For modern-day adolescents, social media is often not just a tool but an environment. (Credits: Pixabay)
When 16-year-old Arav came to my OPD with his parents, he was spending at least nine hours a day on creating or searching for reels on social media platforms. His world was a collection of “shorts,” the only language he could express himself with. In the real world, his academic graph plunged though he was a bright student, he became irritable, could not sleep beyond four hours and attributed his distress to the academic pressure his “parents put on him.” What he didn’t realise was that his lived reality didn’t matter to him anymore.
His self-worth had become inextricably linked to the number of likes and views on these platforms as he constantly measured his life against the “filtered realities” of his peers. He gradually withdrew from normal in-person socialising out of the fear of ridicule and created a “comparison-deficit loop” where the more he scrolled, the more inadequate he felt, leading to further scrolling to seek digital validation. Further interviews showed Arav had social anxiety disorder with mild depression.
We began with Cognitive Behaviour Therapy, or talk therapy sessions to break unhelpful thinking patterns and behaviour. The therapeutic goal was not total abstinence, but a structured digital detox plan. We negotiated a 30-day “social media blackout” with him. This duration was chosen as it takes that much time for withdrawal signs and symptoms to abate and the stabilisation of the stress hormones within the body.
We planned the detox like a challenge, saying “let’s see if we can think of a life other than social media for a month.” He deleted all social media apps and charged his phone outside the bedroom.
During initial interviews, Arav sat slumped in his chair, his thumb reflexively twitching over his palm as if scrolling a non-existent screen. The therapist asked him, “If your social media feed was a room you were standing in, what would it be like?” Arav replied, “It feels like a room where many people are talking, but no one is actually speaking to me. It’s exhausting, but I’m terrified to leave.” The therapist then worked on this fear, elaborating how virtual connections lead to a distorted self-image.
Arav was terrified of the “vacuum” it would cause. To ground him, the therapist encouraged journalling and told him to write down the first three things he noticed when he felt the urge to reach for his phone. Then he asked Arav to write down his feelings, thoughts and physical sensations in relation to that urge. Seven days later, Arav said, “The first night was brutal. I felt like I was vibrating. I reached for my nightstand 20 times. I actually felt itchy.”
This itch is a sign of the brain looking for a dopamine hit. Then Arav opened about what he did in his phone-less time. “I sat on my balcony. I realised I hadn’t looked at the street in years. I noticed the neighbour has a dog I’ve never seen. It was so weird …. so quiet. Quiet in a way that made me realize how loud my thoughts are.”
The therapist encouraged him to go out to a local park and practise the joy of doing something without the intent to post about it. Then we encouraged Arav to participate in engaging activities like high-energy exercises (skipping), drawing and having face-to-face social interactions with people around him.
During the first week, Arav experienced significant digital withdrawal anxiety symptoms where his hands trembled and he had acute shortness of breath. He reported feeling “sad, invisible” and he had angry outbursts for which he had to be prescribed anti-anxiety medication.
By day 10, Arav reported feeling better and said that there was a “quietening of the incessant mental chatter.” His sleep had improved and he could fall asleep in 10 minutes instead of 90 minutes. Without the constant barrage of external stimuli, Arav began to re-engage with long-forgotten hobbies like the guitar. By week 3, Arav began initiating in-person meetings with a small group of friends.
After six weeks, Arav’s depressive symptoms were gone. He was allowed his phone use. He was able to study for 45-minute blocks (with a 5-minute break in between) without the “itch” to check notifications, indicating a significant recovery in his brain’s executive functions. His bodily symptoms of anxiety also subsided significantly as he moved from external validation (from the number of likes on social media) to internal validation with an increase in self-worth. With normal sleep, he could regulate his symptoms better.
He was no longer “reactive” but more “reflective” as he described himself amid peers: “When we are together, they are always on their phones. I realized I was the only one actually in the room!” We tapered and stopped his medication simultaneously but advised him to continue his therapy sessions every two weeks for at least six months.
Arav’s case illustrates that for modern-day adolescents, social media is often not just a tool but an environment. For him, staying away from social media was like recharging oneself in a retreat or a sanctuary. He returned to social media with a “digital hygiene” framework, limiting its use to just 60 minutes a day and disabling all non-human notifications.
So if parents and schools encourage non-digital “analogue” periods in daily routines of adolescents, then digital addiction could be controlled. At the end of 30 days, Arav was more comfortable with his self-image and stopped taking selfie after selfie. “I have my dad’s nose. I have a scar on my chin from when I fell at age six. I look tired. When I’m making a reel, I want to be a version of me that is superior to others, a sort of mask. But the detox period has made me realise that it was this mask which was making me miserable. I looked at a photo of an influencer and didn’t think he was better than me. That person was probably spending many hours just adjusting the camera for that perfect shot. I closed the app and went to play basketball instead …. and I didn’t take a photo on the court!”
(Dr Ajinkya is psychiatrist at Kokilaben Dhirubai Ambani Hospital, Mumbai)