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Depression

How TV Watching May Relate to Depression

Social connection is a crucial factor in mental health.

New research from one of the world’s leading research facilities suggests that social connection is the strongest protective factor against depression, and it also found that reducing activities such as TV watching makes a difference, too. The research from Massachusetts General Hospital considered over 100 factors, and has been published in The American Journal of Psychiatry (Choi, Stein, Nishimi, Gei, Coleman, Chen, Ratanatharathorn, Dunn, Breen, Koenen & Smoller, 2020).

The importance of social connection the research identified confirms what I have seen in my clinical work at facilities from inpatient psychiatric hospitals to private practice. I have found that the sense of belonging and feeling connected to someone is a driving need, and when it's not met, one suffers.

While it may seem intuitive that the need for social belonging and connection is important, it may not seem as obvious that, without it, a person’s sense of overall purpose and value suffers to the point that he or she becomes clinically depressed. Diagnostically, what is known colloquially as “depression” is typically defined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (2013) as Major Depressive Disorder. To qualify for such a diagnosis, one must have a set of serious depressive symptoms for a period of more than two weeks. There are less severe versions of depression, as well as Dysthymic Disorder, which is similar but involves a less severe impact of depressive symptoms. Many people who wonder if they may have the more severe disorder may actually be dysthymic, and consultation with a physician, psychologist, or other mental health clinician can help one understand the differences.

American society, for example, prizes long-term romantic relationshipsmarriage, in particular — and the overall value of having children and large family networks. Weddings can be seen as the ultimate social brass ring, with networks of family, friends, and co-workers in the audience who support the value of the institution of marriage. Friendships are also highly valued, and one sees the extreme degree to which close connections are valued and idealized in everything from Hollywood films to television commercials.

Put simply, not having the social connections of romantic partners, children, or close friends in a society that prizes these constructs can be difficult. When we consider the ideal conditions into which a child could be born, we imagine that child being born to parents who have been waiting for that child to arrive and who will go on to protect and continue to connect with that child for many years to come. At root, a child born into such circumstances knows instinctively and witnesses firsthand how much they belong and are a part of a family and social network.

Later in life, of course, when a child born into near-ideal circumstances leaves the home, they lose some degree of that connection and must work to create a new social network to which they will belong and with which they will identify. Consider, though, the many boys and girls who are not born into such protective circumstances, and the emotional challenges they face later as they try to create a social network — often, a family or primary relationship — but without ever having experienced the comforting foundation of true belonging and interpersonal trust and faith in relationships before.

Individuals who lack social connection, the research suggests, live a daily life without a sense of belonging and caring. What comes to mind are TV commercials showing elderly individuals at home alone who fall and need, say, a medical bracelet to alert help because they are alone. For individuals without social connection who become depressed, who is alerted? What’s more, while a fall at home elicits universal empathy, the stigma of depression is also serious, causing many depressed men and women without social connections to avoid disclosing to others how lonely, uncared for, or depressed they truly feel.

The takeaway from the research cited is that we must, as a society, make a concerted effort to keep an eye out for individuals who may lack social connections, especially the elderly, those who live alone and don’t feel like seeking outside support, and those without adult children or close friends who might otherwise call regularly to check on them. Perhaps there is a neighbor who may be lonely; perhaps it’s a distant relative or co-worker who tends to isolate. Making an effort to connect and show caring can make a difference in the depressed person’s life, and perhaps feeling a little more connected to reduce the risk for a depression that gets worse and causes more severe mental and physical problems over time.

Because the research also cites television-watching, make sure to make a note of any loved ones — especially elderly loved ones — who spend many hours a day watching TV, and come to see this as a possible indicator of depression or lack of social connection. While TV watching may seem to be a harmless activity, it is crucial to note that doing so for many hours per day without sufficient social connection is essentially a solitary activity that bears none of the social reciprocity that we know is a positive influence on one's mental health.

References

Karmel W. Choi, Murray B. Stein, Kristen M. Nishimi, Tian Ge, Jonathan R.I. Coleman, Chia-Yen Chen, Andrew Ratanatharathorn, Amanda B. Zheutlin, Erin C. Dunn, Gerome Breen, Karestan C. Koenen, Jordan W. Smoller. An Exposure-Wide and Mendelian Randomization Approach to Identifying Modifiable Factors for the Prevention of Depression. American Journal of Psychiatry, 2020; appi.ajp.2020.1 DOI: 10.1176/appi.ajp.2020.19111158

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