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  • Writer's pictureH. Paul Putman III, MD

Dys"Like": Problematic Social Media Use

Updated: Sep 2, 2021

Many people spend much of their lives developing and maintaining healthy interpersonal boundaries. In the age of social media, however, many of these boundaries have been forgotten or ignored. When members of younger generations (having not yet fully learned these boundaries and how to apply them) encounter social media, they can lack the tools to protect themselves emotionally. They may also not possess the knowledge of how easy it is to inflict serious harm on others.

Societies with intense social media use have normalized this to the point that intense use does not appear to be linked to mental health problems. In those countries with a low prevalence of intense use, though, it is linked to psychopathology.[1] Furthermore, problematic social media use is a more severe form of interaction. It can be distinguished from intense use by loss of control over, and preoccupation with, social media; the users’ mental wellbeing suffers when separated from it.[2]

The prevalence of problematic social media use in adolescents has been found to be a median of 6.71% across 29 countries studied,1 close to the median prevalence of alcohol or drug abuse or dependence and other behavioral addictions.[3] Authority figures, such as parents and those in education and business, must recognize the need for education and healthy limit setting to allow development of healthy habits and boundaries.[4] Daily use of these same limits keeps parents, teachers and managers intact themselves and able to serve as effective role models.

You would never send your 15-year-old daughter to bed with a fifth of vodka or hand your car keys to your 11-year-old son without any training or supervision. They need to learn what is safe, what is not, what is healthy, what is unhealthy, and what to do when problems arise. Similarly, those in authority must learn what is healthy and teach it, including by example. For example, parents are more successful when they don’t just nag their children to read, but discuss reading, read with them and let them observe their own enjoyment in reading. Neglecting to set limits over social media use, such as limits on screen time, moratoria during meals and other family times, and clear and enforced curfews can similarly set loved ones up for danger. Boundaries for any use must be established, monitored, reinforced and adhered to by everyone.

Familiarity with current social media venues and the content on them is also essential. One of my patients, a father, once complained to me that his young adult daughter must not care about or love him very much because she never answered his calls or responded to his voice messages. I suggested that her age group largely ignored voice communication and suggested he try sending her a text. The next week he arrived for his appointment with a huge grin, informing me that his daughter was thrilled to hear from him and that they were now communicating regularly – by her preferred mode. Many parents monitor the types of books their children read, the games they play and the programs they watch – this same familiarity is just as important for social media, even if the authority figures don’t always use it themselves. Knowing what is available can lead to more effective monitoring and open discussions about managing content, use and boundaries.

At the very least, you and your family members can start by turning off sound and vibration for notifications, or even notifications in general – that way, you only look at your phone or watch when you want to, not when someone else wants you to. Save the notifications for truly urgent messages.

There are reports of successful treatment of problematic social media use with cognitive behavioral therapy (CBT) and motivational interviewing, along with the introduction of periodic abstinences.[5],[6]

As with most problems, however, it is a lot easier and less destructive to actively avoid the development of a problem than to attempt to reverse it. Awareness, engagement, involvement and self-monitoring are important preventative tools.

[1] Adolescents' Intense and Problematic Social Media Use and Their Well-Being in 29 Countries. Boer, Maartje et al. Journal of Adolescent Health, Volume 66, Issue 6, S89 - S99 1054-139X/ 2020 The Author(s). Published by Elsevier Inc. on behalf of Society for Adolescent Health and Medicine. This is an open access article under the CC BY license ( [2] Marino, C. (2018). Quality of social-media use may matter more than frequency of use for adolescents’ depression. Clinical Psychological Science, 6(4), 455. [3] Merikangas KR, Nakamura EF, Kessler RC. Epidemiology of mental disorders in children and adolescents. Dialogues Clin Neurosci. 2009;11(1):7-20. doi:10.31887/DCNS.2009.11.1/krmerikangas [4] Andreassen, C.S. Online Social Network Site Addiction: A Comprehensive Review. Curr Addict Rep 2, 175–184 (2015). [5] Zhou, X., Rau, PL.P., Yang, CL. et al. Cognitive Behavioral Therapy-Based Short-Term Abstinence Intervention for Problematic Social Media Use: Improved Well-Being and Underlying Mechanisms. Psychiatr Q (2020). [6] Miller WR, Rollnick S. Motivational interviewing: preparing people to change. 3rd ed. New York: Guildford Press; 2012.


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