The United States Surgeon General has declared a youth mental health crisis. He says social media is a primary driver and he’s calling for immediate action. Let’s see what’s up.
When asked about the impact of social media on their body image, 46% of adolescents aged 13-17 said social media makes them feel worse…
Molly Rose Russell was 14-years-old when she died on November 21, 2017.
At the conclusion of last September’s judicial inquiry, her death was attributed to “…an act of self-harm while suffering from depression and the negative effects of online content.”
It was the first ruling of its kind.
Social media and youth mental health advisory
On May 23, 2023, the United States Department of Health and Human Services issued a news release announcing that Surgeon General Dr. Vivek Murthy is urging action to ensure social media environments are healthy and safe.
Citing the risk of harm to the mental health and well-being of children and adolescents, he called on policymakers, technology companies, researchers, families, and young people to gain insight into the full impact of social media use.
The goal is to create safer and healthier online environments.
As we consider the crisis, it’s important to keep in mind that children and adolescents are in critical stages of brain development. And that makes them especially vulnerable.
The release introduces a 25-page PDF, “Surgeon General’s Advisory on Social Media and Youth Mental Health.”
Reality
Up to 95% of young people ages 13-17 report using a social media platform and more than a third say they use it “almost constantly.”
From Surgeon General Murthy
Let’s get right on it by going to the source, Surgeon General Murthy…
The most common question parents ask me is, ‘is social media safe for my kids’. The answer is that we don’t have enough evidence to say it’s safe, and in fact, there is growing evidence that social media use is associated with harm to young people’s mental health.
He goes on to point out that children and adolescents are often exposed to violent and sexual content on social media, as well as bullying and harassment.
And for too many young people, hanging out on social media compromises sleep and in-person time with family and friends.
According to Murthy…
We are in the middle of a national youth mental health crisis, and I am concerned that social media is an important driver of that crisis – one that we must urgently address.
Good, sounds like he means business.
The impact of social media on children and adolescents
Of course, the impact of social media on children and adolescents depends upon a number of factors…
Amount of time spent on platforms
Type of content being selected or to which they’re exposed
Degree to which the content disrupts health essential activities, such as sleep and physical activity
Cultural, historical, and socio-economic factors
No doubt, there are more.
Benefits
Is it too much to hope for?
Can children and adolescents benefit from social media? Sure they can, as long as rules pertaining to the factors above are made – and monitored.
That’s not unreasonable, is it?
Let’s catch the view from the adolescent side of the fence. They report that social media helps them feel more accepted (58%), like they have people who can support them through tough times (67%), like they have a place to show their creative side (71%), and more connected to what’s going on in their friends’ lives (80%).
The dark side
Okay, we know social media use can be excessive and problematic for some children and adolescents. Let’s do details…
Recent research shows that adolescents who spend more than three hours per day on social media face double the risk of experiencing poor mental health outcomes, such as depression and anxiety
Relating to the previous point, a recent survey of teenagers found that the average amount of time spent on social media is 3.5 hours a day
One-third or more of girls aged 11-15 say they feel “addicted” to certain social media platforms and over half of teenagers report that it would be hard to give up
When asked about the impact of social media on their body image, 46% of adolescents aged 13-17 said social media makes them feel worse, 40% said it makes them feel neither better nor worse, and only 14% said it makes them feel better
64% of adolescents are “often” or “sometimes” exposed to hate-based content through social media
Studies have shown a relationship between social media use and poor sleep quality, reduced sleep duration, sleep difficulties, and depression among youth
Extremely problematic, don’t you think?
The Surgeon General’s recommendations
The Surgeon General certainly makes the case for a major crisis. And a tip of the hat to him for suggesting ways to address it. Let’s take a look…
Policymakers
Murthy calls upon policymakers to take steps to strengthen safety standards and limit access in ways that make social media safer for children and adolescents. He also suggests funding for additional research.
Tech companies
Murthy states that tech companies can better and more transparently assess the impact of their products on young people, as well as make design and development decisions that prioritize safety and health.
He emphasizes protecting privacy, better adherence to age minimums, and improving systems to provide effective and timely responses to complaints.
Parents and caregivers
For my money, this is where it’s at. Murthy recommends establishing tech-free zones that better foster in-person relationships, teaching kids about responsible online behavior and serving as a model, and reporting problematic content and activity.
Children and adolescents
Children and adolescents can adopt healthy practices like limiting time on platforms, blocking unwanted content, being careful about sharing personal information, and reaching out if they or a friend need help or see harassment or abuse.
Researchers
Researchers need to further prioritize social media and youth mental health work that can support the establishment of standards and evaluation of best practices to support the health of children and adolescents.
Will we pull out of it?
So what do you think? Does the Surgeon General make the case for a social media and youth mental health crisis? How do you feel about his recommendations?
Most important of all, do you think we’ll pull out of it?
My take
We’ve been in an escalating state of social media and youth mental health crisis – along with several contributing crises – for a number of years. And I wouldn’t bet the farm we’ll pull out of it.
Just a few of the things on my mind…
I wrote the first of six Chipur articles on social media’s negative impact upon mental health, most backed by research, 11 years ago. And here we are.
During last year’s judicial inquest into Molly Russell’s death, representatives of the two platforms involved – Pinterest and Instagram (Meta – also owns Facebook) were required to give in-person testimony under oath. That was a first, by the way. The Pinterest rep was contrite. The Meta rep was defiant. Lots of money and power in the equation.
Policymakers and researchers go with the dough. Reference the previous point.
I wonder if we’re past the point of no return when it comes to the involvement of parents and caregivers – children and adolescents. I mean, there are way too many seductive hooks in the world of social media. And the frantic pace of life makes it hard to slow down, consider all the angles, and make adjustments. Our biggest hope are the children, but parents, older siblings, adult family members, and caregivers need to amp up the modeling and guidance.
Pessimistic, I know. Still, I really do believe hope springs eternal.
The chips are down, the stakes are high
The United States Surgeon General has declared a youth mental health crisis. Social media is a primary driver and immediate action is required.
The chips are down, the stakes are high. Will we answer the call?
Any time is right to explore dual diagnosis, but it’s such a great fit for the holiday season. Lord knows the number of times I dosed my anxiety with alcohol all those years ago. Hey, you may be numbing-up now. So what say we toss some things on the wall and see what sticks. Good?
Sooo, if so many people are having a dual diagnosis experience; shouldn’t help, support, or treatment also have a dual diagnosis approach? And it does!
Our “resident” clinical psychologist Dr. Mae Casanova dropped me a line a week ago asking if she could contribute another post. Stating her mission, she wrote…
…focusing on how mental health symptoms or disorders can be the underlying factors in substance abuse…So much of the time people with substance abuse do not get the help they need with their underlying mental health issues. I wanted to shed some light on it…I was going for educational, stigma-breaking, and resourceful.
What can I say? I was – am – all in. So I’ll turn things over to the good doctor…
Exploring Dual Diagnosis
Dr. Mae Casanova
Mental health and substance abuse have found themselves in separate categories for quite some time in the public eye – though they were not put there by professionals.
Substance related and addictive disorders have been considered primary mental health disorders in the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM) since the third edition. They’re just the same as, say, the mood and anxiety disorders.
However, so much of the time in society’s eye, substance abuse and addiction aren’t recognized as mental health disorders, rather more of a lifestyle choice. While mental health disorders, such as mood and anxiety disorders, are still struggling to break the stigma associated with them, substance abuse is having an even more difficult time.
Bringing Disorder Categories Together
Substance related and addictive disorders do deserve their own category, given the combination of physiological and psychological effects, as well as the severity of the consequences of use. But what if they were connected? What if the use of a substance was to manage the symptoms of another mental health diagnosis?
No one starts using a substance with the intention of abusing or becoming physiologically (needing more of the substance to get the desired effect – tolerance) or psychologically (needing more of the substance to get the desired effect – reality detachment) addicted.
Initial substance use could be experimental or social. But the effects – the calm or alertness, the numbing or the attention, the pleasure or the dissociation – could be providing relief from mental health symptoms like mania, depression, anxiety, or even trauma.
In the US, 9.2 million adults experienced both mental illness and a substance use disorder in 2018, according to the National Survey on Drug Use and Health.
Dual Diagnosis: Help, Support, Treatment
Sooo, if so many people are having a dual diagnosis experience; shouldn’t help, support, or treatment also have a dual diagnosis approach? And it does! There are many different options to receive support and guidance through a dual diagnosis. More than you may be aware of!
12-Step + Therapy 12 step programs and abstinence-based programs have a strong support system of members for whom the program has worked – works. This abstinence-based approach (e.g. Alcoholics Anonymous, Narcotics Anonymous) has provided community and constant support systems through meetings and sponsors for people of all ages “in recovery” for decades.
Lots of success and sobriety have been found in these programs. But the question remains – how can they address other underlying mental health disorders or symptoms?
If AA or 12-step programs work for you, then it could be as simple as adding individual therapy weekly with a licensed mental health professional to help guide you. Therapy with a trained professional can help identify, treat, explore, and build a tool box to support and manage underlying mental health symptoms that will come to the surface after the substance use has stopped.
Non 12-Step + Therapy There are quite a few options out there for Non 12-Step approaches to substance use. Some have an emotional component built-in.
SMART Recovery is considered a self-empowering recovery program. The main focus is to help explore and resolve underlying issues and related problems, as well as substance abuse issues.
Refuge Recovery is a Buddhist-based recovery program that focuses on finding compassion for oneself and one’s experiences. The focus is on wisdom and kindness, enabling people to be more mindful of the mental and emotional process associated with their addiction. They see addiction as a suffering state for which one needs to have self-compassion.
Only you can decide the direction that will work best for you and your recovery. If you have not been successful using 12-step options it could be beneficial to look around, remembering to add therapy with a licensed mental health professional.
We are all unique human beings, with our own specific experiences. So our treatment and support options need to be just that – unique and specific.
It’s a Wrap
Thank you, Dr. Mae – always good hearing from you. We’ll look forward to the next time.
In closing, as you reflect upon the concept of dual diagnosis, do so within the context of having interactive diagnoses. Say you’ve been diagnosed with generalized anxiety disorder (GAD) and an alcohol use disorder. Though they’re separate on paper, consider them as one entity, constantly influencing each other. So what’s good for the treatment of one is good for the treatment of the other. Got it?
Hey, wishing you the best for the holidays – as you perceive and acknowledge them. Still, always remember, ’tis the season.
ach and every day in the US some 120 people die subsequent to an opioid overdose. If lives weren’t enough, the total economic burden of prescription opioid abuse is right at $80 billion a year. This is stunning crisis news that calls for action. And action has to include education. So how ’bout we hit the treatment neck of the woods…
As you likely know, opioid withdrawal isn’t deadly, but it sure is horribly uncomfortable. And most folk would struggle making it through even one day without medicine…
True, we work exclusively with the mood and anxiety disorders here on Chipur. However, an opioid crisis discussion is relevant. And that’s because m/a disorder sufferers are perfect candidates for opioid abuse and dependence, should we find ourselves trying to manage significant physical pain.
Why?
Certainly, we have our emotional, mental, and “stress-magnet” leanings. But let’s not forget that opioids can have an anti-depressant effect. In fact, modulation of our endogenous opiate system is at the heart of an antidepressant in the late stages of development (Alkermes: ALKS-5461).
The Opioid Very Basics
So if we’re going to discuss opioid abuse/dependence treatment, we’d better bone-up on some basics…
First, some terminology. “Opioids” include “opiates,” which are drugs derived from opium (e.g. codeine, morphine). The remaining opioids include semi-synthetic and synthetic drugs (hydrocodone, oxycodone, etc.) and endogenous peptides (endorphins, etc.). Bottom-line: “opiate” is typically limited to the natural alkaloids found in the resin of the opium poppy.
Okay, so how do opioids work? Simply, they bind to opioid receptors principally found in the central and peripheral nervous systems, as well as the gastrointestinal tract. Keep in mind, there are numerous receptor classes and the response differs by receptor.
Treatment Considerations
As we discuss treatment for opioid abuse/dependence, we need to keep the following forward and ongoing in our thinking…
Meds play a huge role, but shouldn’t fly solo
Psychosocial interventions are the best co-pilot
Co-occurring disorders (e.g. panic disorder + opioid dependence) are real and there will be trouble if the non-substance piece is ignored
Psychosocial Interventions
Seemed to be the best option to use the term “psychosocial interventions” instead of “therapy.” See, with the exception of co-occurring disorder situations, where, say, the depression or PTSD component require treatment, I’m not so sure formal psychotherapy is a fit. I mean, cognitive-behavioral therapy (CBT) alone in the treatment of opioid abuse/dependence isn’t especially effective.
That said, there’s still a ton of merit to face-to-face work when it addresses motivation, direction, education, frustrations, stress-reduction, family dynamics, and more.
Finally, the power of support groups looms large. After the initial stages of withdrawal, participation in a 12-step, or other, group is extremely helpful.
Medications
A variety of meds are available for the treatment of opioid abuse/dependence. And, of course, the purpose of all of them is to get one off of opioids and continue-on in recovery.
As you likely know, opioid withdrawal isn’t deadly, but it sure is horribly uncomfortable. And most folk would struggle making it through even one day without medicine. So in comes the med – substitute – and then it’s tapered-down.
Okay, here’s a non-all-inclusive list I constructed on drugs.com. I selected prescription meds, including off-label applications. The list is in order of popularity…
Suboxone: A brand name for the combo buprenorphine and naloxone (Narcan). Available in sublingual tablet and film. Details just below.
buprenorphine/naloxone (generic): Buprenorphine is an opioid receptor partial agonist that produces almost big-league opioid effects. Naloxone is an opioid receptor antagonist that blocks the effects of opioids.
buprenorphine: Details above.
Vivitrol: Extended-release naltrexone. Details just below.
naltrexone: An opioid receptor antagonist that may decrease the desire to use opioids over time and decreases overdose risk. It’s not a controlled substance.
Zubsolv: Buprenorphine/naloxone combo that works just about identically to Suboxone; however, it comes in a very small sublingual tablet. Its bioavailability is reported to be superior, which is important because quicker absorption equates to lower dose required to achieve optimal effects. And that means reduced risk of cross-addiction and unwanted side effects.
Bunavail: Buprenorphine/naloxone combo that works just about identically to Suboxone and Zubsolv; however, it delivers its dose via film through the buccal mucosa of the cheek. Same superior bioavailabilty details as Zubsolv.
Probuphine: Buprenorphine delivered via subdermal implant. It’s reported to provide non-fluctuating buprenorphine blood levels around the clock for six months after the treatment procedure.
Sublocade: Long-acting buprenorphine delivered by injection. Restricted to those who have initiated treatment with a transmucosal buprenorphine-containing product and have been stabilized on dose for more than seven days.
lofexidine: An adrenergic (adrenaline/epinephrine) receptor agonist used to reduce the physical symptoms of withdrawal. It’s not a controlled substance.
So there’s a list of med options for you. Of course, you’re encouraged to do your due diligence and openly chat with your doc.
And never, ever, ever forget, buprenorphine is an opioid. That means you can become dependent upon it, and if you get cute with dosing it can kill you.
Got it?
Let’s Wrap It Up
So, yes, the US is smack-dab in the middle of a stunningly deadly opioid crisis. No doubt we need to deal with cause. But at the same time, we have to continue to promote and teach treatment.
Hope you, or someone you know, can use these need-to-knows, and that they help. Please spread the word.
(FYI: The Zubsolv image is not an endorsement. Just thought it would be a good fit.)
Hey, hundreds of Chipur mood and anxiety disorder-related titles are standing-by. Why not dig in?
“Many of these essays refer to the hangnails in life, the annoying and all-encompassing moments that have hijacked my attention and provoked me to consider things in a different light. I have learned to investigate them, to focus on one moment at a time, taking life in bite-sized morsels. Yoga enables me to do this.”
I was using my body to get into my feelings and using my breath to heal my nervous system. I had found the holistic therapy for my holistic disease.
Those are the words of Kyczy Hawk from the intro to her new book Life in Bite-Sized Morsels: Learning to Live Life on Life’s Terms.
Some time ago, I was a member of a Facebook group for addiction recovery and emotional/mental health practitioners. Kyczy (“Keetski”) was a member of that group and I was always so impressed by her knowledge, dedication, and gentleness (come on, just look at the pic).
When she knew Life in Bite-Sized Morsels was about to hit the shelves, she asked if I’d feature it on Chipur. It was easy to happily commit.
Before we get to the book, a bit about Kyczy. Well, she’s been in recovery since 1985 and has been an active yoga practitioner, specializing in addiction recovery, for the past 10 years. Kyczy is the creator of S.O.A.R. (Success Over Addiction and Relapse), a certification program for yoga teachers who want to work with people in recovery and their families.
Kyczy is a certified Y12SR (Yoga of 12 Step Recovery) space holder. She teaches workshops and leads retreats using recovery and yoga principles to invite deeper self-understanding and compassion – key to holistic recovery. Kyczy is the author of the Central Recovery Press best-selling book Yoga and the Twelve Step Path. She writes and practices/teaches in the San Francisco Bay Area.
Hmmm, I’d say she’s qualified to deliver the goods.
Life in Bite-Sized Morsels: Learning to Live Life on Life’s Terms
Let’s set the table for digging-in to the book. This is just huge. Kyczy turned to yoga as she was “falling apart from the inside out.” And, go figure, she’d been clean and sober for years. So in the midst of all but breaking-down, Kyczy strolled-in to a yoga studio and took her first live yoga classes.
Several years later, Kyczy said good-bye to a hectic job (she says, “the one that had defined me as ‘normal’ and ‘successful'”) and trained to become a yoga teacher. Her goal? Teaching yoga to those in recovery. And she continues the same good work.
Along the way, Kyczy developed S.O.A.R. and wrote Yoga and the Twelve Step Path. It was then she began blogging on what she calls “the intersection between yoga, recovery, and daily life.” And the essays in Life in Bite-Sized Morsels are based upon the pieces she posted on her blog.
You know, whenever I consider buying a book, I check-out its Table of Contents. How ’bout it for our featured book?
ETHICS, VALUES AND KARMA YOGA: On the Road to Knowing Right from Not-Right
DREAMS AND DHARMA: Awakening and Waking Up
MEDITATION AND THE BREATH: Looking Inside While Moving Outside
RECOVERY AND YOGA: A Powerful Blend Creating Strength, Balance and Flexibility On and Off the Mat
RESOURCES AND REVIEWS: Recovery, Rather Than the Pain of Active Addiction, Gratefully Makes Its Way Into the Culture
COMMUNITY AND CONFERENCES: Our Community Both Challenges and Sustains Us
FAMILY: Those Closest To Us Teach Us Most
EGO AND ACCEPTANCE: Learning to Discern the Big “E” from the Little “e”
CODEPENDENCE, BOUNDARIES AND BALANCE: Getting Grounded Grants Freedom
DEPRESSION, MOURNING AND HEALING: Both Sides of Disabling Emotions, Going In and Coming Out
Comprehensive as heck. And hopefully it’s obvious by now why I’m recommending Kyczy’s book. Just in case, I’ll slip in a small excerpt…
Yoga was the new skill to add to my recovery repertoire as mindful movement without goal. Exercise had been attractive, but its goals of weight loss, strength, distance or other measure became the focus, not the integration of body, mind and spirit. By contrast, yoga incorporated introspection, sensate movement, breath, and present-time awareness. And it broke me open. I felt feelings in a safe way with tools to knit myself back together – all in a single practice. I was using my body to get into my feelings and using my breath to heal my nervous system. I had found the holistic therapy for my holistic disease.
That’ll Do It
Be it providing assistance with managing a substance use disorder or a mood and anxiety situation, Chipur strives to bring you quality material.
If you’re visiting a site chatting mood disorders and anxiety disorders, I’m guessing drug and alcohol abuse isn’t unfamiliar subject matter. Chipur friend Cathy Taughinbaugh has a sweet ebook waiting for you. I think you’ll find it inspirational, so I’m bringing you the scoop…
It has been my privilege to interview all 28 of these amazing people, to listen to their experiences, their advice and their hopes for the future. What I’ve learned is that we are all in this together and together we can make a difference.
Cathy started her website, CathyTaughinbaugh.com, five years ago. Her motivation? Well, it was to share her experience with the substance use of two of her children.
Initially, blogging was a form of therapy for Cathy. Yeah, but then she bumped into others who shared her concerns, including groups of parents, many of whom had an online presence of their own.
Bottom-line: Cathy shared the passion of parents who were concerned about their children’s health and safety. So her online mission soared beyond her therapy needs to making a difference in the lives of others.
Along the way, Cathy earned credentials in parent coaching, life coaching, and life and recovery coaching. Add that to her bachelor’s in psychology and a teaching credential and you end up with a resourceful – powerful – helping professional. She lives and works in Contra Costa County, CA.
Catch these thoughts from Cathy…
Many young lives are being derailed by drug and alcohol use. Too many are not living up to all they can be because they are falling into the trap of numbing themselves with alcohol or drugs.
This situation is never what any parent expected or intended. They enter unchartered waters, not prepared for what lies ahead when their child begins using drugs and alcohol, sometimes to spiral out of control. Fear takes over and parents are often left struggling for months or even years to make sense of it all.
Parents to Ph.Ds: 28 interviews with people who share heartache, wisdom and healing from first-hand experience with substance use disorder
In her effort to assist anyone somehow involved with substance use disorder, Cathy presents an inspirational ebook containing 28 interviews with folks who know it first-hand.
A few names?
David Sheff, author of the New York Times best-seller Clean: Overcoming Addiction and Ending America’s Greatest Tragedy, Christopher Kennedy Lawford, author, activist, actor, Tommy Rosen, yoga teacher and addiction recovery expert.
Cathy explains…
It has been my privilege to interview all 28 of these amazing people, to listen to their experiences, their advice and their hopes for the future. What I’ve learned is that we are all in this together and together we can make a difference.
Since every experience is different, I hope as you read these interviews you will come away with information that makes sense for your personal situation. You will read a variety of approaches from people who have been there and have in-depth knowledge about substance use disorder.
So what kind of info does Cathy bring our way? Well, the best way I know to get a feel for a book is to review its Table of Contents. Here are just 10 of Cathy’s interviews…
What Are the Recent Drug Trends That Could Be Enticing Your Child? | David Heckinlively
I’m thinkin’ you get the idea. Right? Cathy has gone to great lengths to interview folks who have a wonderful personal perspective on substance use disorder. Best part is, Cathy brings them to us because she truly cares and wants to foster understanding and growth.
Doggone sweet, if you ask me…
The Final Chapter
Chipur is a haven of sharing, learning, and healing for those in the midst of mood disorders and anxiety disorders. Fact of the matter is, problems with drugs and alcohol often come along for the ride. So Cathy’s ebook is a great fit here.
Parents to Ph.Ds is a worthy experience, folks. Cathy did a marvelous job. But that’s so typical of her heart – and hard work.
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