Newsletters

POSTED: April 29th, 2019
POSTED IN: EM Pulse - The Official Newsletter of MOCEP, March/April 2019,

Written by Dennis Hughes DO FACEP
Partner in 360 Medicine-an independent emergency medicine group located in Branson MO.
Member of the ACEP Wellness Committee

FOMO-the fear of missing out.  Are we truly missing something?  Perhaps we are-missing the opportunity to keep the humanity (and balance) in our lives.  I have become a social media crusader. 

I am not anti-technology or nihilistic and embrace early adoption of tech most of the time-it can have a positive impact.  However, I am now striving for the Holy Grail as it applies to keeping this aspect of our lives in check.

DSM-5 lists 11 criteria for addition (specifically substance abuse) many of which can be applied to social media use.  Consider a few:

 

• withdrawal
• tolerance
• using more/longer duration of use
• time spent
• craving

It does not take much of a stretch to see that we can identify some of the same behaviors in the way personal devices and social media permeate current society.  Perhaps dependence is more appropriate a term than addiction, but whichever term one chooses, it is clear “Houston, we may have a problem.”  The phenomena of “social media creep” progresses like any addiction:  one starts a Facebook account and checks it weekly, every 3 days, every day. Then one downloads the mobile app and the notifications come several times an hour — you need the fix.  It is a classic dopamine-reward positive feedback loop.

I propose taking a lesson from Eastern philosophy.  Seeking out the “middle way”-that sweet spot between overindulgence and abstinence. Integration of needs, desires and avoidance of dogmatic extremes is not easy.  Applying this approach to all aspects of life can be rewarding but certainly in the context of this discussion, it means taking control of our interactions with social media and avoidance of their damage on our lives and health.

We know that we have become more slave-like to the EHR in our professional lives and that attachment is unavoidable if we are to practice in nearly any Emergency Department in this country.  This is not a rant on how our lives in medicine have been irrevocably altered by this unstoppable onslaught over the past several years-but it is a call to action for us to carefully examine areas that we can control. 

Some of the damages that social media causes:

• false reality (“what you see is not all there is”)
• promotion of narcissistic behavior (“how many likes did I get”)
• close mindedness (“only follow those whom agree with me”)
• privacy risk (this is real and can have financial implications-hacking, stalking, doxing, etc)
• it is a time sink (self-explanatory)

What is one to do?  Adopt the “JOMO” (“joy of missing out”) mindset?  Perhaps.  Some have coined another colloquial term:  “NEMO” (“nearly, but not totally missing out).  Detox may be necessary just like any addiction.  There are many different approaches to quenching addiction and one size does not fit all.  A plan could include:

• deactivating your accounts
• uninstall social media apps
• use a web filter (examples include: Cold Turkey, Net Nanny, Self-Control, Stay Focused– many of these filters do allow control of times so one could still have some access).
• Leave your phone in your bag at work or at meetings (leave a land-line number on your voicemail greeting for true emergencies)
• fill your time void with other activities

The other question that may come to mind is “what about the important stuff that I learn from the internet?”  There are a number of sites that have proven to be valuable sources of “FOAMed.”  I would caution that these too have potential for some of the same pitfalls as in the social media realm.  Sticking with podcasts and other feeds that you control viewing is preferable to becoming over-engaged in a continuous dialog — particularly if you have seen that you have a propensity to such addictive behavior.  We have seen that many times, sites such as Twitter, etc. can launch unending dialogue that can have unintended consequences. 

If you are a person of moderation already you may be safe for the time being.  However, if you find yourself constantly checking your smartphone between patients or at the next ACEP meeting rather than talking to the person next to you, perhaps a little search for that “Middle Way” may reward you and restore more control to your life. 

References:

1. Griffiths MO.  Addicted to social media? (What can we do about its problematic, excessive use?).  Psychology Today (on-line), May 7, 2018.
2. L’Ecuyer D. How social media is directly affecting your mental health. HealthPrep
3. Bhatt S. NEMO: the new idea for those striving to find a middle path between FOMO and JOMO.  The Economic Times (India), June 3, 2018.
4. Watson KW, Slawson DC. Social media use and mood disorders: when is it time to plug? American Family Physician, October 15, 2017; 96(8): 537-40.