In the July 16, 2012 issue of Newsweek there was an article called “Is the Onslaught Making Us Crazy?” The article is about mounting evidence that the connected world—the world that drives us to obsession in the pursuit of constant Internet, mobile phone, Facebook-obsessesd Twitterosity—is slowly driving us insane. To quote the article:
“The current incarnation of the Internet–portable, social, accelerated, and all-persuasive–may be making us not just dumber or lonelier but more depressed and anxious, prone to obsessive-compulsive and attention-deficit disorders, even outright psychotic. Our digitized minds can scan like those of drug addicts, and normal people are breaking down in sad and seemingly new ways.”
Yes, I appreciate the irony you are reading this in an online blog. You should probably take my decision to even write this thing as evidence that I have already gone off the deep end and am paddling far from shore.
As I read this article, which described large amounts of recent academic research demonstrating the potentially serious negative impacts of excessive technology addiction including ADHD type behavior and a wealth of other miseries, I couldn’t help but be reminded of the funny dog character named Dug in Pixar’s movie “Up.” Dug wears a digitized collar that enables him to speak English.
Dug’s squirrel distraction reminds me exactly of what it is like for people who have spent way too much time in front of their iPads, iPhones, iMacs, iToilets or whatever iThing they derive life from. Their attention spans are like Dug’s: brief moments of intensity interrupted by countless squirrels. The result is a world of people who are constantly multi-tasking (talking to you, looking at their email, sending a text, walking, chewing gum, face-planting) instead of concentrating on the conversation or activity at hand. I am convinced this behavior is, in part, responsible for the increasing stress, anxiety and impatience that permeate the working world. “What? You can’t answer my inquiry immediately by Googling the answer and texting it to me before I finished asking the question? What they hell are you squandering all that extra time on? Look, a squirrel!”
The Newsweek article goes on to say, “This life of continuous connection has come to seem normal, but that’s not the same as saying that it’s healthy or sustainable, as technology—to paraphrase the old line about alcohol—becomes the cause of and solution to all of life’s problems.” Look, a squirrel!
According to the article, the average Americans stares at some form of screen 8 hours/day and the average person sends or receives 400 texts/month, four times the 2007 number; if you’re a teen it’s 3700 texts/month (accidental upside: perhaps this will reduce smoking among kids since they need both hands to text). There is even a new malady known as “phantom-vibration syndrome,” which occurs when you think you feel something in your pocket vibrating (hopefully a phone and not something untoward) but really no one is calling. I’m not sure if this syndrome made it into the new ICD-10, but other codes for injuries that can occur while typing/texting did. See codes Y93C1, Activity, computer keyboarding and Y93C9, Activity, other involving computer technology and electronic devices. No doubt the whole reason for the three (!) different ICD-10 codes involving running into lampposts derives from people’s over-utilization of mobile phones and other wireless devices.
Stanford University School of Medicine psychiatrist Elias Aboujaoude is quoted in the Newsweek article as saying, “There’s little doubt we’re becoming more impulsive and one reason for this is technology use.” He claims that the recent precipitous rise in OCD and ADHD diagnoses is directly related to technology addiction. I’m guessing that Internet addiction is not best treated by the newly-emerging field of cyber-therapy, where therapists “visit” with patients online instead of in person. Can you imagine?
Patient: “Thanks for viewing me doctor, I think I have a problem with excessive iPhone use.”
Therapist: “I’ll be with you as soon as I finish this text.”
Patient: “I’m sorry I didn’t hear you; I was checking the Giants scores.”
One of the things this whole issue made me think about in earnest is how technology, and particularly iPhones and similar metallic marvels, are becoming widely used for patient home monitoring, particularly for patients with high blood pressure, diabetes and other chronic illnesses. The whole discussion about iPhone/Internet addiction and its ills makes me wonder if this continuous remote monitoring thing is such a good idea. On the one hand, it is clearly a positive to regularly be checking patients in the context of their real lives to be sure they are staying at appropriate levels of health. On the other hand, is it really necessary or even a positive thing to continuously monitor people and give them access to the biometric readings? How obsessive, anxious and stressed out might patients become if they are constantly checking their readings on these devices and how might that affect the readings themselves? Would they interrupt texting to check their biometric levels or would they interrupt watching their glucose fluctuate with every bite to check their messages? Either way, probably not a good thing.
I remember when I was pregnant lo those many years ago and I was put on bed rest and given a fetal home monitor to check for premature contractions, as I was having some pre-term labor issues. They stuck me in bed and said, “don’t get up for 3 months except to pee and every day at 5:00 we are going to call you to put this monitor on so we can see how you are doing.” Yeah, that was awesome. For an already Type A person, it was not a highly practical way of living. But okay, it was for the kid and she turned out to be worth it. Anyway, I would feel pretty much fine all day and feel very few contractions, but at 5:00 when the bell tolled for me and the tracking service called to get a formal reading, my contractions would go through the roof. Correlation or causation? I am going with the latter. In my weakened and blob-like state I used to call it “performance anxiety,” which is kind of correct.
Doctors are well aware of what is known as “white coat syndrome,” a condition which causes blood pressure patients’ readings to skyrocket when they are in the doctors’ office (likely due to anxiety) but to otherwise stay in much lower ranges in other circumstances. Is there a risk that we will cause some sort of “iPhone case syndrome” if we are continuously monitoring people’s biometric parameters and they are becoming more and more OCD or stressed out as a result of the constant technology interaction itself?
There are lots of people out there who check their email/texts every two seconds. Would those same addiction-oriented people check their blood pressure or heart rate or glucose score the same compulsive way, driving up stress and anxiety and thus driving up the negative readings? Would those negative readings then be the result of correlation or causation and how in the world could we possibly separate the two? Does this suggest that any continuous monitoring results be shielded from the patient’s view for their own good? If so, what of the engaged healthcare consumer? It feels like a very complex issue to me, but not one I have read anything about.
Here is another quote from the Newsweek article, an article I really encourage you to read if for no other reason than to understand your own budding lunacy:
The Internet “leads to behavior that people are conscious is not in their best interest and does leave them anxious and does make them act compulsively,” says Nicholas Carr, whose book The Shallows, about the Web’s effect on cognition, was nominated for a Pulitzer Prize. It “fosters our obsessions, dependence, and stress reactions,” adds Larry Rosen, a California psychologist who has researched the Net’s effect for decades. It “encourages—and even promotes—insanity.”
Clearly the mobile health movement has some monumental potential advantages, such as bringing needed healthcare to those who can’t otherwise get it and making in-home care available to those who would otherwise forego it. But, if it is true that we are turning into a nation of Internet addicts and if it is also true that, “The brains of Internet addicts, it turns out, look like the brains of drug and alcohol addicts,” then how do we ensure a balance between mobile health applications that help patients and those that add to their woes?
Ok, everybody…put down your iPhone and repeat after me: Om…….