Research suggests social media, video games, and texting may contribute to manic symptoms in early adolescence, highlighting the need for targeted mental health interventions.

Study: Screen time and manic symptoms in early adolescents: prospective findings from the Adolescent Brain Cognitive Development Study. Image Credit: vesna cvorvic / Shutterstock.com

A recent study published in Social Psychiatry and Psychiatric Epidemiology examines the association between excessive screen time and manic symptoms in early adolescence.

Does screen time cause manic episodes?

Current estimates indicate the average adolescent spends over eight hours every day using screens in the United States, which is a rise of nearly two-fold as compared to before the coronavirus disease 2019 (COVID-19) pandemic. Increased screen time among adolescents has been accompanied by a rise in mental health issues, with about 29% of American youth currently experiencing mental health problems.

Despite these observations, the association between manic symptoms and screen time in adolescence remains unclear. Manic symptoms include feelings of high energy, elated or irritable mood, extreme self-importance, needing little sleep, being easily distractable, impulsive behaviors, having thoughts that race or jump from one topic to another, stubborn, and overindulging in pleasurable activities.

Bipolar-spectrum disorder (BSD), which often begin during adolescence, is diagnosed based on manic and hypomanic episodes. Early onset of BSD is associated with worse prognoses and increased symptom severity.

BSD likely begins with hyperresponsiveness to activities or ideas that focus on goal achievement and reward. As a result, the affected individual becomes excessively motivated on seeking rewards.

Problematic screen use (PSU) in adolescents is associated with a similar presentation to addiction and abnormal reward sensitivity. The correlation of PSU with poor sleep may indicate the role of disrupted body rhythms in triggering BSD. Conversely, manic symptoms may contribute to increased screen use in adolescence.

Previous studies have reported that adults with addictive phone use were more likely to have bipolar disorder. Nevertheless, additional research is needed to determine the relationship between BSD and screen use in adolescence.

About the study

In the current study, researchers identified associations, if any, between screen time and manic symptoms in adolescents, and whether problematic use characterized by addiction, conflict, relapse, and withdrawal contributes to this association.

Data were obtained from the Adolescent Brain Cognitive Development Study, which comprised 9,243 participants between 10 and 11 years of age. Six different types of screen use were assessed by self-reported survey in the first year of the study, of which included television, video games, texting, watching videos, video chatting, and social media.

Study findings

The analysis identified a correlation between increased screen time and the risk of manic symptoms after one year. This association was observed for overall screen time, as well as social media, videos, texting, and video games. Texting and social media were most strongly associated with manic symptoms, even after adjusting for confounding factors.

Problematic social media use may explain 48% of the increased risk for manic symptoms, whereas video game use mediates 58% of this risk. Sleep duration in the second year accounts for 9% of the risk of manic symptoms.

Potential mechanisms

Instant gratification and response to user action are characteristic of screen use, especially social media and video games. Social media and video games platforms are designed to reinforce their use; therefore, engaging with these programs leads to the release of dopamine in the brain. Manic episodes are also associated with high dopamine levels, thus indicating a possible shared mechanism.

Sleep deprivation and irregular sleep habits can worsen manic symptoms and overstimulate already activated reward circuits to intensify these symptoms.

Implications for adolescent mental wellbeing

The study findings indicate that limiting screen engagement among adolescent users could help prevent manic symptoms that predict the onset of BSD. Alternatively, early identification of manic symptoms could target individuals who would benefit from secondary prevention.

The current study emphasizes the need for targeted interventions to prevent unhealthy habits and encourage resilience in young adolescents. For example, a previous study reported that grade school digital literacy programs led to multiple healthy behavioral changes including reduced screen time.

Conclusions

Problematic screen use may be a target for mental health prevention and early intervention efforts among adolescents.”.

Future studies are needed to clarify should how manic symptoms associated with excessive screen use arise through underlying psychological, neurologic, biologic, social, and behavioral changes. These data could facilitate the development of optimal interventions to improve adolescent and adult health.