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How are angry mobs storming the Capitol and Facebook driving our daughters to bulimia related? Both were propelled by mass hysteria, a powerful force that drives human behavior.

As a psychiatrist and neuroscientist, I have studied how social contagion and the use of technology affect humans’ brains and behavior since the late 1970s. So I was concerned when whistleblower Francis Haugen exposed Facebook’s awareness of the mental health consequences of its algorithms on users. I instantly feared for my own daughter, as I’m sure many others did too.

I first studied the health effects of social contagion as a psychiatry resident at Massachusetts General Hospital in Boston. I saw a news report about 34 children in a school in Norwood, Mass., a Boston suburb, being rushed to the hospital after sudden onset of dizziness, hyperventilation, headache, and nausea. The study I conducted with my mentor, Armand M. Nicholi, revealed that this mystery illness was due to mass hysteria, a bodily epidemic with psychological rather than physical causes. The psychosomatic symptoms spread rapidly among the children: witnessing their classmates fall ill during a school assembly triggered a spread of symptoms through the 224 students honoring the sixth-graders who were graduating.


My subsequent studies of psychosomatic illness outbreaks show that symptom susceptibility is driven by anxieties in the community, social standing, and sensory cues, especially visual ones.



Reports of mass hysteria, ranging from nun-biting epidemics to outbreaks of fits and seizures, date back to the Middle Ages. Although social contagion sometimes spreads positive emotions and behaviors, like those at sports events, mass hysteria outcomes are generally negative. Our ever-present screens and devices have accelerated the pace at which these events occur. Think mass hysteria on steroids.

The current social media business model that fuels controversy, fear, negativity, divisiveness, and disinformation boosts ad sales and revenues. But it also escalates psychological problems like loneliness, anxiety, and depression, as well as eating disorders, substance abuse, and suicide. When a teenage girl searches for help online because she feels overweight, she gets bombarded with ads and images that make her feel worse about herself. Of course, it’s natural for adolescents to suffer from self-doubt and peer pressure; however, body image messages propelled by Facebook and Instagram have been directly linked to risk for eating disorders.

The technology is designed to get us hooked. As social beings, we crave connections to others, and our brains have evolved to seek novelty. Social media platforms are ideal for the pursuit of fresh content with their incessant offerings of flashy and exciting imagery and information. Scrolling through social media often triggers feel-good dopamine neural circuits, revving up the same neurotransmitters that drive any addictive behavior, whether it involves drugs, gambling, food, or fear of missing out.

Directing people with mental health issues toward harmful media exposure has been even more malicious during the Covid-19 pandemic. Of course, pandemic-related health concerns have been the major focus of health care workers and hospitals, but we also need to address the mental health costs of the pandemic. Children who engage in regular exercise and spend less time on screens experience fewer mood and behavioral symptoms — but children with greater exposure to pandemic-related stressors spend more time with screens and social media and less time being physically active.

Overuse of social media may contribute to heightened attention-deficit disorder symptoms, disrupted sleep, weight gain, memory impairment, social isolation, and even poorer emotional and social intelligence. Fortunately, some of these harmful mental effects may be reversible. Several UCLA colleagues and I studied 54 preteens who spent five days at an overnight nature camp where they could not use television, computers, or mobile phones. We found that heightened face-to-face interactions without use of screen-based media led to significant improvements in participants’ ability to recognize nonverbal emotional cues from both facial expressions and videotaped scenes compared with 54 matched preteens who maintained their usual social media practices.

Humans’ desire to connect, play, and explore online can have some positive outcomes. Certain apps and videogames may improve multitasking skills, memory, fluid intelligence, and other cognitive abilities. Simply searching online can exercise brain cells. Functional MRI scans show limited brain neural activity when volunteers with no internet experience search online for the first time, compared with internet-savvy people who demonstrate a more than twofold greater extent of brain activation during online searches. After just one week of online searching, internet-naïve volunteers showed surges in neural activity in brain regions controlling thinking and memory during their searches. Surgeons who play action videogames for more than three hours each week make fewer surgical errors, respond faster, and score better in measures of surgical skills than those who do not play videogames.

Nearly four years ago, Facebook acknowledged that passive information consumption on social media could make people feel worse. Its solution? Facebook advised people to increase their time on the platform, engaging and interacting with other users. This short-sighted strategy clearly didn’t work.

Strategic action is needed. Social media companies like Facebook, or Meta as its parent company is now known, need to establish behavioral health divisions that strategically drive vulnerable users towards real help instead of steering them down a rabbit hole of loneliness, isolation, and despair. They must stop pushing weight-loss ads on anorexic preteens and instead invite them to join support groups with peers to gain insight and support. Sleep-deprived internet users could be directed to cognitive behavioral therapy programs that are as effective for insomnia as many medicines, and unhappy users could be directed toward mindfulness-based interventions that reduce symptoms of depression. More vigilant parental monitoring that encourages offline social interactions and increased recreational activities can help bolster both mental and physical health, but it is not parents’ fault that these media conglomerates ensnare their children into addictive online use.

I believe that the public desperately wants to find a solution to turn the tide on harmful online practices and the spread of mass hysteria on the internet. Insisting that elected officials pass laws that rein in social media companies and protect kids appears to be the best path to real change. The Covid-19 pandemic is bad enough without the addition of this unrecognized surge of mass hysteria.

Gary W. Small is a psychiatrist, chair of psychiatry at Hackensack University Medical Center, behavioral health physician-in-chief for Hackensack Meridian Health, and co-author with Gigi Vorgan of “The Memory Bible: An Innovative Strategy for Keeping Your Brain Young” (Hachette Books).

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