How Does Social Media Affect Our Mental Health?

A compulsive need to know. The fear of missing out. Mindlessness or numbing out. The freedom to say hateful things under cover of anonymity.

According to Emily Hemendinger, licensed clinical social worker and certified public health practitioner, these are a few of the manifestations of social media use on our mental health. Hemendinger is a therapist in the Department of Psychiatry in the University of Colorado School of Medicine focusing on helping people with obsessive-compulsive disorders, eating disorders, anxiety and related mental health concerns.

‘OK to seek mental healthcare’

Hemendinger said the COVID-19 pandemic, when average social media use skyrocketed, caused a mental health crisis. “Somewhere in the last year, people started to realize, ‘Wow, we are not going to be OK after this.’ This is a cultural experience of trauma on a mass level, and we need to recognize that it’s OK to seek mental healthcare.”

Hemendinger hesitated when asked about body positivity. “I prefer body neutrality,” she said after a beat. “I think body positivity is a great idea, but I don’t feel like that’s a place we can live in all the time. There are going to be days where we don’t feel great about our bodies.”

For all the dangerous parts of social media, Hemendinger noted a few bright spots. Social media can help build community with like-minded people, stay in contact with distant friends and family, and grow social justice movements. “During the pandemic, one good use of social media was a way for people to feel less alone. We’re social beings.”

‘Social media is just a snapshot’

Relative to using social media responsibly, Hemendinger said, “Try to remember that social media is just a snapshot — it’s not real. Our differences make life beautiful, and these should be celebrated.”

If you or someone you know is having suicidal thoughts, please call the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK), or you can reach the Crisis Text Line by texting HELLO to 741-741. Both are free, confidential, and available 24/7.

Full transcript:

Shawna Matthews: Welcome to CU Anschutz 360, a podcast about the CU Anschutz Medical Campus, where we spotlight the interesting and innovative work being done by our faculty, staff and students. I'm Shawna Matthews, a special contributor to the Office of Communications. Just to note that I'm speaking in my personal capacity today and the views I'm going to express are my own.

Before I introduce my guest, as I'm sure you've heard, May is Mental Health Awareness Month. Just know that if you, or someone you know is having suicidal thoughts, please know that there are people who want to help you. You can call +1 800-273-8255. That's 1-800-273-TALK, or you can text 'Hello' to 741-741. Both are free, confidential, and available around the clock. The world is better with you in it.

With that said, my guest today is Emily Hemendinger. Emily is a licensed clinical social worker and certified public health practitioner. She's a therapist in the Department of Psychiatry at CU Anschutz, focused on helping people with obsessive compulsive disorders, eating disorders, anxiety, and related mental health concerns. She describes herself as a strong advocate for radical acceptance and love of self, mindful eating and movement and body neutrality. 

Emily, thank you so much for joining me.

Emily Hemendinger: Thank you so much for having me. I'm really excited to be here.

Shawna Matthews: Yeah, me too. Okay. So this is a podcast about social media, so I feel like we need to put our cards on the table. So do you use social media?

Emily Hemendinger: Yes I do. I have Facebook, Twitter, Instagram, Snapchat and LinkedIn, if you count that as social media.

Shawna Matthews: (Laughs) I think that one is kind of social media.

Emily Hemendinger: Yeah, sort of. I really don't use much other than Instagram, but I do Facebook to remember when people's birthdays are.

Shawna Matthews: Definitely. Are there any types of social media that you actively avoid?

Emily Hemendinger: I used to follow more celebrities or influencers, but in the past year or two, I just honestly didn't want to see that anymore. And so I really only follow accounts that are my friends, people I know, their pets. (Laughs) I follow Colorado Avalanche Information Center; that's a really good one, or just mental health accounts, but I try to avoid some of those more celebrities or influencers for sure.

Shawna Matthews: What about celebrity pets? Will you cross the line for celebrity pets?

Emily Hemendinger: I might just do that. (Laughs)

Shawna Matthews: (Laughs) Okay. I'm curious how you think that that's changed as social media is always ready with a constant flow of information, with a constant source of data points, if you will – things for us to compare ourselves to. So how do you think we've changed just with the constant stream of social media?

Emily Hemendinger: I mean, I think it's fascinating to compare with people in a way like, 'oh, when did you get it in your life' and see how that has had an effect on our society. I think we've changed in helpful – and not so helpful – ways. So, social media and that constant flow of information, I think it's really led our society to be pretty overstimulated and bombarded with information. And sometimes this information is toxic and unhelpful. Led a little bit to, at least I see this a lot with people I know, and some of my clients, shorter attention spans, difficulty being present, trying to multitask, being out to dinner and being on the phone, taking pictures, doing it for the Gram-type stuff.

So, instead of actually experiencing something. Something I've noticed too, is people really focusing on cultivating an image and their self-worth instead of focusing on who they actually are in real life. So, saying one thing on social media and not following through on it, or a lot of that performative activism. I think, as well, it's easier to feel bored.

Social media is a quick fix, whether it serves that boredom or not. But I think it's been beneficial because many years ago we weren't connected in the way we are now, and I think that's really helped some people feel not as alone and find their voice. And I think it's helped a lot of social justice movements gain traction. But overall, I do think it's caused changes in brain development, the way we process information and just how we relate to one another.

Shawna Matthews: Yeah, definitely. So it's interesting what you said about social media being a quick fix. So I'm curious if you think it's addictive.

Emily Hemendinger: Yes. I definitely think it can be. And there's research out there, too, that shows that it's addictive both psychologically and physically. To go into why maybe it's addictive, it can be almost like a behavioral addiction. For some it's like this soothing feeling of just checking and scrolling. What I see a lot with my clients, it's this compulsive need to know, or this overwhelming sense of dread or anxiety that comes along with not knowing or this fear of missing out. For some folks, it provides this false sense of connection. Others use it as a means of doing something mindless to disconnect, turn their brain off, avoid, numb out.

It can be viewed as similar to a substance addiction in some ways, in that there are mood changes, so using social media can lead to favorable mood changes or not-so-favorable mood changes. There can be a preoccupation with social media. There can be increasing use of social media over time, issues with relationships in your life because of social media use and even withdrawal symptoms.

Shawna Matthews: That's interesting. I hadn't heard that before, that you can actually, I mean, I felt it personally, but I didn't know that that was a commonly recognized thing.

Emily Hemendinger: Yeah, no, totally. That's why even if you think about cutting it out, sometimes going just cold turkey can be really hard because of those withdrawal symptoms – that anxiety that can come along with it because of whatever function it's serving for you.

And actually social media creates a dopamine surge, which feels great to us. It affects the same neural circuitry that gambling and drugs and alcohol affect. And so it creates that feeling of wanting to come back for more and more. And some research has shown that social media validation, things like likes, retweets, shares, comments – they affect the brain's reward system, the same way that drugs affect the brain's reward system.

So this creates a very positive reinforcing cycle, which leads to the addictive quality. And then also talking about ourselves gives us a surge of good chemicals that leads to pleasure and more positive reinforcement. So when we talk about ourselves on social media and get that positive reaction, that's just further reinforcement in that reward pathway, and it just goes on and on and on.

Shawna Matthews: That's really interesting that it creates this feed-forward loop that becomes almost impossible to break that cycle. So it affects our brain in this specific way, what can that lead to? What's the dark side of social media?

Emily Hemendinger: Yeah, definitely. There's definitely a dark side to social media. I think one thing we've all seen is that it can be a gathering place and rallying point for hate groups and a lot of toxic, hateful people. It's a way that others bully and harass people from the safety of being anonymous and behind a screen. It takes away that accountability and allows people to say things that they would never say in the real world because of the consequences of saying that.

Social media, posting something, or even just a blog can open you up to, you're being vulnerable, so it can open you up to a lot of harsh criticism and bullying. And obviously this is going to, can have, a devastating effect on someone's self-worth. It has a negative impact on self-worth, especially because of messages being put out there about dieting, nutrition, needing to look a certain way, having a certain appearance, certain ways people look being good, certain ways people look being bad.

I think those messages can affect the self-worth as well as some people might relate their self-worth to the number of likes or comments or whatever, seeking that external validation from others in the social media world. And that's so fleeting. It only provides that temporary feeling of being worthy and all this as well as comparison, it can lead to a lot of anxiety, depression, disordered eating, eating disorders, body image issues, self-harm, and sometimes even suicidal thinking. So I think all of this can really affect our self-esteem and then how we show up in the world, in school work and our relationships.

Shawna Matthews: That's really interesting because I think you got at two separate but related ideas there. Because I think you touched briefly on the photos and the videos that we're posting, what those actually look like. And so that would be just the appearance, whether we're modifying that through filters, body tuners, airbrushing, and then the other concept is ways that this content can actually change our behavior. Whether that's through 'fitspo,' or Fitness Inspiration, or 'thinspo,' Thinness Inspiration. 

So I guess starting with the first one with the way that our photos and videos look, how do we know what's real when there's photo and video editing tools at our fingertips? How do we know what's real and what is not a realistic viewpoint of the human body?

Emily Hemendinger: Yeah, that's a hard question because it's really hard to know. I think it's important to be critical of what's being posted on social media. Don't necessarily accept what you see as reality. We have to be responsible consumers of social media. And remember that social media is just one snapshot of someone's life. And we don't even know if that snapshot is actually what their life is like – the happy couple photo being posted; meanwhile, they were fighting right before that. Or the influencer who has that so-called body, but only has achieved that by certain positioning, like arching back and the camera angle and the lighting. It's really easy to get caught up in that, so we have to, again, be really responsible and remind ourselves that we're enough regardless of what we look like.

Shawna Matthews: Sure. So then getting to the other part about the hashtags on social media, like the 'fitspo' and the 'thinspo' that I mentioned. First of all, can you tell me the difference between those two? Because I'm not completely sure. And also how you feel that movements, for lack of a better word, like those can change our behaviors.

Emily Hemendinger: Fitspo is supposed to be inspiration for being super in-shape, having muscles, being toned, working out. Thinspo is all about being skinny and thin – very much about the thin ideal that our society has internalized. I'm all for being healthy and listening to our bodies and eating well.

However, these sorts of posts seem to really create that comparison that people struggle with, that leads to that anxiety and depression or eating disorders or disordered eating. I think some people can find inspiration in that. However, a lot of people see that, and they might fall into a spiral, a shame spiral and be like, 'I'm not doing enough,' or 'I need to be doing more' or 'a person's life is better than mine.' These sorts of things focus and place the emphasis on appearance being really important and false unattainable appearances being really important.

And I think we need to move towards finding validation and self-worth in activities beyond appearance and celebrating those activities versus more of that thinspo, fitspo, those sorts of movements or communities. Those can be so harmful and really create a lot of that comparison and competition and fuel a lot of shame.

Shawna Matthews: Yeah, it's interesting because I feel like things that started off trying to be inspirational can actually end up, like you said, just making us feel bad about ourselves, like we're not doing enough. We don't have the right tricks or tools or haven't subscribed to the right exercise plan in order to get this body that's being advertised.

Emily Hemendinger: Yeah. Totally.

Shawna Matthews: So, do you think social media is getting more responsible? Is it getting better at filtering out the bad stuff, like removing or flagging content that's hashtag thinspo?

Emily Hemendinger: Yes and no. I think it's much better than the MySpace days. The MySpace days there, I remember all sorts of groups and accounts like thinspiration and pro-ana pro-mia [pro-anorexia and pro-bulimia], where people were just posting very unhelpful things. And it was a place that fueled that community of eating disorders and secrecy and shame.

I'm glad now that we have the ability to flag things, and posts are being taken down. I think there needs to be more that's being done because there are still these social media crazes of measuring yourself against a piece of paper or using headphones to measure yourself and that meaning you succeeded or didn't succeed. And it goes back to really affecting one's self-worth. 

So there needs to be more (done). I don't know if it's some sort of filtering process, but it's moving in the right direction. I'm glad that they, a lot of times, if people search for certain things, they'll provide resources like a suicide hotline or links to the National Eating Disorder Association. So it's moving in the right direction. We still have a ways to go.

Shawna Matthews: For your clients, Emily, you work with people who have mental health disorders, obsessive-compulsive disorders, eating disorders. What do you tell them about social media?

Emily Hemendinger: It depends. I think where they're at typically, I tell them some of the stuff I've already said, that it's just a snapshot and even if they know that logically, it can still feel that it's so real. So I talk to them about self-compassion, and I haven't focused on the bigger picture and what they value. So we talk about moderation with social media, and then I talk to them about, especially if there are body image issues, you can have that, that perfect body or perfect face and still be miserable. 

So, is sitting there and comparing yourself to this person serving you and the life you want and your values, or is it impairing you? How much time are you spending on social media? And how are you feeling after you're using it? Are you feeling bad? Because if you're feeling bad, let's talk about ways to reduce it, or let's talk about what's going through your head.

Shawna Matthews: Yeah. That's really interesting. Like you said, if it's not serving you, then why would you keep engaging in that behavior? But like you said, it's addictive.

Emily Hemendinger: Yes. It's addictive for sure. And that's why that self-compassion piece is important of having people recognize it's not serving them. It's addictive and okay, 'what are you going to do about it'? Are you going to let it consume you, or are we going to take small steps to changing up your routine?

Shawna Matthews: Definitely. And I think having an action plan for that, which we can talk about in a little bit, but having an action plan when you pull out your phone and immediately go to open Instagram or Twitter or whatever it is, you have to have something to do to fill that void because otherwise you're going to feel like you're missing out on something.

Emily Hemendinger: Right. Exactly.

Shawna Matthews: So let's switch gears very quickly and talk about COVID, because I feel like this is a particularly strange and unprecedented time for a lot of people. So for me personally, I feel like the last year has completely changed how much social media I consume and not for the better. 

So our social media manager, Jewel – shout out to Jewel – flagged an NBC story from a few days ago where the National Eating Disorder Association reported more than a 50% increase in call volume to its helpline since we started the pandemic. And I think similar trends have been seen for the National Association of Anorexia Nervosa and Associated Disorders and other associations. So, do you think there's a correlation between more people seeking out help and the pandemic?

Emily Hemendinger: Absolutely. I think, across the board, people are seeking out mental health services, way more since the pandemic started and as it continued. And now that we're seeing people coming back into the world, there's a lot of social anxiety coming out and the demand for mental health care is extremely high. I imagine the rise in calls, and that increase is really related to all the uncertainty and unknowns and stress that came with a pandemic.

Specifically with eating disorders, they're a maladaptive coping skill used to manage feeling a loss of control, trying to manage difficult emotions or relationship issues. And so it's also a way people can try to create a false sense of security or safety. So the lack of safety people felt as well as trying to cope with emotions around disappointment, anger, grief, stress – all that has probably led to that increase in calls.

As well as, again, specifically with eating disorders at the beginning [of the pandemic], people were at home more, around food more. There were all these memes on social media about how much people are eating and the 'quarantine 15'. And some of those were really not great, especially with comparison and not being helpful for people's body image, but being around food more, people may have been more triggered or more prone to binges and then possibly purging.

Other folks might've had less access to their safe foods or foods that their eating disorder lets them eat. It might've been used, quarantine that is, as an excuse to not go to the grocery store or challenge themselves with restaurants. More boredom leads to increased social media use, which can lead to more comparing and falling into those shame spirals. Again, overall the pandemic, COVID, really has caused this mental health crisis where more and more people are seeking access to care.

Shawna Matthews: Emily, it also seems like the pandemic has, in some ways, at least, changed a little bit how we talk about seeking mental health. It seems like maybe people are becoming more willing to talk about the need for mental health care or resources to go to if you're struggling. Have you noticed that the conversation has changed at all during the pandemic? Maybe it's just the circles that I run in, but it definitely seems to be something that's talked about a lot more than it used to be.

Emily Hemendinger: Yeah. I would agree with that. I think there's definitely been a shift. (Joking) I think somewhere in the last year, people started to realize 'wow, we are not going to be okay after this.' (Laughs).

Shawna Matthews: (Laughs)

Emily Hemendinger: This is a cultural joint experience of trauma on a mass level. And we need to recognize that it's okay to seek mental health care and that this has had an effect on every single person because just like everyone has physical health, everyone has mental health. 

And just like we need to treat our physical health, we need to all treat our mental health, too, and get help with that. So I'm glad there's been a shift, and I'm really hoping that that sticks around and we can continue to decrease the stigma around getting help.

Shawna Matthews: Definitely. So now that we've thoroughly dragged social media's reputation through the mud, (laughs) are there any redeeming qualities about it? Are there any treasures among the rubble – so to speak?

Emily Hemendinger: I think social media, as I was saying before, it can be a really great way to build community. I think a lot of people find others on social media who understand them, that they may not have connected to otherwise. It's a good way to stay connected to people who might live far away or have really hectic lives.

Again, that connection piece is so important because we're social beings, and we thrive on connection. And so I think especially during the pandemic, it was a way that people could stay in touch. I think it's a way for people to not feel as alone. And it also is, as I mentioned before, a good way to plan and promote social justice movements, social events. But of course, all of this with a grain of salt. There are positive sides to it though, for sure.

Shawna Matthews: What do you think about body positivity and body inclusivity trends? Do you think that those are going in the right direction?

Emily Hemendinger: I'm all for both of those, especially body inclusivity. I think body positivity is great. I don't want to knock it or anything, I think it's a great thing.

I prefer body neutrality. Body positivity is a great idea, however, my personal philosophy is I don't believe that it's a place we can be in all the time. Realistically, there are going to be days where we don't feel great about our bodies, and body neutrality is about acknowledging that. And trying to deny that we're not going to always, trying to deny that we're going to feel poorly about our bodies, might not be authentic for others.

Body positivity can feel too great of a feat for some, especially if they hate their bodies, and it can lead to feelings of failure or feeling like something's wrong with them. So that's why I like body neutrality and getting to a place where you can respect your body or be grateful for what it's doing.

I think we're slowly moving in the right direction. We do have a ways to go. I mean, we're in a much better place with body inclusivity than we were even five years ago, and our society really still struggles to move away from that white-centered, ableist, cisgendered, thin ideal. And it's really important to have more inclusive representation for helping all of us feel neutral, grateful, and more at peace with our body.

And just a brief side note: someone who's actually doing really good work around advocating and educating around dismantling some of those structures that support unhealthy body and appearance standards is Sonya Renee Taylor. I'm not being paid to say that or anything (laughs), but she's brilliant. And I really encourage everyone to go read her book – The Body Is Not an Apology – or at least go check out that website of the same name because she's doing a lot of really groundbreaking and awesome work around radical self-love and working towards the idea that by loving ourselves, we can make social change for the better.

Shawna Matthews: That's really profound. I haven't really thought about it. The body neutrality thing that there are, no matter who you are or what you do, there are going to be days when you're not happy with your body. And I think that's a really powerful way of thinking about things.

Emily Hemendinger: It's not realistic, it can't be all or nothing, we can't be perfect at loving our body all the time.

Shawna Matthews: Well, it's like waking up and saying, as of today I'm going to work out for three hours every day. Going from zero to three hours a day in the gym. But instead of doing that, maybe you can make small changes and just be compassionate with yourself if you can't do it for a day.

Emily Hemendinger: Exactly.

Shawna Matthews: So we all use social media. How can we do it responsibly?

Emily Hemendinger: Great question. I think the first thing to do is take a moment and check in with yourself, take inventory of your social media use and habits. How much time are you spending on it? Is it getting in the way of your activities of daily living and self-care and hygiene? Is it getting in the way of your friendships, school, work?

Try to set time limits, even if it's just like, you need to only do slightly less. I know Instagram has that thing where you can set time limits, but most people I work with just ignore that. So I think even just trying to switch up a routine of when you're looking at social media can be a start. Again, it doesn't have to be all or nothing. You also want to check in with how certain accounts make you feel, like are you finding that you feel depressed about yourself or less than someone? Really look at, is this helpful or hurtful?

Try to follow accounts that are aligned with what you find important, what you value. And while people might know that social media is just a snapshot of someone's life, like I said before, it can feel real. And so it's important to take this inventory and unfollow or mute accounts that leave you feeling like meh. You can always re-follow or unmute them if you change your mind, but it really might be worth taking a break from certain accounts.

Shawna Matthews: I saw a term today that was identifying whether accounts you follow are bucket fillers or bucket dumpers. Whether you gain something from that interaction or whether you feel like you lose something from viewing whatever content. And I thought that was an interesting way of thinking about it.

Emily Hemendinger: Yeah. I really like that.

Shawna Matthews: I wish I could remember where I saw that.

Emily Hemendinger: Yeah, I'm going to use that as well. Thank you for sharing that.

Shawna Matthews: Sure. If I think of it, I'll link to it in the description for the podcast.

So if we're using social media, we're checking in and we're finding it to be damaging. Do you have any tips on, even if we can't break the cycle, interrupting the cycle, what can we do when we pull out our phones instead of going to Instagram?

Emily Hemendinger: Great question. I think again, just to go back to switching up routines. 

Like if you were reaching for your phone, when you first wake up – try to grab a book instead. Plugging your phone across the room, even if you use it for an alarm clock or try getting up out of bed. Try to make a challenge with a friend or partner that you aren't going to check your phone the whole time you're together.

This might sound silly, but I love using sticker charts even with adults and having a reward at the end of, if you go a certain amount of days or if you go a certain amount of hours without social media. Because again, it's all about those little clock ticks. Just one little movement at a time. Obviously, reaching out for support, friends, family, and therapy are always good to try to break that cycle.

If you're the type of person that always opens your phone, immediately goes on social media. Again, it's all about trying to break that habit. Click on a different app, text someone instead, or try to go to the notes app and write down 'oh, I really want to go on Facebook.' And at least get that out there.

Something that can also be helpful, and this goes for any sort of addictive behavior is what we call 'urge surfing' or 'postponing.' And so just like a wave, an urge has a crash, it gets really high and then it mellows out, the more time you have between the initial urge and wanting to act on that behavior.

So you could do something, I'll have people typically write a list of 10 things they could do intentionally, meaning for a decent amount of time, before acting on whatever urge it is. So it could be go for a walk, call a friend, play with your dog. And they have to go through all 10 of those things. And if at the end of all 10 of those things, they still want to go on social media or they still want to act on an eating disorder behavior or whatnot, okay, great. However, I'm not endorsing them to act on that. It's more, by the time you get through all 10 things, the likelihood is the urge, if it's still there, is going to be way less.

Shawna Matthews: Emily, those are all the questions I have for you. Is there any parting message you want to send to our listeners?

Emily Hemendinger: I think remembering that, what's the saying – comparison is the thief of all joy. And so we really need to, when you find yourself comparing, try to remember that all of our differences, we need to celebrate those because that's what makes life enjoyable and interesting and beautiful. So really just accepting who we are and celebrating our differences.

Shawna Matthews: Absolutely. Well, with that, I will just conclude this to our listeners by saying, check in on your mental health from time to time, find something that makes you happy. If you can't find something that makes you happy, there are options to help you and lots of ways that you can get help with things. So thank you so much, Emily. It was really wonderful talking to you today.

Emily Hemendinger: Thank you.

Disclaimer: Transcripts are generated using a combination of speech recognition software and human transcribers. It may contain minor differences from the audio, including some edits for clarity in print. Please check the recording and with the Communications team before quoting.