Namira's parents couldn't be happier when she started to go to bed early.
It used to be difficult to put the 13-year-old to bed as she would spend hours on the internet and play video games.
But the parents' relief was replaced with worries in less than a week. The eighth grader, pretending to be asleep under her blanket, was found playing on a tablet.
Like Namira, thousands of teenagers in Dhaka city who spend more time on screens but less on physical activities are on higher risks of depression and other health problems, a new research suggests.
Nearly 80 percent teenagers of Dhaka have more than two hours of screen time a day, while one-third of them spend less than an hour on physical activities, found the study titled “Is physical inactivity associated with depressive symptoms among adolescents with high screen time? Evidence from a developing country”.
Screen time includes watching TV and videos, playing video games, using computers and smart phones.
"My daughter used to be an outgoing kid. But in the last few years she apparently lost her interpersonal skills and became grumpy. Doctors say it's because she doesn't interact with other children much. She wouldn't let go of the computer and other smart devices and go out to play in the yard," the teenager's mother Shaila complained.
The kid was taken to an eye specialist and a paediatrician last year. Both strongly recommended that she should be limited to one hour of screen time a day. They also stressed that she should increase her outdoor activities to remain cheerful.
“The double burden of prolonged screen time and low physical activity is a major public health concern for many developing countries… presenting a variety of health and psychosocial problems,” said Asaduzzaman Khan, senior lecturer at the University of Queensland's School of Health and Rehabilitation Sciences, Australia.
He is one of the two researchers of the study published in the Amsterdam based medical journal Mental Health and Physical Activity on March 1.
Asaduzzaman's co-researcher was Nicola W Burton of the School of Human Movement and Nutrition Sciences at the same university.
The study was conducted among 898 students of eight secondary schools in Dhaka, aged between 13 and 17 years, from November 2012 to January 2013.
It found 25 percent of the adolescents with longer screen time and less than an hour of physical activities reporting depressive symptoms. The symptoms were more prevalent in females (29 percent) than in males (20 percent).
“Adolescents with high screen time who did not meet MVPA [moderate-to-vigorous physical activity] recommendations had more than twice the odds of reporting depressive symptoms than their counterparts who met MVPA recommendations,” reads the study.
The findings seem particularly grim when seen in the context of the densely populated capital. According to Population and Housing Census 2011, nearly 14 percent of Dhaka's population of 70 lakh are teenagers. While recent data is not available, it is highly likely that the numbers have increased.
The study suggests that shrinking open spaces in the densely populated city is one of the reasons behind teens spending increasing time on screens.
Children in urban areas of many other countries get to play in open spaces. But that is not an option for many children in Dhaka.
This newspaper in an investigation in 2015 found that at least 10 parks out of the 54 surviving ones in the entire Dhaka city were replaced with a community centre, kitchen market, mosque, rickshaw garage or truck parking lot, mostly by the city corporation itself, while many others were being occupied fast.
According to urban expert Prof Nazrul Islam, every 10,000 city residents need an open space of four acres for healthy growth of children and prevention of diseases related to lack of physical activities.
Asaduzzaman and Nicola's study observes that screen time among young people in many developing nations has increased considerably in the last few years due to socio-economic transition and the advancement of technology.
Bangladesh has quite a high concentration of mobile phones with over 13.37 crore connections. At least 5.41 crore subscribers had active internet connections until 2015, according to Bangladesh Telecommunication Regulatory Commission.
“There has also been an increase in the number of adolescents not meeting physical activity recommendations due to rapid urbanisation, issues of population density, increased traffic, and a lack of open space,” Asaduzzaman said in an email to The Daily Star.
It is important to balance between screen time and physical activities in order to minimise the risks of depressive symptoms and optimise wellbeing, he added.
Different other studies have linked sedentary lifestyle to multiple chronic health conditions, including cardiovascular diseases and obesity, he said.
“Parents and teachers can help them [teens] become responsible screen users,” he said.
Sadia Sharmin Urmee, a consultant of child psychology at 360 Degree Total Solutions in Dhaka, said adolescents in the city are caught in a vicious cycle. "Their social life is shrinking, while technology-based one-way communication is rising. It's not good for their physical and mental growth."
The main factors are limited scope for outdoor sports, study pressures and security concerns, especially for girls, Sadia told The Daily Star.
Policymakers and parents need to seriously think about allowing the teenagers to have time for social interaction and outdoor activities alongside studies.
"We won't have a healthy generation otherwise," Sadia Sharmin said.
Asaduzzaman said they were planning on developing a culturally appropriate intervention to help Bangladeshi adolescents shun their sedentary lifestyle and remain physically active.