Recreational Screen Hours and Your Brain

In our last two posts (here and here), we discussed objective measurement of ADHD symptoms, and new and exciting tools being developed, both with and without technology. However, there is also a basic yet essential data point that potentially every doctor dealing with mental health problems, and certainly with ADHD, should collect from their patients. We’d like to call it RSH, for “recreational screen hours.”

In the same way that doctors collect data about smoking (packs per day has been a statistic for decades) and drinking, as well as other drugs, it’s essential for any medical professional dealing with mental health to ask how many hours of recreational screens people are “taking” each day. A “recreational screen” means screen time that you are not using for work or school. It’s time on TikTok, Instagram, YouTube, and gaming. It’s mindlessly scrolling or going down rabbit holes one link at a time.

Why is this important for mental health? Many people spend hours per day (in our practices, rarely less than three, and frequently six or more hours) on their recreational screens. If you do anything for hours per day, that will affect your thinking. If you train for a race several hours per day, you are going to approach the rest of your day with an athletic mindset: you’re going to think about your nutrition, your gait, etc. If you play music several hours per day, you’re going to think like a musician: you will think about your guitar fingering, hum tunes, etc. If you’re studying for a major exam several hours per day, the material will be something you think about even when you’re not studying.

One way to think about the basic function of your brain is that it’s the mediator between what you think, how you feel, what you do, and what happens in your environment. As such, everything that happens in your environment, and every time you take an action and there is a response in your environment, is an input that adaptively affects your brain’s output—your thoughts, emotions, and actions. In short, it’s fair to say that anything you do several hours per day inevitably shapes the way your brain works.

A basic tenet of neurobiology is that brain connections that get used a lot get stronger. Conversely, you lose what you don’t use. So let’s consider what gets stronger—and what you lose—with a lot of recreational screen hours.

On screens, you look at things you like. If you don’t like it, you swipe it away. What you stick with are things that are naturally entertaining to you. You don’t work to develop an interest—it’s all about what grabs your attention right away. Generally, what tends to grab people’s attention are short, energetic media tidbits filled with very attractive people, perfect lighting, and snappy dialogue. The pace is fast and the concepts are simple. The social media industry, which relies on advertising revenue based on how many clicks these types of “brain candy” get, feeds on this content.

This type of content looks real, but it isn’t. You might see a couple of people breaking into amazing dances coming out of an elevator or on any street. What you don’t see is the hours and hours and hours of practice, mistakes, makeup, costume designers, and lighting equipment that went into the little media bit. If you bother to think about it, you sort of know that it had to be there. But generally you look at the screen, see effortless perfect images, and believe.

So with hours and hours on screens, your brain gets very passive. If you like something, you stick with it—what you don’t like is instantly gone—and what you like is exciting and seems perfect. And it’s a world you don’t have to work for. As implied above, this type of content should be thought of as empty calories for your brain—“brain candy” or “cheap brain snacks." Just as it is very bad for your bodily health to consume a diet of snacks and candy all day, it is very bad for your brain to consume this screen time all day. Social media and other forms of screen time are like sugar for your brain. They are naturally sweet and instantly rewarding. In another post, we described the effects of dopamine in the reward pathway of your brain. Dopamine also does other important things, but in this context, each time you “consume” a little of this “brain candy,” a little dopamine gets released in that reward pathway. This is also exactly what consuming sugar or addictive drugs or engaging in addictive behaviors, like gambling, can do.

At a beautiful beach, why look at your phone?

Source: Cavan-Images/Shutterstock

Here’s the problem: We all live in the real world and your experience there will be best if you have a brain that is able to interact with it well. Just like if your body is out of shape, you may have trouble coping with physical challenges you encounter (i.e. you may be out of breath just from taking a short walk, or unable to carry your own suitcase), if your brain gets “out of shape” because it’s been consuming brain candy and brain snacks all day, it won’t be fit to deal with mental challenges in the real world. Just like your body needs exercise and a healthy diet to stay in shape for the real world, your brain needs a healthy diet of real-world experience and real-world mental challenges in order to stay in shape to deal with the real world. In the real world, your brain isn’t being passively entertained all the time: it has to deal with other people who aren’t saying clever quips, who don’t look instantly attractive, and who may not cooperate with what you want, and situations where you may have to work at keeping your attention focused for more than 30 seconds. In the real world, you can’t simply swipe tasks or responsibilities you don’t like away. If you’ve trained your brain with screens, it’s not really equipped to deal with the challenges and complexities of real life.

It’s like eating sugar all the time and then biting into an apple. The apple will taste very sour. You might think, "What’s wrong with this apple?" It’s not the apple, it’s your taste buds. They have been tuned so that they only deal with pure sugar. After being “stuck with” the apple, you might get discouraged, bored, and decide you just want to eat sugar. Similarly, after being on screens many hours per day, many people have a hard time dealing with reality. Reality does not release dopamine for them as much as it should. Their brains want to go back to the screens and get their easy “fix.” Over time, the reward circuit or their brain gets out of whack. At some point, even screens don’t make them feel good anymore. Several studies have now provided support for the notion that too much screen time contributes to anxiety and depression.

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So how much RSH per day is OK? That’s something that may take researchers a long time to figure out. But, we need to collect the data first. There was a time when doctors didn't ask about how much or frequently people smoked. Now, it's standard to ask about PPD (packs per day). We hope the same type of data collection by doctors will happen for recreational screen use. Like tobacco data, RSH data will lead to how many hours per day poses a mental health risk. As with tobacco, it is likely that those who benefit from the sale of this content will do what they can to muddy the waters and resist any promulgation of the knowledge that this is really bad for people, let alone that it should be discouraged by doctors or regulated by the government. And the relationship between screen time and poor mental health won’t be absolute: just like not everyone who smokes dies of lung cancer, not everyone who spends a lot of time on screens will develop symptoms of depression, anxiety, or ADHD. That said, the relationship is there, and for all of us there probably will be an RSH number that is “too much” for maintaining good mental health.

The key to getting off screens may be looking for rewards in real life. Real life can be wonderful, exciting, and rewarding—but it is also more challenging. It takes more work to activate the reward circuitry in your brain through real-life activity than it does by sitting and looking at brain candy on a screen. In real life, you need to develop interests and skills rather than be served entertainment—but those interests, skills, and the rewards you find with them will also be more real and lasting. You can obtain enormous rewards in the real world from participating in exercise, art, music, a career, and other accomplishments. And those rewards, unlike those from electronic entertainment, are sustainable. They are always yours and always obtainable—even without access to a screen or the internet.