At her Spring 2018 New York Fashion Week show on Thursday, Collina Strada designer Hillary Taymour turned attention to more than just her looks; Vogue reported Hillary highlighted the little-talked about mental health condition Social Media Anxiety Disorder (SMAD). But if you've ever logged on to Instagram, you might have an idea of what this means, even if you've never heard the name. That's why we decided to look into exactly what SMAD really is.

Rachel Kazez, therapist and founder of All Along, says that while it’s not an official psychiatric diagnosis yet, social media definitely affects self esteem and can cause or exacerbate anxiety, depression, and more.

“It's risky to compare your insides to someone else's outsides,” she says. “On social media, people post the best version of themselves. If you compare that to yourself, you are comparing it to your whole self — flaws, fears, and all.”

In other cases, she adds, social media can also be a source of strength and community, for example, LGBTQ folks who don't see people they can connect with regarding that identity IRL.

Over the past few years, teen and adults alike have been measuring their worth, confidence levels, even happiness on the number of shares and likes they get on their posts — or lack thereof. SMAD can leave us wondering if we’re good enough, pretty enough, popular enough — and that can suck up our time and stop us from healthier interactions.

“My teen clients stress over the perfect thing to write to others and sometimes when they don't receive a similar response, it starts real-life feuds,” says Mallory Grimste, LCSW.

Another very real example is the battle between parents and their teens around social media and cell phone usage in general, she says.

“I have had girls sitting on my couch in tears because they followed their parents rule of turning their phone in during homework time only to return to 20 panicky messages from peers that sometimes turn really nasty,” Grimste says. “Part of my work with these girls is helping them learn to prepare their friends for this healthy boundary-setting and also learn not to be responsible for someone else's anxiety.”

In some cases, it mimics the behaviors — both highs and lows — and downfalls that come with any other unhealthy behavior, as noted by Anjhula Mya Singh Bais, Ph.D. International Psychology, trauma specialist and author.

“Social media and the 'likes,' retweets, and other plaudits that it instantly generates mimics the same mechanisms in a drug habit. The kick, the high is not dissimilar to the reward areas that fire up in your brain — like the amygdala and striatum — when you [use a substance]," she says.

“In other words, an endless feedback loop is generated where one needs to post more and garner more likes in order to feel just as good as they did initially,” Dr. Bais continues. “It keeps taking more and more being out there, which explains why if you ride the subway or look around an airport, the majority are glued to their phone. Many adults, but adolescents especially, in my practice display fidgety, anxiety-ridden behavior in the one hour in therapy where they don't have recourse to their phone.”

Facebooking and Instagramming all lead to disruptions in sleep-wake cycles because it takes longer to fall asleep, she adds, which basically leads to a disaster waiting to happen in terms of mental and physical health.

“I keep telling my clients that social media is not reality. The connection and interrelatedness that is embedded in our evolutionary history is premised on sensory experiences like touch and eye contact,” Dr. Bais says.

Numerous studies point to increased depression and anxiety of people who use Facebook and Instagram because everyone is out to represent only the best sides of themselves. For example, a post that says, ‘I am going on an around the world cruise, it's magnificent’ could leave out the fact that half the time was spent with food poisoning and sea sickness. As a result, the FOMO and the feeling of being inadequate is magnified manifold.

Kazez says it's important for us to think about why we use it, and think about how to use it mindfully, consider what the benefits are, and be more “deliberate” about the content you're consuming.

“I'd encourage taking a social media break, even if it might mean ending a streak with someone on Snapchat or missing out on a daily prize post on Instagram,” she says. “I'd also validate that, for many, it is a new way of feeling a sense of community and encourage them to diversify the ways they get community, so that social media doesn't feel like the only option.”

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