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Is ‘Facebook Depression’ For Real?
By Jennifer Van Pelt, MA

In March, news media were flooded with warnings about “Facebook depression” in children and teens. The phrase originated in a report by the American Academy of Pediatrics (AAP) detailing the potential problems associated with social networking sites (e.g., Facebook, Myspace), gaming sites, virtual worlds (e.g., Second Life), YouTube, and blogs.

Facebook depression, according to the AAP report, may result if, for example, young users see status updates, wall posts, and photos that make them feel unpopular. Social media sites may have greater psychosocial impact on kids with low self-esteem or who are already otherwise troubled. The report recommended that pediatricians help families better understand the potential harms of social networking sites and encourage parents to monitor Internet usage and talk to their kids about cyberbullying, sexting, and exposure to social media content that could negatively affect mental health.

The AAP report has generated controversy among other pediatric researchers and mental health professionals who believe the studies cited in the report were inaccurately interpreted and other studies supporting the benefits of social networking sites, such as relationship formation or online therapy, were not considered. The ongoing debate regarding the report has brought to light the potential positive and negative aspects of social networking sites for children and teens who now spend a substantial amount of time online and whose communication with their peers relies heavily on social media.

“Social media is a tool; it cannot in and of itself ‘cause’ a medical illness,” says Megan Moreno, MD, MSEd, MPH, an assistant professor of pediatrics and adolescent medicine at the University of Wisconsin-Madison School of Medicine and Public Health. In March, Moreno and colleagues published a study in Depression and Anxiety that evaluated college students’ Facebook comments for signs of depression. Moreno has also provided comments to several media outlets covering the Facebook depression issue.

Some forms of media may contribute to feelings of depression for those who are already depressed, says Moreno. According to the Media Practice Model, developed by Steele and Brown in 1995, adolescents choose and interact with media based on who they are or who they want to be at a particular moment.

“If an adolescent is experiencing feelings of depression and seeks out media to match those feelings of depression, then yes, Facebook and other social media can contribute to feelings of depression,” Moreno explains.

Facebook and other social media may contribute to depression in three ways—bullying, comparison with others, and influencing self-worth, says Brent L. Fletcher, LCSW, an outpatient mental health therapist who works with children aged 5 and older in individual and family therapy and was recently interviewed by Missouri TV and radio concerning Facebook and depression.

“Bullying can occur when ‘friends’ post mean or derogatory statements about others or upload unflattering photos and make negative comments about them,” says Fletcher.

Facebook friends’ lists and status postings can have a detrimental effect when children or teens begin comparing themselves with others on Facebook and find themselves lacking. Thought processes, such as “They have x number of friends and I don’t” or “They have the relationship status I want or the life I want,” can lead to low self-esteem, Fletcher says.

Concerning self-worth, Fletcher explains, “The child or teen may think, ‘What if I post something and nobody responds to it or clicks the “Like” button on it.’ Consequently, it is easy for them to become depressed when they are getting their sense of self-worth from the approval of others on social networking sites.”

Caution Warranted
While bullying and peer pressure were common problems for children and teens well before the advent of the Internet, social networking sites have made it impossible for kids to escape from these problems when not in outside of school. Internet access at home and on cell phones can expose an adolescent to these issues all day long—and even all night.

In his practice, Fletcher has observed a trend—children and teens experiencing sleep deprivation because they use their phone or computer at all hours. Technology has made it easy to access Facebook anytime, he says, and this can have a detrimental effect on children’s psychosocial health.

Moreno cautions, though, not to view these potentially negative aspects as a direct causative relationship between Facebook and other social media and depression. Other evidence, including her own research, suggests Facebook can actually help identify those at risk for depression. “Our studies have found that adolescents often disclose feelings of depression on Facebook,” she says.

Previous research has found that people may be more likely to open up or report feelings online vs. in person. “It is possible that if a teen displayed depression symptoms online, he or she may receive a rapid response of support online from friends, which may help that teen to feel supported,” she says.

Fletcher agrees, adding that while Facebook and other social media can amplify bullying, it can also increase the likelihood that a troubled child or teen will receive much-needed help from friends and family.

According to Moreno’s study, which evaluated the status updates of 200 college students, despite the potential for stigma associated with reporting depression, almost one-quarter of publicly available Facebook profiles displayed one or more references to depression symptoms that met DSM criteria. Students were more likely to reference depression on their Facebook profiles if they averaged at least one comment from their friends on status postings that disclosed symptoms related to depression.

“This finding suggests that Facebook may be a venue in which today’s adolescents feel safe displaying depression or seeking support from others,” Moreno says.
She and her colleagues have suggested that social networking sites could be an innovative method for addressing the stigma currently associated with mental health conditions or for mental health professionals to identify children and teens at risk of depression.

“From a public health perspective, it is possible that targeted online advertisements could be developed to promote therapy or illustrate resources to help teens who display symptoms of more severe depression,” she says.

Opportunity for Discussion
From a social work perspective, the ongoing debate about the pros and cons of Facebook and its potential influence on depressive thoughts in children and teens gives social workers another venue for approaching clients and families about mental health. Fletcher believes social workers are more aware of the impact of social media on their young clients and should ask questions related to their Internet activities.

“In many sessions, I have had children and teens with cell phones receiving text messages. Usually they are compelled to look at it, so it becomes an opportunity for me to ask what is happening in that social part of their lives,” Fletcher says. Social workers can also ask about how their clients use free time and if they respond with texting or social media, the discussion can then focus on the influence of social networking, he says.

There are pros and cons to Facebook and other social media and children’s and teens’ usage should be monitored. “As with any hobby or interest, social networking should just be one part of their life,” Fletcher notes.

Addiction to and obsession with Facebook and other social networking sites has been documented in users of all ages. For troubled children and teens, overuse may adversely affect mental health, and parents should monitor usage, Fletcher says.

“If the child’s or teen’s life involves hours online per day or social networking seems to be having a negative impact on them, then limiting or even eliminating their social media access should be considered,” he suggests.

Social workers can help in individual and family therapy by encouraging new interests and activities, such as sports, clubs at school, arts, music, or church youth groups, for example, Fletcher says.

Controversy aside, the AAP report has brought attention to the importance of social networking in the psychosocial functioning of children and teens. The report should be viewed as clinicians’ recommendations rather than research findings, according to Moreno. Increasing awareness of both the positive and the negative influences of sites such as Facebook can help pediatric health providers and social workers better understand the complexities of depression in today’s cyber-connected children and teens for improved therapeutic intervention.

— Jennifer Van Pelt, MA, is a Reading, PA-based freelance writer with 15 years of experience as a writer and research analyst in the healthcare field.