As I have been live-tweeting this session, not surprisingly, I've been asked to talk about social media for wellness. So, why are we talking about social media for wellness? Is social media a friend or a foe when it comes to our mental health? You guys probably read a whole bunch in the literature about how it's associated with a slew of negative impacts. So, what potential impacts could there be? Well, there are a number of studies that actually look at this. So, a review of nine different meta-analyses looking at social media and mental health showed mixed positive and negative effects. They did find that active social media use, active means that you are engaging, you're posting, you're replying, you're commenting, whereas passive use is just scrolling, consuming information without contributing to it. So, they did find that active social media use was associated with higher well-being. That passive social media use was also associated with social comparisons, where you're looking at other people on social media and saying like, oh, their life is so much better, they're so much more accomplished, they're so much prettier, they have so much more, you know, the whole grass is greener on the other side thing. And those people actually had social media use associated with lower well-being. And they also found that more intense social media use was associated with a lower well-being. Now, mental illness, patients with mental illness actually report a number of positive benefits from social media use. They say that they experience a feeling of greater social connectedness, that they feel like they belong to a group, that they enjoy the ability to share personal stories and coping strategies. There was a online survey that looked at the role of social media use and burnout, specifically with social comparison, like I mentioned before. And they found that there was a significant positive correlation between social media use and burnout, but that that was moderated by social comparison. So, what that meant is that burnout was more likely in people who had a strong addiction to social media, but specifically those with an inclination towards social comparison. And then here we have another study that shows that routine social media use is actually associated with positive social well-being, with positive mental health, and with positive self-rated health. However, that study did find that an emotional connection to social media, so like if you feel disconnected from the world, if you're not plugged in, you have a fear of missing out if you're not on your device right then. If you have that emotional connection to social media, those were associated negatively with those same impacts. So now that we've confounded things even further, what are some potential cons to social media use? Well, oh, cons. Okay, it can detract from other important things. If you spend too much time on social media, it can detract from your obligations at work, towards your family, from your own self-care, and also maybe from other experiences or things that you'd want to spend your time on that are important to you. Those social comparison with others online can lead to feelings of inadequacy. Negative interactions with trolls, argumentative people online, et cetera, can be harmful to your well-being. It can promote fake news, misinformation, disinformation. If you attended this session yesterday afternoon on that, it was absolutely fantastic. If not, you'll find the live tweet in my feed. It can increase feelings of loneliness. It can encourage antisocial behavior. Instead of spending time with people in person, you spend your time scrolling. It can be disruptive toward your sleep. As a lot of you guys might be pulmonologists as well, I'm sure you have some sleep training and know that blue light and device use before bed is not so great for your melatonin release. And it can also contribute to anxiety and depression. So that's a lot of bad stuff. What about the pros? Well, social media can help to raise awareness for important causes. It can help you to join with others to fight important fights. It can normalize seeking help when you need it. It gives you the ability to interact with other people and to form connections with them. It can also combat loneliness through doing that, but it is important to note that studies do show that it requires face-to-face contact with people in order to trigger release of stress-relieving hormones. So while you can develop these relationships and it can combat loneliness, it is still important to have face-to-face contact with people as well. You can communicate with loved ones, friends, family that are further away, help strengthen your existing relations with people you don't see regularly. You can seek or give emotional support. You can find social connections despite barriers. People who belong to socially marginalized groups, live in underserved areas, et cetera, may have trouble finding people locally that they connect with. And so it gives them a wider audience to find meaning in those social connections. It can provide an outlet for your self-expression. It promotes information sharing, not all of it good. It does give you an increased access to different resources. It can help you share and sharpen your skills, whether those are educational, communicative, graphic design, whatever your passion is. It can inspire healthy lifestyle changes if you're following people who are promoting those things. And it can even help you build community by joining in local meetups, like that meetup group. Those are actually technically social media sites. So it can actually help you develop things in line and in person. So we are here talking about wellness and burnout. There are actually a number of studies that look at potential positive effects of social media use, specifically for burnout. So Demarudi and colleagues found that social media can actually reduce an employee's work pressure. Nabi and colleagues found that social support through social media can reduce emotional exhaustion, one of those domains of burnout. MachBell found that social media can reduce stress from work conflicts. Schutten and colleagues found that social media can increase interaction between colleagues and thus can reduce alienation at work. And Valkenburg and colleagues found that Facebook specifically increased the sense of work participation and the sense of accomplishment of people in their study. So these are some potential warning signs that you might actually be developing an unhealthy relationship with social media and things to look out for that could potentially worsen your mental health. So if you're spending more time on social media than engaging in in-person relationships, if you're comparing yourself unfavorably with others on social media, if you're experiencing cyber bully and interacting with those people, if you find yourself distracted at school or work by social media, if you're having no time for self-reflection because all that time is scrolling, if you're engaging in risky behavior to gain reactions online, posting things that may be viewed as unprofessional, violating HIPAA, et cetera, if you're having sleep problems or if you have worsening anxiety or depression, those are all things to go, wait, stop, is this doing more harm than more good? So these are some strategies for success, things that you can do to help set yourself up to maximize the positive benefits of social media and minimize those negative effects. So you can set time limitations on your social media use. If you have 10 minutes, that's it. You can avoid social media in the morning. Try to put your phone in another room. So the first thing you do when you're sitting on the pod is not pick up Twitter and instead say, I don't touch Twitter or social media until noon or something like that. And then just completely avoid it at night. Set an alarm. I have an alarm set on my phone with the newest iPhone update that has my bedtime set and 45 minutes before bedtime, it gives a little ding ding and my screen brightness goes down and it says, you need to be focusing and relaxing and preparing for bed now. And that reminds me, no more social media. Seek out other kinds of fun. So this is something that I love where I add other apps to my phone that are things other than Twitter. So when I'm walking, I don't just naturally pick up Twitter. If I'm bored in the line, I don't just naturally pick up social media. Instead I go, oh, look at these other things on my phone. Big, big fan of Libby. I'm a big fan of the Kindle app. I read constantly. So if you ever see me not looking both ways, I'm probably in the middle of a book crossing the street. There's games like Heads Up and things that when I'm in line with a friend, instead of just getting there on Twitter, I'm playing games with my friend and engaging with people face to face. You want to be intentional with your social media use. Focus on being active rather than passive, as we discussed earlier. You want to minimize social comparison. If you find yourself comparing yourself to others, it's probably time to back off your use. Adopting an attitude of gratitude is shown in study after study after study to have positive effects on so many different outcomes. You want to curate your content. Liberal, liberal use of those block and mute buttons is highly recommended. I felt really guilty about that for a while. But if someone is contributing negatively to your mental health, then they're not someone you need to be interacting with in person or online. Make sure you're spending more time with your offline friends. Make sure you understand what's happening in your brain. So understand how your fundamental psychological needs like autonomy, relatedness, et cetera, how those are being affected by your time on social media. Get curious about your behavior. Why am I doing this? Why am I posting this? What am I gaining from this? How do I feel when I'm logging on, logging off? Take stock of how your feeds make you feel. If you're getting frustrated, sad, angry while you're looking at things, then you're probably not curating your content. But if you're going, oh, we're fuzzies, then that's a good thing. In terms of doing that, for instance, I follow a whole bunch of pet accounts. Red Pan every hour, Otter every hour, et cetera. So every hour I get all of these different animals that pop up in my feeds. I follow a lot of accounts that have lots of dogs, cats, focus on wellness, communication, the things that are important to me so that when I am on social media, I by and large see things that leave me with a positive aftertaste instead of a negative one. You wanna work on your offline well-being just as much as your online well-being. You wanna live in the moment. This is something I struggle with. So enjoying the food instead of just snapping pictures of it. It's fine to take pictures. It's fine to post online. But if you're ignoring the experience of the moment because you're so focused on what's going on online, that's a negative thing. Make sure you take a break every once in a while. I will often give up something for a lint. Maybe say for this weekend, I'm gonna disconnect. I'm gonna go on this camping trip for five days. I'm not gonna look at my phone even if I have reception. Take breaks from social media. And then you can even consider, especially if you're struggling, starting over or stepping away completely. Starting over may look at deleting the app, starting a new profile, going through your follower list and other people that you follow and deleting people that don't contribute positively to your feed, et cetera. And then you can even do other steps like taking the Twitter app or the Facebook app off of your phone. And then, so if you wanna get on Instagram, you wanna get on Twitter, you have to actually log onto a PC. So doing things like that can also help to minimize your use and make sure it's more productive when you are on there. So what about my personal experience? Because social media and its pros and cons are obviously pretty divergent depending on the person and their experiences. Like many of you guys, or at least the older ones in the audience, I joined Facebook way back when it was the hot thing to do in 2005. At first, I found that it was a great place to connect with friends and family, to post pictures, to stay in touch with people from college. And over time, I found that my feed became more of a social comparison feed. Everyone was just posting the positive in their life and then more political, more inundated with multi-level marketing companies. And eventually I realized I wasn't having a good feeling when I got off Facebook. So while I still have a Facebook account, I'm on there very rarely except to engage in certain Facebook groups like the one for my local animal rescue and things like that. I did try Instagram and Snapchat, but it turns out my 40-year-old brain is just too darn old to understand how those work, so I gave up on those. So I actually found my social media home on Twitter. Initially, I used Twitter just to live tweet at conferences. And then over time, I started posting more personal experiences and personal anecdotes along with that medical content. And as my followers grew, I found smaller communities that I had shared interests with like social, like medical education Twitter, like dog Twitter, Peloton Med Twitter, book Twitter, and even Swifty Taylor, Taylor Swift's Twitter, which I'm a little bit embarrassed about, but yes, I am a Swifty. So why do I stay on social media? Why am I up here talking about social media? Because I do feel like it has positive effects on my mental health. Some of those things are that I'm able to engage with shared interests like animals, like medicine, like Taylor Swift. Some of those things are the connections and the relationships that I have developed with people that I'm able to engage with and strengthen online. Deanna and I have been friends online for a very long time through Peloton Med Twitter, and we actually ended up, even though we never met, co-running the Peloton Med account, and I literally just met her like two nights ago for the first time in person, but I felt like I'd known her for years because of the relationships that we develop online. Those can be just as real as the ones that you know in person. Research and programs. I have joined with friends and colleagues that I've met online to do projects and research in person, and just through email. I've actually published on social media with people I met on social media. And then social support. My Twitter online community has helped me through difficult breakups, personal health scares, loss of pets, and even a terrifying night when my 14-year-old sister was lost. So I have found it to be a very beneficial thing overall in my life. But what are some of the negatives, things I struggle with? Well, the first is doom scrolling. Sitting there just scrolling, scrolling, scrolling, the world sucks, the world sucks, COVID, murder hornets, elections, everything. And I find myself getting deeper and deeper into that dark, dark hole. So ways that I deal with that are to limit my time on social media, to make sure that I'm engaging active rather than passively. I spend very little time actually scrolling my feed. I spend more time posting things and then engaging with people on what I do see, and then responding to comments, things like that. And then having those other apps on my phone to distract myself from only the social media apps. And then trolls. I am all for positive engagement and meaningful discussions. And I mean, I was a debater in college, I'll get into it with anyone. But the negative just, I'm going to attack you with misinformation, disinformation and tell you that you're a horrible person because even though you were wearing a mask the rest of the conference, you took it off to give a talk and so you must not care about immunocompromised patients at all. Like I literally will get those comments when this talk goes online. So what I deal with those people is I say, that's not worth it. It's not worth my time, right? Someone who says, hey, why aren't you wearing a mask? And I say, actually I was, I took it off for this presentation or because it's a personal choice I've made and my risk reduction and then no longer attacks me, I'm happy to engage with those people. But if you're just out to attack, to be negative, to minimize, and even if you're not attacking me, but I find that your content is very negative, is anti-science, is leaving me with a negative aftertaste, I block, I mute liberally. You used to feel bad about it, I don't know. Because if I would not spend my time with you in person because of the impact you have on my life, I shouldn't spend my time with you online either. So I feel like you have the confidence and the ability to block liberally. So here are some references from the things that we just talked about.

social media

mental health

wellness

positive effects

negative effects