Digital transformation of anxiety and depression in adolescents: Phenomenology, neurobiology, clinical challenges

Although numerous studies have examined digital activity’s impact on mental health, how the digital environment transforms the phenomenology of mental disorders remains insufficiently understood. This narrative review synthesizes evidence on how the digital environment influences the clinical manifestations of anxiety and depression in adolescents. Digital phenomena such as social comparison, fear of missed opportunities, problematic use of social networks and internet games, and doomscrolling not only accompany affective symptoms but also become integral behavioral and cognitive components, serving a dual function: they act as ‘masks’ that complicate diagnosis and as factors contributing to chronicity. The neurobiological ground of this process includes dysregulation of the reward system, overload of the prefrontal cortex, and hyperactivation of the default mode network, which together establish a self-perpetuating cycle of emotional distress, maladaptive digital behavior, and increased distress. Clinically, these findings underscore the importance of incorporating a ‘digital history’ into standard diagnostic interviews and developing integrative therapeutic approaches that address both affective disorders and maladaptive digital behavioral patterns.