Facebook Depression Major Threat to Teens or False Alarm

A few weeks ago, a sometimes-visitor to this blog, Cara,  emailed me a link to a news article about this report from the American Academy of Pediatrics on teens and social media. Although it's actually a pretty balanced report, it does include one paragraph on what it calls "Facebook Depression". You can find that report here, but the paragraph in question is below:

Researchers have proposed a new phenomenon called “Facebook depression,” defined as depression that develops when preteens and teens spend a great deal of time on social media sites, such as Facebook, and then begin to exhibit classic symptoms of depression. Acceptance by and contact with peers is an important element of adolescent life. The intensity of the online world is thought to be a factor that may trigger depression in some adolescents. As with offline depression, preadolescents and adolescents who suffer from Facebook depression are at risk for social isolation and sometimes turn to risky Internet sites and blogs for “help” that may promote substance abuse, unsafe sexual practices, or aggressive or self-destructive behaviors.

If you read this paragraph carefully, it clearly implies that spending "a great deal of time" using social media causes depression in some teens. Specifically, the "intensity of the online world" may "trigger" the problem.




Whoa. That's serious. I mean, at least three-quarters of teens use some type of social media. And we know that depression is a serious problem (I've blogged about it here and here).  So to say that use of social media can cause depression? Yipes! And remember, the people making this claim are not from Joe Blow's Emporium of Discount Docs, they are the AMERICAN ACADEMY OF PEDIATRICS. Double yipes!

But then some folks took a closer look at the articles cited in that report that supposedly supported this conclusion. Turns out four of the six of them were third party news reports, not original research studies. And neither of the two actual peer-reviewed studies they cited used the term "Facebook depression" or established that use of social media can cause depression. Actually, the studies they cite show it's a lot more complicated than that--for example, only teens with "low quality friendships" show this tendency toward depression with increased social media use. Teens with solid, high quality friendships aren't affected.

You can read an in-depth critique of the "Facebook depression" part of that AAP report at PsychCentral. One of the major criticisms is the basic confusion between correlation and causation. Two things can be related, but that doesn't mean one causes the other. Because of the prevalence of depression in teens, it's likely that many depressed teens use social media. But isn't it possible that depressed teens intensify their use of some social media as escape from the in-person world? Or to cope with the fact that they don't have great offline friendships? In those cases, depression or a predisposition to it would actually be causing increased use of social media in some kids, not the other way around.

The other major criticism was that this report didn't bother to cite conflicting evidence. It reads like ALL researchers have come to this conclusion. But there are several studies that show that use of social media actually has some positive outcomes for teens, including increased access to social support.

Now--if you're interested in this, I do suggest you read the entire report. In my opinion, most of it is pretty well-balanced and raises some pretty good points about teens and social media.

But the take-away message here: be careful, folks. When you see a report like this blared throughout the media, don't take it at face value. If it impacts you, do a little digging. You may be surprised to find there's no scientific consensus, or someone is grossly oversimplifying a nuanced issue, or perhaps the media has just latched on to something sexy and is making more of it than is warranted. All of those seem to be in play here.

Did you hear about this "new condition"? If so, what did you make of it? Is it believable that use of social media could trigger depression in a teenager (apart from cyberbullying, that is)? How about the other way around? Could it help an isolated teen reach out?

And if any of you ever have questions regarding the interpretation of psychological reports in the media or from one of those major professional groups (especially if it relates to children or adolescents), you can always do what Cara did and shoot it my way! I'd be happy to take a look.

This week, for the Sisterhood of the Traveling Blog, Lydia answers the question, "Does each story you write have an overarching theme, and if so, do you think of it ahead of time or discover it after?" And just in case you missed it, here's Laura's post from last week.

Starting or stopping anti depressant use can be an unpleasant experience

To many with panic, anxiety, and/or depression, SSRIs are a gift -- a ticket to contentment, to an ease of mind that makes life liveable again. But anti-depressant use can be unpleasant, especially as you're beginning or stopping usage, as one recent article discusses:

Difficulties can develop at any time in the course of antidepressant therapy, but they seem to cluster at the beginning and the end.

Although it usually takes weeks for a therapeutic response, many adverse reactions—nausea, headache, somnolence, and agitation—appear soon after the first dose.

On the other hand, when some of the most widely used agents are discontinued, multiple symptoms across diverse bodily systems are common.

Early and late difficulties may be understood in terms of antidepressant neurobiology, said Dr. Pierre Blier, professor of psychiatry at the University of Ottawa.

“When serotonin reuptake inhibitors [SRIs] are initiated, there's an immediate surge in the neurotransmitter throughout the brain,” Dr. Blier said.

“It appears to be accentuated in certain regions [such as those that regulate nausea], while in areas involved in depression, like the hippocampus and frontal cortex, the surge of serotonin goes down because of negative feedback actions.”

Specifically, autoreceptors on serotonin neurons are activated by elevated levels of the neurotransmitter, inhibiting its release. Over time—the weeks before an effective response—these receptors become desensitized, allowing serotonin to rise in a consistent manner.

Discontinuation phenomena probably involve multiple neurotransmission systems that must adapt to reduced serotonin, Dr. Blier said.

I can speak to the unpleasantness of starting and stopping SSRIs from personal experience. While I've never experienced the heightened anxiety that some report when starting a new SSRI, I've definitely gone through the frustration, discussed in the article, of waiting for an SSRI to start working ("It's like purgatory," as I told my psychiatrist). And when coming off Paxil last year, I was in a constant dizzy-zombie state, punctuated by occasional moments of feeling like there was an electrical storm passing through my brain. (Apparently, this is called "the zaps," and I'm not the only one to have experienced 'em.)

Overall, though, in my experience the good of SSRIs far outweighs the bad; I'm very happy to have the opportunity to use SSRIs as part of my efforts to manage my panic, anxiety, and depression.

Researchers Arent Wasting Time Looking for Cures for Alzheimers Disease or Schizophrenia

As I did on my posts of November 30, 2011,  October 2, 2012, and September 17, 2013, it’s once again time to look over the highlights of the latest issue of one of my two favorite medical journals, Duh! and No Sh*t, Sherlock. Let’s take a look at the unsurprising findings published in the latest issue of Duh! My comments in bronze.

As I pointed out in those earlier posts, research dollars are very limited and therefore precious. Why waste good money trying to study new, cutting edge or controversial ideas that might turn out to be wrong, when we can study things that that are already known to be true but have yet to be "proven"? Such an approach increases the success rate of studies almost astronomically. And studies with positive results are far more likely to be published than those that come up negative.

9/13/13. Effects of Child Abuse Can Carry Over, Study Finds.

Researchers with the National Academy of Sciences reported Thursday that the damaging consequences of abuse can not only reshape a child’s brain, but can last a lifetime. Untreated, the effects of child abuse and neglect, the researchers found, can profoundly influence a child’s physical and mental health, their ability to control emotions and impulses, their achievement in school, and the relationships they form as children and as adults.

Cognitive behavioral therapists are all up in arms in reaction to this, thoroughly annoyed that the psychoanalysts were right about some things.

9/16/13.  Teens Who Text About Fighting, Drug Use More Likely To Engage In Those Behaviors.

HealthDay (9/14, Preidt) reported that research published in the Journal of Abnormal Child Psychology suggests that “teens who text about bad behaviors such as drug use or fighting are more likely to actually engage in those behaviors.” Researchers examined the text messages of more than 170 ninth-graders. Their behaviors were rated by their teachers, parents, and fellow students. The investigators “found a strong link between antisocial text messages and higher ratings of antisocial and aggressive behavior at the end of the school year.”

If they were real sociopaths, they wouldn’t have to brag about it.

 

9/27/13. Common Pain Relievers May Reduce Depression In Individuals With Osteoarthritis.

Reuters (9/27, Doyle) reports that research published in the American Journal of Medicine suggests that common pain relievers may reduce both pain and depression among individuals with osteoarthritis. Investigators came to this conclusion after looking at data from five trials that included approximately 1,500 patients.

Pain causes people unhappiness??  I always thought pain was something that causes unremitting happiness and celebration.

10/21/13. Stalking May Cause Psychological Distress.

HealthDay (10/19, Dallas) reported that, according to a study published online in the journal Social Science Quarterly, “women who are the victims of stalkers are up to three times more likely than their peers to experience psychological distress.” Researchers arrived at this conclusion after examining data “compiled on over 8,100 women from three major surveys.”

And here I thought stalkers were spreading joy wherever they went.

2/27/14.  Suicide Attempts Early in Life Signal Long-Term Social, Health Problems, Study Finds

Young people who attempt suicide are not only more likely to have persistent psychiatric problems as they approach midlife than non-attempters, but they are also more likely to have physical health problems, engage in violence, and need more social supports as they age. These are key findings from a study by led by Sidra Goldman-Mellor, Ph.D., and colleagues at Duke University and several other institutions and reported in JAMA Psychiatry.

The best predictor of future behavior is past behavior?  Who knew?

2/27/14. Study: Stigma Associated With Mental Illness May Prevent Many People From Seeking Care.

HealthDay (2/27) reports that research published in Psychological Medicine suggests that “the stigma often associated with mental illness prevents many people from getting the care they need.” Investigators looked at data from 144 studies that included a total of approximately 90,000 people. The researchers found that “stigma ranked as the fourth highest of 10 barriers to care.” The investigators also found that, “aside from the stigma of using mental health services or being treated for mental illness, the participants also reported feelings of shame and embarrassment as reasons for not seeking care.”

Caring about what other people think?  Worrying about your reputation?  Who does THAT?

3/17/14. Stress May Impact Kid's Health, Well- Being  

HealthDay (3/15, Preidt) reported that according to research presented at the American Psychosomatic Society’s annual meeting, “stressful events can have an almost immediate impact on children’s health and well-being.” After analyzing data on some 96,000 US children, researchers also found that youngsters “who experienced three or more stressful events were six times more likely to have physical or mental health problems or a learning disorder than those who had no stressful experiences.”

Nonsense.  Learning how to react to constant threats to your well being builds character!

4/8/14. Study: Physician appointment availability greater with private insurance than Medicaid.

Reuters (4/8, Seaman) reports on a new study, published in the current edition of JAMA Internal Medicine, which shows the availability of physicians varies depending on a patient’s insurance coverage. Researchers, from the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, found they were able to book appointments 85% of the time when claiming private insurance, compared to just 58% when they claimed to be covered by Medicaid.

Oh come on. Doctors absolutely hate to make money.

4/14/14. Paternal Alcoholism Tied To Family Conflict.

Reuters (4/11, Bond) reported that according to a study published online March 15 in the journal Addictive Behaviors, families in which the father had a problem with alcohol appeared to experience increased levels of conflict. However, treating men for alcoholism may result in an improved home life for their children.

Gee, and I thought drug addiction was a symptom of family harmony.

4/22/14.  False-Positive Mammograms Linked To Increased, But Temporary, Anxiety.

The Los Angeles Times(4/22, Kaplan) “Science Now” blog reports that in a study published in JAMA Internal Medicine, investigators “examined data from a large clinical trial of digital mammography and concluded that false-positives produced a ‘significant increase in anxiety,’ though it was only temporary.”

       

People get nervous if they think they might die. Really?

5/1/14. Effects of Recurrent Violence on Post-traumatic Stress Disorder and Severe Distress in Conflict-affected Timor-Leste: a 6-year longitudinal study

Silove D, et al. – Recurrent violence resulted in a major increase in post–traumatic stress disorder and severe distress in a community previously exposed to mass conflict. Poverty, ongoing community tensions, and persisting feelings of injustice contributed to mental disorders. The findings underscore the importance of preventing recurrent violence, alleviating poverty, and addressing injustices in countries emerging from conflict.

So what does trauma have to do with PTSD anyway?

Are You Right or Left Brain Thinker!