Reacción a "Adults who use Instagram a lot overestimate its “addictive” nature, making self-control difficult dificulta el autocontrol"

The article is of high quality. What are the implications? We cannot confuse society with what a habit is and what an addiction is, because they are completely different. A habit is a behaviour that you repeat over time. In fact, human beings are quite prone to developing habits; we constantly develop habits in our daily lives. The problem arises when a habit becomes a need, and I would emphasise the concept of need. That is when we have an addiction.

According to the clinical guidelines we use to diagnose an addiction, three elements must be present: tolerance, withdrawal and negative consequences. I am talking mainly about substance addictions. Addictions to social media, such as Instagram, TikTok and others, or internet addictions, would fall under the umbrella of digital addictions, which are not covered in these manuals. Therefore, the fundamental problem we have here as healthcare professionals is that we cannot diagnose these conditions because they do not exist in the international guidelines, which for us are the DSM-5, which is American, and in Europe the ICD-11, which is from the World Health Organisation. As there is no condition called internet addiction or TikTok addiction or social media addiction in general, it is difficult to draw the line between excessive or problematic use (as it is often referred to in science) and addictive use.

But, I insist, a habit should not be confused with an addiction. An addiction to social media, the internet or video games has very similar symptoms to those of substance addiction: symptoms of tolerance, withdrawal and, of course, negative consequences.

A habit can become an addiction when the need arises, that is, we start checking social media for the sake of doing so, we usually do it all the time, for example, when we go to bed and pick up our mobile phone and start scrolling and looking at social media. This can become a habit so that every night when I lie down in bed and calm down, that's when I look at social media or check my networks. Up to that point, there would be no problem; the problem arises when, if one day I don't have that moment to scroll and check my social media, it makes me feel uncomfortable, restless, irritable or dysphoric. These are signs that it is no longer becoming a habit but a need. ‘I need to do this to feel good.’ When that happens, we have to start looking at what is going on.

Tolerance means that I have to consume more and more social media in order to achieve the pleasant effect of disconnection, so I spend more and more time connected. And withdrawal, when I cannot access social media, triggers an obvious dysphoric feeling: I feel irritable, I feel uncomfortable... That is when we have to start asking ourselves whether we are actually developing a problem or not. We must not confuse society between what is a habit and what is an addiction.

The problem that we researchers and health professionals who are dedicated to this field fundamentally have is that, as we do not have manuals that allow us to establish clear diagnostic criteria, there is a kind of diagnostic maelstrom. We rely on questionnaires, as the study mentions, to diagnose, but we are seeing it in clinical practice. We have cases, we have very serious cases, and, in addition, in the child and adolescent population, we are seeing quite significant cases of school failure and family problems. Social media also has components that are potentially addictive, such as endless scrolling, so we must be very careful. We must not demonise them, because social media has very important functions for society, but we must treat them with caution, not underestimate them, and educate society about the signs we need to look out for.

Also, the fact that we have an increasing need to consume social media, for longer and longer periods of time, even though this has negative consequences for us, is another very clear indication that we may be addicted. For example, I sleep fewer hours, I wake up much more tired because I am using social media, or at work, instead of working, I am using social media and this has negative consequences, or I do not do my schoolwork, or there are family problems because I do not put my mobile phone down and it is time for dinner or homework.

Do we see people in consultation who tell us they are addicted to Instagram? It's rare. Generally, they come to us with other types of problems associated with digital addictions; this is what we call comorbidity or dual pathology. Dual pathology means that you may have a substance addiction and it is accompanied by a digital addiction, or you have another condition, such as anxiety or depression, and suddenly you realise that there are also digital addictions involved. We are seeing that society is not aware of the importance of setting clear boundaries, especially adults, who are role models for minors.

In short, it is interesting to read studies of this type to see if we are indeed in this situation or if it is a self-fulfilling prophecy, ‘yes, I am addicted’. Saying that a person is addicted is a serious matter. We have to consider how we invest our time: whether we are investing it rationally and with a conscious decision, or whether time is being consumed, because it happens often and is part of the addictive elements. I pick up my phone or tablet and start without any clear intention, simply wanting to escape from a hard day at work, and when I realise it, I've been there for four hours. That's four hours I've lost doing other things, and in minors, with social interactions, it's very obvious. We have a reduction in social interactions in minors because they are interacting virtually, but social interaction is much more powerful and much more beneficial for them than virtual interaction.

Therefore, when a behaviour that I do for the sake of having fun or passing the time becomes a necessity, it is a problem that needs to be addressed because it is not going to go away; it will probably tend to get worse.