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February 19, 2019 Tuesday 10:22:04 AM IST


Cover Story

In this era of information technology, social media has become an integral part of our lives. Hardly anyone can keep away from it completely. Social media has increased our connectivity to the world, making it possible for us to share information and knowledge virtually to everyone. We are able to find people with similar interests and ways of thinking and share our views with them.  At the same time, social media has several disadvantages and, in some instances, produces distress and harm.

Internet has registered an exponential growth as a critical tool which enables people to live life at a faster pace, catering to online commerce and communication needs, apart from serving as a means of knowledge sharing. It has attracted people due to its features such as round-the-clock availability, simple operation, low cost and anonymity of its users, but it has also led to one of its grave consequences: virtual addiction.

Children and teens account for a very large proportion of internet users and they use the services mostly for social networking. Social media websites (Facebook, Twitter, etc.) have now become an integral part of the society, helping users to create a public profile to connect with others though the resultant popularity may cause adverse reactions too.

Social media and behavior: Social networking has many behavioral consequences like impaired psychological well-being, less interaction with peers and family, poor academic performance, and arrested psycho-social development. Violence has frequently been reported, involving a male predominance, coupled with hyperactivity and conduct problems. Addicts suffer from exactly the same consequences as people addicted to substances like alcohol -- low self-esteem, low motivation and fear of rejection. Addictive nature of social networking has serious effects on health, ranging from eye strain and back pain to eating disorders, obesity, heart problems, sleep disorders etc.

Internet Addiction: Five sub-types can be identified:

i)                  Cyber-sexual addiction:  viewing, downloading and trading online pornography,

ii)                Cyber-relational addiction: over involvement in online relationship, often associated with marital and family instability,

iii)             Net compulsions: gambling, shopping, etc.

iv)              Information overload: excessive web surfing and information and database search, and

v)                Computer addiction: over use of pre-programmed games.

Younger age, male gender, early exposure to the net, frequent use and availability of time are some of the predisposing factors for addiction. The proposed criteria for internet addiction include excessive Internet use, associated with loss of sense of time or neglect of basic drives; withdrawal, including feelings of anger, depression and tension when internet is not accessible; focusing on the need for better computer equipment, more software, or more hours of use; and adverse consequences (e.g., sleep deprivation, marital difficulties, lateness for early morning appointments, neglect of occupational duties).

Many people use social networking sites for ethical and healthy reasons, but there are a few who exploit others, particularly children and adolescents. By assuming fake identities, criminals carry out their trade in a less risky manner. Internet exposes youngsters to many dangers like child pornography or to inappropriate images or content, solicitation by sexual predators, online bullying or harassment, inappropriate disclosure of personal information and data theft, spyware, viruses and malicious software, scams etc. Excessive commercialism by advertising and product-related websites and the consequences of software piracy etc. are other issues before us.

Illustrative cases

The adverse consequences of social media and the internet are problems not merely of adolescents or young people -- it can affect children also. Recently, a 12- year-old girl, a student of 7th class at a CBSE school in central Kerala, was brought to the hospital for consultation. Two years back, her father, a govt employee, had given her a smart phone on her persistent request to “listen to music”. Later, she became addicted to YouTube, but claimed that she was seeing the videos only during her free time. She was having headache and poor sleep during the past six months. She was also easily irritable and disobedient. The girl was brought for consultation after she refused to go to school for a month. Things reached such a pass that she assaulted her mother severely a fortnight ago. She even tried to strangulate her mother when the girl’s father came to the rescue. The child was well built and strong. Her father told me, “If I had not come at that time, she would have even killed her mother”.  The child was not interested in studies, but was sleeping very late, sometimes past midnight “playing” with her mobile phone. Her parents tried to get back the phone at least after 10 pm, but the child vehemently resisted it. In the end, her parents gave in, in order to avoid a “show-down”.  One day, when the parents were away, her elder sister found her with the room bolted from inside. She got suspicious and later when the child was away, checked the phone for download history. The elder sister was shocked to find that the child had visited several porn sites! The child had become very anxious and worried after visiting these sites and then refused to go to school. We had to see her over a number of sessions and counsel her repeatedly to bring her out of her trauma.

Another recent case of consultation is that of a 21-year-old girl, a student of architecture.  She had befriended a young boy, a B. Com. student, though Facebook. The friendship gradually flourished and they started moving around in his bike. On one occasion, they went for an evening show of cinema and got late. She could go back neither to her hostel nor her home, as she won’t be able to explain her return at odd time. Then he invited her to his home, where they both slept in his room. Her mother had called the hostel in the morning and as she was not there, the police was alerted. The police caught up with her, as she was returning to the college. We were amazed as to how the young girl had compromised her safety in the company of an FB friend, of whom she knew little!

Yet another case is that of a 25-year-old girl, hailing from Kottayam.  She was a student of B.Sc. Nursing at Bangalore. She had a Facebook friend with whom she had become very intimate. After six months of friendship, she married him and left her studies in the 3rd year of her course. She belongs to a low-income family and her father now owes Rs. 3 lakh loan to a bank, with no means to repay. She is now mother of a two-year-old child, and has no job; her husband has no steady income and they have severe financial difficulties. At present, she regrets having left her B.Sc. Nursing course and the opportunity of a bright career!

Preventive approaches:  It is almost impossible to ban activities bearing a potential danger, on the internet; a much healthier approach is education and empowerment that will enable parents, educators, mental health professionals and the government to address such issues. Enhancing resilience (ability to adapt to changed circumstances while fulfilling one’s core purpose) is an essential skill in the current age of unforeseeable disruption.

Prevention is the key to reducing the morbidity associated with internet abuse. Placing the computer in the common living room and ensuring availability of alternative social activities are some of the initial steps.  Improved parent-child relationship and family functioning, as well as positive social support foster resilience and problem-solving capacity.  Helping children to understand the concepts of risk and safety online, allow them to make independent informed decisions, ensuring ‘online’ safety. The threats raised by internet can be external (‘inappropriate’ content and activities e.g. gambling or contact with the ‘wrong’ people. e.g. bullying, scams), or internal (such as disclosure of too much personal information). By working together with children, we can enable them to make use of the opportunities that the Internet offers, while being safe and responsible.

Useful guidelines

We list below 10 actions for parents and teachers to make a child's online experience safer and educational:

1.      Limit the amount of time a child spends online and ‘surfing the web’.

2.    Teach a child that talking to ‘screen names’ in a ‘chat room’ is the same as talking with strangers; never disclose any information that could lead to identification of the person, to another individual or website online.

3.    Teach a child to never agree to actually meet someone they have met online.

4.    Never give a child credit card numbers or passwords that will enable online purchases or access to inappropriate services or sites.

5.     Remind a child that not everything they see or read online is true.

6.    Make use of the parental control features offered with your online service, or by obtaining commercially available software programs, to restrict access to "chat lines," news groups, and inappropriate websites.

7.     Provide for an individual e-mail address only if a child is mature enough to manage it, and plan to periodically monitor the child's e-mail and online activity.

8.    Monitor the content of a child's personal webpage and screen name profile information

9.    Teach a child to use the same courtesy in communicating with others online as they would while speaking in person -- i.e. no vulgar or profane language, no name calling, etc.

10.         Insist on children to follow the same guidelines at other computers that they might have access to, such as those at school, libraries, or friends' homes.

 Language skills hit

Excessive use of social media in the growing up years of children can seriously impair their language learning abilities. Social media often use letters or symbols instead of words and ignore grammatical correctness. Language learning is an important domain which no one can afford to neglect. Use of social media has become part of our lives, but restricting the time for this is important in the emotional development of children and adolescents. Social media like Facebook, YouTube, Twitter, Instagram, Linked-in, WhatsApp and Google are used by billions of people all over the world and their influence, both positive and negative, can no longer be ignored. Social media can bring people together across national boundaries to work for the common good of humanity. At the same time, there can be alarming problems like social media addiction, internet pornography, sex crimes and the potential for criminal activities. Social media can facilitate academic learning, research, health education, disaster management and medical emergencies. But social media can also pave way for cyber bullying, spread of fake news, anti-national or terrorist activities, sexual harassment and social media related psychiatric problems. Thus, judicious use of social media is warranted. As technology advances, our responsibility is to remain forever cautious and vigilant!

(*Prof Roy Abraham Kallivayalil MD,DPM
Secretary General, World Psychiatric Association   
Professor & Head, Dept of Psychiatry

Pushpagiri Institute of Medical Sciences,  

Tiruvalla, Kerala- 689 101, India;


**Dr Soumya P Thomas MD

Senior Resident, Pushpagiri Institute of Medical Sciences,  

Tiruvalla, Kerala- 689 101, India.)