Internet Usage & Depression

The background is given in this CNN.com article:

How long have you been sitting there, staring at this screen? Are you spending more and more of your time clicking and typing, typing and clicking? Is there nothing else you'd rather do? Think carefully about the answers to these questions, say psychologists; they may tell a lot about your mental health.

A growing body of research suggests that excessive Internet use carries some of the same risks as gambling: It can lead to social isolation, depression and failure at work or school.

Some people -- particularly those who were isolated to begin with -- have forged healthy friendships by meeting kindred souls online. But using the Internet too much can hurt face-to-face relationships. And psychologists say an increasing number of people are using the Internet so obsessively that they are ruining their marriages and careers.

In one survey of 1,700 Internet users, presented August 24, 1999 at a meeting of the American Psychological Association, 6 percent of those surveyed met the criteria for addiction: They felt a building tension before the act, a rush of relief afterwards and distortions of mood and bingeing.

Many get hooked on Internet pornography. "We're a nation of puritans," says Dr. Kimberly S. Young, the survey's author and executive director of the Center for On-Line Addiction in Pennsylvania. "And this is the first time in our history we've had something so uncensored in our homes. You can get to very objectionable material in a few keystrokes -- even by accident -- and then it's hard to get out of the site."

Dan Moore (not his real name), a self-defined compulsive personality-type and workaholic from a Midwestern state, says the Internet destroyed his life. This middle-aged professional is currently going through divorce proceedings from his wife of nine years and has been denied visitation rights with his two children due to his addiction to sex sites. According to Dan, his wife claims that some of the "soft porn" sites he regularly logged on to used minors. "She became obsessed with the thought that I was getting involved in child pornography. She even accused me of molesting my children." Although Dan vehemently denies both charges, he admits that determining the age of women on the plethora of available pornography sites is virtually impossible. "It's like having access to a million adult videos, all for free. It's seductive. You get mesmerized."

Dan, who has recently begun treatment with an Internet addiction specialist and is taking antidepressant medication, rid his home of both PC and modem. "When I finally realized how it has affected my life, I felt like smashing it, throwing it out the window. Now my compulsion is to try and understand what I've done to myself and my family."

But it isn't only pornography that attracts addicts to the Internet, says Paul Gallant, a licensed addiction counselor at the Sierra Tucson Center for Addiction in Arizona. Some people are lured by the appeal of creating new identities for themselves. Other users make a habit of online gambling, auctions or stock trading. "Your life may be really boring in reality, but online you're a competitive superhero," Gallant says.

Even innocent inquiries can become obsessions in a medium where information is limitless, he adds. "Say you're a wine connoisseur, you find this great site and it's linked to another great site. Fine, you've learned a lot more about wine. Then all of a sudden you realize six hours have gone by. You're obsessed with getting more and more information."

Experts are still debating nearly every aspect of the Internet's effect on mental health. Advocates argue that the new medium's social benefits outweigh its risks. They point to studies like one in the February 2000 issue of the journal American Psychologist that found that many people draw comfort from anonymous discussions with others who share their medical conditions.

But these studies are balanced by others that reveal a strong link between excessive Internet use and serious mental disorders. For a study in the March 2000 issue of the Journal of Affective Disorders, researchers interviewed 20 people like Moore whose lives had been disrupted by the Internet. Nearly all of them were diagnosed with serious mental illness, such as bipolar disorder. Many were sacrificing sleep to spend an average of 30 hours a week online outside work.

But does the Internet cause the mental illness, or does mental illness lead people to abuse the Internet? Researchers tried to answer that question in a 1998 study by providing Internet access to 169 people who previously had not been able to log on from home. The researchers reported in American Psychologist that the more time these people spent online, the less time they spent with their families, the smaller their social circles became and the more depressed and lonely they felt. "Even for people who don't manifest addictive behavior, the Internet is almost an invitation to obsession," says Young.

Many psychologists who accept that the Internet can be abused still hesitate to use the phrase "addiction." University of Florida psychiatrist Dr. Nathan Shapira, -- who co-authored the Journal of Affective Disorders study -- prefers "internetomania." But whatever you call it, he says, it's clear that the problem needs more attention. "It concerns me that we're bustling along blind. ... There is a tremendous amount of money going into the development of this technology and almost nothing going into understanding how it affects people. That may spell trouble ahead."

We will now cite some survey data from the 2003 MARS OTC/DTC Pharmaceutical Study.  This is a mail survey of 21,106 adults in the United States conducted in the first quarter of 2003.  The subject of our analysis will be the relationship between Internet usage and depression.  We are mindful that there have been other heavily publicized studies on the same subject.  For example, both New York Times and Salon reported on the HomeNet study at Carnegie Mellon University.  The HomeNet study involved a total of only 160 people selected from four schools and community groups in the Pittsburgh area, at a cost of US$1.5 million contributed by Intel Corp., Hewlett Packard, AT&T Research, Apple Computer and the National Science Foundation.  The generalizability of the HomeNet results is uncertain.  By comparison, the MARS study is a commercial survey that is conducted using a probability sample design with results that can be projected with confidence to the adult population of the United States.

Within the MARS study, 10.1% said that they have experienced depression in the past 12 months, either self-diagnosed or professional diagnosed.  Within this study, 59.2% of the respondents said that they have used the Internet within the past seven days.  Among these Internet users, 10.0% of them said that they have experienced depression in the past 12 months.  So this incidence is about the same as in the general adult population.

In the graph below, we show the incidences of depression by the number of hours spent on the Internet during the past week.  People who only spend minutes online per week clearly do not count on the Internet as a major determinant of their lives.  Conversely, people who spend many hours online a day are more likely to develop obsessive symptoms.  From this graph, we see that those who spent the most time are more likely to suffer from depression.

The cited Salon article had this plea for researchers: "Don't just tally the hours people spend on the Net, but track where they go and what they do with their time.  Look at the differences between people who frequent anonymous chat rooms and those who join real communities. Then, and only then, ask them if they're happy."  From the MARS study, we produce the following graph of the incidences of depression according to the types of Internet activity.  This list has been sought in descending order of incidences.  Certainly, people who are looking for a new job or checking out health/medical information are most likely unhappy, but that would be a result of external circumstances as opposed to the Internet activity itself.  On the other side, people who are planning travel, checking up stock quotes and following sports are active because they are engaged with the outside world.  In neither case can the Internet itself said to be the causal agent. 

(posted by Roland Soong, 03/16/2004)