Zach Irwin MSSA, LISW: Finding hobbies is extremely important, not only to just have something to do with your time that you enjoy, but also when struggles do happen, hobbies very quickly become coping skills too.

Caitlin Whyte (Host): Clear correlations have linked mental health disorders in adolescents with an increased use of social media and or chemical substance abuse disorder, such as vapes, alcohol, and more. Zach Irwin is a Counselor at Oak View Behavioral Health Services at Southwest General and joins us to highlight how social media and substance abuse disorder can alter an adolescent's mental health.

This is Southwest General Health Talk, I'm Caitlin Whyte. So Zach, to start us off today, let's look at technology and social media apps. As they continue to develop and be enhanced, how is the concept of mental health growing simultaneously?

Zach Irwin MSSA, LISW: So this is a double edged sword here. It's great that there's an exposure happening on social media,regarding mental health and mental health disorders and people sharing their stories of their struggles in mental health. And, it's been an awesome platform to do that. Unfortunately at the same time, there's also misconceptions that are getting broadcasted out there.Diagnoses being misrepresented, peopleunfortunately, faking mental illnesses, for the attention on social media. So it really is a double edged sword, and it's kind of hard to delineate. It's hard to separate that content of, well, here's the healthy content related to mental health, and here's the unhealthy things, and how do I only see one and not the other?So that's, that's really introduced a new battle.

Host: Well then how can parents appropriately monitor the content on social media that their child consumes? And what are those negative forms of content that should be addressed?

Zach Irwin MSSA, LISW: So there's many different apps out there that offer parents control, to an extent, over certain apps on a person's phone. You can shut off certain apps at certain times saying, I don't want my kid on TikTok after 8 p. m. or I don't want my kid on Instagram, during the day while they're at school.

So on and so on. So there's many different apps that offer that. Aside from that, as far as the negative forms of content,social media has really introduced a lot of new struggles. I was fortunate enough to have done some projects on this when I was an undergrad, definitively, like, related to social media and mental health.

One of the things that we're seeing is, unfortunately, there's a rising rate of narcissistic traits that are coming out in people. I want to be very clear about that. Not saying there are more people with narcissistic personality disorder. But traits of that disorder that we're starting to see sprout up in different places.

And there's a few reasons for that. One of them is, I like to jokingly call it the, anything you can do, I can do better syndrome. So, unfortunately, well again, fortunately, and unfortunately, you see these kids that are making millions playing video games on YouTube or on Twitch and they're streaming and making content.

And so, at the age of, let's say, 12, 13 years old, you see somebody that's maybe your age or a couple years older, and all they're doing is playing video games and making millions of dollars, and you're sitting there telling yourself, wow, I play that same game, and I have a computer that I can record things on too. I can do exactly what that person's doing. And again, like we've mentioned in the past, unfortunately on social media, things gain a lot of overexposure. The very small minoritygets blasted all across social media to look like the majority. So while all you see on YouTube is these kids who make millions off of playing games, the reality is that's such a small, small, minute percentage of people that can do that.

And now we have hundreds of thousands or millions of teens that are trying to do the same thing that are not successful at it. So that's one part of the negatives about social media. And then the other part being, the fact that there's the comparison syndrome. Where if I see, I'm 29 years old and I see somebody that's my age, that's out on their yacht on a vacation around the world.

And I say, man, that, that could be me. Like I, what am I doing wrong in my life that I don't have a yacht and that I can't just travel the world. The reality is that people post what they want you to see. There's, there's more behind the scenes that you're not getting a taste of. So while all I see is that person on their yacht, what I'm not seeing on social media from that same person is the brutal divorce they went through, years ago, and all the stuff that took place there and blah, blah, blah, blah, blah.

So. There's the comparisons, and then there's the anything you can do, I can do better, that really,cause a lot of symptoms of different mental health disorders to rise up, and that people struggle with when they see people that are hyper successful, and it looks like the majority of people are hyper successful, when ion reality, that's just such a small percentage.

Host: Well then, Zach, what are some activities that can be done outside of therapy that can promote less screen time and time spent scrolling through social media and therefore allow for more face to face and social interactions among peers and family?

Zach Irwin MSSA, LISW: Finding hobbies is extremely important, not only to just have something to do with your time that you enjoy, but also when struggles do happen, hobbies very quickly become coping skills too. So getting established in some different hobbies, whether that be sports, whether that be music, whether that be art,but finding what you enjoy.

And that's kind of the trick with coping skills too, is there's a million coping skills out there. But it's all trial and error to find the ones that are important to you. So hobbies are fantastic. Having family time together, just time with your friends in person, getting out and going to do, whatever activity, whether that just be going for a walk. Exercise is great for the endorphins that make us feel happier and feel better being physically active.

There's a different process that happens in our brains when we're spending time face to face with people rather than just, texting or being on the phone. So, there's also support groups that are out there,that are a really great resource too. There's very, like, group specific support groups.

So, for example, a group regarding grief, if that's something you struggle with, groups for those who have struggled with addiction, groups for those who have struggled with depression, so on and so on. So if you are struggling to find people that you're comfortable being around, support groups are a really good step to take, especially once you've completed like an intensive outpatient or a partial hospitalization program; the support groups are a really good transition afterwards.

Host: You know, with increased social media use and more hours spent scrolling by adolescents, how can schools incorporate the necessary medical warnings on the dangers of vapes, drugs, other things like this, to students that can promote the awareness, maybe highlight the risks?

Zach Irwin MSSA, LISW: Yeah, this is a very tall task for schools to undergo. Luckily we've taken a step in the right direction here in Ohio. I believe there was a bill that was passed not all that long ago that actually removes or makes it illegal to sell the flavored vapes. All those cotton candy, watermelon things that, those flavors in and of themselves make nicotine very alluring.

So that's a step in the right direction to remove those and have just like the strict tobacco flavors,which are obviously less desirable amongst adolescents at least. But as far as, the warnings,I think it's good for schools to partner up with medical professionals that can come into the school.

There's DARE groups and things that are similar to DARE that are programs coming to the school to talk about drug awareness, understanding what they can do to you physically, what they can do to you mentally. But ultimately, there's some new approaches that are happening in substance use treatment in teens.

One of the ones that I had been trained on in the past was rather than kind of like a 12-step model, like Alcoholics Anonymous or Narcotics Anonymous, or one of those types of groups, this new model had focused more on the educational component and helping students make informed decisions so that by the time you get to the end of the program, it's not the counselors, or not the staff telling you, you need to stop smoking.

It's that you understand the risks of it and you're making that decision for yourself, which is really the direction we want to be moving, that just, to be honest, it, it has better outcomes, but it does make it more difficult on us on making sure we really nail that educational component so that there is a full understanding there of what's going on.

Host: Well, Zach, the American Heart Association reports that young people between the ages of 13 and 24 who vape, whether it's THC or nicotine based, indicated they experienced a greater percentage of depression, anxiety, and suicidal thoughts compared to participants who do not use those products. So why are these products posing such a threat?

Zach Irwin MSSA, LISW: So this really gets into what we now view as the disease model of addiction. In this disease model of addiction, again, there, there used to be the 12-step model that we would look at, which is all your, two letter groups, your AA, your NA, your OA, so on and so forth. In the disease model of addiction, we look at addiction as an actual disease rather than a choice.

And what we mean by disease is that there is an organ that's impacted by this illness, and because of that impact, there's side effects that take place throughout the body. So when we say addiction is the disease, what we mean by that, is the brain is the organ that is impacted by that. And as a result, your body craves, whether it be different substances or whether it be different behaviors, but your brain has these neuropathways that kind of lead to the reward center.

And for those that struggle with addiction, that reward center is hit by these different addictive behaviors or different addictive substances. What we have identified too, is there is a absolutely a genetic component to addiction where you have this gene that determines whether or not you even have the ability to become addicted to a substance or to a behavior.

So what happens in that disease model with that pathway to that reward center kind of gets hijacked so that you're only having certain things hitting that reward center that release that dopamine, which is what makes us feel good and what makes us happy. And so when you struggle with addiction and you're constantly having that reward center activated by different substances or behaviors, you're losing the ability to activate that same reward center through things that you would typically do.

So if I struggle, let's say, with addiction to alcohol, that alcohol really releases that dopamine for me, for my reward center; I'm not going to maybe enjoy hanging out with family like I used to. I'm not going to get the same reward out of that. And so over time, that's causing us to, have different symptoms of depression, different symptoms of anxiety, a lack of serotonin, a lack of dopamine is also associated with suicidal thoughts, so often too, what happens historically, Mondays have been the highest rates of completed suicide.People would call it the Monday Blues. Why that is happening is because when people are, whether it be partying all weekend or going out on a bender or binging or whatever it may be partying Thursday, Friday, Saturday, or Friday, Saturday, Sunday, and you're just absolutely flooding your brain with dopamine, throughout that constant substance use. So by the time Monday rolls around, your brain is not producing anymore right now because it was previously flooded with it. So it's saying, hold on, let's take a break and not produce too much dopamine, when in reality, you have none left because you've used it all through partying that weekend and now you're empty on Monday.

And so that's why depression, anxiety, and suicidal thoughts really do get linked with substance use is because of that dopamine response in our bodies.

Host: Well, Zach, how does Southwest General gear adolescents diagnosed with a mental health disorder as a result of chemical dependency, away from repeating those behaviors? And what resources does Southwest General provide to give that proper support?

Zach Irwin MSSA, LISW: While our adolescent IOP is not specifically a substance use IOP, it is a mental health IOP. We are cross trained in treating both. So we do actually talk a bit about different substances and substance use. We talk about the disease model of addiction. We talk about the impacts that these drugs have on us mentally and physically.

And so, when we do those groups, that's kind of an open forum where we give the adolescents an opportunity to ask anything and everything related to whatever drugs or alcohol or whatever it is they want to talk about. We give them that opportunity to talk about those things so that we can introduce that educational component, and just have open and honest conversations.

A lot of this, when it comes to substance use is very stigmatized. And so, some teens are in households where we don't talk about those things. You don't talk about drugs here. You don't bring drugs here. So on and so on. And,while that's not inherently an unhealthy thing, unfortunately, one of the consequences of that is, you've closed that door to conversation.

And so we kind of provide an open forum about maybe once or twice a month in our, in our IOP where teens are allowed to just talk anything and everything related to drugs and just be able to ask those questions that they feel like they don't really have other trained professionals to go to and ask about those things.

So we do kind of address both,throughout the course of the program. As far as other resources that we provide at Southwest,we work in our program, with other places in the community that can help with other substance use issues if need be.

So we have people go through our mental health program and if the substance use is still a concern by the end of that, we'll make appropriate referrals to other places that we work closely with.

Host: Another great episode full of important information. Thanks for joining us today, Zach. To learn more about how social media and substance abuse disorder can alter an adolescent's mental health, visit swgeneral.com. I'm Caitlin Whyte, and this has been Southwest General Health Talk.