip to the whole scene of what really is going on. Thank you so much. And to take the free online social media and mental health assessment, you can visit Henry Mayo Newhall Hospital's online health library at library.henrymayo.com and type social media into the search box. Really important for parents to do this.

And that concludes this episode of It's Your Health Radio with Henry Mayo Newhall Hospital. Please always remember to subscribe, rate, and review It's Your Health Radio on Apple Podcasts, Spotify, iHeart, and Pandora. I'm Melanie Cole. Thanks so very much for joining us today.