Doc Discussions with Dr. Jason Edwards
THIS is the podcast you have been looking for! "Doc Discussions" are just what the title says they are: physicians from a wide range of specialties, talking about relevant, up-to-date medical topics, not to mention tips on habits to help you live your best life. Your host, Jason Edwards, MD, is a board-certified radiation oncologist with a PhD in cellular and integrative physiology at St. Luke's Hospital in St. Louis, Missouri. Dr. Edwards explores not only diseases but also suggests techniques to optimize mental and physical health for a long and good life. Real people. Real advice. Real good. This is Doc Discussions, with Dr. Jason Edwards!
Doc Discussions with Dr. Jason Edwards
Balancing Screen Time: Protecting Children's Health and Mental Well-being with Dr. Lisa Ryan
Ever wondered how screen time is impacting your child's development? Join us as we chat with Dr. Lisa Ryan, a pediatrician and former immunology researcher, who explains the hidden dangers of excessive screen use and offers practical tips for parents to strike a healthy balance. As the school year begins, she shares invaluable advice for ensuring your children engage in essential activities like social interaction, problem-solving, and physical exercise, without getting lost in the digital world.
Concerned about the impact of social media on your child's mental health? Dr. Ryan dives deep into this pressing issue, referencing Jonathan Haidt's "Anxious Generation" and discussing the alarming rise in youth suicide rates. She highlights the toxic effects of online comparison and immersive video games while advocating for community-based initiatives like "Wait Until Eighth." Learn how to foster resilience and real-world interactions for your children, helping them build the coping skills they need to navigate life's challenges.
Welcome to Doc Discussions. I'm Jason Edwards and this is, in my opinion, the world's best medical podcast where we have discussions with physicians about who they are and what they do. I'm joined today by Dr Lisa Ryan, who's a pediatrician former researcher and she works here on campus at St Luke's. Welcome, lisa.
Speaker 2:Hi, thanks for having me.
Speaker 1:Thank you, and so just a quick overview. You had done a PhD in immunology, maybe, or what was it. It was in Nebraska, is that right?
Speaker 2:Yeah, yeah. So when I did a combined MD-PhD program, so I spent three years working in a lab where we studied HIV dementia. So technically we were in the department of pathology, but HIV dementia which, by the way, we don't really see anymore because of all of the antiretroviral treatments but it was a macrophage disease, so that's where it was part of the immunology. So we studied the macrophage, part of it and it was?
Speaker 2:yeah, it was it was really cool. It was great as a med student to kind of have that that kind of real world place to put the research that you were doing.
Speaker 1:Yeah, Very cool. And then. So from there you went into a pediatrician residency. Is that right, yeah?
Speaker 2:So we moved here to St Louis about 20 years ago now, and so I did my residency down at children's and you know I thought a lot about different fellowships but I really just enjoyed. I enjoyed working with kids and I enjoyed seeing them grow and I enjoyed, you know, talking with their parents, and so I ended up doing primary care and really haven't looked back.
Speaker 1:Very cool and you have three children and what are their ages?
Speaker 2:So, yeah, I have three kids. So my oldest is 21 and she is my med school baby. Okay, the next one is 17 and he is my residency baby. And a shout out to my son, henry, who turns 13 today. Shout out Henry, yeah, so we will be going home and celebrating that Very cool.
Speaker 1:Well, tell him you're on a podcast today and you're very hip now. Absolutely, I'll make him listen to it and so you know, I mean school's starting up again and I thought it would be great to talk to you about kind of what's going on with the youth these days, and I would assume from being a mother and your husband is a school teacher. Is that right?
Speaker 2:Yeah, he's actually a middle school teacher.
Speaker 1:Very good English, perfect and so that and then and then interacting with children and adolescents on a day-to-day basis. As I get older, I realize I'm not as in touch with the youth as I would like to think I am, and so what are some of the challenges that the kids are dealing with these days?
Speaker 2:Yeah, so this is physical season, so we're doing a lot of you know just just well visits and talking about a lot of different things. And you know, there's there's a lot of stuff out there. Yeah, we end up talking a lot about just being healthy and you know, when you and I were young, that probably just involved hey, eat lots of fruits and vegetables, which, by the way, we still really encourage, you know. Go outside and exercise Again, we still really encourage. But I end up finding a lot of times that I'm talking about screens and screen time and how kids are using their downtime.
Speaker 2:And you know, I find when I'm doing these well visits and I'm talking about some of these things, you know the parents are kind of spacing off a little bit. Maybe when I'm talking about fruits and vegetables, they're telling their kids the same thing, but as soon as we kind of hit on the screens, everyone kind of perks up a little bit and is like yes, this is a problem that we're having at home and it's something that affects all age groups. Even so, I you know, I think that's kind of one of the big one of the big things that's going on with kids. That might not have been an issue when we were young.
Speaker 1:For sure. In the last 10 years it's kind of become an issue, I think, very much with children and probably adults to some degree. What is it specifically about the screens that's causing children problems?
Speaker 2:Sure, I think if you had to like kind of put it in one sentence, maybe it would be that it takes them away from doing other things.
Speaker 1:Okay, yeah.
Speaker 2:So, for example, when you talk about really young children and screens, you know we we don't recommend screens prior to 18 months, 24 months of age, and it's largely because we want these kids to interact with their world. So when they're, when they're young, when they're, you know, preschool toddlers, we need them to be absorbing the world around them, and they just don't do that. When they're on a screen, they're involved in that or they have the screen kind of telling them what's in the world around them, rather than them problem solving and picking through things. And you know, I think it's somewhat similar in the older ages groups. You know, if you're on a screen all the time, you're not out talking to your friend, You're not out learning to interact with others, have social interactions, you're not again, same sort of thing You're not learning to problem solve and you're also not maybe exercising or doing those sort of healthy habits too. So I think, if you have to sum it up, that would be the one thing.
Speaker 1:Yeah, I recently read a book by Jonathan Haidt called Anxious Generation, which has kind of been popular lately, and that was kind of the crux of the book that kids are probably oversupervised outside in play, where their parents are kind of watching them and if there's a fight they intervene, instead of watching them kind of work it out on their an argument, watching them work it out on their own and kind of figure out how to do that and that.
Speaker 1:Online, um, it's just like the wild west that kids are kind of not watched and and especially with tiktok and some of the social media, um things, it seems like with young girls it's an issue with their kind of internal sociometer and and, like you know, usually they would compare themselves to like their small group of girls not every girl their age in the world. And and then boys, you have these immersive video games that, um, you know, you know, can um suck up their time and kind of cause dopamine hits so where they like like almost need it, and it just so happens that it's in this critical period where it makes kind of some consequential changes later on.
Speaker 2:Yeah, yeah, exactly, you know the the human brain isn't fully formed for quite some time and kids, the brain is still developing through middle school, through high school, even into into college a little bit, and all of these inputs through the screens, through the social media, are really changing that in ways that we're not completely aware of. I thought it was really interesting. I think it was back in June. The Surgeon General came out and he's like we need to have a label on social media the same way we have a label on cigarettes, like really making that similar comparison, and he's saying you know, when we put a label on cigarettes, people started thinking, hey, wait, maybe this isn't as healthy as I thought. And he's like that might be kind of the same thing we need to do with our social media.
Speaker 2:You know, I was looking at some of the statistics earlier today and it was surprising but also not so surprising that it said 95% of kids between the ages of 13 to 17 are on social media, and then they were saying that even 40% of kids it was like nine to 12 are on social media, which that part was a little more astounding to me, you know, in terms of signing up for a social media account, you have to say you're 13. And that's for legal reasons, about like checking. You know child privacy and that sort of thing, but for no other reason. If this kid is on social media under age 13, they've already kind of they're lying about their age, you know, and that's the first step to getting it.
Speaker 1:Yeah, and you know there's you know, you and I, you know, watch, you know unsolved mysteries and things like this, and so you know you worry about your kids, like playing at the playground, and you don't realize there's, there are plenty of predators online, probably more so than have access to your kids, and it's not just predators. But it's like you said, it's just the time suck. It's the dopamine issue, but it's. It is a real issue to try to tighten that up and make some of these social media, um, uh, to be a member of a social media entity, um, uh, at a higher age, you know, 16 or so Um, right, right, yeah, the some of that legislation is kind of um, I guess in the works, um, and that's sort of where the surgeon general is pushing this as well as trying to get just more research.
Speaker 2:We just don't know.
Speaker 2:I mean, you know, I was talking earlier about my kids and I, for whatever reason, whether it was right or not really didn't have a whole lot of issues with my my bigger kids getting Instagram accounts.
Speaker 2:Yeah, I can tell you so my son knows when I come home today that you know, at age 13, in our house you get to sit in the front seat of the car and you get your first cell phone. So he has his cell phone now and we said we would talk about social media when he was 13. Yeah, and I mean he's not getting Instagram. Like I'm a lot more nervous about that than I was with my bigger kids just because of some of the more research out there. And I mean he actually doesn't want Instagram Like Snapchat is the one that he's most excited about. Doesn't want Instagram Like Snapchat is the one that he's most excited about. And that was one that I think, with my bigger kids, we were a little bit on edge about too, because we were like, oh, you know, snapchat's that one where you send something and it disappears in 20 seconds.
Speaker 1:And like with predators.
Speaker 2:that was something we were really worried about, but over the course of time, Snapchat is kind of how all these kids interact with one another.
Speaker 1:So it's tough because there are cultures, you know, some schools like everybody's going to have that and I'm sure some. There's going to be some schools where it's kind of more strictly regulated by the parents, where it's not. But but that's tough if you're in an environment where 95 percent of the kids are talking. I mean that's the way they communicate, what do you do? I mean you're kind of stuck.
Speaker 2:It is. It's really hard. There's this really great website I like it's called Wait Until Eighth and they're basically. Their premise is parents should get together when our kids are in elementary school and we should all decide as a group when our kids are getting cell phones, when our kids are getting these things Collusion yeah and they suggest that it be eighth grade, and I think that is a fantastic idea and it would be so great if we were actually able to do something like that.
Speaker 2:But I mean, like today in my office I had a nine-year-old who you know, she was on her phone and I had to actually ask her to put her phone down so we could talk about her. Well, visit, you know so, and that's not that uncommon. So then, when you have, like this subset of kids who are able to text each other and able to communicate that way it does, it sort of pushes the other parents who maybe wanted to wait, to have to do these things a little bit earlier. And there's some, you know, kind of ways around that and all. But you know, you see that too, with the social media just feeling left out and everybody has this but me and it's it's a lot harder as a parent to really make those decisions and to explain to your kid why this is the decision.
Speaker 1:And, yeah, make those decisions and to explain to your kid why this is the decision, yeah, and so when we, you know, to talk about this, we talk about surge in general warnings. I, you know, I would get it if people are out there like rolling their eyes, but that the suicide rate has increased significantly from 2010 to 2020 in children and they think that the social media has a lot to do with it. And so it's not that, you know, we're trying to be hateful parents. It's that, like this stuff matters for the long term health of the child and I think it's. I think it's a more important thing than most people would kind of initially think.
Speaker 2:Yeah, I agree, which I think is why it's really nice to be having these these sorts of conversations, I agree, which I think is why it's really nice to be having these these sorts of conversations. And you know, there's obviously not one reason why you know the suicide rates would be increasing, that sort of thing. There's a lot of thoughts, you know, that social media kind of breeds loneliness Is that, is that part of it. There's also thoughts that on social media there's almost how to's, you know there's, um, this is how this, you could do this to kill yourself or this is, you know, cutting behaviors and those.
Speaker 2:those behaviors are kind of out there and sort of put into the mainstream. So maybe a kid who's kind of on the edge and didn't really wasn't really sure what to do could be influenced by something like that.
Speaker 1:And you do see, like some of these social contagions where they're like ticks and stuff like that, that all of a sudden like groups of people will develop. I don't know if that's true or not, but I've read news stories on that.
Speaker 1:Just some of these things that go viral, yeah it's like a behavior that there was like a tick, you know that somebody was like doing online like a physical tick, and then, like other children in that demographic, started having the same kind of thing, and then it was um, it was not really a medical issue, it was just kind of a well, it's, it's it's sort of group conformity, right, just something that you know.
Speaker 2:Maybe if I feel alone and I'm looking for my place and I see these people who you know I'd like and I'd like to be like them, and you start just sort of imitating some of the behaviors, and it's just unclear how far that might go, you know, and if you really get into these algorithms that encourage you to spend more time on them and kind of get the dopamine going, you could easily have kids who are, you know, spending five hours a day going through these social media feeds which you just don't really even know what they're seeing, and the rates of the depression and anxiety we see increase after it's only more than like three hours a day. So just just really it's out there and nobody's quite sure why, which is where the research aspect of it comes in.
Speaker 1:And so let's take it the opposite side and so, um. So what people are missing out on are um, interactions with other people, arguments, discussions, doing difficult things that are anxiety provoking, but in kind of a safe context. I'll tell a quick story. My son, I had gotten him a Pokemon card on eBay and it came in the mailbox Now our mailbox. You actually can't see it from the house.
Speaker 1:And so he said, hey, will you walk with me down to the mailbox? And I said I want you to walk by yourself down to the mailbox and I know it's scary, but I need you to do it by yourself because you got to learn to be brave. And he said you know, I don't want that, you know I want you to go. And I said, well, I'll stay outside and if you yell I'll know. And he was worried about snakes falling out of the tree. That's a fair concern, but he did it and I was proud of him. And I think that you this is called hormesis, where you take small doses of something that and large doses could be bad for you, like stress in large doses could be bad for you, like stress in large doses could be bad for you. But small, safe, stressful situations probably make situations like you would have in residency. You know, your first lumbar puncture of a baby.
Speaker 2:That's scary, there's anxiety.
Speaker 1:But if you've been through situations for many years up to that point that were anxiety provoking and your heart is racing and you say you know what? I've had this feeling before, I've been nervous before, but everything worked out and so I've got to do this difficult thing because somebody in society has to do those lumbar punctures on babies and yeah, you know I don't want it to be me, but you know you're in that situation and it's very scary, but you have the capability of doing it because you've been out there in life and you've done stressful things and I think that's kind of the opposite of being on your phone, of interacting with humans, of running up hills, of falling down, skinning your knee, kind of doing that kind of stuff. I think that's what people are missing out on, that kind of stuff. I think that's what people are missing out on, and so they're not progressing as human beings. You know through, you know kind of normal milestones, as they should.
Speaker 2:Yeah, and that's exactly it when you're talking, especially with these younger kids who are given phones too soon. One of the one of the prime examples similar to what you were saying is so obviously, when kids come into my office, they are nervous and upset and worried about things and, you know, a lot of the times will. And I'm not saying it's wrong, necessarily, but in order to distract their kid, their parent will give them a phone.
Speaker 1:Yeah.
Speaker 2:And some of them eventually just start to expect it. You know, I'm here at the doctor, I get my phone and I get to start looking at videos or pictures or whatever it is and that's great.
Speaker 2:In the moment they do fine. They sit still for my exam, but they're not necessarily learning the skill of hey, I come to the doctor's office and this is what happens and, like you said, maybe I get nervous and maybe my heart is racing, but I have now developed these coping skills and I know it's okay on the other side have now developed these coping skills and I know it's okay on the other side.
Speaker 2:Yeah, so that's some of the things that these kids are missing out on when they're basically given given the screen to kind of get them through whatever situation they're involved in.
Speaker 1:And and so, and then when they, those people get into adulthood or young adulthood, um, you know you're starting to see some of these issues come up. Um, there was a recent uh I think it was an NBC News article where they were saying 25% of I don't know what the early 20s generation maybe that's like late millennials had their parents go with them to their first job interview and then 12% of their parents asked questions during the job interview. And you know me and you would be like that's crazy. You know you would never have your parents. That would be like the last thing you would want to do is bring your parent to a job interview.
Speaker 1:You know we would be embarrassed, but and I'm not trying to throw shade on anybody out there who's done it, but it's in the crux, the article is that's kind of not a good thing to do. You should show up to a independently. They're kind of dealing with the anxiety of the moment, and so I think we're starting to see some real-world consequences of this kind of lack of normal amounts of stress that you would adapt to and become stronger with. You know, when this generation who kind of grew up with the iPhones, is reaching young adulthood.
Speaker 2:Yeah, yeah, it's so, my oldest is in college.
Speaker 1:Yeah.
Speaker 2:And so, while social media, I'm in the Facebook group for her college and it's it's kind of amazing, like some of the questions or some of the some of the things that are asked there. You know, it's everything from. My kid is struggling in this class. I'm getting ready to call the professor. What do I say, you know, to my kid? Is he just got into a car accident, or he has a flat tire and I'm across the country. Can someone go help him?
Speaker 1:Yeah.
Speaker 2:And I scroll through these and it's just, it's just astounding to me, like first of all, I mean, and again, not to say my kid doesn't have problems, but I would be the last person she would call if she was in some kind of car accident at school and we have discussions about her professor. She would never ask me to make that call. I think maybe I've just embarrassed her enough times over the years that she's really worried about what I would do.
Speaker 2:But it is. It's really a different way of thinking about this and when we, when our kids, are able to be out on their own and do their own things because it should be these college kids, that's what college is for.
Speaker 1:Yeah.
Speaker 2:It's a safe environment to learn to be an adult. And you know, if our little college group is any indication, I mean it's, it's just not happening, yeah.
Speaker 1:Yeah, you know, I had the experience of being around, um, some really incredible adults as a child my parents and a lot of teachers that I looked up to, uh, coaches and stuff like that. And and I do remember thinking like I need, at some point, I need to be like coach, so-and-so, or I need to be like my grandfather or my father, and and and. So there are some things. I need to be like coach, so-and-so, or I need to be like my grandfather or my father, and and and. So there are some things I have to do to get to that spot, because there's no, you know there's nobody they call for anything, and so it's to kind of strive, you know, to to be like those people who are around you, who are strong, and you kind of have to slowly do difficult things. And and you know another thing I'll say you know I deal with a lot of patients going through cancer, and so you know that's a tough point in their life.
Speaker 1:And you know, I try to impress upon them, while also acknowledging that it's really tough but that, like a comfort zone, is a nice place to be but nothing grows there, and it's the difficult situations in life that you see the growth as a person. And so you should seek out kind of, if you're young out there and you're listening, you should seek out kind of safe but uncomfortable situations. If you're in line at the supermarket, talk to the person in front of you, see what happens. It will be a little nerve wracking but it's okay. You will get better at talking to people and so if you go into some job where you're in sales or something like that, you're going to be better than the next guy and it will help you. Yeah, I love that.
Speaker 1:Lisa, it's always good talking to you. I really appreciate your insight and I hope to have you back someday.
Speaker 2:I'd love to yeah. Thank you so much. Thanks so much.
Speaker 1:To the listeners tune in next week for.