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How Much Smartphone Use Is Too Much?

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Since the iPhone debuted in 2007, ushering in the age of the phone-as-computer, smartphone use has exploded worldwide, with an estimated 2.3 billion users last year. According to a 2016 Pew Research survey, 77 percent of Americans own a smartphone, and other recent stats have found that users are on their phones an average of more than five hours per day—almost double the rate in 2013. More people now use a mobile device to get online than they do a computer. This is especially true in regions where people may not be able to afford a personal computer but can buy a smartphone.

We love our smartphones perhaps a little too much, and the desire to unplug is growing among people who see 24/7 connectedness as damaging to their mental health. This week, Apple announced new iPhone features meant to curb our dependence on our devices, including a weekly "Report" app that shows your phone and app usage, as well as how many times you physically pick up your phone. (One small study by the consumer research firm Dscout found that we touch our phones more than 2600 times a day.) You can also set customized limits for overall phone usage with the "Screen Time" app.

Many of us feel anxiety at the very thought of being without their phone and the access it offers to the internet. Researchers have a term for it: nomophobia ("no mobile phone phobia"). So how much smartphone use is too much?

That turns out to be a surprisingly difficult question to answer. "Smartphone addiction" isn't an official medical diagnosis. Even the experts haven't decided how much is too much—or even whether smartphone addiction is real.

DEFINING ADDICTION

To understand what's going on, we have to first step back and define what addiction is. It's different from habits, which are subconsciously performed routines, and dependence, when repeated use of something causes withdrawals when you stop. You can be dependent on something without it ruining your life. Addiction is a mental disorder characterized by compulsive consumption despite serious adverse consequences.

Yet, our understanding of behavioral addictions—especially ones that don't involve ingesting mind-altering chemicals—is still evolving. Actions that result in psychological rewards, such as a crushing a castle in Clash Royale or getting a new ping from Instagram, can turn compulsive as our brains rewire to seek that payoff (just like our smartphones, our brains use electricity to operate, and circuits of neurons can restructure to skew toward rewards). For a minority of people, it seems those compulsions can turn to addictions.

Psychologists have been treating internet addiction for almost as long as the internet has been around: Kimberly Young, a clinical psychologist and program director at St. Bonaventure University, founded the Center for Internet Addiction back in 1995. By 2013, addictive behavior connected to personal technology was common enough that in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), the bible for mental disorder diagnoses, the American Psychiatric Association included "internet gaming disorder" as a condition "warranting further study." These days, thanks to an abundance of horror stories involving people who were glued to the internet until they died—and living gamers who are so engrossed in their games that they ignore paramedics removing dead gamers—internet rehabs are popping up all over the world.

But in virtually all of the medical literature published so far about internet addiction—including the WHO's forthcoming 11th edition of International Classification of Diseases (ICD-11), whose "excessive use of the internet" is built around how much gaming interferes with daily life—there's no mention of smartphones.

According to Marc Potenza, a professor of psychiatry and neuroscience at the Yale School of Medicine, there's a reason for these omissions: Despite the official definitions included in the DSM-V and ICD-11, "there's debate regarding the use of those terms [internet addiction]. Both the ICD-11 group and the DSM-V group chose to focus on the behavior rather than the delivery device."

So while you may feel nomophobia when you can't find your internet "delivery device," the global psychiatric community thinks it's the internet itself that's the problem—not the phone in your hand.

THE REWARDS THAT COME FROM OUR PHONES

We are getting something from our phones, though, and it's not just access to the internet. Receiving a notification gives us a small dopamine burst, and we learn to associate that dose of pleasure with the smartphone. You may pull your phone from your pocket a dozen times an hour to check for notifications—even if you know they're not there because your phone would have, well, notified you.

It's not unusual for people to become attached to an action (checking the phone) rather than its reward (getting a notification). Sometimes smokers trying to quit feel the urge to chew or bite and need to replace cigarettes with gum or sunflower seeds. According to Stephanie Borgland, a neuroscientist and associate professor at University of Calgary, this is called a Pavlovian-instrumental transfer—a reference to Ivan Pavlov's experiments, in which he reinforced behavior in dogs through signals and rewards. Borgland tells Mental Floss that we can become compulsively attached to the cues of phone use. We cling to the physical stimuli our brains have linked to the reward.

There may be an evolutionary basis to this behavior. Like other primates, humans are social mammals, but we have dramatically higher levels of dopamine than our cousins. This neurotransmitter is associated with reward-motivated behavior. So when we get a notification on an app that tells us someone has engaged us in social interaction—which we naturally crave—it triggers our natural inclinations.

HOW TO CURB YOUR ENTHUSIASM (FOR YOUR PHONE)

The global psychiatric community may not be convinced our smartphones are a problem, and no one has died from checking Snapchat too often—or at least it hasn't been reported. But most of us would say that spending five hours a day on our smartphones is too much. So are there any guidelines?

At this stage of research into smartphone use, there are no specific time-limit recommendations, though some researchers are working on a smartphone addiction scale; one was proposed in a 2013 study in the journal PLOS One. Based on what's said to be coming out in the ICD-11, here's one simple guideline: Problematic smartphone use negatively interferes with your life. Some research suggests Facebook, Instagram, and even online gaming make us feel more isolated and less connected. The more we try to fill that hole by tapping away at our phones, the more we crave social interaction. "There are a number of factors that have been associated with these behaviors or conditions," says Potenza, who is developing tools to screen for and assess problematic internet use and has consulted with the WHO on these issues. "And arguably one of the most consistent ones is depression."

One way to assess whether your smartphone is a problem is noting how you react when you're cut off from it, according to the PLOS One study. The study proposed a "smartphone addiction scale" based on negative responses to being without a smartphone, among other criteria. What happens on a day when you accidentally leave it at home? Are you irritable or anxious? Do you feel isolated from friends or unsafe? Do you have trouble concentrating on work, school, or other important responsibilities, whether or not you have your phone?

While smartphones may not be truly addictive in a medical sense, learning how to use them in a more mindful, healthy manner couldn't hurt. Test yourself for nomophobia [PDF]—knowing how much time you spend online is the first step to identifying how that can be problematic. Block distracting sites or track usage via a timer or an app (beware third-party apps' privacy settings, however). Delete the apps that keep the phone in your hand even when you're not online, like games. If you're still struggling, you could ditch smartphones altogether and downgrade to a "dumb" phone or get a Light Phone, a cellular device "designed to be used as little as possible."

A recent WIRED feature argued that using the internet five hours per day isn't a personal failing so much as a reflection of the way many apps are purposely designed to keep you salivating for more. So perhaps the best measure is to leave your phone behind once in a while. Schedule a screen-free Sunday. Go for a walk in the woods. Meditate. Socialize instead of binging The Office again. Don’t worry—you’ll be fine.

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Medicine
Charles Dickens Museum Highlights the Author's Contributions to Science and Medicine

Charles Dickens is celebrated for his verbose prose and memorable opening lines, but lesser known are his contributions to science—particularly the field of medicine.

A new exhibition at London’s Charles Dickens Museum—titled "Charles Dickens: Man of Science"—is showcasing the English author’s scientific side. In several instances, the writer's detailed descriptions of medical conditions predated and sometimes even inspired the discovery of several diseases, The Guardian reports.

In his novel Dombey and Son, the character of Mrs. Skewton was paralyzed on her right side and unable to speak. Dickens was the first person to document this inexplicable condition, and a scientist later discovered that one side of the brain was largely responsible for speech production. "Fat boy" Joe, a character in The Pickwick Papers who snored loudly while sleeping, later lent his namesake to Pickwickian Syndrome, otherwise known as obesity hypoventilation syndrome.

A figurine of Fat Boy Joe
Courtesy of the Charles Dickens Museum

Dickens also wrote eloquently about the symptoms of tuberculosis and dyslexia, and some of his passages were used to teach diagnosis to students of medicine.

“Dickens is an unbelievably acute observer of human behaviors,” museum curator Frankie Kubicki told The Guardian. “He captures these behaviors so perfectly that his descriptions can be used to build relationships between symptoms and disease.”

Dickens was also chummy with some of the leading scientists of his day, including Michael Faraday, Charles Darwin, and chemist Jane Marcet, and the exhibition showcases some of the writer's correspondence with these notable figures. Beyond medicine, Dickens also contributed to the fields of chemistry, geology, and environmental science.

Less scientifically sound was the author’s affinity for mesmerism, a form of hypnotism introduced in the 1770s as a method of controlling “animal magnetism,” a magnetic fluid which proponents of the practice believed flowed through all people. Dickens studied the methods of mesmerism and was so convinced by his powers that he later wrote, “I have the perfect conviction that I could magnetize a frying-pan.” A playbill of Animal Magnetism, an 1857 production that Dickens starred in, is also part of the exhibit.

A play script from Animal Magnetism
Courtesy of the Charles Dickens Museum

Located at 48-49 Doughty Street in London, the exhibition will be on display until November 11, 2018.

[h/t The Guardian]

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Health
Feeling Down? Lifting Weights Can Lift Your Mood, Too
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There’s plenty of research that suggests that exercise can be an effective treatment for depression. In some cases of depression, in fact—particularly less-severe ones—scientists have found that exercise can be as effective as antidepressants, which don’t work for everyone and can come with some annoying side effects. Previous studies have largely concentrated on aerobic exercise, like running, but new research shows that weight lifting can be a useful depression treatment, too.

The study in JAMA Psychiatry, led by sports scientists at the University of Limerick in Ireland, examined the results of 33 previous clinical trials that analyzed a total of 1877 participants. It found that resistance training—lifting weights, using resistance bands, doing push ups, and any other exercises targeted at strengthening muscles rather than increasing heart rate—significantly reduced symptoms of depression.

This held true regardless of how healthy people were overall, how much of the exercises they were assigned to do, or how much stronger they got as a result. While the effect wasn’t as strong in blinded trials—where the assessors don’t know who is in the control group and who isn’t, as is the case in higher-quality studies—it was still notable. According to first author Brett Gordon, these trials showed a medium effect, while others showed a large effect, but both were statistically significant.

The studies in the paper all looked at the effects of these training regimes on people with mild to moderate depression, and the results might not translate to people with severe depression. Unfortunately, many of the studies analyzed didn’t include information on whether or not the patients were taking antidepressants, so the researchers weren’t able to determine what role medications might play in this. However, Gordon tells Mental Floss in an email that “the available evidence supports that [resistance training] may be an effective alternative and/or adjuvant therapy for depressive symptoms that could be prescribed on its own and/or in conjunction with other depression treatments,” like therapy or medication.

There haven’t been a lot of studies yet comparing whether aerobic exercise or resistance training might be better at alleviating depressive symptoms, and future research might tackle that question. Even if one does turn out to be better than the other, though, it seems that just getting to the gym can make a big difference.

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