As we maintain social distancing guidelines and our relationships have become more remote, many of us are using social media more and more to feel connected to the world outside of homes. One study showed social media engagement increasing 61% since the pandemic's start. Social media can, like any tool, cause great good and great harm, and one of the risks with increased social media usage is social media addiction.

Dr. Kaz Nelson is a practicing psychiatrist with the University of Minnesota and M Health Fairview and an associate professor and vice chair for education in the Department of Psychiatry and Behavioral Sciences at the U of M. Her clinical interests focus on severe personality disorders, suicide, and psychotherapeutic communication with patients in acute settings. You can find her and her work on Twitter here. Nelson joined The Current's Jill Riley to discuss social media addiction, from how it works in our brains to what signs to look for when identifying any kind of addiction.

Listen to the interview above, and read a transcript of the complete conversation below. Every Wednesday at 8:30 CDT, Morning Show host Jill Riley connects with experts and local personalities for some real talk about keeping our minds and bodies healthy -- from staying safe in the music scene, to exercising during a pandemic, to voting and civic engagement. Looking for more resources and support? Visit our friends at Call to Mind, MPR's initiative to foster new conversations about mental health.

Dr. Nelson, thank you for joining me.

My pleasure, thank you so much for featuring this important topic.

You know, it is an important topic, and I feel like it's really timely for a number of reasons right now, but I will tell you that I just watched that movie, that documentary The Social Dilemma on Netflix. And to tell you the truth — I mean, it covers a lot about issues with tech and social media, but it really did get me thinking about just the idea of social media addiction. And I wonder, Dr. Nelson, I know this is kind of a really basic place to start, but, you know, as a professional, as a psychiatrist, could you just give a definition of the word "addiction"?

Absolutely. When we think about addiction generally, often we think of things like drugs or alcohol addiction. But people have noted over time that behaviors can actually seem or feel addictive. But when we think of addiction generally, we think of it as a very complex condition, a brain disease actually that's manifested by compulsive use despite harmful consequences.

For those of us who are having more discussions about what addiction is, what it looks like, I think it's easier maybe to wrap our heads around, you know, substance use disorder and have that conversation. But really when you talk about the behaviors, so, let's say that I'm on my social media account, and I've posted a picture of my new haircut, and then I look back and I have 50 likes. I'm just gonna use myself as an example there, that makes me feel really good to see all of those likes. I mean, what is happening in my brain at that moment?

Well, this kind of usage of social media falls in a category with other things that humans like to do that bring pleasure potentially. Eating food, sexual behavior, social relationships, all of those things are pleasurable and enjoyable. And each time we engage with something that's pleasurable like that, a little bit of dopamine, the pleasure molecule in the brain, is released and reinforces us, rewards us for engaging in those behaviors because they feel good.

Now when it comes to social media, how do we compare that to, you know, just something like eating?

What we need to understand is that our early ancestors really relied on one another, relied on social relationships within our tribes in order to survive. And so, we as human beings have evolved this sensitivity to social connection, a sensitivity to social relationships, because our ancestors would have died if they did not have close social bonds. And so, this is something that even today our brains note as being very important and ascribe a little bit of reward when we engage in pro-social behaviors. When we get those likes, our brain sees that as very important.

I'm talking with Dr. Kaz Nelson. Dr. Nelson is a psychiatrist with the University of Minnesota Medical School and M Health Fairview. So when it comes to, you know, lighting up that pleasure center in our brain, whether it's through, you know, substances or food or shopping or, you know, getting that like or needing to check in with social media. I mean, when does it go from a normal response to something that's a concern?

Everyone wants to know, where is that line?

Right.

Where is that line between healthy and unhealthy engagement in any kind of behavior? Well, we take our lessons on that from the field of substance use or substance abuse. And how we would really describe some of the consequences that somebody might note, where some of the consequences outweigh the benefits. There's actually four things we look for. One would be impaired control. Maybe the craving to go online or the craving to engage in shopping is so strong that even though you're trying to cut down or desire to cut down or want to use the internet less, you fail and just feel totally out of control of the behavior.

Another thing we look for is social problems or problems meeting goals. So, maybe you miss completing major tasks at work or school or at home, or other activities that you enjoy, other hobbies that you enjoy are then sacrificed.

Risky use! Are you using this in a way that is illegal or damaging in some way or costing a lot of money or having other consequences?

And then there's also this very interesting effect when it comes to addictive behaviors and that's this phenomena of tolerance or withdrawal, where you need larger and larger amounts of time or engagement or a higher number of likes on that haircut post to get the same affect or the same reward. Or these withdrawal symptoms where you feel sick or unwell when you're not engaging. If you've ever, you know, left your phone on the counter when you go to the bathroom, and you feel, "Oh darn! I forgot my phone! I won't be able to browse my social media posts when I'm using the restroom," and you just feel sick that you left the phone on the counter, that's a sign of a withdrawal symptom.

And so, Dr. Nelson, I wonder, you know, there are probably folks maybe checking a couple boxes as they're listening to us, or perhaps not, but I think if you have checked a couple boxes, what are some solutions or what are some helpful tips for anyone who's thinking, "okay yeah, I might be overindulging, I think that I may be addicted to my smartphone and social media"?

That's such a good question, and we actually lack guidance right now as a country and as a field of mental health. Social media use or addiction is not necessarily classified as a psychiatric or a mental health disorder in our country. And so we are really left as individuals to look at our behaviors, look at our goals, and whether the consequences are really getting in the way of us meeting our personal goals. And if that's the case, there are resources available. Often times seeing a counselor or a mental health therapist or talking to your primary care provider or psychiatrist about your concerns is a good place to start. Or, if you notice that you are trying to cut back, you watched The Social Dilemma and you heard this talk and you think, "maybe I'll cut back," and it's just impossible to do that, that could be a sign that the consequences are starting to rack up.

You know, at the start of our conversation, I just had you throw out a definition of the word "addiction," and as I've been listening to you, we're in agreement. Addiction is real. Pick your poison, basically, and social media can definitely go in there. Addiction can affect anyone of any walk of life, of any age. But when it comes to social media addiction, is it particularly concerning for young people?

We do see this type of addictive or overuse behavior in all walks of life, as you point out. Where we get concerned with young people is that the brain's still developing, and the stakes for engagement in social media feel very high for young people. So, people are still developing their identity. They're connecting with the world in more public and broad ways than ever before. And so, now, what used to be, you know, when we were young perhaps if something embarrassing happened at school, it sort of stayed at school, and we could move on from that and heal and mourn and feel embarrassed that it happened, but ultimately it would be behind us and we could move forward. Now, these types of events are public and often archived, and the stakes are just much higher. And so the impact for potential shame, guilt, embarrassment — very strong and very powerful emotions in the life of anyone but particularly of young people — it is leading to stress and strain and that can of course contribute to things like anxiety, depression, suicide thoughts.

So, I don't want you to get the message that I'm against social media at all. I think it's like food! Some people would consider it an essential tool, essential to wellbeing, essential to connection, particularly during this pandemic. But yes, there is this line where something that is a healthy and productive tool or really even for self-management or to even feel better, connect with others, there is a line where the consequences can outweigh those benefits, and it's important that we watch for that line.

Dr. Nelson, I appreciate your time this morning, you know, talking about the subject of addiction but social media addiction, and even just talking about this very subject during a global pandemic where we're connected, feeling closed off but we're connected and, you know, trying to find that line between what's real and what's fake, and I know that there are a lot of things that I'm wrapping in here that are probably alarms or concerning just about social media in general, but really the affect that it has on an individual human being and our brains, I think it's really important to note.

Absolutely.