Ashlee Williams, MD: From endless social media scrolling and online gaming, to remote work and virtual learning, our screen time has never been higher. But what does this surge in screen time really mean for our mental health? And what practical strategies can we adopt to establish healthier boundaries? Welcome to the Healthier You Podcast.

I'm Dr. Ashlee Williams. And today I'm joined by Dr. Asha Patton-Smith, a Board Certified Child and Adolescent Psychiatrist here at Kaiser Permanente. Together, we'll dive into ways screens and social media use affect our brains, emotions, and self-esteem. Plus, we'll share practical tips on how to navigate our tech-driven world while prioritizing our mental wellbeing.

Dr. Patton-Smith, thank you so much for joining me today.

Asha Patton-Smith, MD: Thank you so much for having me. We have quite a bit to tackle today. today Let's get into it.

Host: Yeah, we really do. So to start off, let's explore what the research is telling us about the effects of screen time on our mental health. Dr. Patton-Smith, what does the latest research tell us about the impact of screen time on our mental health? And from your experience as a psychiatrist, what trends are you seeing in your practice?

Asha Patton-Smith, MD: Great question. So, what we know about screen time is that it's really not a one size fits all approach for a situation. It really, in many ways, depends on the individual. It depends on the age of the individual. And it depends on kind of what type or category of screen time we're using. From a data standpoint, we have some data that had looked at in 2023 out of the Journal of the American Medical Association Pediatrics, a group of kids, a cohort between the ages of 3 and 5. And I think we all have been in situations in restaurants or grocery stores, where a kid's getting ready or is having a tantrum and parent or caregiver whips out their phone and it's like magic. They calm and all is well. The challenge with that that we are seeing and that this study looked at is that it may not be best for that to happen because there are challenges with the ability for the child, in this case, that three to five year old, so toddler like child, to be able to calm and self-soothe on their own.

We also are seeing some delays in language development, as well as reading, in kids that are using excessive screens. And some of that is because the way that we learn is more in-person and not based on a two dimensional screen. So when the brain is developing and we don't have that in-person interaction, that can delay things as well.

It also seems that there may be some delays in executive functioning. So where we do our focus, attending, and planning, And that's in that three to five year old range. For our older kids, so kids between the ages of 10 to 19, there was a study that came out in June of last year, 2024, that looked at brain signaling.

And what was found was that there was a decrease in brain signaling in that prefrontal cortex, there we go again, where we do our executive functioning, our focus, attending, and planning. And so what we know is that that can lead to challenges with impulse control, issues with focus and concentration. And in this study, decrease in the ability to finish homework in a timely manner.

So we do have some data in younger kids and in older kids that shows that screen time in excess, may not be what's recommended.

Host: So, in terms of social media specifically, because it seems like everyone is on social media in one form or another, what role does that play in creating feelings of connection versus isolation?

Asha Patton-Smith, MD: So it's kind of a double edged sword, really, and what I mean by that is when we're looking at, let's just talk about where we were during the global pandemic. Social media for many people was a lifeline, right, because it allowed for that connection and that has accelerated as we've continued to move forward out of the pandemic.

For marginalized groups or people that are feeling misunderstood; social media can also be a huge lifesaver, especially for teenagers. The challenge is that you just don't have a sense of what's coming in with social media. So there are a significant amount of potentially negative influences in the social media space that sometimes come up without you even doing anything, depending on what you're looking at. So that's what we call those reinforcing spirals. So, you're looking at something and then content comes in that is similar to what you're looking at or may deviate a bit and then it's capturing kind of how you're moving in the social media space. So that can increase negativity, that can increase the challenge of especially in teenage girls, development of depression and anxiety.

There are also, I mean, in social media, for the most part, not always, everyone's happy. Everyone looks great. Things are going well. And so that can kind of start that isolation of gosh, I'm missing out. Everyone's having a fun time and looking fantastic. And I'm not a part of that. I don't have an interesting life.

It can also lead to, especially in girls, challenges with body image. That can be an issue as well.

Host: And what about adults? How much screen time should we be aiming for for ourselves?

Asha Patton-Smith, MD: So the answer is, it's not as black and white as a particular period of time. We know that kids under two, no screen time is recommended. So your younger daughter kind of falls in that range. Between the ages of two to five, it's an hour or so, with parental engagement or caregiver engagement. So, you may be looking at something educational with your child, Sesame Street, or something.

Your child is not using the phone or using the screen on its own. And then when we get older into school age kids, the recommendation is between that 2 to 3 hour range, not including whatever is happening educationally at any given time. Adults, it's not as clear, and it really is one of those things where we used to think that there were some hard and fast rules. Like everything else, it really depends on the individual and the type of content that is being used.

So if you're passively scrolling and looking through things through a feed or on social media, versus actually creating content or coding or doing something that is more interactive really does impact what it is that you're doing and how you're feeling while you're doing it. I think for younger kids, it really is up to the parent or caregiver to kind of determine what's happening with social media.

I know in my practice, I have a lot of kids with ADHD and on the autism spectrum and because of especially with video gaming, using the video games excessively and causing a dopamine surge can sometimes get a little bit challenging. So sometimes even with small amounts of screens or gaming, it allows for tantrums and challenges.

So that may be 30 minutes to an hour for some kids. It may be two hours for others. So that's the part where I say you have to know your kid. And for adults, you have to know yourself. How are you feeling when you're using social media? I think the biggest thing that we have to talk about with just screens in general and something that I try to live myself is when you're using screens or on social media, you're not doing something else. And what is that something else that you're not doing? Are you not getting out and exercising? Are you not interacting in real time with other people? Are you not sleeping well because you're on until late at night, which then impacts your next day? So you have to ask yourself when you have this time that kind of goes by as you're scrolling through; what other things could you be doing with that precious amount of time that you have each day?

Host: And it's tough because it feels like screens are everywhere, you know, in our work practices, at home. Can you give us some practical strategies on how we can set healthier boundaries around screen time?

Asha Patton-Smith, MD: So from kind of adult and teenage standpoint, the first thing you have to do is set boundaries. Have a sense for yourself of how long you're going to be on social media or be on a screen, non work or educational related. And it is recommended about 20 to 30 minutes at a time. Take a breath, kind of look at something else, focus on something else, and then return, just from a standpoint of eye strain, and just from a standpoint of being able to keep your focus and attention.

The other thing is turn off notifications. That's something that is very easy to do because when you get a notification, you're going to look and depending on what it is, it's going to move you in that direction. So, just make sure that you're dictating when you're looking at social media or when you're on a screen and it's not dictating to you based on notifications.

You also should set time where you're not using a screen and have a routine. Morning and evening or break times, kind of turn off screens, put them away and try other things like reading an actual book, or meditating, or interacting with family.

From a standpoint of working with kids, I think parents and caregivers, obviously you can show kids better than you can tell them. So make sure that you are a great steward of social media time and not preaching to your kids to get off screens while you're consistently on a screen and they see that. Dinner time is a great time if you're able to eat as a family, to have a no screen zone, and that means that parents and caregivers have to be a part of that as well.

One of the things that typically comes up in my practice is parents say, Hey, I hear what you're saying, how can I start this? And what can I do to get my kid on board? It's a little bit easier with the younger kids because they just haven't had that consistency of using the screen. It will not be easy. So with the younger kids, it's something that kind of can be slowly kind of taken away if you will, as far as the time. So pushing back the time a bit. And it doesn't really require a lot of explanation because the kids are super young and don't quite understand. They just want to look at what they want to look at because it's fun and because it's creative for them to look at it more.

For the older kids, I mean even elementary school kids, I think it's important to be transparent on what your concerns are. Maybe even talk about what you're dealing with and trying to reduce the amount of screen time so you can do more fun things. That's typically how I present it.

And understand that it's not going to be easy for you as an adult and it's not going to be easy for you as a parent because kids will push back. They'll have tantrums, they will say you're the worst parent in the world. That's okay because with time and being able to show them that there are family activities that can be done without a screen and there are other things that can be done to help in that space; they'll realize that, hey, I really didn't miss it as much anyway. So we're not saying no screens, we're just talking about a reduction in that and being very intentional of what you're using and why you're using it.

Host: Yeah. I love the leading by example. That's a great tip. And the pick up a book. Yeah, that's great. Well, thank you for sharing such valuable insights, Dr. Patton-Smith. We've learned so much about how screen time impacts our mental health.

Here are the key takeaways. 1. Research shows that excessive screen time can negatively affect our sleep, memory, attention span, focus, and overall mental health.

2. Social media use particularly among teens and young adults, can offer some benefits. However, overuse can lead to harmful self-comparisons and feelings of loneliness.


3. Excessive screen time can be especially damaging to the developing brains of children and teens. Parents should avoid using devices as distraction, as this can lead to issues with emotional regulation later on.


4. For children under two, no screen time is recommended. Instead, unstructured play should be prioritized. For older children and adults, it's best to limit non work screen time to no more than two hours per day.


5. Setting boundaries around screen time is essential, even though it may be difficult. Parents should have open, honest discussions with their kids and establish clear rules. For adults, we can set personal limits and use tools like disabling notifications to help stay on track. Additionally, creating device free zones and establishing screen free routines can be incredibly beneficial.

For more information on mental health from our experts, visit kp.org/doctor and listen to more episodes of Healthier You wherever you get your podcast. If you enjoyed this episode, be sure to share it with others. From all of us at Kaiser Permanente, be well.