As anyone who has spent time on Twitter knows, Americans believe the world is in a dark place. The news has been wall to wall tragedies for years: climate change, the war in Syria, natural disasters, racist violence and then a deadly global pandemic. Most recently, our timelines and newsfeeds were flooded with the blue and yellow of the Ukrainian flag as news of the Russian invasion broke. We watched on social media as Russian soldiers flooded into Ukrainian cities, and we added "war with a nuclear superpower" to our list of things to worry about. Every day terrible things are happening somewhere in the world, and thanks to social media, no matter how far away the suffering, we all have a front row seat.
If television brought war into America's living rooms for the first time, then social media has brought the full range of human suffering into not only our living rooms but also our bedrooms, bathrooms, coffee shops, commutes and offices—really anywhere in the world with a cell signal. It is no wonder many of us feel we are living in extraordinary times. We are all witnessing a never-ending stream of global suffering every day on social media.
But the experience of suffering has not only been virtual. The COVID-19 pandemic turned every American's world upside down. Our day-to-day lives were disrupted as normal activities like meeting friends at a restaurant or getting groceries became potentially deadly. We all witnessed the disaster of the pandemic personally and online through social media.
We saw the ever-climbing death counts on the news. Twitter showed us photos of mobile morgue trucks on the streets of New York City. Images of Americans dying alone on ventilators were seemingly everywhere.
All this suffering is having an impact on America's mental health, and it is not just our own personal tragedies that are hurting us. The never-ending stream of human suffering on social media can hurt us, too.
A widely cited 2013 study on the mental health effects of viewing graphic news footage found that "vicariously experienced events can become collective traumas." Simply put, watching far off suffering on television can trigger real stress responses in viewers, leading to negative health outcomes. Researchers also found that these negative mental health effects were cumulative. Stress responses to graphic media accumulate as viewers watch each new global tragedy.
Living in a global pandemic for the past two years had already stretched many Americans to their breaking points, but in recent weeks, pandemic conditions have been improving. Case counts, hospitalizations and deaths began falling in February 2022 as the Omicron variant receded. Some of us may have breathed a sigh of relief as mask mandates began lifting and vaccine requirements were relaxed. Maybe this would give us a change to rest after years of turmoil. To reset—to return to feelings of normalcy.
Then Russia invaded Ukraine. Suddenly, we were all watching a war unfold via social media. Some have called Russia's invasion of Ukraine "the first TikTok war," a nod to how frequently and widely content related to the invasion is being shared on the platform. Though the accuracy of this moniker has been debated, Americans are undoubtedly spending a lot of time watching this war in real time on TikTok, Instagram and Twitter.
Americans spend a lot of time on social media in general. Every age cohort from Zoomers to Boomers spends on average at least an hour on social media per day with Americans ages 16-29 spending a staggering three hours per day on social media.
Though we all crave a "break," this is the world we live in now. Social media is not going anywhere, and neither will catastrophes. Tragedy is unfolding around the world all the time, and we will only continue to become more connected to one another as globalization accelerates and media technology improves and evolves.
Given this reality, how do we all learn to cope? As a psychiatrist and the founder of Mindful Care, a psychiatric urgent care provider, I think we could all learn something from medical professionals.
Doctors, nurses, social workers and first responders have long born witness to incredible amounts of human suffering, and researchers have been studying the effects of this vicarious trauma exposure on helping professionals for years. There's even a name for the negative effects of witnessing the suffering of others, listed in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, as post-traumatic stress disorder secondary to trauma exposure. This diagnosis was previously referred to as secondary traumatic stress disorder (STSD) and is caused not by personally experiencing a traumatic event but rather by witnessing the trauma of others. Symptoms can include feelings of anxiety, isolation and depression as well as dissociation, difficulty sleeping, nightmares, flashbacks and more.
Compassion fatigue is a related, but milder, condition that is also often seen in helping professionals. Compassion fatigue is characterized by feelings of isolation, helplessness, numbness and avoidance. People with compassion fatigue often describe feeling burnt out, like they have nothing left to give to their clients or patients.
Thanks to our social media consumption, these symptoms might sound familiar to many Americans. But how are we to manage the negative mental health effects of witnessing war, a pandemic and disasters day after day on social media?
Some people are more resilient to the negative effects of vicarious trauma than others. Studies of helping professionals have shown that people with fewer existing stress management skills are at a higher risk for developing compassion fatigue and burnout. Those who manage stress via what the mental health field calls maladaptive coping mechanisms, such as excessive drinking, are more likely to develop serious secondary traumatic stress. Excessive self-criticism and relinquishing control in the face of trauma exposure were also found to be risk factors for secondary traumatic stress.
The amount of distressing content that you are viewing also matters. The more vicarious trauma you experience, the more likely you are to develop symptoms of secondary traumatic stress.
These studies suggest a few potential strategies for avoiding compassion fatigue and secondary traumatic stress. We all need to develop healthy stress management skills, and we should limit the amount of time we spend consuming distressing content on social media. But what do we do if compassion fatigue has already set in?
We in the helping professions do not have all the answers. Strategies for treating compassion fatigue and secondary traumatic stress are still evolving. However, mindfulness techniques like meditation have been shown to reduce burnout as have simple stress management interventions such as spending time outside, cooking, or exercising. Creative activities such as drawing, painting and making music have also been shown to reduce the symptoms of compassion fatigue.
Finally, we need to learn to set better boundaries. For helping professionals, this might look like assertiveness training that helps us learn to set healthy boundaries at work. For the average American, this means putting down the smartphone. Stop the doomscrolling.
Social media is not going anywhere, and neither is human suffering. Horrifying world events will continue to play out on our smartphones in intimate detail. Given this new reality, we must all learn how to be engaged, empathetic global citizens without sacrificing our own mental health in the process.
Dr. Tamir Aldad is a fellowship trained addiction psychiatrist and the founder and CEO of Mindful Care—the award winning first-ever psychiatric urgent care in the United States. Dr. Aldad graduated with an MBA from University of Chicago Booth School of Business, and completed residency and fellowship training at Northwell Health, after graduating medical school. He also conducted several years of behavioral health research as a physician scientist at Yale School of Medicine. He is passionate about acute mental health issues, public mental health and improving access to affordable care.
