May
16
2015

Facebook Use And Depression

There has been a recent study that showed that too much time spent on Facebook could have negative effects on your mood. In the most extreme case it could cause depression.

A person who is lonely and spends a lot of time on Facebook will learn about how much fun others have who report about what they have done or achieved. They may also brag about parties they have gone to. But they rarely talk about the times when they are down. When people read about others on Facebook, those who are sensitive or are in a dull mood could get discouraged. As they compare their own lives with those who portray themselves as upbeat people it leaves some with feelings of low self worth, of depression, of isolation and worsening loneliness and isolation. On the other hand, some people do share negative experiences on Facebook. There is the chance that friends can offer encouragement and support, but this is far removed from the personal, close interaction. Even a phone call is more tangible!

We all are subject to feeling blue at times, but a normal blues can turn into depression, which is part of a mental disease.

What is depression?

Depression belongs into the mood disorders. Psychiatrists have found out in the 1970’s and 1980’s that a lack of serotonin, an important brain hormone is associated with depression.

It is a mental condition where the person sees everything negative feels hollowed out and may have a lack of energy. A depressed person sees no way out of their bleak situation; they ruminate about any problems in their lives, but do not have the strength to reason things out and solve their problems. They start having problems falling asleep and sleeping through; their sex live fades due to a lack of sex drive. They are tearful and anxious. There may be a tendency of committing suicide, which is one of the things the psychiatrist will monitor for. In severe cases of depression the suicide potential may be the main reason to commit a person to a psychiatric ward for intensive treatments, either involving antidepressants or using electro convulsive therapy (ECT).

Facebook/depression research

In the Houston University study mentioned at the beginning of this blog it was found that the more hours people spent on Facebook the more depressed they were, at least for men, not so much for women. A second study showed that the more time they spent on Facebook, the more depressive symptoms they had in both sexes. This study found that the depressive symptoms were initiated because of social comparisons between what the Facebook friends did in their lives and how the lives of the subjects of the study were perceived to be. But Mai-Ly Steers, the author, said that “most of our Facebook friends tend to post about the good things that occur in their lives, while leaving out the bad”. The author went on to say: “the act of socially comparing oneself to others is related to long-term destructive emotions“. In plain English: the chronic braggers on Facebook sites are not really doing anything constructive for their friends; they are just on an annoying ego-trip!

If blues turns into depression, it is important to know more about the how depression is treated.

Treatment of depression

Here are the most common treatment modalities.

1. Drug therapy

In mild to moderate depression the caregiver may want to use an anti-depressant drug. It is important to study the side effect of drugs before treatment is even begun. The reason this is important is that the severity of side effects will decide how compliant the patient will be in continuing to take the antidepressant for a period of time. The anti-depressants amitriptyline (Elavil) and imipramine (Tofranil) tend to produce a dry mouth as a side effect. Some people can put up with this, others find it simply too much and they will discontinue treatment, which often can lead to suicide, because the negative thoughts come back when the treatment is stopped. There are newer anti-depressants like fluoxetine (Prozac), but there is a disclaimer that it could bring on suicide in teenagers who are put on this. Discuss the side effects with your physician before you are put on anything. One of the safest mild to moderate anti-depressants is St. John’s wort. This is an ancient herb and a lot is known about it. Side effects are minimal and for this reason it is well tolerated.

2. Cognitive therapy and behavioral therapy

These two forms of psychological intervention strategies have been found to be very useful to help depressed patients to normalize their thinking.

It is in the area of “self-talk” that patients learn how to reprogram their internal thoughts. They learn to use their cognitive thoughts to intervene when they get caught in negative, stereotype thought patterns or negative generalizations (“I always do everything wrong” etc.). You learn how to use rational questioning to expose generalizations: “are you really always wrong? Tell me the last time you were successful in something!” This way the generalization of “always” being wrong is put into the right context.

3. Electroconvulsive therapy

For more severe depression admission to a psychiatric ward in a hospital equipped for psychiatric patients may be required. The psychiatrist who is involved in these cases needs to observe the patient closely and determine the suicide risk. Some patients are put on special psychiatric monitoring involving psychiatric nurses that frequently talk to the patient and monitor the suicide risk. Some patients will respond fairly well to anti-depressant therapy combined with cognitive therapy, behavioral therapy or both. If the patient does not respond adequately to this treatment approach, the psychiatrist may recommend a brief course of unilateral ECT treatments.

They are more gentle than the bilateral ECT treatments. Memory loss that was a big issue with bilateral ECT treatments is not so much an issue any more with unilateral ECT treatments. One of the advantages with ECT treatments is that after 6 to 9 such treatments there is often an impressive response of depression where the suicidal risk gets overcome. Other treatment modalities like anti-depressant therapy and cognitive/behavioral therapy will then guide the patient to a full recovery from depression.

Bipolar disorder, a special form of depression

In the past bipolar disorder was termed “manic/depressive illness”. This can be inherited, and certain triggering factors can suddenly bring on a manic phase where the person is hyperactive, has racing thoughts and behaves in weird ways. But on other occasions the same person may present with strong depressive symptoms including suicidal thoughts and behaviors. These patients need to be brought to the attention of a psychiatrist right away, because untreated they may do harm to themselves (suicide) or they may do harm to others. Sadly it is often not recognized by police or firefighters if a person presents with psychiatric symptoms. Some of these cases make news headlines when police responds by firing shots, but the underlying mental disease is often not detected and treated. As fast as patients with bipolar disorder can flare up with their symptoms, they can also calm down and regain their normal controlled condition very rapidly as well. Often a person in a manic state is sleep deprived and when relaxed with a major tranquilizer drug, they fall into a deep prolonged sleep from which they wake up with much of their manic symptoms having resolved. If the psychiatrist now decides to put them on a simple mineral, called lithium carbonate, as a maintenance therapy, the mood fluctuations may never come back. The person stays equal tempered and you would not think that they could ever have needed psychiatric intervention.

Facebook and mental disease

I like to come back to the topic of this blog, namely what influence the social media and in particular Facebook has on mental illness.

We all have certain needs that we may or may not be aware of and that need to be met. Abraham Maslow, an American psychologist has taught about this many years ago. I like to simplify these needs and point out four of these basic needs as follows: we have a need for self worth, a need for autonomy, a need to belong and a need for love. If any of those needs is not met, we will feel hurt inside and our thinking may get disbalanced. Once we are on a negative internal spin and there are no friends that help us see things in perspective, this could grow into depression as found in the study discussed in the beginning of this blog. When a semi-depressed person reads some of the upbeat communications on Facebook, comparing oneself to others, it can lead to a feeling that they do not belong to this upbeat group, but they are left out. They may feel that they are not loved and the need of self worth is undermined. It is easy to see how one’s self-talk could get into a negative spin and the mood would be spiraling downwards toward depression. It depends on how emotionally stable the person is who reads these Facebook entries. An emotionally robust person will be able to reason within oneself that people tend to show the rosy part of them on Facebook. They may also limit Facebook time and contact some of their friends and meet them in person rather than only by computer or texting. The electronic world can be a lonely experience. There is no substitute for personal touch, talking, listening and interacting with real people, and this is still one of the valuable tools of preventing mental illness. But if depression or other mental illness sets in, contact your family doctor to get a referral to a psychologist or psychiatrist.

Facebook Use And Depression

Facebook Use And Depression

Conclusion

Mental illness still has a stigma from the past. However, now we know that the symptoms of mental disease are just due to a disbalance of brain hormones that can be rebalanced through the treatment protocols mentioned above. Facebook can have a negative influence on the development of mental illness, because the basic needs mentioned above are unmet or even are being undermined, which in turn tends to make mental symptoms worse. The solution to this is to limit Facebook time, to meet real people and share all of the feelings with them and listen to their feelings as well. This human interaction tends to stabilize our mental well-being. It is also important to realize when professional help is needed and to seek it.

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About Ray Schilling

Dr. Ray Schilling born in Tübingen, Germany and Graduated from Eberhard-Karls-University Medical School, Tuebingen in 1971. Once Post-doctoral cancer research position holder at the Ontario Cancer Institute in Toronto, is now a member of the American Academy of Anti-Aging Medicine (A4M).