Tag Archives: Mental health

Teen mental health deteriorates

Studies link demise to increased cellphone use

by Jean Twenge, San Diego State University

Around 2012, something started going wrong in the lives of teens.

In just the five years between 2010 and 2015, the number of U.S. teens who felt useless and joyless—classic symptoms of depression—surged 33 percent in large national surveys. Teen suicide attempts increased 23 percent. Even more troubling, the number of 13- to 18-year-olds who committed suicide jumped 31 percent.

In a new paper published in Clinical Psychological Science, my colleagues and I found that the increases in depression, suicide attempts and suicide appeared among teens from every background—more privileged and less privileged, across all races and ethnicities and in every region of the country. All told, our analysis found that the generation of teens I call “iGen”—those born after 1995—is much more likely to experience mental health issues than their millennial predecessors.

What happened that so many more teens, in such a short period of time, would feel depressed, attempt suicide and commit suicide? After scouring several large surveys of teens for clues, I found that all of the possibilities traced back to a major change in teens’ lives: the sudden ascendance of the smartphone.

All signs point to the screen

Because the years between 2010 to 2015 were a period of steady economic growth and falling unemployment, it’s unlikely that economic malaise was a factor. Income inequality was (and still is) an issue, but it didn’t suddenly appear in the early 2010s: This gap between the rich and poor had been widening for decades. We found that the time teens spent on homework barely budged between 2010 and 2015, effectively ruling out academic pressure as a cause.

However, according to the Pew Research Center, smartphone ownership crossed the 50 percent threshold in late 2012 – right when teen depression and suicide began to increase. By 2015, 73 percent of teens had access to a smartphone.

Not only did smartphone use and depression increase in tandem, but time spent online was linked to mental health issues across two different data sets. We found that teens who spent five or more hours a day online were 71 percent more likely than those who spent only one hour a day to have at least one suicide risk factor (depression, thinking about suicide, making a suicide plan or attempting suicide). Overall, suicide risk factors rose significantly after two or more hours a day of time online.

Of course, it’s possible that instead of time online causing depression, depression causes more time online. But three other studies show that is unlikely (at least, when viewed through social media use).

Two followed people over time, with both studies finding that spending more time on social media led to unhappiness, while unhappiness did not lead to more social media use. A third study randomly assigned participants to give up Facebook for a week versus continuing their usual use. Those who avoided Facebook reported feeling less depressed at the end of the week.

The argument that depression might cause people to spend more time online doesn’t also explain why depression increased so suddenly after 2012. Under that scenario, more teens became depressed for an unknown reason and then started buying smartphones, which doesn’t seem too logical.

What’s lost when we’re plugged in

Even if online time doesn’t directly harm mental health, it could still adversely affect it in indirect ways, especially if time online crowds out time for other activities.

For example, while conducting research for my book on iGen, I found that teens now spend much less time interacting with their friends in person. Interacting with people face to face is one of the deepest wellsprings of human happiness; without it, our moods start to suffer and depression often follows. Feeling socially isolated is also one of the major risk factors for suicide. We found that teens who spent more time than average online and less time than average with friends in person were the most likely to be depressed. Since 2012, that’s what has occurred en masse: Teens have spent less time on activities known to benefit mental health (in-person social interaction) and more time on activities that may harm it (time online).

Teens are also sleeping less, and teens who spend more time on their phones are more likely to not be getting enough sleep. Not sleeping enough is a major risk factor for depression, so if smartphones are causing less sleep, that alone could explain why depression and suicide increased so suddenly.

Depression and suicide have many causes: Genetic predisposition, family environments, bullying and trauma can all play a role. Some teens would experience mental health problems no matter what era they lived in.

But some vulnerable teens who would otherwise not have had mental health issues may have slipped into depression due to too much screen time, not enough face-to-face social interaction, inadequate sleep or a combination of all three.

It might be argued that it’s too soon to recommend less screen time, given that the research isn’t completely definitive. However, the downside to limiting screen time – say, to two hours a day or less – is minimal. In contrast, the downside to doing nothing – given the possible consequences of depression and suicide – seems, to me, quite high.

The ConversationIt’s not too early to think about limiting screen time; let’s hope it’s not too late. §

Jean Twenge is professor of psychology at San Diego State University. This article was originally published on The Conversation,and is published with permission. 

Trump’s Troubled Mental State

Psychiatrists warn of president’s alarming behavior

Association sacks Goldwater Gag Rule preventing analysis of POTUS

by SHARON BEGLEY @sxbegle

A leading psychiatry group has told its members they should not feel bound by a longstanding rule against commenting publicly on the mental state of public figures — even the president.

The statement, an email this month from the executive committee of the American Psychoanalytic Association to its 3,500 members, represents the first significant crack in the profession’s decades-old united front aimed at preventing experts from discussing the psychiatric aspects of politicians’ behavior. It will likely make many of its members feel more comfortable speaking openly about President Trump’s mental health.

The impetus for the email was “belief in the value of psychoanalytic knowledge in explaining human behavior,” said psychoanalytic association past president Dr. Prudence Gourguechon, a psychiatrist in Chicago. “We don’t want to prohibit our members from using their knowledge responsibly.”

That responsibility is especially great today, she told STAT, “since Trump’s behavior is so different from anything we’ve seen before” in a commander in chief.

An increasing number of psychologists and psychiatrists have denounced the restriction as a “gag rule” and flouted it, with some arguing they have a “duty to warn” the public about what they see as Trump’s narcissism, impulsivity, poor attention span, paranoia, and other traits that, they believe, impair his ability to lead.

Reporters, pundits, and government officials “have been stumbling around trying to explain Trump’s unusual behavior,” from his seemingly compulsive tweeting to his grandiosity, said Dr. Leonard Glass, a psychiatrist at Harvard Medical School. The rule against psychiatrists offering their analysis of the emotions, thought patterns, and beliefs underlying such behaviors, Glass said, robs the public “of our professional judgment and prevents us from communicating our understanding” of the president’s mental state.

Last week, in an essay in Psychiatric Times, Glass called the prohibition on such communication “an unacceptable infringement on my right and duty” to discuss issues “where the perspective of psychiatrists could be very relevant and enlightening.” He ended the essay by announcing his resignation from the American Psychiatric Association, which adopted the rule in 1973. He had been a member for 41 years.

Called the “Goldwater rule,” the prohibition on offering opinions about the mental state of public figures was adopted after some psychiatrists answered a 1964 survey on whether Sen. Barry Goldwater, the Republican presidential candidate that year, was mentally fit for the Oval Office. The rule states that it is unethical to offer a professional opinion about a public figure’s mental health, including the presence or absence of a disorder, without that person’s consent and without doing a standard examination. In March, the psychiatric association reaffirmed the rule.

The group acted despite growing criticism that the Goldwater rule is outdated and even unethical for preventing psychiatrists from pointing out behaviors that raise questions about a government official’s mental state. No other medical specialty has such a rule; cardiologists are not prohibited from offering their views of an official’s fainting spell, for instance, as long as they make clear that they have not examined the person.

Although opposition to the Goldwater rule has existed for years, it intensified with Trump’s candidacy and then election. In October, a book titled “The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President” will be published.

“When the book comes out, there will be renewed furor about the Goldwater rule, since it is precisely about what is wrong with him,” said psychiatrist Dr. Lance Dodes, a retired professor at Harvard Medical School who is now in private practice in Los Angeles.

A number of psychologists have spoken to reporters about what Trump’s statements and actions might reveal about his emotional and cognitive state. Although the American Psychological Association “prefers” that its members not offer opinions on the psychology of someone they have not examined, it does not have a Goldwater rule and is not considering implementing one, an official told STAT.

The psychoanalytic association went further. In its July 6 email, it explicitly stated for the first time that the organization does not subscribe to the rule. That position had been implicit for years, but the association’s “leadership has been extremely reluctant to make a statement and publicly challenge the American Psychiatric Association,” said one psychoanalytic association member who asked not to be publicly identified criticizing the other group.

One stated rationale for the Goldwater rule is that psychiatrists need to examine patients in order to properly evaluate them. In fact, for decades the State Department and other federal agencies have asked psychiatrists to offer their views on the psychological state of foreign leaders, Glass pointed out, evidence that government officials believe it is possible to make informed inferences about mental states based on public behavior and speech.

“In the case of Donald Trump, there is an extraordinary abundance of speech and behavior on which one could form a judgment,” Glass said. “It’s not definitive, it’s an informed hypothesis, and one we should be able to offer rather than the stunning silence demanded by the Goldwater rule.”

The Goldwater rule has long been odd in that violating it carries no penalties. In principle the psychiatric association could file a complaint with a member’s state medical board. That has apparently never happened. Nor has the association ejected a member for violating the Goldwater rule. That is something it, as a private association, would be legally permitted to do.

A state agency, however, is subject to the U.S. Constitution, civil liberties experts say, and penalizing psychiatrists for speaking out would likely be a violation of their First Amendment rights. §

Sharon Begley, senior science writer, covers genetics, cancer, neuroscience, and other fields of basic biomedical research. This article is posted with the permission of STAT, where it originally appeared.