Category: depression

“Screentime”  is not enough

Lately it seems, not a day goes by, that we don’t hear that social media is doing untold damage to our young people. We see headlines comparing the use of social media to the use of cigarettes, alcohol and even cocaine or heroin. We hear that the time kids are spending online is destroying their brains, or at least, having a detrimental effect of their development. The media seems awash with op-ed pieces on  “social media addiction“, “Facebook Addiction” or “Smartphone addiction“. More and more, we hear strident voices claiming that teenagers are incapable of caring for themselves in the online environment and that the landscape is “dark and full of terrors”. Kids are spending too much time online, we don’t know what they’re up to, and we have to put a stop to it.

Among young people, the use of smartphones, social media and social networking sites is ubiquitous. Along with the smartphone, computer mediated communication has, in a short time, become the norm for a generation. In Ireland, smartphone ownership of those aged between 16 and 29 has all but reached saturation point; 96% of those in that age group use mobile phones or smartphones to access the internet. Of those young smartphone users, 91% are likely to use their devices for social networking. Further, studies show that young smartphone owners check their devices between  50 and 85 times per day. So, given this widespread adoption of both hardware and social software packages,  it is important that we investigate if this technology is having an effect on its users, what the outcomes are, and whether these outcomes are having positive or negative consequences for wellbeing.

Firstly, though, let’s get some social media myths out of the way. There is an opinion out there, that social media or technology is having an overall detrimental effect on wellbeing, that it causes depression and/or increases loneliness, among other things. While there may be anecdotal evidence that this is true, or perhaps public sentiment  that this is the case, these anecdotes are not underpinned by scientific evidence. Social media use, both frequency and intensity, has been implicated in a host of negative social, emotional and behavioural outcomes for users: decreased motivation and poor academic performance,  greater psychosocial maladjustment, poor subjective wellbeing and depression,  negative body image comparisons,  and cyberbullying. That said, the vast majority of studies that find links between social media use and psychological effects are correlational, making it difficult to draw causal inferences.

We also hear that people are “addicted ” to social media, smartphones or particular platforms. This is also not the case; there are no such disorders. While some may use social media problematically, and for some, social media use may impinge on their lives, there are no clinically recognised addictions to these platforms or these devices; the term “addiction” is being used in the colloquial sense. In fact, it has been argued that using this type of language does a disservice to those who are suffering from addictions. The other myth that needs busting is that these addictions are driven by “Dopamine”; that every time we use social media we get a neurochemical reward, that we like and crave this reward, and that we keep going back for more. Dopamine is sloshing around us all the time. Anything pleasurable can lead to increased dopamine availability in the brain but only very few (such as drugs of abuse) lead to chemical dependence.

Amy Orben (Follow her @OrbenAmy), a social media researcher from Oxford University, likens the use of social media to eating, when we talk of outcomes of social media use. When we think of it this way, we can see how difficult it is to say that one thing leads to another. It would be like saying “Eating causes depression”. We see, immediately, how unreasonable this sounds. We need more information – What and how much was eaten? When did our particpants eat it? Who were they with? How were they feeling before they ate? Did they eat because they were depressed? What were the ingredients? Does the person have allergies? Why did they eat what they ate? The list of really pertinent questions goes on. So it is with social media research. There are so many variables that must be accounted for, that it is nearly impossible to apportion blame solely to the use of social media or a simple metric like “screentime”. Indeed, social media allows us to do so many things with so many others, that disentangling what exactly is responsible for what, is extremely difficult.

That is not to say that social media is blameless – it is to say, though, that we need more research. Not only this, but we need more nuanced research; research that shows the effects of social media unambiguously. Firstly, we need to situate research in the world of the user, knowing that they use a dynamic, evolving media, in a socially connected environment. We need to examine the assumptions we make when we describe young people as “digital natives”. Is mere membership of a social networking community enough to draw conclusions about the psychological state of the user? We need integrated, contextual, user-defined examinations, combined with research and theory, to provide us with accurate information. With this kind of research we can compare the effects of social media with the effects of other events happening in the lives of our young people; diet, parenting, education, sleep, etc. This kind of research helps us to inform, to educate and to help. It is not adequate to correlate “screentime” with complex psychological constructs using online, self-report surveys; this type of research is misleading. Taking into account the perspective and social interactivity of young people, the shifting, dynamic landscape of social media and that fact that users experience both positive and negative consequences, will ensure that correct, appropriate and relevant information enters the public domain.

We social media researchers, need to explain to the public that the relationship young people have with technology is complex; it’s not as simple as “screentime”. Young social media users reason, choose and decide how to spend their time and these decisions are based on their goals, interests and temperament. These decisions are not made in a vacuum either; context, family situation, and social relationships all play a key role in time spent on line, whether this time is active or passive, skilled or not. When we consider metrics, not only do age and gender need to be considered, but we also have to think of social class, the device itself and its connectivity, the affordances and constraints of life, who is being connected to and when, where these connections are being made and why and, importantly, what type of activity is occurring. Communicating this complexity is not going to be easy, but it has to be done. Simplistic answers lead to simplistic, ineffective solutions.

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Severe mental illness and social media

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At present, I am conducting a qualitative study on young people’s opinions of the consequences of their social media experiences. Without going into detail, participants were asked to think deeply about the implications of social media use and suggest arguments for and against the proposition that “Use of the internet and social media has psychological benefits”. Participants have made propositions and I am currently categorising these into positive and negative “Societal”, “Social &Interpersonal” and “Cognitive” arguments. There are literally thousands of arguments and, while there is some repetition, young people’s thoughts on the advantages and disadvantages of social media use are interesting and imaginative.

I have been particularly intrigued by the suggestion by some participants that social media provides a positive social and interpersonal advantage to those with severe mental illness. If I am honest, this was not an area I had given much thought to and, certainly, when one looks to the research or opinion in this area, there is very little written.

Research which examines the use of the internet and social media by those with severe mental illness (schizophrenia, bipolar, depression etc) begins with findings that those with mental illness use computers and that they have similar attitudes to technology as others (Salzar & Burks, 2003). As expected, reasons for internet use among those with mental illnesses vary from shopping, telecommunication, information seeking and news (Cook et al, 2005). Further, it has been shown that, along with taking online courses and seeking information on medication, some participate in online skills, therapy or support interventions aimed at their community (Kaplan et al, 2014). Some with severe mental illness have taken to blogging their experiences (www.theinsideoutman.wordpress.com, Fiona Kennedy’s fantastic http://sunnyspellsandscatteredshowers.org/ and an excellent essay on sharing one’s severe mental illness online here). Moreover, it has been shown that those with severe mental illness also use various social media. While 74% of U.S. adults may have at least one social media account, there is evidence which shows that those living with severe mental illness use the internet and social media at significantly lower rates than the general population (Miller et al, 2015).

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In studies, social media use relates to negative outcomes for some users; impaired subjective wellbeing (Kross et al, 2013), loneliness and depression (O’Keefe & Clarke-Pearson, 2011) and social anxiety (Caplan, 2007). However, there are also numerous studies which show relationships between social media and positive consequences. Social media users enjoy the experience and find it useful (Lin & Lu , 2011), it helps them maintain relationships (Ellison et al, 2007) and it has been associated with lower levels of loneliness (Ryan & Xenos, 2011), enhanced self-esteem (Barker, 2009) and participation in community (Hampton et al, 2009). Similarly, for those with severe mental illness, social media use has been shown to have positive health-related outcomes. Miller et al (2015) found, in a study of 80 participants with schizophrenia, that 47% reported having a social media account, with 27% reporting daily social media use. Social media users said that platforms helped them with interacting and socializing with friends and family. Additionally, Gowen et al (2011) reported, in a study of 140 young adults with severe mental illness, that 93% used social media, 94% believed that social media use helped them feel less isolated (communicating with othes, making new friends, etc.). Although some social media users with severe mental illness have reported that social media activity correlated with increased psychiatric symptoms (Mittal et al, 2015) or that reading about their illness increased symptoms, there is evidence  to show greater socialisation and connectedness (Alvarez-Jiminez et al, 2015) and community integration (Snethen & Zook, 2016).

Despite the fact that there is little research in this area, it is clear that those living with severe mental illness use social media and that the motivation to do so is no different from anyone else. Social media not only provides information and a connection to professionals, but importantly, it provides a connection to peers. The communication environment is asynchronous, it does not require one to respond verbally and there can be a degree on anonymity or at least, some control in how one presents one’s self. Time and again, in discussions around severe mental illness, the issue of stigma is raised. Could social media be a boon for those living with mental illness? Perhaps, because the stigma associated with mental illness might be less pronounced online than in face-to-face communication, those with severe mental illness can interact more freely with individuals from other social groups.

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References

Alvarez-Jimenez, M., Alcazar-Corcoles, M., Gonzalez-Blanch, C., Bendall, S., McGorry, P., & Gleeson, J. (2014). Online, social media and mobile technologies for psychosis treatment: A systematic review on novel user-led interventions. Schizophrenia Research, 156, 96–106.

Barker, V. (2009). Older adolescents’ motivations for social network site use: The influence of gender, group identity, and collective self-esteem. Cyber Psychology & Behavior, 12, 209–213.

Caplan, S. (2007). Relations Among Loneliness, Social Anxiety, and Problematic Internet Use. CyberPsychology & Behavior, 10(2), 234-242.

Cook, J., Fitzgibbon, G., Batteiger, D., Grey, D., Caras, S., Dansky, H. (2005). Information technology attitudes and behaviors among individuals with psychiatric disabilities who use the internet: Results of a web-based survey. Disability Studies Quarterly, 25 (2).

Gowen, K., Deschaine, M., Gruttadara, D., & Markey, D. (2012). Young adults with mental health conditions and social networking websites: Seeking tools to build community. Psychiatric Rehabilitation Journal, 35 (3), 245–250.

Hampton, K., Sessions, L., Her, E. (2009). Social isolation and new technology

Kaplan, K., Solomon, P., Brusilovskiy, E., Cousonis, P., Salzer, M. (2011). Internet peer support for individuals with psychiatric disabilities: A randomized controlled trial. Social Science and Medicine, 72 (1), 54–62.

Lin, K., & Lu, H. Why people use social networking sites: An empirical study integrating network externalities and motivation theory. Computers in Human Behavior, 27 (3), 1152–1161.

Miller, B., Stewart, A., Schrimsher, J., Peeples, D., Buckley, P. (2015). How connected are people with schizophrenia? Cell phone, computer, email, and social media use. Psychiatry Research, 225 (3), 458–463.

Pew Internet and American Life Project. http://www.pewinternet.org/2009/11/04/social-isolation-and-new-technology/

Ryan, T., & Xenos, S. (2011). Who uses Facebook? An investigation into the relationship between the Big Five, shyness, narcissism, loneliness, and Facebook usage. Computers in Human Behavior, 27 (5), 1658–1664.

Salzer, M. & Burks, V. (203). A mediational study of computer attitudes, experience, and training interests among people with severe mental illnesses. Computers in Human Behavior, 19 (5), 511–521.

Snethen, G., & Zook, P. (2016). Utilizing social media to support community integration. American Journal of Psychiatric Rehabilitation, 19(22).