Social media and smartphones linked to depression in PHL children, adolescents — expert

Published November 7, 2019 2:47am

Social media and using smartphones often are one of the causes of depression in Pinoy children and
adolescents, according to child psychiatry expert Dr. Cornelio Banaag, Jr., based in The Medical City.

"Iyon blue light na yan [sa smartphone], iniinhibit ang production ng melatonin kaya di sila inaantok.
[Pag ginagamit mo ang phone], puyat ka lang, sleep deprived ka lang... that will lead to anxiety and
depression," Banaag said, in the report of Bernadette Reyes on State of the Nation with Jessica Soho.

Banaag observed that the first thing that children and adolescents do in the morning is to check their
phones.

"Para silang lumalangoy, nalulunod sa teknolohiya every morning. The first thing they do is check their
cellphone. Bago matulog, its their cellphone," he said.

According to data from the World Health Organization (WHO), 10 to 20 % of children and adolescents
experience mental disorders.

The WHO describes depression as a common mental disorder.

"At its worst, depression can lead to suicide," WHO said, in its fact sheet.

At present, there are some non-government organizations such as the Natasha Goulbourn Foundation
(NGF), that aim to help people cope with depression.

Jun Sy, the chairman of the NGF-Mindstrong Movement, noted that the country lacked experts who
could help young children diagnosed with depression.

"There are only 75 registered child psychiatrists in this country. It's now estimated 1 million
teenagers...have been diagnosed with having depression," he said.

Young Filipinos are in the midst of a mental health crisis

Philippine Daily Inquirer | November 05, 2019

After her European boyfriend breaks up with her, a 17-year-old girl falls into a suicidal depression, even
though they had never met in real life and the relationship existed purely online.

When his father takes away his cellphone and tablet, a 10-year-old boy is so distraught that he tries to
kill himself by drinking bleach.

A young girl has taken to cutting herself because, she says, “there is something imploding inside of me,
and I don’t know what it is, but when I cut myself it relieves that pain.”

After being hounded online for his supposed involvement in fraternity hazing, a student leader in a state
university hangs himself in his bedroom.

“There’s a mental health crisis going on,” says Dr. Cornelio Banaag Jr., speaking at a seminar for parents
and teachers organized by the Raya School.

A practicing psychiatrist, Banaag is professor emeritus at the University of the Philippines College of
Medicine and is widely acknowledged in the profession as the father of child psychiatry in the
Philippines.

“I have been in practice for over half a century—that’s how old I am—and I have never seen anything
like this,” he says.

“I’ve seen depression and anxiety but not to the degree that we have now. I’ve seen suicidal patients
but not to the extent that we see now. It worries me. There’s not a week that goes by when you don’t
hear about people cutting themselves, people so depressed that they threaten to kill themselves,
attempt to kill themselves or actually dying.”

Alarming statistics

Citing statistics from the World Health Organization, Banaag says an estimated 10 to 20 percent of
children and adolescents suffer from some form of mental health disorder.
The statistics on suicide are even more alarming.

A 2015 survey of Philippine high school students age 13 to 17 revealed that nearly 17 percent had
attempted suicide in the previous year, while 12 percent had thought about it.

Most vulnerable are the postmillennials, says Banaag, that generation of Filipinos born after 1994, the
oldest of whom are just on the threshold of adulthood.

“The question is, what happened to this generation?” he asks. “What makes them so different from
previous generations?”

The science is still developing, but it’s hard to get around the sharp spike in mental health issues after
the emergence of the smartphone and 24/7 connectivity.

Smartphones

Citing the American psychologist Jean Twenge’s much-quoted 2017 Atlantic magazine article, “Have
smartphones destroyed a generation?,” Banaag pointed to the Philippine correlates based on statistics,
studies and his own clinical experience.

“Smartphones came out in 2007,” he says.

“By 2010, mental health professionals all over the world began to see changes in the behavior of young
people. They’re meeting up less and less, they’re not eager to go out, they spend more and more time
on the internet and social media. After a bad exam, they don’t go out together to drink or hang out, they
go home to their smartphones.

“I’ve never seen a group of people so stressed,” he adds. “Have you ever heard a 5-year-old say, ‘I’m
stressed’? I have!”

The current generation are “digital natives” who grew up with smartphones and don’t remember a time
when there was no internet.

“In 2012 only 43 percent of our population was on the internet,” says Banaag.

“By 2018 it was 74 percent and in 2019 I’m sure it’s bigger than that. It cuts across ages, and economic
lines, but the biggest users are ages 10 to 19. They were born and raised in the digital era; gadgets are
not just tools for them but extensions of themselves. They’re always connected: 94 percent used the
internet in the previous four weeks, in contrast to 74 percent of the total population. For many of them,
virtual reality is more important than actual reality.”

These young Filipinos spend five or more hours a day online, checking their social networks, getting
information. They tend to sleep with their phones beside them.

Spending time online

Banaag observes a strong correlation between time spent online and mental health issues.

“There are more chances of having a high risk for depressive symptoms for those who spend more time
in social networking, on TV and the internet, than for those who are engaged in what we call ‘real life’
activities. People who interact with others, do sports and exercise, attend religious services, read print
media, talk, work have less chances of becoming lonely.”

Banaag hastens to add that it is not the technology itself that causes mental health issues, but how its
use changes our behavior patterns, leading to chronic stress.

Chronic stress actually rewires our brains, he says. The prefrontal cortex and the hippocampus—those
areas of the brain that control decision-making, planning, organizing, emotional regulation and impulse
control—actually shrink with chronic stress.

Meanwhile, the amygdala—the so-called “emotional brain”—enlarges.

Emotions

“That’s why when you’re stressed, panay emote,” he says. “Negative lagi. We are trapped by our
emotions because it’s the emotional brain that’s grown big. We cannot access our problem-solving
abilities because we’re driven by negative emotions. And maybe that’s the reason we have so many
people who cut themselves, get very anxious and want to die. They are trapped by their emotions.”

Stress is the major trigger for mental disorders, says Banaag.

“We need stress to perform well, but if the stress is excessive, we begin to experience the symptoms:
headaches, nightmares, loss of appetite, depression, anxiety, panic, breakdown and suicidal behavior.
Home, relationships, social media—these are the major sources of their stress. But when I ask my
patients where the stress is coming from, almost universally they say school is becoming very stressful.”

One student complained that the pace of schoolwork was “relentless.” Just to keep up, the student got
up at four or five so as not to be late, went for tutoring after school and worked on school projects until
two in the morning.

“I don’t have any time to practice what I’m learning,” he complained. “I don’t even have time to reflect
on what this is for.”

Guilt

Another student became suicidal after flunking three subjects. He was so racked with guilt because his
mother was a single parent and was working so hard to keep him in a good school. It was only after his
mother reassured him that he was more important to her than a passing grade that he began to feel
better.

Some schools are even dropping Physical Education to have more time for Science and Math, which
Banaag feels is a step in entirely the wrong direction.

“I love learning, but I think DepEd (Department of Education) needs to review what’s happening,” he
says.

Physical activity and exercise, getting enough sleep, connecting with others and embracing spirituality
are important factors for mental health, he adds.

Meanwhile, parents, teachers and counselors need to be alert when youngsters begin to exhibit the
warning signs of chronic stress: feeling sad, withdrawal for more than two weeks, sudden overwhelming
fear for no apparent reason, signs of bullying, out of control behavior, not eating, difficulty
concentrating, increased use of cigarettes or alcohol, suicidal talk and a preoccupation with death.

“We have to take these seriously unless they’re proven to be benign,” he says. Most mental health
disorders begin at age 14, but it takes as long as 10 years before they’re diagnosed.

The increase in mental health issues is also rapidly outpacing the expansion in mental health services.
While a number of private counseling services and suicide prevention hotlines have emerged in recent
years, the ratio of mental health professionals to the total population remains very low.

While it is increasingly common to see antidepressants and other psychiatric meds being prescribed for
young people, Banaag warns against relying solely on them.

“A good psychiatrist will think of meds only as an option, it’s really more talking. If people are depressed,
angry or manic, you can’t talk to them and they cannot think right. I always tell them, ‘[Meds] are not
going to solve your problem, but at least we can talk now, and maybe we can think of some solutions.’”

The hardest thing is to set limits on smartphone and internet use, which is best done early while the
child is still open.

Best approach

The best approach, he says, is collaborative: parents, educators and mental health professionals should
work together to detect problems early and nip them in the bud if possible.

“Gen Z is a very young generation needing to be understood and supported,” says Banaag. “They want
to change the world, but they want to do it their way. They don’t trust anybody else. We have to make
ourselves into people they can trust, people who can understand their struggle—then they can come to
us.”

With patience, empathy, understanding and unconditional support, it is possible to raise children to be
emotionally resilient so they can withstand the stresses of modern life.
“The only element they need is the fullest confidence that their parents love them and will be there for
them,” says Banaag.

“That their parents will set reasonable limits, help them deal with stresses and be around to help them
out if necessary. If we can do that while they’re very young, they grow up being confident about
themselves.

“If we can share that kind of relationship with our children, and the teachers are there, we are
inoculating them against a lot of the hazards and also preparing them for the changes they face.”