Teens, Screens, and Anxiety/Depression

Smartphone use is a big part of our lives, and the pandemic has magnified that, particularly for teens and adolescents. What effect could all that screen time have on these younger, still developing brains? Dr. Jayesh Kamath from UConn Health’s mood and anxiety disorders program joins Carolyn and Chris to discuss his research in the area, including how some preliminary findings could help inform the evolution of the approach treating anxiety and depression.

(Dr. Jayesh Kamath, Carolyn Pennington, Chris DeFrancesco, May 2021)

Transcript

Chris: Can a teen’s seemingly innocent use of social media bring unintended consequences like social deficiencies or even depression and anxiety? Today on the Pulse we’ll talk to an expert who’s been looking into this.

This is the UConn Health Pulse, a podcast to help you get to know UConn Health, and its people, a little better, and hopefully leave you with some health information you’ll find useful. With Carolyn Pennington, I’m Chris DeFrancesco. Human connection has taken on some different meanings over the last decade, perhaps magnified over the last year as we’ve largely been in ” all in this together, but separately” mode.

Carolyn: And for many of us, staying connected has become a way of life. For many among the current generation of adolescents and young adults, it’s the only way of life they know. What kind of impact could high volumes of social media screen time be having on these still developing brains?

Dr. Jayesh Kamath runs UConn Health’s mood and anxiety disorders program, and he joins us today to talk about it. Thank you for joining us.

Dr. Kamath: Thank you.

Carolyn: So you’ve been doing some research in this area. Let’s start off by just finding out what you’re studying, and what have you observed so far?

Dr. Kamath: OK, thank you. Thank you for the kind words. We have been running some interesting studies, especially at our UConn Storrs campus, which is students of very early age and young age. And the studies have been looking at association between depression and several different aspects of people’s lives, if we can actually predict depression in the students, if the depression gets better or worse based on their behaviors. And one of the behaviors where we looked at is in fact their use of smartphones in their daily lives. The way we kind of look at that is, we have an app that goes on their smartphone. It tracks many different things, just passively. It just sits there, tracks, with their consent.

Carolyn: And so what did you find out?

Dr. Kamath: We had some, so just to be clear, we didn’t look at if use of smartphones more or less is the cause or the consequence of depression. I would say what we exactly looked at is association. Can we say if somebody is using their smartphone in a certain way, and especially these young students, can we predict if they have depression or if their depression is getting worse or better, if they already have established depression?

And the reason I’m saying that is because what we did was we sent them these questionnaires, depression questionnaires, every two weeks to see where the depression is. And during those weeks we are tracking a lot of their smartphone use. The most interesting thing we found in our studies is, if the students, first of all, what time of the day? It seems like if they are using their phones late at night, even if the use is equal between the two groups, if the ones that were using their phones late at night, clearly had an association with depression in general and more depression, severity. Not a surprise for a psychiatrist, because that’s what we know: insomnia is one of the major symptoms of depression. But it’s interesting that we can actually capture that in a behavior on a smartphone.

There was actually, I would say, equal use of smartphones between the ones who had depression versus who didn’t, the overall–

Carolyn: So the amount of time they’re on their phones was the same?

Dr. Kamath: Was the same, almost the same. It was a little bit more in the ones that were depressed, but the ones who had depression had quite a bit use also, just different time of the day. The other big difference we found, in terms of what kind of smartphone use, we had two major categories: communicative versus noncommunicative use. And in the communicative use, there is more of really interacting with your family, your friends, via a social media, via text, via emails, via phone calls, talking with people. Noncommunicative? More of watching videos, shopping, and a lot of gaming actually, just simply gaming. And what we found was the ones who had depression clearly were isolating themselves. They were not talking. They were not communicating. Their use was almost similar to the other group, but it was a lot more –  use of the smartphone was similar, but the use, the specific use was more for noncommunicative purposes.

Chris: Dr. Jayesh Kamath from UConn Health’s mood and anxiety disorders center, one part I’m really interested in hearing about is that differentiation between the communication seems to help with the depression. I would have gone into this interview thinking too much communication or too much reliance on social media could actually cause depression. Because for example, I might be a 17-year-old and I’m on social media and I see what everyone else is doing, and I think, “Oh, this is how life’s supposed to be, and they’re having so much fun and I’m not,” and that’s going to put me down a bad path. But it surprises me that what you’re finding almost goes the other way. So there must be some level of balance between how much you’re using it and all kinds of other factors, and you can’t pinpoint all of them, but, talk a little bit about that.

Dr. Kamath: I think you’re right. I think what we didn’t look at is what kind of communications.

Carolyn: Yeah, because couldn’t they still just be scrolling through their feed and seeing all this and getting depressed? They might not be communicating with their friends, but they’re looking at all of the posts and thinking, “Wow, you know, everybody’s at a party that I’m not at. Why wasn’t I invited?”

Dr. Kamath: Yeah. And that might be true. I think if I had to hypothesize in what kind of communication, if they are actually talking with their friends. I think that probably is good, that they feel close to somebody and they’re talking just in real life. We know when people have depression or their depression gets worse, they pull back, and they can’t, even if they want to, because it just coming from inside. And we push them. As psychiatrists and psychologists, we try to incorporate them talking with their friends. But you’re right, there is a possibility they’re on social media, they’re looking at these celebrities, other things, influencers, and they feel, “Oh God, I don’t have that. And I don’t have that one. And I don’t have that one.” That might be bad.

And I think that’s the, the future for research in terms of what we need to look at. Now, we have these general categories, but we need to really get to the meat, to find out what kind of communication, because we can actually use that in our treatment. Because that’s the next thing we aspire to, is not only just look at that as relation to depression, but if people are less depressed because they’re communicating with their friends, how can we use that as part of our treatment? Because as you said, this generation is growing on smartphones.

Chris: That’s for sure.

Dr. Kamath: So we need to adjust ourselves as mental health providers. To incorporate that in our practices.

Carolyn: I think the time of day too is big. Like you were talking about earlier, that if it’s in the middle of the night and they’re on their phone, just playing a game or whatever, plus it just impacts sleep so much, right? All the studies say the light from the screen–

Dr. Kamath: Oh, it’s a vicious cycle, because insomnia, and I think it’s a treatment target in a way, because the fact is, insomnia is part of depression. So they might not be able to shut down and they’re trying to do anything they can to engage themselves. It’s not that they want to, but they’re wide awake and they can’t help it. Those are the things we need to look at, how to make that go away so they can get good night’s sleep, for example.

Chris: Dr. Jayesh Kamath from UConn Health’s mood and anxiety disorders program, one of the things that I can’t help think about is, even if communicating more on the smartphone helps perhaps — and again, we’re just to make clear, we’re not showing that it causes or doesn’t cause depression we’re showing an association, right? So even if it seems as though there is more of a relationship between communication and better outcomes in terms of anxiety and depression, I wonder how much is, if I’m communicating or if a teenager’s communicating too much with his or her friends, exclusively using the phone to do that, texting, social media, how does that impair that person’s ability to communicate and have real face-to-face, person-to-person relationships from that point in life and moving forward? Because I’d worry about that.

Dr. Kamath: Oh, I think you’re absolutely right there, because this is a new age and we don’t know the answers to that. They need to navigate in their life, and all the challenges they are going to have when they grow up, they work in a team, sitting in the room with people and working on a project. There are challenges that are going to come up and some of that you learn growing up. They’re not, you’re right, they’re not learning that. And, and we don’t even know the answers because this is a huge experiment that’s ongoing.

Chris: And, in terms of conflict resolution or civil discourse, there’s no training for that, right? You just anonymously post a comment that can be incendiary and you never really know how to have a civilized discussion, if you don’t agree on something. And I think that’s another thing that this generation, I don’t know, I’d be worried about.

Dr. Kamath: And to build on that thought, I think the worst thing that some of these social media apps do, that’s part of how they work, is they have algorithms. And you look at a certain kind of news, they will keep on building on that news and feed you very similar and even more incendiary information, if you’re looking at that, and never present you the other side. And that is a problem.

Chris: And you see in our society kind of where that can lead us. I mean, we see real life, examples of that.

Carolyn: From this study, and from the results that you have gathered so far, are there any tips that you could give students, young adults, who know that they may have issues with phone use and anxiety and depression? Any just lifestyle tips, any advice?

Dr. Kamath: As I say about everything in life, anything that’s done in extreme is bad, but not necessarily everything is bad if it’s not done in extremes. So with this new generation, we want to be careful that we don’t punish them or say their smartphone or social media use is all that. There has to be limitations. There are clearly studies that have shown too much use is bad. But I think, for example, as I said, if they’re talking with their friends, That’s probably a good thing because they’re not talking in person with their friends. So this is their only social contact, especially in the midst of COVID. But you want to make sure they’re talking with their friends and not getting bullied because, yes, I have seen that with my own children. Not them, but their friends. So yes, we want to make sure, because especially at that age, they are very vulnerable. They want to fit in, and they will take all kinds of abuse to fit in and not tell parents, not tell teachers. And you really want to keep your eyes out for that and make sure that none of that is happening for your children, but also for others.

Carolyn: And encourage that in-person or phone call instead of just passive.

Dr. Kamath: Yes. Yes.

Carolyn: Hey, why don’t you, you know, actually call your friend?

Dr. Kamath: Yes, and the passive use is bad. That’s what we saw. I mean, maybe, once again, to a certain extent, it’s OK to let them, because that is the culture within their  generation. But really you want to restrict that to a certain extent.

Chris: Excellent. Dr. Jayesh Kamath from the UConn Health mood and anxiety disorders program, thank you so much for your time today. It’s been very insightful. That is our time for today. And for Dr. Jayesh Kamath and Carolyn Pennington, I’m Chris DeFrancesco. Thank you for listening to the UConn Health Pulse. Be sure to subscribe so you can catch us next time, and please share with a friend.