Two major mental health trends, with one unifying theme

Two articles jumped out at me over this weekend. The first was this extremely long and in-depth look at a major suicide study done decades ago, which showed that even the occasional letter from a therapist can get someone through a crisis and significantly reduce suicide rates. The second touches on the topic you’ve all heard me discuss many times before: The rise of depression and suicide in young adults, and the potential role that smart phones may play.

The commonality here is obvious: The importance of relationships in stopping a mental health crisis and maintaining happy lives.

The Huffington Post article tracks the work of Dr. Jerome Motto, who engaged in a massive suicide study. His team tracked tracked mentally ill patients and found that sending letters to them could dramatically reduce suicide attempts, a study that, according to the article, has been backed up by other, similar studies, including this one by Gregory Carter:

Gregory Carter, who ran a psychiatry service in New South Wales, Australia, orchestrated a study in which Motto’s words were typed onto a postcard illustrated with a cartoon dog clutching an envelope in its mouth. The notes were sent eight times over the course of 12 months to patients who were among the hardest to treat. The majority had histories of trauma, including rape and molestation. Some had made repeated suicide attempts. But Carter found there was a 50 percent reduction in attempts by those who received the postcards. When he checked in on the study’s participants five years later, the letters’ effects were still strong. And the cost per patient was a little over $11.

Meanwhile, the USA Today article I noted above places at least some of the blame of the rise in depression among teenagers and young adults on cell phones:

San Diego State University psychologist Jean Twenge sees a direct link between how much time teens spend on smartphones and troubling signs of mental health distress.

In her 2017 book “iGen,” she cited national health surveys and other statistics to argue that a generation of teens have turned to smartphones as their preferred social outlet, and teens who spend the most time on their screens are more likely to be unhappy.

“What you get is a fundamental shift in how teens spend their leisure time,” Twenge told USA TODAY. “They are spending less time sleeping, less time with their friends face to face. … It is not something that happened to their parents. It is not something that happens as a world event.”

There’s a common connection here, and it’s pretty obvious: People – all of us – need each other.

The simple fact is this: iPhones and social media are build on the premise of building a further connection between people, and while that’s certainly possible, I’d argue that they really just keep us apart. I’m just as guilty of this as anyone else, but when we use our phones instead of talking to people face to face, we’re not building anything. It may increase our surface knowledge of someone’s life, but it’s not a substitute for a real interaction. It’s like heaving sugar for dinner instead of a healthy meal – it may fill you up, but there’s nutritious about what you are eating, and eventually, it rots you from the inside.

The article about sending letters to suicidal people backs up this point, in my opinion. People can, apparently, be brought back from the brink by hearing from someone who truly cares. I will not presume to imagine what is going through the mind of someone who is at the point of a suicide attempt. But from what I’ve read – and what I’ve experienced when I was close to that point – suicide isn’t really about dying, per se. It’s about someone wanting to stop their pain. To know that they have a reason to hope. So, if you get an authentic person sending a real message – hey, how are you doing, I’m thinking about you and I care about you – can that fill a void? Can that bring a person back from the edge? Dr. Motto’s research, and that of others, would certainly seem to imply that the answer to that question is yes.

It seems to me that these two articles detailing the rise in suicide and depression have someone in common – humans are losing their innate ability to connect with others, and doing so can solve many of our mental health issues.

As always, I welcome your thoughts. Let us know your thoughts in the comments below!

Your smartphone can tell if you’re depressed

person using phonwYou know how I’ve written about how social media and phones can cause depression? Well, it turns out, your phone can also tell if you are depressed.

The study, from the University of Stanford, shows that face and speech software on your phone can detect depression based on your facial expressions and speech patterns:

The researchers fed video footage of depressed and non-depressed people into a machine-learning model that was trained to learn from a combination of signals: facial expressions, voice tone, and spoken words. The data was collected from interviews in which a patient spoke to an avatar controlled by a physician.

In testing, it was able to detect whether someone was depressed more than 80% of the time. The research was led by Fei-Fei Li, a prominent AI expert who recently returned to Stanford from Google.

The article did caution that, due to the way the study was conducted, the therapeutic applications aren’t clear. According to David Sontag, an assistant professor at MIT:

…that the training data was gathered during an interview with a real clinician, albeit one behind an avatar, so it isn’t clear if the diagnosis could be entirely automated. “The line of work is interesting,” he says,“but it’s not yet clear to me how it’ll be used clinically.”

I have two thoughts about this type of treatment. First, this is fascinating – and this type of technology be helpful in terms of closing the gap between those who have access to treatment and those who don’t. In addition to studies like the one above, Stanford has also developed apps which can be used to treat depression – and which apparently work. I’ve touched on this topic in previous entries as well: Apps which treat depression can work.

In other words, apps and automated programs can help to treat depression. That’s fascinating to me – I never would have believed that depression could be treated without a live, human person, but apparently it can work.

On the other hand, there are some rather frightening potential applications of this sort of treatment. First is privacy: I am sure that any app working right now is operating with the strictest of privacy measures and data safeguards, but as we have seen repeatedly, data hacks and breaches occur with relative consistency. This has some very serious implications for something like text therapy or therapy which occurs over a device, because it begs the question: What data is recorded, and how could it potentially be accessed? I mean, I’m pretty open about the fact that I receive treatment, but even I wouldn’t want the items I discuss with my therapist broadcasted to the whole word. Is that possible with these apps? I don’t know, and it may not be. But there are real privacy and technological concerns which must be addressed when it comes to therapy delivered electronically.

Second: Can someone be diagnosed against their will? I don’t think so. Not yet, anyway. Later down the line, programs like the one discussed above may also have issues with consent. It seems to me that the Stanford program is not yet ready to be used in a public or even therapeutic setting. But, when it is, will people be able to use it on others without their consent? That…that’s kind of a scary thought.

These are questions which are only somewhat hypothetical. Technology is clearly advancing, and I can only hope privacy and ethical safeguards can advance with it.

Let us know your thoughts in the comments below!

Your smartphone may be making you depressed

I remember catching this story ages ago: A study found that the more time you spend on your iPhone, the more likely you are to be depressed.

Then, yesterday, a friend was kind enough to send me this article about how the University of Berkeley was offering students “counseling” in response to a conservative speaker coming onto campus.  I totally agreed with the article’s premise: That it is absurd to offer counseling for an optional speaker who some students may disagree with, and that such an offer does real harm to the mental health world be further stigmatizing and cheapening the need to get help.  However, there was a passage in the article which really caught my eye:

Researchers have, however, identified reasons to be concerned about the psychological health of teenagers and young adults. In her new book, “iGen,” social psychologist Jean Twenge argues that we may be on the brink of a major mental-health crisis among the generation born between 1995 and 2012, a crisis she links to smartphones and social media.

This made me wonder: Just how true is this statement?  As always, standard disclaimer: I’m not a scientist, just an observer with a real interest in mental health.  That being said, it certainly appears that the answer may be yes.

First, there’s this powerful Atlantic piece, written by Jean Twenge, which makes the case that iPhones are, without a doubt, leading to a “mental health crisis.”  It also argues that smartphones are causing problems at rates previously unheard of in past generational changes:

Psychologically, however, they are more vulnerable than Millennials were: Rates of teen depression and suicide have skyrocketed since 2011. It’s not an exaggeration to describe iGen as being on the brink of the worst mental-health crisis in decades. Much of this deterioration can be traced to their phones.

The articles conclusions are stark and tie directly to smartphones.  It makes the case that teens are going out less, spending less time with friends, showing less independence, dating less, having less sex and driving less than cohorts from previous generations.

So what are they doing with all that time? They are on their phone, in their room, alone and often distressed.

The case here is clear: Screen time makes teens less happy, and more likely to screen for depression.  Seriously, there’s a ton in this article, so if this is an area of interest to you, I highly suggest you read it.  It made me want to set my phone on fire.

Anyway….

Other articles have confirmed the link between smartphones, depression and anxiety.  What is most interesting to me is the nature of this relationship.  Anyone who has ever taken Psych 101 knows that correlation does not equal causation, meaning that just because two things are connected does not mean that one (smartphone use) causes the other (depression or anxiety).  That may be the case, but it may be that depression and/or anxiety actually cause an uptick in smartphone use; personally, I can vouch for this – when I get anxious, I frequently turn to my phone as a crutch or escape from reality.  It also may be a third item, like lack of self-confidence, simultaneously causes both depression and an uptick in smartphone use.

That being said, the Atlantic article I discussed above makes the case that the relationship is linked, and that smartphone use is causing depression.  That conclusion, however, is not uniform, per this meta-analysis:

…the studies examined were correlational, meaning that it is not clear if smartphone use causes symptoms of mental illnesses or if symptoms of mental illness cause greater smartphone use.

As I said above, I’m not a doctor or a scientist, but I do know that smartphones can have a deleterious effect on mental health and social development.  I suspect this is an area that will be the subject of increasing research as time goes on, and I certainly hope that is the case.

Now, go outside!