May 9, 2025
Cindy Lopez: Welcome. My name is Cindy Lopez, the host of this CHC podcast, Voices of Compassion. We hope you find a little courage, feel connected and experience compassion every time you listen.
In this Voices of Compassion podcast episode, we explore the complex relationship between digital devices and family well-being. We talk about how screen time affects developing brains and physical health, from things like disruption to attention impacts. Our CHC experts, Dr. Vidya Krishnan and Dr. Olivia McDonald, share practical strategies for establishing healthy boundaries around technology use, emphasizing the importance of age-appropriate limits and parental modeling. We also talk about why personalized approaches work better than rigid rules. It’s important to consider each child’s unique temperament, interests, and their developmental needs. So, join us for an insightful conversation about fostering digital wellness, while embracing the benefits technology can bring to our lives.
Welcome Dr. Krishnan and Dr. McDonald. I’m really excited about this conversation today talking about digital wellness. Before we dive into our conversation and the content of our conversation, I’d love for you to take a minute to tell our listeners a little bit more about yourselves.
Vidya Krishnan, MD: Hi, I am Vidya Krishnan. I’m a child, adolescent, and adult psychiatrist. I’m the chief psychiatrist and medical director at Children’s Health Council. I work with children, teens, young adults, and their families, helping them through their mental health needs.
Olivia McDonald, PsyD: I’m so excited to be here. I’m Dr. Olivia McDonald. I’ve been here at CHC for two and a half years now. I started as a postdoctoral fellow and just fell in love with CHC, our mission and the community we work with. So I’ve stayed on, and now I’m a fully licensed clinical psychologist working with teens, kids, and their families as well, and I just want to say I’m really excited about today’s topic. I did my dissertation on social media and its impact on our mental health. So, exploring and discussing technology habits is something I’m really passionate about.
Cindy Lopez: I am really excited to talk with both of you about this today because I think you both bring a lot of expertise and insight to our conversation today. Before we get into the content, let’s provide some context. So what do we mean by digital wellness?
Olivia McDonald, PsyD: So, I think digital wellness is this really wonderful idea of figuring out a) what is digital to us? b) how do we create intentionality and healthy relationships with technology and like finding our own personal harmony. So, kind of starting with the digital definition, something I like to think about is defining it really broadly as anything that has a screen. So, like phones, computers, iPads, gaming consoles. Those are the really obvious ones to me and I think to parents as well. But I also like to add under the umbrella, like e-readers and like wearables, like watches, just because those tend to have internet access, whether that be to social media or even just being able to generally message, like some of my kids have watches and they can stay connected with their friends on like a really consistent basis because they have that messaging capacity.
Vidya Krishnan, MD: And to add to that, just seeing how ubiquitous this has become. The World Health Organization, which basically looks at overall health and wellbeing in a global sense is under consideration to add digital wellbeing as part of their overall definition of health as being a state of complete physical, mental, social, and digital wellbeing, and not merely just an absence of disease or infirmity.
Cindy Lopez: So you, you alluded to this, Dr. Krishnan, why is it so important to have a healthy relationship with the digital world? It’s probably obvious to our listeners, like, well, yeah, we’re on it like 90% of our day. But, just wondering what your thoughts are?
Vidya Krishnan, MD: Anything that then gets introduced into our life, when it’s new and special, we adopt it in all kinds of ways that we sometimes can anticipate and sometimes really cannot even anticipate. And I think as these things become part of our daily existence, which I do think digital technology has at this point, I think we need to become more intentional in our relationship with them like we’ve done with all the technologies that have come to us over the years, right? Whether it’s a bicycle, a car, a tv, it doesn’t matter what it is, we now have a place for them in our life and how we use them and we choose to use them, and I think we are in that place with digital as well.
Cindy Lopez: So as we think about our interaction with digital devices and screens,what are some of the things that we should be mindful of, whether it’s consequences or other types of things we need to think about?
Vidya Krishnan, MD: Through millennia of evolution, our body is structured for a particular type of life. And our genes support that. And then they manifest in various ways, whether it’s the way we walk, the way we talk, the way we do daily activities. The way our brain is wired, the way we take in information, the way we interact with other people have been shaped over a long period of time. And I would say in every one of those domains, digital adds a very new and different piece to the conversation and that is a very important impact. So, we are basically intervening to evolution and people who come after us, those genes will take in all of this and this will become part of our collective DNA actually and when you’re talking about something that’s structurally happening, there is always more happening neurochemically and biochemically in your body as well.
There is really no neurotransmitter in the brain that is untouched in one way or the other from our use of digital technology–whether it is a use of melatonin through the exposure to light–whether it is cortisol from the stress that these things bring in –whether it’s dopamine and the reward pathways in the brain as to what we find pleasurable and not–whether it’s GABA, which is the neurotransmitter that provides us a sense of calm. And if we are in an excitable state, GABA has to work overtime to bring us back to those less excitable states, and all of these are on a seesaw, which basically is a delicate balance. So when any of them move, whether we choose to or not, the other ones move too. We are basically intervening in, like basically we have a finger in every pie.
Olivia McDonald, PsyD: I also like to think of it from the standpoint of what our teenagers might be able to recognize. So, like how does your body feel? So, I think about things like increased headaches, neck pain, shoulder pain. I know we talk about especially in this day and age, like tech neck and then something that’s newer to me that’s come up is like the smartphone fingers, so like having tendonitis in your thumb, or even some of our teens have pointed out like having a divot on their pinky from holding their smartphone up. So, these are all small things that I also think about as like these physical health negative consequences. And then I also recognize, in tandem with that, with everything, that Dr. Krishnan has brought up today, that this also impacts our social wellbeing and our ability to cope and interact in relationships.
Cindy Lopez: Yeah, and as both of you are talking, I’m thinking, for myself, just as I’m looking at my social, you know, Instagram, Facebook, all those kinds of things, it’s so easy just to keep on going. It’s so easy just to like, keep on scrolling, and I think that points back to some of the things that you were just saying, Dr. Krishnan. There’s these neurotransmitters and things that are happening in our brain when we are using digital devices, and especially like that social media where everything’s just like a flow of constant information. And because of all that, is it important to define screen time and screen time limits?
Vidya Krishnan, MD: The American Academy of Pediatrics for the longest of time had these guidelines in terms of screen time limits. They’ve done away with them recently as the main driver for exactly the reason you mentioned. As Dr. McDonald very beautifully put it, there are things that we think of as screens and there’s lots of things we don’t think of as screens that are screens. And so, this is an area where intentionality matters more and how we are using it matters more. So, I think a combination of consideration of everything we’ve talked about so far is what would be expected in terms of going into screen time use. What I mean by that is there are certain things we absolutely need to use for screens at this point because schools are expecting it or educational work is expecting it, and we need to fulfill those obligations. Whether we like it or not a lot of social dating, romantic life, maybe family interactions have sometimes moved to screens because of people being in far-flung places, and that has got a lot of value and community and connection. And also there are places where there is recreational stuff related to screens as well. So, I think what you’re looking for is a balance between, is it affecting my physical health, and being mindful in all the ways, is this actually serving me well? Other things am I doing for my social relationship, academic kinds of things that don’t involve a screen. So, I would say that rather than guidelines, the direction in which we are going is independent plan. Individual plans for each person is going to vary based on what is required of them, how it affects them, and how their overall functioning when you look at a whole, at a very global life level, is what it’s going to be.
Olivia McDonald, PsyD: For sure, and I think finding that balance, I really like to tell my families that it’s not a one-size fits all, like even what works. If you think about a family of siblings, what works for one sibling might not work for the others. Especially when we think about if you have a kindergartner and then someone who’s on the way to ninth grade, that balance is going to look incredibly different based off of the different expectations in their life, as well as like, just even the social kind of implications, where also to the time that you’re managing for someone who’s in elementary school, they might want to be playing more video games and watching more YouTube videos versus your high schooler is going to be thinking about things like social media usage. They’re going to have different accounts. Maybe they’re into content creation, they’re into forums, Discord, all of these different things. So, I think that’s where that balance also gets really tricky.
What I try to really encourage families to do is to like really acknowledge it and open up what it looks like in reality, which can cause a lot of discomfort and sometimes be jarring, especially if like in your mind, and I know I’m guilty of this as well, I’m like, oh, maybe I spend like two hours a day and then I’ll go into kind of like my systems and preferences and look at my actual screen use and it’s like actually six hours a day, and that can feel really intense. But, I also like to think of it as like the idea of the same as like evaluating your finances, that we can’t problem solve and decide what does and doesn’t work for us, even as that ebbs and flows over time, if we’re not looking at the actuality of the situation behind the curtain and that there’s no moral failing behind having different numbers than what you expected, and it’s okay to have feelings of shame, but we want to figure out what are the components that do work for you? What are the components that you don’t have a choice but to keep in your life because of work and school expectations? And then what are the things that maybe you feel drawn to because of that dopamine reward that keeps you grabbing for your phone that maybe aren’t serving you? And then we create new habits around that time.
Vidya Krishnan, MD: The one place where I would say that maybe limits are more important actually is in the really younger crew. Like, we wouldn’t give the keys to a car to an 8-year-old. You want to be very intentional in ages and stages of life where developmentally the child is not in a position to be able to regulate use of these devices. Just two weeks ago, Common Sense Media did a survey in the zero to eight age range where they looked at media use. 50% of children under the age of two have a device of their own, and one in four children under the age of eight have a personal cell phone. I mean, a 2-year-old or an 8-year-old don’t have the brain cells and the connections in the brain necessary to be able to regulate this type of use. So that is where the intentionality is more adult-driven because while they may not be clear guidelines as to what is safe versus unsafe, there is clear data suggesting that exclusive consumption of digital media or digital device related things can be detrimental in terms of various aspects of development, whether it’s development of various types of motor skills, various type of language, children develop through experience, and they need to have as much an abundance of different experiences, as compared to be able to grow in the ways they need to. And the thing that always sticks in my mind, which I mentioned to our family the other day is and a good number of these kids are consuming YouTube videos or short-form content in terms of TikToks, other kinds of things. Every single book in the world I know is longer than a TikTok video. And the reason I mentioned this is eventually these are kids we are trying to get ready for education and the work world that requires that sustained attention, being able to work concepts over time. And when you deprive them of practicing those skills ahead of time, we see struggles with readiness for education and school and work environments.
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Cindy Lopez: As you both are talking, I’m thinking about, especially as you considered like different ages, and how parents might develop different kinds of practices with their family around different ages of their kids. For young children, obviously parents, they need to be the ones, as you said, Dr. Krishnan, like thinking with intentionality, like what are my boundaries and parameters for our 2, 3, 4, 5-year-old. And, as they get older, would it be true that you want to include older kids, even school age, you get into fourth and fifth grade and on up, where they could be included in the conversation about setting up the boundaries or whatever.
Olivia McDonald, PsyD: Yeah, I think it makes a lot of sense to help bring in the skillset of self-management by collaborating as a family from young ages about whether that’s asking reflective questions of like, how does this make me feel, or even modeling, asking those questions of like, oh, I’ve sat at my desk for eight hours today. Do I really want to sit down and be on my iPad now because my neck is kind of hurting. Maybe I want to go ride a bike instead. But, also having those family meeting discussions about like what are the expectations? Do we have devices at the table? Do we use like a device garage where everyone turns it in at night to like set everything up to charge and they’re not scrolling at night because we all have a family goal of getting a good night’s rest, or if we’re watching a movie together and we’re engaging in that kind of technology together, do we also put our phones and iPads away? Or is there an expectation that maybe our oldest teen really wants to be involved in movie night, but she has a paper to write and needs to be on her laptop at the same time. How do we have that discussion so that way, all the family members also feel in agreement and alignment with these decisions that we’re making? And that lends itself to the self-management as they get older, especially when you’re thinking about like our elementary age and middle school age kids, we want them to have this ability to regulate themselves, and if we’re totally in control all the time and we’re always the one making the rule, then they’re just following an expectation rather than learning how and why that expectation exists and how it benefits them to have those limits and boundaries.
Vidya Krishnan, MD: I completely agree with everything Dr. McDonald said. The two other things I would add is as parents, we always have to lead by example. So, the idea is not to create a plan for somebody else, but to create a plan for the family that all of us follow. Because I do think, just like Dr. McDonald was saying, it’s not just about how we use, what we do, what choices we make, are something our kids are always watching and learning from. And, I think having mutual accountability to a common plan creates agency and creates buy-in and creates community in the family because then you have shared values and shared goals, which I think really help a lot, not just with digital use, but also in terms of family bonding and family cohesion, which was just really valuable.
The other thing I would mention for real younger children is there is a lot of value to say that it’s not that we would grab a device out of the hands of a two-year-old or a five-year-old, but there are ways in which you can make that time actually work for you, right? Jointly watching those shows or things rather than them passively watching it, not using devices if possible for a regulation purposes. There are other ways in skills you’re learning, the digital experience for a younger child it’s really nice when it’s part of a larger diet of multiple other activities that they’re doing and my focus is on the younger children because there is maybe more agency that parents can have. I think once they are school age and beyond, like Dr. McDonald beautifully put it, I think it needs to be more of a collaborative process, but there are certain ages where maybe there’s not even enough language for that full collaboration yet, or not even enough development for that. And in those ages, being intentional about it helps a lot.
Olivia McDonald, PsyD: Yeah, and I think something I’ll highlight here as well in terms of the older kids in the collaboration is also the idea that like we’re also teaching them that these rules and boundaries and limits that we’re setting ebb and flow over time. Because the expectations and limits that you might have on devices during the school year when they have homework and extracurriculars and have a more solid bedtime routine might look different compared to like winter break and summer break, and helping them to kind of evaluate that nuance so that they don’t get stuck in the rigidity of it all and know how to have flexibility and also can evaluate that nuance when there are maybe situations where they do have to be involved more heavily because maybe they have an event coming up and they’re on the school committee for setting up props, so they have an expectation to be more connected to others during that period of time. So, they’re changing a limit to meet an expectation. But, then they’re not feeling necessarily negatively about it within themselves and having a negative self-concept or feelings of guilt around it. So, I think that’s where I really like the collaborative piece for our older teens, when it does make sense age-wise, so that way they’re also learning about how to manage themselves without a hard and fast, this is always the rule that I live and die by.
Vidya Krishnan, MD: And also taking an overall a growth mindset approach to it because these are kids who are going to just, at some point, transition into being young adults and self-managing. And sort of thinking of every single experience that you have along the digital journey as an opportunity to learn and grow from what you’ve learned and what works and not. So, I think that is where that capacity for reflection can be becauseI feel like rather than mandating certain things, having them manage more of this by themselves with the idea that overall of the functioning feels like it’s in a good place, this is preparation for the rest of life as well because most of us don’t want to be standing over the bedside of a college-age kid, trying to say, when it’s time to not be on a device anymore, right? We want them to learn those skills.
Cindy Lopez: Dr. Krishnan and Dr. McDonald, thinking about our listeners, what can they do? Maybe a family media plan or something like that. Can you tell us a little bit more about your thoughts around what they can do now?
Olivia McDonald, PsyD: So I really love discussing family media plans because I think this brings into the idea what we were talking before about having those collaborative discussions with our older kids or making specific guidelines for our younger kids about what feels good and fits into our life. And with this, this is also kind of like the idea of then evaluating the type of screen time that you’re using and how it’s like impacting your life. Something that we say a lot here at CHC and I find myself repeating myself often to families, so, if you know me, this is probably a familiar conversation, but not all screen time is created equally. And there’s the idea of passive and active communication driven media as well as like content creation. And this is something that I’m really excited to talk about because like the differences between active and passive are really helpful when we’re evaluating what is the benefits or the consequences of using this amount of media.
So active, for those of you listening, is the idea that we’re not just consuming content passively while scrolling through, but we’re also engaging with others. So this can be a combination of us like commenting on other people’s posts, participating in forums, having chats off to the side while you’re on Discord, playing multiplayer games that are cooperative. The key element here is the reciprocity, that you are engaging with other people and there’s a give and take that you made a comment, they answered you back. And that kind of like you and I having a conversation right now, all of us are interacting together, and that’s the key component of active is that there’s an intention behind it and that you’re basically getting a community benefit.
Whereas passive, which is not necessarily a negative thing because I know a lot of families are like, well if you’re not actively participating, is this really a good use of your time? And passive can include things like scrolling through content and reading articles. Like that is still passive consumption in a lot of ways. And when I think about, you or I, we have to read articles for work. Our teens have to read articles and books in order to write papers and that can be really helpful in a lot of ways, but then there’s also what our teens are calling doom scrolling these days where you’re just kind of like mindlessly scrolling through lots of different content, whether it’s Instagram or TikTok, YouTube, whatever it may be. And you’re not necessarily on there for a particular purpose other than like distracting mindlessly from the life around you, which can lend itself to negative coping skills of distracting or self-soothing in ways that aren’t productive, but I think this is something, when we think about a family media plan, is a really helpful way to kind of evaluate the amount of time or the limits or how we’re interacting.
And then, I’ll let Dr. Krishnan add in her own thoughts as well.
Vidya Krishnan, MD: Dr. McDonald, I completely agree with those kinds of very important distinctions and ways to think about it. I think of a family media plan as a great opportunity to set some central pieces to a family’s value system. Because what ends up happening is that there will be some level of digital use by various members of the family, and I think it would be really helpful if we can get them to wrap around what is central to the family. For some families that might mean having a vacation that is screen-free and is about engaging with each other, and that’s the purpose of it, weekend camping trip, or for some families it is that family dinner that they have. So first, identify your safe space. What is it that makes you together as a family, where you want every single person to be together, engaged and participating with each other? It might be your weekly Sunday morning where you all do a big Sunday meal. It doesn’t matter. Figure that out. That’s always a central cornerstone, no matter the kids’ age, and make that a screen-free experience where you’re really just being with each other and being intentional about that time.
There are lots of other things that are available to us. I look at all of these things as tools. No one of them is in and of itself a full digital strategy. It never can be. For example, some people have a strategy where they don’t let their children have a personal device of their own until they hit say, eighth grade, but they may still have laptops that they share with their other family members for work, or they maybe text through their mom’s phone or, you know, or share their dad’s iPad. So, that’s different from having your own personal device that you’re kind of then on board with. Parental controls are very popular, and they can be a tool in the management of digital time, but I think that relationship trumps tools. And I think that the collaboration and the interaction and the communication have to be central. And then you can use the tool to then monitor and enforce some of these things, but that cannot be by itself, the strategy.
I think that, if you think of that very digital diet that we are talking about, thinking of times in the day when maybe you are intentionally putting off screens, maybe it is that time before bed where you’re deciding you won’t do that. But figuring out certain times. Some people find digital detox is helpful, where almost as a way to prove to themselves they can do it. They will actually decide a time and basically for an entire weekend not do it or for an entire week. Some people, because they can’t find a way to do it any other way, will schedule vacations where the device actually won’t work because it’s too wilderness or wifi has not touched that place yet. Unless you take a satellite phone along, of course. But those kinds of things, but also doing other things, right? You don’t want to be in a situation with your family, but everything you do with them is everybody trying to manage everybody’s time, activities… The central goal for families and in mental health is family time, like spending positive time with each other, where we are mutually doing things that we all like and enjoy, can make everything else a little bit more smoother.
Olivia McDonald, PsyD: Absolutely. I totally agree with that point, Dr. Krishnan because I oftentimes recognize that when we talk about like limits and boundaries, we can throw ourselves into like a lack or restrictive mindset around it. And this is where I talk to families about the idea of like, how do we offer alternatives and enrich that family time or that screen free time, whether they’re independently doing something or we’re connecting as a family, or they’re connecting in the community with other people, or we’re giving them those options of like, well, we have Legos, and we have books, and we have our scooters. Or, you can go play basketball with your friend down the street at the park, or this is what we’re going to do as an activity together. There’s nothing that’s going to set you up more for an argument than having, hey, this six hours we’re all going to be screen free as a family, but then there’s no plan because then your kids are going to ask for the phone because they’re bored. But if it’s like, we’re not going to do this as a family, we’re all going to leave our phones at home, or we’re going to go play mini golf and then get lunch and then go for a walk in the park, that is like adding to that time where it is filling that time with enrichment and connection that makes it a positive experience, rather than we’ve deprived our kids of the devices for six hours. They’re super bored and now they’re engaging in over consumption to make up for that time because they had a restrictive mindset around it.
Cindy Lopez: There’s so much to this topic, and you’ve given us so much to think about and for our listeners to think about today. As you think about this topic of digital wellness, what is it that you hope our listeners really hear from this conversation today?
Vidya Krishnan, MD: If there’s one takeaway, many times conversations about digital wellbeing speak a lot about all the challenges that digital devices might bring to our life, but for all the challenges they bring, they’ve enriched our lives in innumerable ways. So, I think if there’s one takeaway…for each of us the relationship is personal, but I hope we all find our balance and a way to have this be an enriching enhancement to our existence is what my hope and takeaway from this is.
Olivia McDonald, PsyD: Wow, that’s a, I feel like that’s such a hard takeaway to follow on. I really love that one, Dr. Krishan.
I think an additional takeaway might be, just around the idea that there is no one right way to involve technology in your life and that things are going to ebb and flow over time, and that we should just really center the limitations that we want around our own personal values, rather than comparing ourselves to other families or other communities who maybe have more relaxed or more strict roles.
Cindy Lopez: I really appreciate your insights and your expertise, Dr. McDonald and Dr. Krishnan. If you’re listening today, and you’re thinking, I could really use some guidance around how I communicate this and how we set up these kinds of things and perhaps even the communication with your child, teen, adolescent, whatever doesn’t flow that well, we have resources at CHC that you can take advantage of. You can find out more about parent coaching and that opportunity. You know, if your child needs more support from a mental health perspective, we have all kinds of services for therapy and even evaluation if that’s what’s needed. You can email us at careteam@chconline.org, or you can call us at 650-688-3625. Also just want to say, Dr. Krishnan mentioned the Common Sense Media report that came out recently for a young child. We will make sure that we include that in our resources list, so make sure to check that out if that’s something that would be helpful to you. And there’s lots of other resources there as well. So thank you again, Dr. Krishnan and Dr. McDonald for joining us today. And thank you to our listeners.
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