Ananya Jain never planned on becoming addicted to TikTok.
Jain, who is 24 years old, downloaded the app right during the peak of Covid. She had heard about TikTok’s data privacy issues, so she promised herself that she wouldn’t post or comment on anything – just watch a few videos and call it a day. That lasted less than a month.
“It just pulled me in because I was so lonely,” Jain said. “I was looking for friends.”
And TikTok delivered. A huge Harry Potter fan, Jain was roped into the BOOKtalk community. She was struggling with acne, but dancing dermatologists told her about over-the-counter skincare products. Later, #polo and #horsesoftiktok became enthralling since she could live vicariously through the players – from underneath her covers. Whenever Jain felt the loneliness creep in, the platform gave her a quick dopamine hit.
Innocuous 15-second videos would lead to two hours of scrolling. Soon, Jain would watch TikToks during work breaks to de-stress, or in her bedroom as she was trying to go to sleep. The app became the source of all her social and entertainment needs. Yet she also felt lonelier than ever.
“I was addicted to my phone, I had the worst mental health possible that you can imagine,” Jain said. Her online friends were anonymous strangers, after all, not the kind of people you’d ask to pick you up from the airport or call up in the middle of the night. It was a vicious cycle: TikTok fed her loneliness but was also what she used to try to alleviate it.
Jain is the founder of mental health startup FullCircle. Running it was all-consuming work, but now she could barely concentrate. Her co-founder, Ankit Kukadia, began noticing how Jain was increasingly retreating to her phone, sneaking off during meetings to scroll through TikTok and neglecting her responsibilities. So, he staged a two-day protest to get Jain to delete the app, giving her an ultimatum that he’d refuse to work with her if she didn’t put a stop to her obsession. “The minute you think about opening up TikTok,” Kukadia said, “give me control of your phone.”
Three tries and 38 days after her first attempt, Jain finally deleted the app for good. The experience was excruciating: living alone, she would find herself sitting at the dining table, anxious and fidgety, not knowing how to fill up the time. She’d lie in bed at night, twisting and turning, the loneliness that had fuelled her TikTok habit burning hotter than ever.
“Your brain behaves differently when it’s addicted to something,” Jain said quietly. “I don’t want to say it was like trying to quit alcohol, but I empathize with people who are trying to quit an addiction because it really is an uphill battle.”
In its simplest form, addiction is the tipping point at which compulsion turns into dependency, when a person’s behavior or drug use spirals out of control despite harmful consequences. Think having the occasional glass of wine versus repeatedly showing up to work hungover.
With no standard diagnostic criteria, the line between excessive phone use and addiction is blurry. Nevertheless, researchers have been exploring this question for the past two decades, and a recent summary of all the best scientific evidence – 82 studies across 150,000 participants – estimated that over 25% of people worldwide had “smartphone addiction”.
The authors of this review demurred on a specific definition, accepting 14 different “commonly used screening tools”. Nevertheless, they showed that the problem of excessive phone use has been getting worse over time, with studies in 2020 and 2021 reporting smartphone addiction at much higher rates – around 35%. A recent survey from the Pew Research Center similarly found that 95% of teens had a smartphone, and almost half reported they were online “almost constantly” – up from 24% nearly a decade ago.
In May, concerns about phone use were brought to the forefront when the US surgeon general, Vivek Murthy, issued an advisory on social media’s harms to youth mental health, drawing upon decades of scientific research. Arguing that individual action was necessary but insufficient, Murthy called for safety standards for tech platforms, similar to those for toys and car seats. He also called for greater social infrastructure to promote in-person connections, such as parks, libraries and volunteer organizations.
The report suggests that phone and social media use overstimulates the brain’s reward center and can trigger pathways similar to addiction, but other mental health experts and policymakers have been more explicit. Mandy Saligari, clinical director of Charter Harley Street in London, compared giving children smartphones to “giving them a gram of cocaine”, while the Stanford psychiatrist Anna Lembke described phones as “the modern-day hypodermic needle”, offering digital heroin at the ready.
Meanwhile, in a congressional hearing, Senator Bernie Sanders described how social media companies “keep coming up with new ways to get teenagers addicted”, while the Republican senator Tommy Tuberville called phones “the biggest drug we got”, more so than even fentanyl.
How much of this rhetoric is fearmongering? Technically speaking, “phone addiction” isn’t a real medical condition, at least according to the bible of psychiatry, the Diagnostic and Statistical Manual of Mental Disorders (DSM). And that’s largely because scientists aren’t sure if phone use has crossed that critical tipping point into social harm. “To be an addictive disorder, you need impairment in daily functioning and psychological distress,” said Dar Meshi, a cognitive neuroscientist at Michigan State University. “There’s a high bar to be set.”
Whether excessive phone use deserves to be called an “addiction” is more than just simple semantics or a debate between academics. By creating a new mental health diagnosis, we risk pathologizing an unfortunate but normal aspect of the human experience.
On one hand, a diagnosis could legitimize the suffering that some people face and enable treatment. But on the other, with all the cultural and historical baggage surrounding “addiction”, the label could misrepresent phone overuse as the absence of free will and do more harm than good.
The history of addiction is one of two competing forces – criminalization and medicalization. In the US, opiates and cocaine were first banned in 1914, followed by alcohol between 1920 to 1933. Drug consumption was seen as a mark of depravity, and treatment options were nearly nonexistent, leaving incarceration the primary recourse.
But as drug addiction began spreading among white middle-class youth in the 1960s, medicine – and a grassroots movement of free clinics – increasingly came to serve these more sympathetic victims. The rise of healthcare had enduring effects: when Richard Nixon declared a “war on drugs” in 1971, what he really meant was developing a crime-control strategy for urban minority neighborhoods, and a public health approach for the white suburbs.
We evolved to find social interaction rewarding
Within this segregated system, George HW Bush pushed forward the medical project, anointing the 1990s as the “decade of the brain”. He called for a renaissance of research into this mysterious organ, delving in particular “into how people become addicted to drugs”.
The idea was to go beyond grounding addiction in character flaws and social influences, instead finding “root causation in some kind of genetic or neurophysiological defect”, said Helena Hansen, a psychiatrist at the University of California Los Angeles. New advances in brain imaging aided this quest, and by 1997, the National Institute on Drug Abuse had officially rebranded addiction as a “chronic relapsing brain disease”.
The goal was destigmatization, Hansen added, but it ended up painting the brain as a universal, disembodied organ devoid of social or environmental influences. Correspondingly, stressors like racism, poverty and state violence were largely bypassed, and pharmaceutical treatment was elevated as the solution to this neural defect.
Over 25 years later, this has remained the official party line for nearly all addictions.
To date, there has been only one longitudinal study about how social media affects brain development, according to Meshi, the Michigan State neuroscientist. Following 189 Dutch adolescents over five years, the researchers reported baseline differences in the brains of high and low social media users – and that high users had accelerated thinning in parts of their brains responsible for decision-making and social awareness. But the researchers also cautioned that these findings were subtle at best with “little evidence for severe negative consequences of social media use on brain development”.
That’s a key point when distinguishing between phone and drug use, according to Gabriel Rubio, a psychiatrist at the Complutense University of Madrid who researches cravings and dependence. He argued that excessive phone use might not change our brains’ structure like alcoholism does but might change how our brains function. Namely, phones affect how our brains deal with internal emotions (eg boredom, loneliness) and external stimuli (eg seeing someone else pull out their phone).
“As in all addictive behaviors,” Rubio wrote in an email, “the biological substrate is the brain’s reward circuit.” In other words, phones mess with our brain chemicals to make us feel good and ensure that we keep on using them.
These functional changes aren’t necessarily problematic on their own. “We evolved to find social interaction rewarding,” said Meshi, and the need to belong is one of the most powerful, universal human drives. Imagine the pleasure of receiving a compliment – the flurry of happiness, warmth on your cheeks – “and then along comes technology that can tap into that drive, that biological hardwiring”, offering a nearly limitless supply of dopamine bursts at any time of the day. “Just you nodding while I’m talking activates that reward system,” Meshi said. “Now I can get 100 people nodding and giving me a like.”
In his own work, Meshi has shown that decision-making is similarly impaired with excessive social media use and drug addiction, and that overusing social media is associated with decreased real-life social support, as well as greater mental illness and social isolation.
But Meshi is quick to note that research into phone and social media use is in its infancy, with potential harms still poorly understood. “The decision-making stuff and most of my work is all correlational,” said Meshi. “Nothing is causal.”
Social scientists have a word for labels like addiction: they call it an “empty signifier”, bearing no specific meaning beyond what’s been imposed on to it. “Folks can have a mutually intelligible conversation about ‘addiction’ and believe they’re talking about the same thing,” said Jennifer Carroll, a medical anthropologist at North Carolina State University, “and they’re really not.”
When the American Society of Addiction Medicine and other medical organizations talk about addiction, they’re usually referring to the DSM-5 criteria and addiction as a chronic brain disease. But for the everyday person, “addiction” has become something of a metaphor, referring to something they enjoy, do a lot and feel is unhealthy. “I like ice-cream a lot, so I used to tell everyone I’m an ice-cream addict,” said Meshi. “The average person uses addiction in a different way than a clinician uses it.”
But over the past two decades, the lines between professionals and the public have become increasingly blurred – particularly after the DSM-5 reclassified excessive gambling as an “addiction” in 2013. Although some experts criticized the lack of evidence and consensus, the controversy wasn’t really about gambling itself, but the seismic shift this decision signaled.
For the first time, a non-substance addiction – a behavior – had become a psychiatric diagnosis by the highest medical court in the land, fueling concerns that now “virtually almost everything may be considered pathological”, according to Antonio Maturo, a sociologist at the University of Bologna.
If we start lowering that bar, then it’s like everything can be an addictive disorder
And these premonitions have slowly begun to materialize. Within the hallowed halls of academic literature, researchers have been coining all sorts of new addictions to shopping, fortune-telling, selfie-taking and more. “For the substance use addictions, there’s a well-worked out pharmacologic substrate, you can see receptors, drug-metabolizing enzymes upregulated, downregulated,” said David Jones, a psychiatrist and historian of science at Harvard Medical School. For many of these “conditions”, however, there’s none of this – just a catchy new label.
In the case of “phone addiction”, however, a similar dismissal feels overly flippant, if only because the term has become a part of everyday discourse. From Reddit forums to the halls of Congress, omnipresence, rather than judicial decree, has begun to reify this issue.
In fact, in a June Senate health committee hearing on the youth mental health crisis, phones and social media were all anybody could talk about. Murthy, the surgeon general, condemned social media companies’ “utter lack” of accountability and offered support for an electronic warning label on social media, like those already on cigarette packages. The Democratic senator Chris Murphy similarly spoke about his bill to rein in social media’s addictive practices, with his colleagues offering other testimonies on the unique harms of this technology.
“Instead of our children talking to their friends, their colleagues, their teachers, their coaches, they talk to social media; that’s their best friend,” said the Republican senator and OB/GYN Roger Marshall. “I look at social media today as worse than pornography.”
Beyond such theatrical comparisons, some scientists have also sought to legitimize phone addiction by surrounding the phrase with a cast of characters. For his part, Rubio offered up “textaphrenia” (the phantom sense of receiving a text), “ringxiety” (anxiety over getting a phone call), and “nomophobia” (a portmanteau of no mobile phone and phobia) as a few examples. After all, how can there be a diagnosis without symptoms?
Meshi is sympathetic toward these efforts; he told me how he had to fire a research assistant who couldn’t stay off Facebook. But he’s also worried that this discourse is running ahead of the evidence and could cheapen the death and devastation of nicotine, opioids and other drugs.
“If we start lowering that bar, then it’s like everything can be an addictive disorder,” he said. “I don’t want to go down that path.”
In general, Americans probably overstretch medical terms – for example, the simultaneous “pandemics” of disinformation, loneliness and poverty. It’s probably innocuous and maybe even helpful to drive attention to important social issues. However, for many experts I spoke with, the overuse of “addiction” isn’t the same value-free proposition.
For one, it risks creating a two-tiered system for patients, similar to how opioid addiction treatments have long been segregated, according to the UCLA psychiatrist Hansen. Methadone is dispensed in clinics regulated by the Drug Enforcement Administration and located almost exclusively in low-income neighborhoods, while buprenorphine is prescribed in private doctors’ offices, “removed from poverty, ethnic minorities and street crime”. The aggressive regulation of methadone – with its daily observed dosing and frequent urine checks – simply wouldn’t do for the white middle class.
For Hansen, “there’s no question” that creating a diagnosis around phone addiction would promote a similar kind of segregation. Specifically, she envisioned a future in which social media and phones themselves become racialized. “Whatever platforms, whatever software tends to be used by poor Black and brown people, that’ll be demonized first,” said Hansen, with minorities subsequently labeled as “sicker” and “more diseased”.
This racial profiling might seep into the potential remedies as well, Hansen predicted. Namely, the well-off will channel their children to bucolic summer detox camps costing up to $11,000 while the marginalized are relegated to underfunded, crowded public clinics.
Some of these decisions might even be taken out of the hands of parents and into the courts, according to Carroll, the medical anthropologist. With the brain disease model ingrained over decades, addiction has increasingly been seen as a lack of rationality and inability to make authentic choices, which has enabled all sorts of violations of people’s agency and autonomy.
In Massachusetts, for instance, any person with an addiction can be coerced into treatment under the state’s Section 35 law. Family members, police officers and healthcare providers can all ask a judge for a warrant to take patients into custody. And if the judge agrees they are a danger to themselves or others, patients are then sent for addiction treatment – often in prison – and held against their will for up to 90 days. From 2011 to 2018, 42,853 Massachusetts residents were involuntarily committed in this way; about 38 states have similarly coercive policies.
It’s a really slippery slope – this idea of technology as a tool sliding into technology infiltrating every part of your life and structuring reality
Under a label of addiction, excessive phone use could be employed in a similarly dehumanizing logic: “You can’t make the choice to go on your own, so I have to make the choice for you,” said Carroll. While the research is clear that compulsory drug treatment doesn’t actually work (and might even do more harm than good), these programs remain incredibly popular because they seem like a compassionate response to someone’s brain being fundamentally compromised.
“I hear it used all the time – things ‘hijack your brain’ – which is an incredible metaphor if you think about it,” Carroll added. “It’s like Ratatouille, but it’s TikTok.”
Regardless of whether addiction is the right term, everyone I spoke with agreed that our growing reliance on phones is a real problem.
Never before in history have we had such immediate, infinitesimal access – with literal supercomputers in our pockets. “It’s a really slippery slope – this idea of technology as a tool sliding into technology infiltrating every part of your life and structuring reality,” said Stacy Torres, a sociologist at the University of California San Francisco. “We’re in a brave new world.”
Torres herself has been trying to hold on to the past: at the age of 43, she has never used social media or owned a smartphone. Poverty made her a late adopter; she got her first phone – a prepaid Nokia brick – when she was 26. But her fear of addiction, given a long family history of alcoholism, kept her away from anything more advanced.
Of course, not everyone who uses a smartphone will have a problem, but it’s easy to understand why some might. For these people, a medical diagnosis would probably help, validating their suffering and ensuring they get the care they need.
“The moment you call something an ‘addiction’, the move is to medicalize it, to push policy in the direction of treatment, to push social reactions from judgment and condemnation towards empathy and patience,” said Jones, the Harvard historian of science. Despite the risks, there’s real promise in moving beyond a status quo where patients languish alone.
Even Hansen acknowledged that a label of “addiction” could spread awareness about how repetitive, compulsive screen use can ruin people’s lives. She’s seen it first-hand: her brother-in-law flunked out of college because he couldn’t stop playing video games. “He had friends who were rushed to the ER for rehydration after the release of one of their favorite video games,” Hansen added. “They could not pull themselves away from the screen to drink water.”
However, if society is going to medicalize phone use, Hansen wants to make sure we’re pointing our fingers in the right direction – away from brain disease notions that “people are a slave to their own habits and behaviors”. The real problem, Hansen argues, are the social and environmental drivers, from schools cutting arts and physical education programs to tech companies’ increasingly aggressive business schemes.
Hansen thus argues that excessive phone use shouldn’t be called an addiction but instead something like “manufacturer-induced compulsive behavior”. It’s a mouthful, yes, but getting the language right is critically important since it implies something about causation, and where the solutions ought to begin.
In other words, rather than punting the problem to the healthcare system, Hansen believes that we should be regulating how software is developed and what’s permitted to come to market. There’s a reason why social media apps are often compared to slot machines, with their bright designs, infinite scrolling and pull-to-refresh feature suspending our brains in anticipation. You can mitigate some of these effects by changing your screen to grayscale or turning off notifications, but it’s almost impossible to win on your own, suggested Jones, because we live in such highly engineered environments.
Jain just celebrated six months of “TikTok sobriety”, telling me that the decision to quit brought her back into reality. Her mind wanders during breaks. She’s started swimming, playing tennis and going horseback riding – two hours a day without fail. She’s been more actively making friends rather than relying on anonymous strangers online. And she finally went to see a dermatologist for her acne.
“It’s costly, oh my God,” said Jain. “It’s definitely more cost-intensive than downloading a free app on your phone.” But for the first time in a long time, Jain feels happy.
“A lot of our generation is more connected than ever on social media, but we’re more lonely than ever,” she said. “It’s such a weird thing.”