Depression

Technology, Electronics, and Mental Health

With online classes, distance learning, homework time, and remote work; people are increasingly spending more time with electronic devices and technology than in the past.  This increased screen time for work, school may cause previously used screen time for leisure activities not as restorative; as this may increase total screen time and sedentary behavior.

Zhai and colleague’s review of 24 studies shows that too much screen time (> 6 hours per day) can impact depression (1).  Similar, a review of 31 studies concluded that sedentary behavior may also impact anxiety (2).

More devices are now available than ever before: computers, televisions, tablet pcs, smartphones, smart watches, etc.

While healthy technology use can have benefits of productivity, social connection, entertainment,  and improved health; unhealthy technology use can worsen our distraction,  isolate us socially, increase stress, expose us negative social influences; and negatively impact our health.

The American Psychological Association (3) offers the following strategies to use technology in healthy ways:

  1. Avoid distracted driving (3): APA advises us to turn off notifications and place your phone out of reach when driving.
  2. Avoid electronic devices before bedtime (3). Previous research showed blue light from electronic devices used at bedtime can impact sleep (4), stressful material on electronic devices can also interfere with our ability to fall asleep (3).
  3. When smartphone users turned off smartphone notifications, they reported lower levels of inattention and hyperactivity than they did during weeks when their notifications were turned on (3, 5).  Frequent notifications were also associated with lower levels of productivity, social connectedness and psychological well-being (3,5).
  4. Schedule time for email, when possible. People who checked email continuously reported more stress than those who checked email only three times per day (3, 6).
  5. Manage expectations (3). If possible, schedule time to check messages, email, notifications etc and if possible, let others (family members, boss, etc) know how often you do this, to help manage their expectations.
  6. While social media can help us connect with others, it can also impact feelings of sadness or depression (3, 7), other people may find it helpful. Consider how social media use makes you feel and adjust your use accordingly.
  7. Face to face interactions are important for mental health. The 2017 Stress in America survey found 44 percent of people who check email, texts and social media often or constantly report feeling disconnected from their family, even when they’re together (3). When you’re with friends and family, make an effort to unplug: consider silencing your phone and put it out of reach at dinnertime or during family outings (3).
  8. Disconnect: Instead of grabbing your phone during spare time, disconnect from electronics to reflect, recharge, relax; and collect yourself (3).

To counteract excessive screen time, sedentary behavior from remote work/learning, consider the following:

  • Periodic breaks away from the screen, even a few minutes per hour may help.
  • Stretching, walking during these breaks may be helpful.
  • Instead of mindless “infinite” scrolling, consider your goal before starting a device or program.
  • Consider time outside, in nature and other leisure activities for mental health.
  • Exercise, playing sports can also help address the negative mental health effects of excessive sedentary behavior and screen time.
  • Check out mindful technology use by OSU Digital Flagship

By R. Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References:

  1. Zhai L, Zhang Y, Zhang D. Sedentary behaviour and the risk of depression: a meta-analysis. Br J Sports Med. 2015 Jun;49(11):705-9. doi: 10.1136/bjsports-2014-093613. Epub 2014 Sep 2. PMID: 25183627.
  2. Stanczykiewicz B, Banik A, Knoll N, Keller J, Hohl DH, Rosińczuk J, Luszczynska A. Sedentary behaviors and anxiety among children, adolescents and adults: a systematic review and meta-analysis. BMC Public Health. 2019 Apr 30;19(1):459. doi: 10.1186/s12889-019-6715-3. PMID: 31039760; PMCID: PMC6492316.
  3. Ballard D. Connected and content: Managing healthy technology use. American Psychological Association.  https://www.apa.org/topics/healthy-technology-use
  4. https://u.osu.edu/emotionalfitness/2015/07/17/blue-blockers-and-other-ways-to-reduce-electronics-induced-sleep-disruption-and-daytime-tiredness/
  5. Kostadin Kushlev, Jason Proulx, and Elizabeth W. Dunn. 2016. “Silence Your Phones”: Smartphone Notifications Increase Inattention and Hyperactivity Symptoms. In Proceedings of the 2016 CHI Conference on Human Factors in Computing Systems (CHI ’16). Association for Computing Machinery, New York, NY, USA, 1011–1020. DOI:https://doi.org/10.1145/2858036.2858359
  6. Kostadin Kushlev, Elizabeth W. Dunn, Checking email less frequently reduces stress, Computers in Human Behavior, Volume 43, 2015, Pages 220-228, ISSN 0747-5632, https://doi.org/10.1016/j.chb.2014.11.005.

(http://www.sciencedirect.com/science/article/pii/S0747563214005810)

  1. Lin LY, Sidani JE, Shensa A, Radovic A, Miller E, Colditz JB, Hoffman BL, Giles LM, Primack BA. ASSOCIATION BETWEEN SOCIAL MEDIA USE AND DEPRESSION AMONG U.S. YOUNG ADULTS. Depress Anxiety. 2016 Apr;33(4):323-31. doi: 10.1002/da.22466. Epub 2016 Jan 19. PMID: 26783723; PMCID: PMC4853817.

 

Study: Light therapy for S.A.D. may also help with sleep, alertness

By R. Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

S.A.D. or Seasonal Affective Disorder, is depression that occurs in a seasonal pattern, most commonly in the winter months, and sometimes it is called “winter depression” (1).

Additional symptoms may include fatigue, weight gain, increased appetite, oversleeping (1) occurring in a seasonal pattern.

SAD may often co-occur with a variety of other mental health conditions.

It can often occur as part of other mood disorders such as depressive disorders, bipolar disorder, etc (2).

What are some Treatment options for S.A.D.? (3)

  • Counseling
  • Medication
  • Vitamin D (5)
  • Light therapy
  • Other helpful strategies for improving depression may include :  nutrition (6 ), exercise (7 ), and being socially active.

A recent study looked at the impact of light therapy on sleep and circadian rhythm.

What was the study?

The study authors (8) identified and reviewed 40 available studies on the subject.

What were the results?

  • The study authors (8) found that while both bright light and SSRi’s helped mood, bright light therapy also helped with sleep wake cycle.
  • Separately (9), an analysis of 3 randomized trials found that dawn simulation ( a type of light therapy delivered in the mornings) helped with mood and reduced difficulty awakening and reduced morning drowsiness (9).

What are some caveats?

While the treatments are beneficial:

  • Light therapy can have side effects (10) such as mania, hyperactivity, irritability, headaches, etc.
  • Other treatment options mentioned above can also have side effects.

For this reason, if you are experiencing a seasonal pattern of depression, please seek the help of a mental health professional to determine IF and how much and what type of treatment may be best for you.

What are some of OSU’s campus resources for S.A.D. ?
•  OSU Office of Student Life- Counseling and Consultation Service
• OSU Wilce Student health center

• OSU Student Wellness center (Wellness coaching, nutrition)
• Exercise at the RPAC

Are there any other helpful resources?

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References

  1. http://www.nlm.nih.gov/medlineplus/seasonalaffectivedisorder.html
  2. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), American Psychiatric Association, Arlington, VA 2013.
  3. Lam RW, Levitt AJ (editors). Canadian Consensus Guidelines for the Treatment of Seasonal Affective Disorder. Vancouver, British Columbia, Clinical & Academic Publishing, 1999. http://www.ubcsad.ca/.
  4. American Psychiatric Association. Practice Guideline for the Treatment of Patients with Major Depressive Disorder, Third Edition. October, 2010. http://psychiatryonline.org/guidelines
  5. https://www.nimh.nih.gov/health/topics/seasonal-affective-disorder/index.shtml
  6. https://u.osu.edu/emotionalfitness/2018/06/28/food-choices-to-improve-depression/
  7. https://u.osu.edu/emotionalfitness/2017/10/20/weight-lifting-exercise-and-mental-health/
  8. Menculini G, Verdolini N, Murru A, et. al. Depressive mood and circadian rhythms disturbances as outcomes of seasonal affective disorder treatment: A systematic review. J Affect Disord. 2018 Dec 1;241:608-626. doi: 10.1016/j.jad.2018.08.071. Epub 2018 Aug 15.
  9. Avery DH, Kouri ME, Monaghan K, Bolte MA, Hellekson C, Eder D. Is dawn simulation effective in ameliorating the difficulty awakening in seasonal affective disorder associated with hypersomnia? J Affect Disord. 2002 May;69(1-3):231-6.
  10. https://www.mayoclinic.org/tests-procedures/light-therapy/about/pac-20384604

 

Electronic Gaming and Mental Health

By R. Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

Electronic gaming is very common among young adults and comes in many forms including smartphones, tablets, computers, game consoles, etc.

By some estimates, the market size for electronic gaming is almost the same size as the movie industry.

Almost 90% of people ages 16 to 24 play video games (1); and almost half were at risk of video game addiction (2).

While many adults engage in gaming in healthy ways, gaming addiction has been linked to insomnia, anxiety, depression, stress among college students (3).

One study looked at  gaming addiction, and depression (4).

Who was studied?

3267 undergraduate students from United States, China and Singapore(4).

What was studied?

Rates of addictions to Internet use, online gaming, and online social networking,

Their association with depressive symptoms (4).

What were the results?

31% of male students were addicted to online gaming, compared to 13% of female students (OR = 0.522, 95% CI = 0.440-0.620) (4)

37.3% of female students were addicted to social networking compared to 27.8% of male students (OR = 1.543, 95% CI = 1.329-1.791). (4)

Regarding depression rates:

  • Among students with online gaming addiction depression rates were 65.5% for students in United States, 70.8% for China, and 69.6% for Singapore. (4)
  • Among students with internet addiction, depression rates were 76.5% for students in United States, 88.9% for China, and 75.9% for Singapore. (4)
  • Among students with online social networking addiction, depression rates were 68.8% for students in United States, 76% for China, and 71% for Singapore. (4)

What are some signs of Internet gaming disorder?

While there is no uniform criteria, some signs could include (5,6):

  • Preoccupation. (The individual thinks about previous gaming activity or anticipates playing the next game; internet gaming becomes the dominant activity in daily life.)
  • Experienced withdrawal symptoms when internet gaming is taken away. (These symptoms are typically described as irritability, anxiety, or sadness, but there are no physical signs of pharmacological withdrawal.)
  • Developed Tolerance—the need to spend increasing amounts of time engaged in games.
  • Unsuccessful attempts to control the participation in gaming.
  • Continued excessive use despite knowledge of psychosocial problems.
  • Mislead/deceive family members, therapists, or others regarding the amount of gaming.
  • Use as escape or relieve a negative mood (e.g., feelings of helplessness, guilt, anxiety).
  • Loss of interest in previous hobbies and entertainment as a result of, and with the exception of gaming.
  • Jeopardized or lost a significant relationship, job, or educational or career opportunity because of participation in electronic gaming.

What are some caveats?

  • Further study is needed in the area of internet, and gaming addiction.
  • To learn more about internet addiction, click here.
  • While this study shows that males were more likely to have gaming addiction and female students were more likely to have internet addiction, newer research indicates that this gap appears to be narrowing.
  • For other studies on men and mental health, click here, and here.
  • To learn more about disparities of men, suicide, and mental health, go here:  Movember National Men’s Health Campaign.

Any other useful links?

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References:

  1. Brand J. (2012). Digital Australia (2012). National Research Prepared by Bond University for the Interactive Games and Entertainment Association. School of Communication and Media, Faculty of Humanities and Social Sciences, Bond University.
  2. Hussain Z, Griffiths MD, Baguley T. Online gaming addiction: classification, prediction and associated risk factors. Addict Res Theory. 2012;20:359-371.
  3. Younes F, Halawi G, Jabbour H, et al. Internet addiction and relationships with insomnia, anxiety, Depression, stress and self-esteem in university students: a cross-sectional designed study. PLoS One. 2016;11:e0161126
  4. Catherine So-Kum Tang, PhD, Yee Woen Koh, PhD, and YiQun Gan, PhD Asia Pacific Journal of Public Health Vol 29, Issue 8, pp. 673 – 682 First Published November 30, 2017 https://doi.org/10.1177/1010539517739558
  5. American Psychiatric Association: Diagnostic and StatisticalManual of Mental Disorders, 5th ed. Washington, DC, American Psychiatric Publishing, 2013Section III (“Emerging Measures and Models”) of DSM-5 (1, pp. 795–796).
  6. Andrew K. Przybylski, Ph.D., Netta Weinstein, Ph.D., Kou Murayama, Ph.D. Internet Gaming Disorder: Investigating the Clinical Relevance of a New Phenomenon. Am J Psychiatry 2017; 174:230–236; doi: 10.1176/appi.ajp.2016.16020224.