«The algorithm switches off thinking»

Mr Bilke-Hentsch, digital media is often portrayed as a risk factor for healthy mental development. What is this all about?

We have been having this discussion for a good 15 years. For a long time, the focus was only on computer games. The concern was with boys and the question of how to prevent gaming addiction. Pathological gaming exists, no question, but it is overrated compared to mental disorders where social media plays a catalysing role. With killer games, the content is obviously not positive, whereas social networks operate subtly.

What is their danger?

Firstly, there is the constant comparison with others, although this phenomenon is normal in itself. Offline, a 13-year-old will often have a similarly insecure peer who thinks they are too fat or too thin, not smart or not pretty enough. On social media, however, she meets hundreds of seemingly marvellous peers. We know that such ideals have a negative impact on young women in particular. In this respect, social media are more disastrous than the women's magazines of the past.

In what way?

Firstly, the magazine can be closed, it doesn't interact with the viewer, unlike social media, which draws her attention to such stories at any time without being asked. Secondly, idols are becoming increasingly accessible through social media. The fact that their content is the result of elaborate staging is easily forgotten.

It is not only celebrities who present themselves on these channels, but also seemingly normal people of the same age who have similar prerequisites to the young user: they go to school, live with their parents, have similar interests - but have a much better life. The constant confrontation with a seemingly comparable counterpart who, however, remains unreachable is tricky. The radical economisation of channels exacerbates the problem.

What do you mean by that?

More and more content is being generated by professionals who know exactly which psychological mechanisms they can use to increase the length of time users stay: They can see in real time which anchors they respond to, and the algorithm suggests further content accordingly. The speed at which this content hits young people outwits their still immature frontal brain and switches off their thinking.

There is hardly any reflection: Does this suit me? Is someone trying to sell me something? We also know that negative content is shown for milliseconds longer than positive content. If young people tend to focus on negative things, this creates a pull that has addictive potential and can increase depressive moods or anxiety. If there are no likes for their own content, negative comments or no comments at all, this does the rest.

Girls are on social media more often - and are more affected by depression and anxiety disorders. Is gaming a healthier way for boys to distract themselves?

Different media preferences certainly play a role, but do not explain this gender gap alone. We have observed that girls and young women are generally more inclined to scrutinise things.

People faking illnesses is nothing new. What is new are the opportunities offered by social media.

They try to solve problems by organising relationships and want to resolve grievances. Boys find it easier to come to terms with this - although they regret the situation, they accept it as a given for the time being. As a result, boys generally survive divorces better. They also have a different attitude towards themselves, which seems to have a positive effect on their self-efficacy.

Explain.

Boys are often satisfied with smaller successes and tend to deduce from these that they can also score points elsewhere. Girls tend to set the bar higher and are less likely to conclude from a good performance that they are also competent in other areas. We are also noticing that more and more young women are asking themselves the question of meaning. Overall, they are more at risk of indulging in merciless self-criticism or becoming overly preoccupied with incriminating content.

Mental health is a hot topic online. The British Medical Journal, for example, reported an «explosive increase» in Tourette's tics among young people, which experts attribute to imitation behaviour - inspired by Tiktok and co.

People faking illnesses to get attention is nothing new. What is new are the opportunities offered by social media: The reaction is immediate. However, the illnesses we deal with most clinically, depression and anxiety disorders, are hardly suitable for this type of scandalisation.

Why not?

When a depressed teenager says that she didn't make it to school because she was exhausted, it doesn't have the sensational effect of a self-harm display or a Tourette's-like tic.

It becomes problematic when someone receives more recognition on social media than offline in the long term.

In addition, people with an inward-looking disorder would probably not expose themselves in this way. Such acts of imitation are not what we tend to deal with in practice. What we often see in clinics, however, are patients who have found a second home in social media.

Is that problematic?

Yes, if they experience more social recognition there than offline in the long term. The analogue world becomes the second choice because people feel more comfortable in the virtual world. The channels deliberately design their offerings in such a way that normal psychological phenomena are easily interwoven with the pathological. In the worst case scenario, the search for belonging that drives every young person becomes an escape into virtual worlds that are virtually customised for them thanks to the memory capacity of algorithms. In these filter bubbles, encouragement is more numerous, more immediate and often more personal - whether it comes from bots or humans is unclear. It is difficult to reappear there.

Nevertheless, most young people can handle social media without getting sick of it.

That's right. It's also only a small group of skiers who break their legs - Rega picks them up anyway and people are campaigning for safety on the piste. The appeasing speeches of a minority should not obscure the fact that there are social media addicts - and a need for action.