Digital Stimulation

Introduction

Vision Disturbances

Sleep Disorders

Headache

Concentrating Difficulties

Dizziness

Epilepsy

Fantasy World

Hallucination

Social Isolation

Neuromuscular and Musculoskeletal Complications

Author

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Introduction:

Digital stimulation refers to the physical and psychological impact that arises from using digital devices such as smartphones, computers, tablets, and TV screens. These devices provide continuous information, entertainment, and interaction, which can have both positive and negative effects on human health. On the positive side, digital stimulation can enhance productivity, education, and communication while offering quick access to knowledge and entertainment. However, prolonged or excessive exposure to digital stimulation can have negative consequences, such as vision problems, sleep disturbances, and other physical and mental health issues, including pain in the hands, fingers, back, and neck, as well as anxiety, stress, and hallucination. It is therefore important to find a balance and take breaks from digital stimulation to reduce the risk of these negative effects.

Vision Disturbances:

Using mobile devices and tablets (screens) can affect both vision and visual perception by altering how the surrounding environment is perceived and interacted with. Through spending long periods staring at a flat, two-dimensional screen, the eyes adapt to short distances, which affects eye muscle activity and adjustment. Unlike the natural environment, which offers a variety of depths and distances to focus on, the mobile screen provides a flat and limited view, reducing the need to shift focus between near and distant objects.

Over time, this adaptation can lead to eye strain, reduced clarity at long distances (myopia), and an increased risk of digital eye strain. The static, two-dimensional perspective offered by these devices also impacts how the brain processes visual input, as we increasingly take in information through a flat surface rather than a dynamic, three-dimensional environment. This can lead to visual disturbances such as blurred or double vision and affect the ability to quickly switch focus between different distances. Another aspect is that screen time reduces blink frequency, leading to dry eyes and increased discomfort.

Additionally, exposure to blue light from screens can disrupt the sleep cycle and affect circadian rhythms, which, in turn, can have long-term effects on both physical and mental health. Long-term screen use has been shown to increase the risk of symptoms associated with computer vision syndrome, including dry eyes, headaches, and difficulty concentrating.

To protect vision, it is recommended to follow the 20-20-20 rule: take a break every 20 minutes and look at something 20 feet (6 meters) away for 20 seconds. It is also important to ensure that screens are properly adjusted to reduce strain and create a more comfortable visual environment. 

Sleep Disorders: 

As smartphones and similar devices have become increasingly integrated into daily life, studies have shown a concerning trend where excessive or improper use of mobile phones correlates with sleep problems. In recent decades, the use of digital screens before bedtime has increased drastically, especially among adolescents and young adults. This trend has raised questions about the impact of screen light on melatonin production and the body’s natural circadian rhythm, as well as the psychological effects that constant digital interactions can have on sleep quality.

Blue light, which is common in mobile screens, has been shown to inhibit melatonin production, a hormone that plays a central role in regulating the sleep cycle. 

When melatonin levels are disrupted, it can lengthen the time it takes to fall asleep and reduce total sleep time, leading to a range of long-term health consequences such as increased fatigue, concentration difficulties, and heightened stress sensitivity.

Studies have also found that the frequent use of social media and other stimulating digital activities just before bedtime can increase mental stress and create a heightened level of attentiveness, making it harder for the body to wind down before sleep. Beyond the light effects, there is also a psychological aspect of mobile use that negatively affects sleep. Users may feel pressure to respond immediately to messages or notifications, creating a form of "digital stress." This stress, associated with FOMO (fear of missing out) and the need for constant connectivity, is linked to worry and anxiety, which can delay sleep onset or impair sleep quality.

Several studies have linked nighttime phone use to a lower proportion of deep sleep, which has far-reaching effects on the body’s ability to recover. Thus, it is important to develop strategies to minimize the impact of mobile phones on sleep. Interventions such as limiting phone use to early evening, introducing blue light filters, and raising awareness about the effects of phone use on sleep can be effective methods to reduce negative effects on sleep quality. 

Headache: 

Prolonged screen time often involves holding the head in a forward-leaning position, which causes neck muscles to tense and increases the risk of muscle pain. This tension in the neck and shoulders can spread to the head, triggering or worsening tension headaches.

Additionally, intense focus on a mobile screen can lead to visual strain, which further contributes to headache symptoms. A prolonged forward-leaning position can strain the spine and worsen posture, which over time can lead to the development of kyphosis, an abnormal curvature of the upper back. This can also cause pain and limited mobility, making it difficult to maintain correct posture. Mobile screens also emit blue light, which has been shown to disrupt sleep patterns and can lead to increased fatigue—a common trigger for migraines.

For people sensitive to light, blue light can also trigger migraine attacks. Prolonged exposure to this light, especially in dark environments, can worsen symptoms. Using mobile phones can also involve constant small eye movements and focusing on nearby objects, which can lead to visual fatigue. This, in turn, can create a vicious cycle of eye strain, tension in the neck and shoulders, and increased pain that exacerbates both migraines and tension headaches. To reduce these effects, regular breaks, adjusting screen brightness and color temperature, and holding the mobile in a more ergonomic position so that the neck doesn’t have to bend too much are recommended. 

Concentrating Difficulties:

Mobile device use can act as a way for children with ADHD to mask their concentration difficulties. Mobile activities, such as games and short videos, provide quick and continuous stimulation, which children with ADHD are often drawn to. These activities can be adjusted in speed and interactivity, allowing children to set the pace according to their needs and brain activity levels.

The rapid shift between different stimuli and activities offered by mobile use often aligns more closely with the level of stimulation that suits their brain function, which can make it easier for them to maintain focus for longer periods compared to other, more static activities. In this way, mobile use can create a temporary illusion of improved concentration, even though the underlying difficulty in focusing on tasks requiring longer patience remains.

Hyperactivity may also be suppressed or masked. Hyperactivity in individuals with ADHD can partly result from an imbalance between brain activity levels and the amount of stimulation it experiences, leading to a compensatory search for stimulation.

For children with ADHD, however, excessive mobile use risks further reinforcing the need for immediate stimulation and difficulty in tolerating quiet activities that require more sustained focus. Therefore, it is important to balance mobile use with other activities that support concentration and endurance for longer, less stimulating tasks. 

Dizziness:

Some individuals who use mobile phones intensively may experience dizziness, often caused by a complex interaction between visual strain, close focus on the small two-dimensional screen, and the physical effects on eye muscles and the balance system.

During prolonged screen time, the eye muscles can become fatigued, affecting both muscle control and balance. This visual fatigue can result in dizziness or a feeling of unsteadiness. Screen movements, such as rapid scrolling and video playback, can also create a form of virtual motion sickness. When the eyes perceive movement on the screen while the body remains still, the brain may interpret this as a conflict between visual input and the body’s balance system. This phenomenon, similar to motion sickness, can cause dizziness, nausea, and general discomfort. Another factor that may contribute to dizziness is head position. Constantly looking down at a mobile device can cause neck strain, increasing the risk of dizziness.

To reduce the risk of dizziness from mobile use, it is important to take regular breaks, limit screen time to shorter periods, and hold the phone at eye level to avoid unnecessary neck strain. Reducing screen brightness and avoiding excessive screen movement can also be helpful.

Epilepsy:

The misuse of mobile devices like smartphones and tablets can worsen epilepsy in some individuals by triggering seizures or increasing seizure frequency. This can particularly affect people with photosensitive epilepsy, a form where seizures can be triggered by light patterns, flashing lights, or screen movements. Photostimulation and light-related triggers have proven especially provoking for individuals with occipital lobe epilepsy. This sensitivity to visual stimuli is due to the occipital lobe’s direct connection to the visual cortex, making it more susceptible to visual disturbances.

Flashing lights, rapidly moving images and animations, blue light, prolonged screen time, overstrain, and visual fatigue can reduce the brain’s treshold against seizures, especially if device use occurs under stress or in dark environments. To reduce the risk of seizures, it’s important for individuals with epilepsy to limit screen time, use "dark mode" or other settings to reduce contrast and glare, and avoid games or videos with flashing lights or rapid visual changes. 

Fantasy World:

Digital platforms such as social media, games, and various apps offer constant access to content that can be more stimulating and immediately rewarding than everyday reality. This makes it easy for individuals to be drawn into digital worlds where they can create idealized versions of themselves or engage in escapist activities, potentially increasing the tendency to live in a fantasy world. Another factor is that mobile content is often designed to engage and retain the user’s attention, with tailored feeds and personalized recommendations.

This makes it easier for users to get absorbed in a digital universe of personally interesting content, which may feel more satisfying than the physical world. For some, this can become an escape from difficult emotions or challenges in real life, leading to a heightened dependency on digital stimulation to feel engaged or satisfied. Spending significant time in digital environments can also affect how one perceives social relationships.

Communicating and interacting via text or images rather than face-to-face relation, can create a sense of distance from others. Over time, this may make it harder to feel fully present in social situations, causing real-life relationships to feel less engaging. 

Hallucination:

Digital stimulation from mobile devices can be intense for the brain and may sometimes contribute to or exacerbate hallucinations, especially in individuals with neuropsychiatric or psychiatric conditions such as schizophrenia, bipolar disorder, autism or ADHD. This overstimulation can trigger or worsen hallucinations, particularly in people with sensitive brain function.

Individuals with psychiatric conditions are more vulnerable to sensory overload, which can lead to visual or auditory hallucinations when the brain becomes overwhelmed. Prolonged exposure to blue light from screens disrupts melatonin production and impairs sleep quality, a common trigger for psychotic symptoms. Sleep deprivation, secondary to this exposure, increases the risk of hallucinations, particularly in those already vulnerable due to psychiatric disorders, creating a vicious cycle where sleep loss leads to greater vulnerability to hallucinations and anxiety.

For individuals with neuropsychiatric or psychiatric conditions, mobile use can become a form of escape from social and emotional challenges, leading to increased isolation. When mobile use replaces real interactions, it can exacerbate psychotic symptoms, making fantasies and inner images feel more real.

Additionally, the constant flow of information on social media can increase paranoia, especially for people prone to suspicion or other psychiatric conditions. The influence of digital media and news can reinforce feelings of being watched, which in turn may lead to hallucinatory experiences during periods of heightened stress or anxiety. 

Social Isolation:

Social isolation can be defined as the lack of physical or psychological presence of social contacts, which can lead to feelings of loneliness, depression, and anxiety. The role of mobile phones and social media in either reinforcing or alleviating these feelings is complex and contradictory. On one hand, these platforms provide an accessible arena for social support and interactions, which can reduce feelings of isolation, especially for individuals with limited physical mobility or geographic distance. On the other hand, excessive use of mobile phones for social purposes can paradoxically increase feelings of loneliness and isolation.

One phenomenon often discussed in this context is "phubbing," or the tendency to ignore people nearby in favor of using a mobile phone. Studies have shown that phubbing can create distance in interpersonal relationships by signaling a lack of interest in the ongoing conversation or relationship. This can lead to a reduced sense of belonging and trust between individuals, which, over time, can intensify feelings of social isolation.

Furthermore, social media on mobile phones can give rise to FOMO (fear of missing out), a form of psychological discomfort that arises when individuals feel they are missing important or exciting events that others are part of. This feeling can create a self-reinforcing cycle where individuals spend more time online to stay updated but paradoxically experience stronger feelings of loneliness and social inadequacy. FOMO and the constant need to validate one’s social status online have been shown to increase stress levels and anxiety, negatively impacting overall mental health.

The mobile phone’s role as an escape in uncomfortable social situations also contributes to the issue of isolation. Instead of seeking genuine social interaction in times of loneliness or insecurity, some individuals use their phones as a temporary distraction. This escape mechanism can prevent the development of deeper social skills and the ability to form meaningful relationships. In the long term, this may lead to individuals feeling increasingly disconnected from their surroundings and more reliant on their mobile phones as the primary source of social contact, further reinforcing social isolation. To counter this trend, some researchers and public health organizations have begun exploring strategies to reduce the impact of mobile phones on social relationships.

Examples of such strategies include awareness campaigns on digital balance, promoting "digital detox" or time-limited use of social media, and developing programs and apps that remind users to take breaks and engage in real-life social interactions.

Neuromuscular and Musculoskeletal Complications:

Pain in the hands and fingers resulting from mobile holding is a growing issue, paralleling the increase in digital interaction and excessive smartphone use. This type of pain, sometimes referred to as "mobile phone hand" or "text hand," can involve both acute and chronic pain in the fingers, wrists, and hand muscles. The pain is often related to repetitive strain and the static positions held when using a mobile phone for extended periods. 

• Tendinitis: Overuse of thumbs for typing, scrolling, and handling apps can lead to inflammation in the thumb tendons (De Quervain’s tendinitis), resulting in pain along the thumb side of the wrist and sometimes down into the forearm.
• Trigger Finger: Repeated pressure and bending of the fingers to manage the mobile phone can irritate tendons and create a "trigger" where the finger gets stuck in a bent position. This can cause both pain and stiffness in the fingers, particularly the middle and index fingers.
• Carpal Tunnel Syndrome: Prolonged holding a mobile phone combined with an uncomfortable wrist position can lead to pressure on the median nerve in the carpal tunnel, causing numbness, tingling, and pain in the hand, especially in the thumb, index, and middle fingers.
• Strain on Small Hand Muscles: Mobile use requires the hand and fingers to work in demanding positions for extended periods. This can lead to strain in the small hand muscles, which in turn causes muscle pain and fatigue.

To reduce pain in the hand and fingers related to mobile phone use, the following preventative measures can be useful:

• Switch Hands Frequently: To reduce strain on the same hand or fingers, it's helpful to alternate between the right and left hands.
• Accessories like Grip Holders or Stands: Using holders that provide a better grip and place less strain on the fingers can help reduce pressure.
• Regular Stretching Exercises: Stretching fingers, hands, and wrists can improve flexibility and reduce stiffness. Light stretching and hand exercises every hour can improve blood circulation and relieve tension.
• Limit Use and Take Breaks: Shorter periods of mobile use with regular breaks can help avoid overstraining the muscles and tendons in the hand.
• Ergonomic Adjustments: Adjusting the phone’s user interface to reduce strain on certain fingers and using voice control when possible can help lessen the load.
• Seek Medical Help for Chronic Pain: For long-term pain, physical therapy or assistance from a hand rehabilitation specialist can be valuable. A physiotherapist or occupational therapist can help develop individual exercises and apply techniques like thermotherapy and ultrasound to relieve pain and inflammation.

Author:

AmirHossein Mahdavian MD,

Pediatric Neurologist