Smartphone Use During Quarantine: Ways in which to keep it in Check

As you read this article, potentially on your smartphone, you may wonder if you may be overusing your smartphone during the radical shift in schedule that is this quarantine.  Keep in mind that, in the US, 41 states, 3 counties, 8 cities, the District of Columbia and Puerto Rico have enacted abrupt and extreme social distancing measures.  This amounts to approximately 310 million people being asked to stay and work at home, except for emergency needs.  Know that while the USA is waiting this out in their homes, so too are countries worldwide restricting the movement of people.  This may mean a lot of people with more free time, or at least some time to kill, now that the commute times have been reduced to getting up from the bed and walking to your home office.

What is likely to happen while we are sheltering in place?  While many of us have the best intentions to use this time to bond with our families at home, we still need to keep in touch with our work groups and our extended families who may live in other states or countries.  Additionally, more options are available for online learning, reading and video content options, including those with socializing elements, and they are getting more trendy as we hunker down.  While a smartphone can be a tremendous tool to allow us to venture virtually out of our houses and connect with distant family, it can also be emotionally isolating, physically harmful for us, and a disconnect to the family in house.

What most people don’t realize is the negative impact of excessive use of smartphones. When one has difficulty regulating the amount of time they spend on the phone or have negative consequences from use such as relationship strain, financial issues, accidents and loss of productivity, smart phone use becomes problematic or addictive.  One study suggested that the prevalence of problematic smartphone use is common (about 38%). During this shelter-in-place period, you might be tempted to spend the better part of the day on your smartphone, or quickly realize that what started as a “quick check” just ate up more time than you planned.

One common behavior seen with any dependence, including substances and devices, is that it becomes the first and last thing done each day.  When a smoker wakes up, there is a stimulus to use, as serotonin and dopamine deficiencies increase cravings and the brain triggers an action or a person goes through withdrawal.  Prior to going to bed, a smoker may take a cigarette to reduce withdrawal at night.  These behaviors are usually reflexive and outside of the realm of  conscious awareness.  Though they describe a pattern that is seen in dependence.

Does this apply to you?  Do you find yourself looking at your phone the moment you get up and just prior to calling it the night?  You are not alone.  One survey of 536 online respondents in 2017 found that nearly half of those surveyed checked their phones just after waking up and half checked their phones just before going to bed.

 

The World on Smartphones, the Brain’s Wiring and Where did all the time go?

Over the last twenty years, there has been an expansion of internet use around the world.  Some of this has been fueled by smartphones and increased availability of Wi-Fi and satellite coverage.  It is estimated that approximately half of the world’s population has access to a smartphone.  With increased access comes increased use.  With increased use comes increased dependence.

In his thought-provoking book, “The Shallows: What the internet is doing to our brains,”  Nicholas Carr outlines the neuroscience of technologies like the internet and smartphones and how they affect the neurotransmitters and neural maps in our brains.  Essentially, our brains incorporate smartphones as if they were an appendage of our bodies.  That harkens back to that sudden visceral feeling we get when we think we lost our phones.  Interesting research discussed in the book is how our attention spans and memory are altered with smartphone use.  Essentially, the internet, and smartphone use, is dumbing us down.

The problem with smartphone use is that it is insidious and can be hard to know when it has become too much – and even harder to limit.  According to research conducted by a senior living community provider Provision Living,  the average person spends approximately 5.4 hours on their smartphones each day, with millennials spending 5.7 hours a day.  Facebook and Instagram each took up about one hour daily.  While this is a substantial amount, people tend to underestimate their use.  When you put that time together, it makes up about 81 days a year, or about one and a half days a week on the phones.  Sure, some of the time may be work-related, but probably a lot less than you think.

 

Side Effects of Smart Phone Overuse

Here is a list of some of the known side effects of smart phone overuse:

Neck pain or “Text Neck”

Excessive use of smartphone can result in neck strain.  This occurs when the neck is flexed forward and there is rounding of the shoulders.  With normal posture, the neck supports the 10-12 pound weight of the head well.  Looking down at your smartphone flexes the neck and exerts a force on it that may be up to 60 pounds.  Since our smartphone use can be almost subconscious, we often don’t realize that we are forward flexed until we start noticing the neck tension and headaches.  The ongoing strain can eventually lead to degenerative disk disease and cause you increased pain issues and severe disability.

Other than generally spending less time on the phone, taking care to look at the phone for shorter durations, doing neck stretches, and keeping the phone at a higher viewing angle may reduce the strain.

Eye strain or “Computer vision syndrome”

Also referred to as “digital eye strain“, eye strain is associated with the excessive use of mobile phones and tablets. It generally causes the following problems:

• Blurred vision and eye fatigue
• Pain and discomfort due to looking at a digital screen for more than two hours
• Eye burning and itching from dry eye
• Frontal headaches

Eye strain and dry eye are worsened by a greater duration of smartphone use and a brighter intensity of light.

Distraction

Driving a car requires one’s full attention, and greater velocities require shorter reaction times for emergency stops.  The use of a phone while driving increases the chance of an accident 6 times more than driving while drunk.  Given the average person checks their phones once every 12 minutes, it isn’t unreasonable to predict that the brain would want to look at it anytime — even while driving.  But it’s a completely unreasonable behavior and anyone would agree.

Yet, it happens and it can be lethal.  The National Safety council reports that phone use, whether talking, texting or checking, leads to 1.6 million crashes each year.  That’s nearly one in every four car crashes, and one in ten that are fatal.  An estimated 3,500 people (and probably more) die from distracted driving in the United States each year.

And it isn’t just deaths from cars.  There is a growing list of sometimes bizarre, all of the times tragic, deaths caused by distraction from smartphone use.  Whether it is a person who falls to their death while taking a selfie or dies trying to rescue their phone, it begs the question:  was it worth it?

 

Sleep issues

Interrupted or Self-induced sleep deprivation.  Smartphone use can impact sleep in a number of ways.  The use of smartphone can reduce the duration of sleep and increase pre-sleep arousal, either from spending time binge-watching movies or checking social media in bed.  If the phone is not turned off or to silent mode, it can interrupt sleep with a chime, ring or buzz alert.    Even after you check the message and see that it wasn’t important – just an email about a coming discount at a store you only went to once – getting back to sleep is not always successful.  In one study, the majority (76.5%) of sleep disruptions that were caused by smartphones were outgoing message, while calls (21.7%) and Facebook checks (1.8%) occurred less commonly.  The interruptions were seen in 41% of subjects in the study period of month, amounting to at least one weekday in a four week period.  Those with frequent interruptions were also found to have less sleep duration and a higher  body mass index.

Insomnia.  Computer screens, TV screens and phone screens emit a greater degree of blue light.  Our brains take in environmental cues to sleep, including a decrease in ambient light.  These signals trigger the release of melatonin from our pineal gland, which prepares the body for the sleep state.  When we see the blue lights of a screen, the body is receiving the light which causes mixed signals and impairs the ability to sleep.  Just a simple behavioral change of turning the phones off thirty minutes before bedtime made a significant improvement of sleep quality and duration.

 

Mood alterations with increased risk of depression and loneliness

Multiple studies have shown a correlation between smartphone dependence and depressive symptoms and reports of loneliness.  This is particularly prevalent in cell phone dependence in adolescents.  It is likely that the overuse of smartphones leads to destabilization and development of poor coping skills and reduced resilience that provokes depression, anxiety, loneliness. As with other dependent states, an imbalance of neurotransmitters, gamma aminobutyric acid (GABA) and glutamate, is likely involved.

 

Exposure to radiofrequency (RF) radiation

The CDC does not report any definite evidence of cancer from smartphone.  However, smartphones give off radiofrequency radiation.  The International Agency for Research on Cancer (IARC) does classify RF radiation as a “possible human carcinogen!” (cancer-causing agent).  It is possible to mitigate the risk of this possible carcinogen by using a hand-free headset, airpods, or headphones, using the speaker of the phone, and turning the phone in airplane mode or placing the phone in another room while charging.

 

 

Strategies to Protect Yourself From Problematic Smartphone Use During the Quarantine

Anyone in their forties like me recalls the day that they bought their first smartphone.  I was in my early twenties and in my medical training.  Beside handy books for the white coat, many of us residents, interns and students used personal desktop assistants (PDA), which were aptly termed “peripheral brains.”  With the PDA, cellphone and a pager, we carried the devices to keep us informed and stay within-reach.  There was an immediate appeal to have an all-in-one device with a resource available at hand to review literature and link our curiosity to answers.

Now children are getting phones at an increasingly younger age.  In one European study in 2015, 46% of children between the ages of 9 and 16 had a smartphone.  As parents we are unwittingly enrolling our children in a research study on how the smartphones affect the developing brain.  It is becoming increasingly harder to unplug, in part because of increased convenience, but more so because of dependence.

The only time we can experience smartphone-free time (aside from powering down our devices!) is in locations where Wi-Fi service is unavailable, such as hiking or traveling – though I am amazed at many people I see toying with their phones even in remote areas.  In the year 2020, a child operating a device without Wi-Fi loses interest rapidly.   We are fast approaching a day when satellite internet access will be available in all reaches of the world – and people are working on this now.

During the current situation, there are even less options to distract yourself from using your smartphone.  Other than breaking it, locking it away, or going off the grid, here are some of the ways everyone can still enjoy the benefits of smartphone technology while limiting excessive, problematic use:

 

1. Set a daily time limit on the phone.

Time use can add up throughout the day.  A check every 12 minutes could be a set-up for checking sites, responding to other’s texts.  Most smartphones have a program that does a daily assessment of your use and calculates an average usage during a week.

Another way around counting your time is simply to change a behavior that you normally do.  For example, if you check your phone immediately when you wake up, use the bathroom, or fall asleep you could avoid that behavior.  This will likely cut down on the total time.  While it is hard to say an exact time of healthy smartphone use, it likely a “less is more” thing.

 

2.  Set aside the smartphone and other electronics for one days each week and set that as an example for all family members.

One important point is that children’s screen-time used is influenced by their parent’s use.  Techniques such as selecting one day a week without electronic devices, including smart phones, may be a welcome strategy for keeping overuse in check.  I have encouraged our family to do this once a week – I am calling it, somewhat ironically, “Sunday Funday.”  It is interesting to see how often topics of electronics and smartphones come up during the day.

 

3. Set up some daily time-out routines with phone use.

During this quarantine for COVID-19, there is much more time to fall into the use of a smartphone.  Setting up a routine, such as all the phones are switched off or to airplane mode by 8:00pm may prevent the time creep of evening use and sleep issues.

 

4. Practice Mindfulness. Know when you might need to limit.

One thing about human behavior is that it occurs below the level of conscious detection.  Yes your brain makes you do things that you don’t realize that you are doing. Although smartphone doesn’t seem to overlap with mindfulness, the use of this practice may help you by slowing down reflex decision-making to use or staying aware of the passing of time.

 

5.  Get outside and power down.

Aside from the (peculiar) behavior of using an outdoor smartphone app (e.g. Pokémon go), getting outside may provide a chance to power off your phone and connect to the present moment.  Smell the flowers, hear the birds chirp, and hear the wind.  Nature doesn’t know that there is a pandemic.

 

5. Refer to a number of applications that are designed to curb phone addiction.

There are a number of Apps available on Android and IPhone that can help regulate time and curb smartphone overuse.  Some of these include AppDetox  (free/android), Flipd (free/android/ios), Offtime (ios/android), ClearLock (paid/android), and QualityTime (free/android).

It’s always a slippery slope when using an app on your smartphone to modify your smartphone overuse.  It is always possible to turn off the alarm and just continue to use it.  Nevertheless, they may be beneficial in creating mindfulness of the behavior.

6.  Consider getting help if the above efforts don’t work.

Cognitive behavioral therapy (CBT) has a role in the treatment of forms of dependence, including smartphone addiction.  The idea of CBT is to increase one’s awareness of how emotions and thoughts shape an action that leads to the dependence and how to break that arc.  There are several online conferencing CBT sites available as well.

 

Summary

At least for the next three or four weeks, the United States and other countries will continue these strict social distancing measures, which result in a change in the usual schedule.  If it hadn’t been a problem already, it is likely that this adjustment might come with it increased smartphone use.  Besides increasing the risk of physical problems, problematic smartphone use can lead to disrupted sleep, increases in anxiety and depression and relationship problems, and increase distraction.  An awareness and attention to this problem can ensure that this time is one of growth and productivity.

 

Resources:

Proposed Diagnostic Criteria for Smartphone Addiction

Take the Nomophobia Test   Nomophobia  “No mobile phone phobia”

Screen Time and Children:  Advice regarding setting limits on screen time for children

Bank my cell website:  Informational Website regarding tools to manage overuse of smartphones

Nurturing the Resilient Spirit: Ways to Support Mental Wellness during the COVID-19 Quarantine