The Weekly Wellbeing Round-Up #13: digital wellbeing.

Any doctor reading this who had a pound for every patient who has uttered the words “I think I need an MOT, doc” would probably be reading this from the deck of their yacht, floating on the Mediterranean.  Usually when this is said, it’s in the context of a physical and sometimes interrelated mental health concern.   No one, however, has ever come into my consulting room and said they need an MOT for their digital wellbeing.   This doesn’t mean there is not a problem…it just means that they are not aware of it.  When a health professional asks questions about a person’s health, they will usually ask about things like physical and mental symptoms, smoking, alcohol, sleep, diet, work and social issues.  But how often do we think about our digital health?  The topic of my blog this week was prompted by the news that YouTube has created tools to help users manage their digital wellbeing.  Here is the official YouTube blog on this topic.  Users can now monitor how much time they spend watching YouTube, set reminders to take a break, reduce their notifications to once a day and disable notification sounds and vibrations.   So today I will be focussing on digital wellbeing – the scale of the challenge, the signs and symptoms of digital health problems and how to increase your wellbeing so you feel better as a result.

Is there really a problem?

Don’t get me wrong..digital technology, the internet, smartphones and social media can improve our lives significantly.  However,  when all of this stuff was invented, no one was sitting down thinking “we can do this, but should we?” or  “how should we use it best?”.  The genie is out of the bottle, and the times, they are a changin’.   In 1996, 16% of households owned a mobile phone.  In 2017 it was 95%.  95% of people between 16 and 34 years of age own a mobile phone, 51% up to the age of 64.   I got my first mobile in my twenties.  The average starting age of smartphone ownership is now 10.3 years.  We have other mobile devices now with software that also allows us to always be connected.  My household has five people in it and between us we own 5 mobile phones, two ipads, 5 laptops, a kindle, a desktop computer, two apple TV’s, a games console and various ipods.

“So what?”, I hear you ask.  The way we live is changing.  People have been predicting the end of the world as we know it on a regular basis since time immemorial.  Is this just another example of moral panic?  Sadly, I don’t think so.

In 2014, Ofcom reported that britons spend more time on screens than they do asleep.  When it comes to devices, the same report found that 6 year olds had the same level of knowledge about them as 45 year olds.  It’s not that hard to believe.  Over-reliance on devices has significant potential drawbacks including the effects upon our ability to maintain real life relationships, concentration levels, being present and  in touch with real world.  This article in the Independent in 2017 reports on the findings of  a study that the average briton touches their phone 10,000 times a year or 28 times a day.  That number may not seem particularly high but other studies claim that there are some groups of higher uses who touch their phone thousands of times a day.  Just think about the implications of that in terms of the time spent checking the phone for new updates and content, never mind the time spent reading some of them.

There is increasing evidence to suggest that activities done without a screen are generally associated with increased happiness and screen based activities are generally associated with decreased happiness.    More specifically, the case is being built for increased social media use being related to unhappiness, having consequences for us both personally and professionally.  A good friend of mine has worked in recruitment for various large companies over the years and has seen the consequences both in terms of its impact upon productivity and professionalism at work, and people’s inability to communicate properly when applying for jobs, struggling with simple things like eye contact and a handshake.

One of the most significant impacts on our wellbeing is how devices and being always-on, with the blurring of home and work life, affect our sleep.  This is a particular issue because the type of light (blue/white light) emitted by these screens disrupts out sleep by interfering the natural rise in levels of melatonin that normally occur as the day goes on and natural light diminishes.   The blurring of our boundaries between work and home also means that we find it harder to relax, dominated by the sympathetic nervous system (responsible for our fight-or-flight), at a time of day when our parasympathetic nervous system should be taking over and slowing things down.  A great quote from Dr Rangan Chatterjee, whose Feel Better Live More podcasts I heartily recommend, is that a sympathetic nervous system response for a short burst of adrenaline fuelled fight or flight activity was appropriate when a lion was trying to kill us but now “it’s our life that’s trying to kill us”.

Symptoms and signs of the problem

All identified disease have signs and symptoms.   Digital malaise is no different.   Like other diseases, having one or two of these might not necessarily indicate a person has a significant problem.  However, if they begin to add up, it’s a red flag.  These might include:

1.  Checking your device last thing at night and as soon as you are awake.
2. Cutting off a face to face conversation or any other form of social interaction with someone to check or answer your phone.
3. Repeatedly checking your phone in any gap in the day no matter how small (on the loo, in the advert breaks, when you get into the car, when the traffic lights are red etc, whilst waiting for the kettle to boil, the microwave to ping or the download to finish) and regardless of when you last checked it.
4. Feeling worried if you are separated from your phone.  You know where it is, but somehow it doesn’t feel right.  You list to one side when you walk because it isn’t in your pocket.  You start to wonder if your twitter following has grown in the five minutes since you last checked it, and are now concerned you cannot find this out instantly.  Note this is not the same as actually losing your phone.  My friend dropped his iphone on our bike ride the other day and we spent 15-20 mins calling it and then getting his family to Find My Iphone to locate it on the maps app and then ping it until we found it…..fair enough!
5. Falling behind with your work and personal deadlines but being bang up to date with having checked and responded to the lastest social media updates.   No point getting a snapchat streak and getting canned at the same time.
6. You get phantom vibrations.  We’ve all felt that sensation that makes us think we have a call or notification.  However, people who are addicted to their phones are more likely to feel this and check for it.
7. Checking and answering work emails at weekends/evenings.  Of course we’ve all done it, from time to time.  But do you do it regularly…and particularly late at night?
8. Meaning to go to bed/do that piece of work, but just finding yourself scrolling through social media for hours, disappearing down various side tracks and rabbit holes along the way.

Tips for improving your digital wellbeing…and the rest of your wellbeing as a result

1.  Do not have your phone by your bedside.  Charge it in another room or at least in the corner.  And before you protest…buy an alarm clock.  With red not blue light in the display.  Or an actual old fashioned clock.  Or get your fitbit/other quantifiable self type gadget to vibrate to wake you up.
2. If you can’t go cold turkey with your phone out of arms’ reach, then at least use the operating system’s do-not-disturb options to stop notifications after a certain time (e.g. 10pm to 7am) and if your phone has an option to cut out blue light (e.g. Nightmode on iOS) then use that in the evenings.  Ideally get into the habit of not using your phone for 1-2 hours before you want to be asleep.  I should point out that if you are considering option 2 because you couldn’t contemplate option 1, that’s a red flag and the reason why you should choose option 1.
3. Turn off notifications on your phone.  This means you will at least be making an active choice to check for updates, instead of having your phone ping/vibrate/display new updates constantly.   You can be selective and turn off notifications from certain apps if you wish.  I have done this and found it a huge release.   I know my wife or kids will ring or text me if it’s something really important.   The rest doesn’t matter and can wait until I’ve got some free time.  You will be less distracted and able to focus on other things like hitting that work deadline, or the conversation you are having with the person in front of you.
4. Speaking of the person in front of you, think very carefully before you ever interrupt a real life conversation to check or respond to something on your phone. Doing that says to that person that they are less important than someone or something virtual .  Would you turn your back on someone mid sentence?  Or break off to walk away and talk to someone else?  And before you protest that sometimes the message/update might be “very important”, let’s just think about that for a second.  Ask yourself the question “Am I a super hero with a secret identity who needs to look for a phone box to change in/a highly trained special forces operative/a member of the emergency services on call?”  If the answer to those questions is no then take a breath and get a grip.  Your family,  friends and work colleagues will appreciate this.   I apply this during most of my consultations, when I don’t answer the phone unless I am the emergency doctor.  It tells the patient that what they are saying to me is more important, and whoever’s ringing can try again later.
5. Think about whether you need to answer that work email.  There is a mistaken assumption that working long hours and answering emails even when you are on holiday or at home with your family that it makes you more productive and a better worker.  It’s not true.  You could consider turning on inbox rules.  For example, you could autoreply to all emails between 10pm and 7 am that you will deal with them the next working day.  Or more radically, auto delete all emails that arrive whilst you are on annual leave, with a response advising the sender who to contact if it is urgent and needs dealing with before you return.  If you are a boss, lead by example.  Think about the culture that you want to create within your organisation. If you need to, make a deliberate decision to get up early the next day rather than staying up late.  You will be better for a night’s sleep and it’s a conscious choice to do some focussed work, as opposed to just browsing your inbox.
6. If you really need help with self control, you can configure the wifi network in your house for time restricted access.  This can be device specific, using what’s called the MAC or wifi address for each device in question.  If your laptop or tablet can’t connect to the internet, it seriously limits some of your options.  More details on this in a future post about looking after our children’s digital wellbeing.
7.  Think about whether using certain social media platforms is to your benefit and makes you happy.  If you find yourself irritated by most of what you read, feel bad because people’s lives on Instagram look a lot better than yours, or end up getting into spats with people on a regular basis on your local Facebook Mum’s group, ask yourself the question whether this is really life enhancing and what purpose it actually serves.  Does it make you a better and happier person?  A better parent? A better employee?
8. Take a digital sabbatical.  Why not try a few days or a even a week without social media or reading your (non-urgent) emails?  Or 24 hours with your notifications turned off?  If you feel that’s too much, start with a shorter period of time.   You may start with suffering from FOMO (fear of missing out), but after you’ve got over that, it can be liberating.  You may like to consider Scroll Free September , launched by the Royal Society for Public Health.  Fear not, you don’t have to abandon all forms of social media if that’s a bit too drastic.  They have lots of options that you might like to consider.   I am taking up the Sleeping Dog (no social media after 6pm) and Social Butterfly (no use of social media at social events….just enjoy the moment) options.
9. Find other enjoyable stuff to do.  If you spend hours on a screen, just think about what else you might be able to do with that time.  Go for a walk, spend time with your kids, make that call you’ve been meaning to, read a book, listen to some music, cook a really nice meal, catch up with your friends, take up a new hobby.   I stopped reading the news every day a couple of months ago.  It’s always the same old depressing nonsense anyway and leaves me with a jaundiced view of humanity. Just listening to the today program for 5 mins in the morning  once or twice a week tells me all I need to know.  I have spent the time reading instead.  OK, and writing this blog.

If we all did some of these things we would find ourselves happier and healthier, more focussed and with better relationships.  If you have any tips for improving your digital wellbeing, they would be most welcome.  Please do share them in the comments section. If you would like to do some further thinking and listening, I recommend the TED Radio Hour Screen Time podcasts, part 1 and part 2.  Good, thought provoking stuff.

That’s it for this week.   Your comments on the blog would be really helpful.  If you like it, please share with other people…particularly anyone you know who might benefit from a digital detox!   Until next week, take care of yourself.