Scott Webb (Host): Okay let's be honest, most of us are addicted to our phones and many of us spend far too much time on social media and this is perhaps especially true for our kids. I'm joined today by Pediatrician Dr. Mandy Jackson. She's here to discuss how social media and screen time is affecting our kids and how we can best help them.

 This is Ask the Experts, the podcast from Salinas Valley Health. I'm Scott Webb.

Doctor, it's so nice to have you here today. We're gonna talk about how social media affects kids' mental health so, let's just start there. How does social media affect kids' mental health? Do you believe social media is causing a mental health crisis and really and I know the answer, my personal answer but your answer, are kids addicted to their phones and social media?

Mandy Jackson, MD: Thanks Scott for inviting me. I'm Finding from more research that we've had that we adults also have an issue with, with social media so we'll get there a little bit later. In terms of mental health and addictions; we do have some research studies that show that young people who use more social media are more likely to report depression symptoms.

Ah depression symptoms can be sadness, hopelessness, thoughts of suicide, low self-esteem, not wanting to interact with others. The study couldn't really say if social media caused the depression symptoms because one thought is that what if a depressed child is more apt to use social media. So there's lots of questions with the research and the good thing that we're, have a lot more researchers right now and importantly they're talking with the young people in a very nonjudgmental and safe way to get real information to help us all move forward in the healthiest way we can.

 Like you and I just mentioned. We know our kids are on screens the think of the last time you were with your child. I mean I can think of like the last ten minutes my child was on a screen ah, so the answer is yes for most of us. Some families of course do not let their children engage with screens or they, it's jut not part of their

culture. But the majority of the people not only in the United States but around the world are on a screen. The trick with mental health is to watch what kind of social media we're using so there's a lot of inspiring things out there. For example, some kids will use social media just to connect with friends and family in a really healthy way cuz they're living long distance or like my child likes to talk with her cousins who live in México which is two thousand miles away.

So pictures, or there are certain groups of people who have more self identity talking with people like in our culture the Latinx community or it could be people are interested in Engineering or gay and lesbians. Um, these things can be very positive. They can use it for education, they can start their own business based on a craft they saw TikTok or they can you know advertise themselves to Molans.

On the flip side, there's a lot of dark material out there. Sometimes they're looking at mostly violence or they're exposed to drugs or precocious sexuality actual kids talking about and idealizing thoughts of self harm and and more than that.

Host: Yeah it's a lot to take in as you many of us adultare guilty,if you will, as well just sort of always looking at our screens, staring at our screens being a bit obsessed with social media. It may be different than our kids, like I'm more of a Facebook and X guy, maybe Instagram, whereas I'm sure that my daughter is on more like TikTok and SnapChat but you know as you say pros and cons and just wondering what you're seeing in clinic and do you find that girls are more affected than boys?

Mandy Jackson, MD: I'm seeing quite a few things on in the clinic. One thing that is really important, which you just mentioned, is that we adult are on the screens a lot, so for our really young kids, I'm talking like age birth to age three years old. If parents are on their phones as much as I am buying plane tickets, for example; they're gonna limit their opportunities to directly interact with their kid.

When kids get less face to face and facial expression and language interaction; then we already know that they language delay or lack of kindergarten readiness. So it's a really big thing as you have a lot of kids aged birth to three who have language delay and I walk in the clinic room and their parents is on their phone and I don't say it judgementally. I'm on my phone when I'm not with somebody also. But when your child, it's really important to put your phone down and interact with your child. Second thing I see the most is especially for my teenagers, is regarding time management. So kids are busy. They've got school, they've got to do their homework, they have a lot of them have sports or music or theater. Some are working in jobs. Some are dating. We're all supposed to hang out with our family. We're all supposed to shower. We're all supposed to sleep and of all those things I see sleep getting let go the most and we already know that that affects our mental health if we don't sleep enough we're more apt to be angry quickly. It can cause us to

 be anxious and also depressed. When kids are on other

social media platforms umwhich irregardless of the time commitment,

we're seeing a lot of kids in our clinic what we call body dysmorhpia. It's when they're unhappy with how he she looks. That definitely affects girls more than boys but it affects both. Social media tends to portray skinny people and people with perfect skin whereas a normal adolescent, I'm talking like eighty of a hundred adolescents are gonna have a fluctuating body mass.

They're gonna have moments where they look overweight, moments when they look too skinny and a lot of them go through really bad acne. So when their skin's not perfect and their body mass isn't matching up with what's portrayed on there, I see a of kids who are just shying away from any social real time face-to-face interaction.I'll even see kids in my clinicwhit their hoodies on and they are there for acne but they're just covering themselves up or I'll even have kids who aren't eating anything they actually have anorexia. Anorexia nervosa

 and um they're covering their bodies up so that their parents will stop telling them to eat.

Host: Mmm.

Mandy Jackson, MD: So these pictures and videos on social media they're very powerful and we have to help kids interpret that in a, in a real realistic way.

Host: You know on a more serious note doctor, over the years I think we've learned that many kids have taken their lives due to abuse and bullying, just that they're subjected to by peers on social media or whomever. What are some of the signs that we can look for to hopefully prevent our kids from harming themselves?

Mandy Jackson, MD: That's a really good question Scott. It is really important. It happens quickly and we're all asking ourselves what happened. What could we have done?

Host: Yeah.

Mandy Jackson, MD: It's really hard to detect number one if we don't have a routine communication with our child. A lot of families are just so busy that there's not a routine check in. So the number one thing I think we can do to prevent is just to have good communication with our kids. Check in every day. I've been trained to ask open-ended questions but a lot of times I'll say how was your day and I get the answer fine, or I don't get an answer at all and I'm like okay, let me go to my specific questions. Ah, what happened in school?

Host: Yeah that that all I get is good or fine. How was your day? Good. How was this? Fine great thanks.

Mandy Jackson, MD: How was school? Fine. And then I'll say what was the best part? Lunch. Ah, what was the worst part. Oh, you know what I'm really having trouble in math and then we can have a real conversation. And I'll specifically say I was with Rosa at lunch today and you know what she really made me mad you know and so you can get a lot of what's going on socially and academically and all of that affects our self esteem and our our regular mental health. And then if we get any inkling of a problem, we can promptly the next day talk to the school counselor, get 'em connected with our kid. A lot of times kids will talk to people outside of the home more then they will talk to us.

Host: Right.

Mandy Jackson, MD: Also of course at the clinic we've got referrals to mental health counselors and some kids actually need medications just to help keep them above water there. It's a really tough thing but I would say the most important thing is to have really good communication with your child.

Host: Yeah just wondering what uh schools and parents can do to keep kids safe when it comes to social media. One thing that my daughter's high school has done now is they take their cell phones away or they're supposed to anyway. Not all the teachers do. But, they're supposed to take their cell phones away when they enter the classroom and give them back to them on their way out and I don't know that that's so much about social media as it is a about just maybe having the kids be able to pay attention and not be distracted but I'm sure social media is a part of it as well so what do you recommend?

Mandy Jackson, MD: That's a very good question. Some teachers even requires your phone just to get your homework done or some kind of.

Host: Right right.

Mandy Jackson, MD: School provided screen. A lot of kids are so more than we adults they're able to get to whatever website they want to ah without us even knowing about it. So it's really challenging. I would say to help with safety,number one, don't let our kids watch violence. There's violent video games, violent movies, violent TV shows. Just to give full confession, my partner and I love to watch narco traffic and movies at night.

Ahm but that that can really traumatize a twelve year old and maybe it's traumatizing me but it's out there and we need to limit that stuff. Also scary movies. Anything with um, drugs or precocious sexual activity. Those are all safety concerns and even more Scott, there's like physical safety. The number one thing I see with teenage having a problem with traffic. It could be an accident of course. Um, there's of course tragic deaths. Sometimes it's just getting pulled over cuz you you didn't go at a red light and the police notices that you're on a phone. Some kids are walking across the street texting and a car will hit them literally. The Ahm I have a course at the clinic and the hospitals we see the worst things so there's a lot of safety precautions to do. But the main thing is putting it down for important moments and then watching like including in the classroom and then watching the content to avoid those negative triggering exposures.

Host: Yeah wondering you know the minimum age is thirteen for social media, but I feel personally like that should be higher and I, I feel like we shouldn't have allowed our daughter access to social media. I feel like a bad parent you know maybe for letting her have access earlier. Just wondering do you think that it should be higher than thirteen should it be fifteen, sixteen, twenty five? What, what's the right age to begin on social media?

Mandy Jackson, MD: I tell adolescent kids if they're ready to have a phone, they're ready to do chores, drive,learn to cook, get a job. It's a hard question. I do think it should be higher but I think enforcing it isnear to impossible for a lot of families.

Some families are really organized, maybe yours Scott is really organized and supervised. Studies show that eight year olds are on social media in an unsupervised way and some of those kids will get on as thirteen up because an older sibling will let them in or even a babysitter or parent who doesn't have time or energy to argue.

So, it, it's really tough but yes I agree it should be higher but I think the enforcement of it is gonna be up to each household and parent and caregiver. And that is really, really challenging.

Host: Is there an appropriate amount of time that kids should spend on social media? I mean I confess Doctor, the first thing I do when I wake up in the morning besides looking at news headlines, is I go to Twitter or X in this case, and I go to Facebook and I go to Instagram and I'm sure my daughter does the same thing. I'm sure hers is more you know TikTok and SnapChat. But is there an appropriate amount of time cuz I feel like I'm on my phone and social media all day every day and if I am, then she probably is too. So is there a number we canput on that?

Mandy Jackson, MD: In a perfect world Scott, we would spend two hours or less on what I call recreational screen time cuz there's also productive screen time, so, in a perfect world. Again it's more about when and the quality, the content of the social media. So there's good evidence that having what we call a family media plan can really work. So again it's adults and kids everybody's following the same rules and we invite the kids to help us make the rules. So for example, everybody puts their phone down for dinner. Everybody puts their phone down whenyou're going to visit grandma.

Everybody puts their phone down when there's time for homework, especially for sleep. A lot of families have success when everybody in the family puts their phone in the kitchen, goes to their room and has uninterrupted sleep. So ah, that's what we call family media plan and that helps limit this kind of unlimited opportunity even though, of course the goal is two hours or less and it's also very hard to calculate cause they will be doing their homework on their phone plus TikToking or messaging, so its really hard to really delineate how much time is being spent on what.

Host: Yeah.

Mandy Jackson, MD: And then, just again we need to be role models so if our kids see us on our phones just like if we like a certain kind of shoes,they're going to probably copy us.

Host: Yeah.

Mandy Jackson, MD: We're speaking English right now,that's because our parents probably taught us English. So we need to model with our phone and screen time also.

Host: Yeah it does seem like it becomes one of those do as I say not as I do, but as you say some of these things are easier said than done I guess and I wanted to talk to you about the large migrant community in Monterey County in particular South Monterey County where you work. A lot of families, there's a language barrier. Parents may only speak Spanish or an indigenous language. Like what's your advice for families how handle that when you're mixing all these different languages together or the kids speak one language at home but then they go to school and they speak English. Like help us sort that out.

Mandy Jackson, MD: Very, very challenging Scott, really important question. Language tends to cause this perceived power dynamic

between the kids and their parents. So let's say a parent speaks Spanish only or Triqui only or Triqui and Spanish and then the kidis learning English at school. And fortunately there are some , bicultural elementary school programs at this point. Um, however some of the kids will say things to their parents who often have not had a lot of years in school and they will say things that are not exactly true from the school about their screens. You know I need to, I need this to do my homework and sure that may be true, it might not be true. So its really challenging because we want parents informed and we want them to get

professional interactions just like the kids are at school. The, the biggest thing I see again cuz I'm a pediatrician is this early preschool language delay thing. So it's really important and I know that the phones we talked a little bit about addiction before. Parents, we're also addicted. So these younger kids of migrant families I'm seeing them not getting a lot of eye contact and facial expressions and heh lets go to the park and lets have a play a date for a friend because it is so much easier, cause we're stressed out with physical labor in the fields, we're tired. And it's just a lot easier to have your child watching a movie or there's a lot of great cartoons out there that I love to myself. Ah, so that just kind inhibits this face to face interaction with facial expressions and real time language interaction reading books with kids, going over numbers and letters and colors and shapes that we're getting lost because of the screens. That's the biggest thing I, I see and I don't, there's no judgment or anything, it's just a very natural course of what's going on.

Host: Yeah it really is. I'm sure all of us just wanna be the best parents we can, model the best we can for our kiddos and as you say this is an ongoing conversation, an ongoing battle if you will but uh for today thank you so much.

Mandy Jackson, MD: Thank you too Scott.

Host: Dr. Mandy Jackson is accepting pediatric patients at Taylor Farm's Family Health and Wellness Center in Gonzalez. To schedule an appointment please call 831-675-3601. That's 831-675-3601.

And to listen to more of our podcasts, please visit salinasvalleyhealth.com/podcasts. And if you found this podcast to be helpful, please be sure to tell a friend, neighbor, or family member. And subscribe, rate and review this podcast, and check out the entire podcast library for additional topics of interest. This is Ask the Experts from Salinas Valley Health. I'm Scott Webb. Stay well, and we'll talk again next time.