Mental health and social media: Does digital depression exist?

OKLAHOMA CITY - Long before the internet, people have struggled with depression, anxiety and other forms of mental illness.

Often considered taboo, treatment and awareness for mental illnesses have come a long way, but there is a new element in this equation that mental healthcare professionals know little about.

"Social media can be very stigmatizing or very positive,” Dianne, a depression support group member, said. “You really don't know what you're going to find when you log on."

Dr. Britta Ostermeyer, Chairman of Psychiatry and Behavioral Sciences at OU Medical Center, said the role social media plays on our well-being is not yet clear. Does digital depression exist?

"It is not a psychiatric or mental health diagnosis at this point,” Ostermeyer said. "The relationship between our behavior and our feelings and the internet is quite complex."

Many members in mental health support groups that did not grow up with Instagram or Snapchat believe if they had, it would have made their conditions much worse.

"I think it would have had a terrible effect on me, because instead of having to be the best in 500 kids in my school, I'd have to be the best in 500,000 people,” one support group member said.

It can be overwhelming for some to look through the endless stream of multi-filtered selfies.

"They'll take 20 before they post one,” Julia Reed, director of Counseling and Well Being at the University of Central Oklahoma, said.

Edited highlight reels of perfect lives, at least that is an impression many would like others to believe.

"All of us to a degree chase the thumb up when we are on Facebook, and it makes us happy to be endorsed by others, just like if we are getting socially together and somebody reassures us or passes a good compliment. That has a lot of positive influence and brings positive and reassuring feelings. Likewise when we get the thumbs down on Facebook or somebody is negative about us or somebody has so much more when we are really faced with hardship, then that can have an impact and on some, a quite negative impact,” Ostermeyer said.

There have not been many studies on the effects of social media, but Ostermeyer says one thing is clear from what little data does exist.

"Those who had excessive internet activity had more signs and symptoms of depression,” she said.  "It was significant."

So does Internet use create depression or simply exacerbate it?

"It's like which came first, the chicken or the egg?” Reed said.

Reed says social media is affecting students in multiple ways.

"We do a National College Health Assessment here on our campus, and a lot of students are reporting a lot more use. I mean hours a day on social media,” she said.

But there is a hang-up.

"One cannot conclude that the depression is simply from the internet use, because we know that depressed persons more and more narrow down their focus and their activity in life because they lack motivation,” Ostermeyer said. “They lack energy. They're easily fatigued. Everything becomes a burden."

For 20-year-old Alex Olliver, even getting out of bed was a burden.

"I spent a lot of time on social media because I was depressed and didn't want to go out into the world, and so I would just sit in my room and simmer on social media,” she said.

Alex has struggled with depression and anxiety since her early teens.

"I would get really upset looking at everyone's lives that looked so perfect, and I was like, 'Why am I so messed up? What is wrong with me?'" Olliver said.

"We are built and wired for connection,” Reed said. “So when we're looking to the digital side to build those connections, then we're missing out on that interpersonal and relationship side that we're hardwired to have."

Instant gratification, real or not, becomes a habit.

"Which would kind of be a mindful technique, and we know mindfulness can change the structure of the brain,” Reed said. "If the only thing that we're repeating to ourselves over and over and over is 'Everybody else is doing fine, and I'm not,' then wellness would be hard to attain and keep."

While the internet can increase an already depressed person’s condition, that is not the case with everyone. When someone is mentally healthy and active in other aspects of their lives, social media does not have such a critical impact.

"If there's a good balance, good mix then I would say that's quite positive,” Ostermeyer said. “However, if there is a person who restricts more and more in the sense that regular activities are replaced by virtual activities, that becomes alarming."

Like most things in life, moderation is key.

"Sometimes it would be looking at the student and saying, 'What were you like? Let's talk about what you were like before you ever even clicked one like button or before you even started looking at your own like button?" Reed said.

The number of virtual likes may be instant, but researchers are still counting the long-term effects.

"I think it'll be very interesting to study that over the years to come,” Ostermeyer said. "It's relatively new. There is little to no research, and it's not going to go away."