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The “It’s complicated” relationship between social media and mental illness

This past week, the Fulcrum reported on new technology from University of Ottawa professor Diana Inkpen, which detects mental illness using a social media algorithm. This initiative postulates that you can use inputs from a user’s social media activity to determine whether they could be in need of mental health care.

We already know that the nature of social media is that users hugely affect platforms and their content, bringing researchers like Inkpen enough data to create her software. But what if we were to flip that around, and ask about how social media affects the mental health of its users? In this case, the answer is less clear.

To shed some light on the current research behind this relationship, I sat down with U of O psychology professor and cyberpsychologist Krystelle Shaughnessy.

The Fulcrum: First of all, could you tell me a bit about your research in the area of cyberpsychology?

Krystelle Shaughnessy: Most of my publications and research to date are focused on cybersexuality, so how people use the Internet for online sexual activities, who uses it, who are they engaging with if there’s somebody else involved, and what are the outcomes of that.

And I did a post-doc in social anxiety at the University of Waterloo, so we started talking about and looking at, and sort of finding that there’s very little research to help us understand how people who are higher in social anxiety use the Internet and online social forms as a way of connecting with other people in an environment that might be less threatening than offline. But part of my research is actually looking at the nuance of these online environments, and recognizing that there is some threat there.

If you read the research, it’s really the cyberpsychologists who do more of the theorizing and research that looks at these nuances, that doesn’t look at the Internet or smart phone use as if it’s one thing.

So my research from the beginning, in either sexuality or social anxiety has really tried to start to talk about these behaviours that we do online regardless of … if I’m doing it on Facebook, or if I’m doing it on Twitter. Let’s look at the behaviour that’s happening regardless of what domain it is.

And then talk about the fact that depending on what you’re using you may be anonymous or you may not be anonymous. You may be talking with someone you know or you may not be talking with someone you know. You may be posting for a broad audience, or you might be posting for a few people who have access to your stuff. That’s a good transition I think into why there’s no straightforward answer on how social media impacts mental health, or the other way around.

F: To your knowledge, what does current research suggest about the relationship between a user’s mental illness and their social media use?

KS: When people first started studying the Internet and social uses of the Internet, they were really focused on email, and discussion boards, news boards, things that a lot of people don’t use anymore.

The first studies that came out really problematized this activity. Some of them were even longitudinal studies, so they would ask someone a question at one point in time and they would actually follow up with them later on and later on. And those initial studies, and I’m talking like 1999, 2000, came out and they very clearly stated that if you follow someone who has access to the Internet over time, their social ties that are immediate become weaker over time, even though they tend to connect more broadly with other people, and that’s what seemed to be part of what’s interfering with social relationships.

The clinicians and researchers and funders kind of jumped on this, and we see that be perpetuated into today. So there’s a lot more research from the get go that I would say is trying to show social media as a bad thing. And when we’re trying to show something, we end up pretty easily showing it.

And so… with my own research, we’ve gone in and said we can’t just talk about the negative, we have to see what’s the positive, because if there’s nothing good about this, why are people doing it as much as they are? There’s obviously something good about it.

And so when we look at the research that tries to take a more balanced view, we see mixed findings. So things like normalizing a lot of behaviour that for a long time was normal and naturally occurring, but maybe because it occurs in a smaller group of people or it’s behaviours that people don’t talk about, that can have a positive impact on mental health later on.

On the flip side, there are behaviours we know that are terrible that happen through social media. So cyberbullying does not have any positive impact, so this is what I mean, we gotta get into the nuances, it’s not like it’s straightforward.

And then the other piece is the reverse, it’s people with mental health problems who then go online, and what’s the impact of that? Is it, I use social media and that leads me to be more anxious or more depressed? It’s looking a little more like, people who are starting to have symptoms of depression or have depression, people who have difficulties with social anxiety, people who have, there’s a little bit of research on people who have ADHD, actually go and use social media in a way that’s not helpful to them.

A very classic symptom of depression and social anxiety is pulling away from your social contacts, so if I’m already in this withdrawal and then I go online… one idea is that if you’re connecting and getting social support, and that social support is about trying to encourage you to do things, and go out and meet people, and stay active in your life, and live a happy life, and you’re talking about positive things, that can be super beneficial for people with depression or social anxiety, or other mental health conditions.

If, on the other hand, it becomes an, “I’m staying up late to connect with people in another part of the world, or the only social connections I have are online, or I’m connecting with people who are sort of commiserating in their symptoms…” that’s not going to have a good impact on these people.

F: Are there any unhealthy behaviours that are independent of connecting with other people?

KS: There’s actually a lot of research on Facebook specifically… and I would say a lot of that is focused on your profile, and what you post. So there’s two things. First, it’s a realm of self-presentation, and it would fit in any other realm like Twitter or Instagram. And that research has pretty conclusively told us that people find the positive parts of them, stuff that they think looks best, and then that’s what we put out there.

And then there is this social comparison that happens. So there’s even been in lab studies… and researchers expose them to different types of profiles, and typically we are looking at other people’s profiles and thinking about how much better their life is from us, how much happier they are than us, how much better looking they are than us, whatever, all of that. The point being that we are often looking at other people’s profiles and thinking worse of ourselves. So that can have a negative effect, the question is whether that effect lasts.

And then you get into different individual factors around levels of self-esteem, and the way you tend to approach relationships and attachment. And we’re talking profile but that would be the same with putting out anything that’s about you.

F: Are there any relationships between user mental health and the frequency at which they post, the types of posts they make, or the types of platforms on which they engage with people?

KS: I don’t know if there’s anything on the types of platforms to be honest because I think the research tends to focus in on a platform instead of looking at multi-platforms.

The indicators of depression getting worse, or anxiety getting worse, have to do with what they’re posting. It’s two things, actually—it’s what they’re posting, and there’s some research in the States that is using not just posts to social media, but how many phone calls you make and how many text messages you send. That shows that as people develop depressive symptoms, and as those symptoms get worse, they actually drop off on all those things.

So we can use that automated data collection that happens in our smartphones to see that, oh this person was typically texting and posting at this frequency, and all of a sudden the frequency at which they’re doing it has plummeted. And when it plummets, it means we need to go and connect with this person.

So it’s almost the opposite of what we talk about or think about, that the frequency goes way up. I think with things like depression and social anxiety, there’s a pulling away from people when symptoms get worse. So my guess is that if we looked at any type of mental health problem where pulling away from people is part of that symptom or part of the impact of that symptom, we’re going to see posts go down. And anything where actually going out more, doing more risky behaviours, we’ll probably see posts go up.

It’s more the change from what your typical post looks like, if there’s a change it probably means that there’s something happening in someone’s life.

F: Given the research discussed, how can social media users engage with online platforms in a way that will support their mental health?

KS: We’re not all that insightful into why we’re doing something, but I think one thing would be to be more reflective on what you’re doing and why you’re doing it, and what you’re trying to get out of it, and how you feel after. If we’re binging on social media the same way we binge on Netflix, and at the end of it we don’t feel very good, or we feel even a little bit crappier, or we feel crappy because of what we didn’t do during that period, probably that’s not what we want to keep doing.

On the other hand, if you are tired, and you don’t have anything important to do and you binge on Netflix all night, and you’re like “oh that was fun,” and now I’m gonna go to bed, that would be the same as binging on social media, it’s probably not having a bad impact.

The other thing is to choose what you’re engaging in. As I mentioned, there are a lot of very positive things, positive people, positive groups… so connecting with those, getting those types of streams in your feed would probably be good, because they’re doing things like talking about gratitude and commenting on how beautiful nature is, or different things that are positive. So when you open your Facebook, a lot of what you see is positive stuff as opposed to negative stuff.

F: Does it tend to be difficult for users to break their habits if they’re identified as unhealthy?

KS: It can be a pretty vicious cycle, and for a lot of people it’s not the easiest thing to break. And that’s why one of my tips is think about how do you feel after, and why are you doing what you’re doing, what are you getting out of it.

Part of breaking that cycle is getting people to become more aware of what is driving that cycle to begin with, and making sure we have other tools, and then getting people motivated to use the other tools first.

F: Do clinicians currently tend to take social media use into account for their patient’s recovery?

KS: This is actually an area I’d like my research to go into more. I would say that the vast majority of clinicians don’t take anything to do with online… into consideration. The area that’s been up and coming and is more booming would be using it for interventions, trying to connect with people who need help, accessing help by using the Internet. But not, how is your use of technology impacting you, is there a role for technology in what’s happening to you right now? Those are kind of really broad questions I would like to see people include.

I would say generally speaking, it’s definitely not widespread.

F: Should it be?

KS: Yeah, 100 per cent. I do think that technology and social media use, especially any social activity that involves connecting with other people, should be part of something that we’re asking up front. Because it could be playing a role in ways that we don’t really realize.