Even without social media, phones have a subtle, damaging effect on our mental health | Devi Sridhar

WWhen I started teaching at Oxford in 2005, I offered “office hours” several times a week. It was literally the time when students would come to my office and discuss whatever was on their mind. The emails were formal and intended for rare occasions, with the expectation that most issues would be discussed in person. Fast forward to 2026, and office hours have been replaced at many universities by constant communication via email and Teams. These are incessant, with responses often expected within hours or even minutes, blurring the line between evenings, weekends and normal working hours.

I have to admit that every time a notification pops up on my phone or laptop, before I even read it, I feel my stress levels rise. It got me thinking about how modern communication pushes our minds to their limits. While most recent discussions about mental health and technology have focused on social media, we forget how even older forms of digital communication can push us into a stressful, “always on” way of being.

If we go back to our basic wiring, the human brain and society did not evolve in a world of instant virtual communication. For most of our history, communication has taken place face-to-face in small, stable groups, usually no larger than 150 people. Prominent anthropologists argue that this is the number of meaningful social relationships we can maintain. Until recently, social interaction took place in person and in context – that is, facial expressions, tone of voice, eye contact and body language. We learn a lot not only from someone’s words, but also from their nonverbal cues.

Modern digital messaging has removed this extra dimension. Instead, we rely on short, text-based interactions, devoid of nuance and prone to misinterpretation. And studies show that it’s generally more stressful than an in-person interaction. For example, a 2022 study in Boston examined various forms of communication about participants’ stress levels. They found that days with more frequent text messages were linked to greater stress and more negative feelings, while days with in-person contact were linked to feeling more positive. A 2026 review of numerous studies on texting versus in-person interactions found the same thing: Quite simply, our well-being is better with in-person interaction compared to screen-based communication.

Which brings me to two blue checkmarks, which indicate whether a message has been read, an even step further than simple SMS once was. As such, this creates a new source of stress and emotional burden for many people. From a neuroscience perspective, delayed or ignored messages can activate the same brain regions associated with physical pain, particularly the anterior cingulate cortex and anterior insula. This is called social pain and it reflects how our brains respond to exclusion or rejection.

When someone abruptly ends communication without explanation, often referred to as “ghosting” or “patching” someone, it can be incredibly painful. For most of human history, people lived in small, close-knit groups where disappearing from someone’s life was not an option. You couldn’t just disappear. Modern studies show that unexplained disconnection in romantic relationships activates our biological alarm systems, including elevated stress levels, heart rate, and blood pressure, which prompt us to do something to reestablish connection or seek an explanation: “But why did they ghost me? What did I do?” Without a story, our brain has no way of resolving what happened.

Even short periods of no reading, or “reading” and no responding, can lead to feelings of micro-rejection, because the brain is primed to detect tiny changes in social availability, and this can be particularly difficult for those already suffering from low self-esteem. We are wired for in-person conversation: we don’t wait for a response that could come instantly if the other person chooses to engage…but doesn’t.

There is a parallel group: those who feel pressured to respond quickly, especially when they have been seen online or their message has been marked as read. The introduction of read receipts and the ability to know when someone was last typing or logged in has intensified the pressure to be constantly present. These features create an environment in which you may feel like you need to engage, even if you don’t want to, to avoid appearing rude or emotionally distant.

This constant availability to others has consequences. The brain’s cognitive functional system, responsible for decision-making, can easily become overloaded by the demands of digital interaction. Each notification represents a small decision: should I respond now, later, or just forget about it? Multiply that by dozens of times per day and this constant multitasking leads to cognitive fatigue and emotional exhaustion.

We have studied after study on the high rates of burnout, exhaustion and loneliness, not just in the UK but around the world. We are more in touch than ever, but more alone and stressed than ever. Perhaps that’s because our nervous system was designed to deal with immediate, tangible threats, not the constant ping in our pocket – and the stress of not being read.

• Professor Devi Sridhar is Chair of Global Public Health at the University of Edinburgh and author of How Not to Die (Too Soon)