COVID-19, Doomscrolling and Depression in Adolescence and Emerging Adulthood: A Literature Review

Abstract

Prior to 2020, the rates of youth mental health issues were estimated to be between 11.6% and 12.9%, however, the current rate of youth mental health issues has doubled in comparison post-pandemic (Rancine et al. 2021). Professional bodies such as the Ontario Science Table have expressed concern at the increased usage of screen time among youth, citing in part concerns about mental health (Tooms et al. 2022). In light of these concerns, this literature review analyzes past and present studies involving depression and technology in adolescents and includes emergent adult research into the effects of problematic news consumption (otherwise known as doomscrolling) on mental health.

Introduction

In April, the Ontario Science Table produced a brief discussing the increased screen time usage of youth within the province as a result of the COVID-19 pandemic, expressing concerns for the potential consequences on their physical, cognitive, and emotional wellbeing (Toombs et al. 2022). Prior to 2020, the rates of youth mental health issues were estimated to be between 11.6% and 12.9%, however, recent meta-analysis on the current rate of youth mental health issues has found that rates have doubled in comparison post-pandemic (Rancine et al. 2021). Traditionally, the times of adolescence and emerging adulthood can be lined with many pitfalls and challenges–this is without consideration of a global health crisis. Awkward growth spurts and bodily changes, rapidly changing friend groups, conflict with parents and an increasing desire for independence are all things which provide challenge, and subsequent changes in mood. While changes in mood are par for the course with adolescence, not all mood changes are normal. Uncharacteristic behaviour over a two-week or longer timespan may be a sign of an underlying issue: changes in sleep, food intake, increased agitation, apathetic mood, or marked disinterest in prior activities that brought joy are all classic signs of Major Depressive Disorder (MDD, Diagnostic and Statistical Manual of Mental Disorders, 5th edition TR, American Psychological Association 2022). An increased rate of mental health issues such as MDD are therefore cause for concern, and therefore, investigating links between youth mental health issues and their potential causes are of the utmost importance in the aftermath of an exacerbating effect like a global pandemic, as further research can help lead to innovative therapy methods and treatment in the long-term for those affected. 

This literature review focuses on rates of depression in adolescents in relation to the COVID-19 pandemic and suspected causes. In particular, specific focus is given to investigating the link between gender differences in depression rates, with an overarching focus on tracing the link between depression and technology and social media use.

Depression and Technology

Prior to 2020, the use of technology had been increasing steadily for many years along with subsequent concerns about potential psychological and other health effects (Ohannessian 2009, Nick et al. 2022). Twenge (2019) theorized that social media may be to blame for the uptick in teen depression and suicide statistics post-2012 but pre-pandemic, citing socio-ecological reasons like the increasing availability of cellphones and changes in how adolescents communicate due to technology changes. However, pre-pandemic research literature has been inconsistent at times regarding the exact risk to adolescents when it comes to the interaction between technology use and depression. Research conducted in the early 2000s into gendered differences in rates of depression and technology have shown that increased video game usage may form a protective factor for boys by lowering their rates of anxiety, but have the opposite effect for girls, correlating to higher anxiety levels (Ohannessian 2009). Additionally, one oft-cited study by Orben and Przybylski (2019) using a newly developed method of statistical analysis found that the correlational effect between digital technology use and adolescent mental health was small, accounting for a mere 0.4 of variance–a correlation they lauded as being as meaningless as the link between health and potato-eating. A follow-up study by Twenge et al. (2022) accounted for issues in Orben and Przybylski’s analysis design, and found a much higher correlational effect between social media and mental health issues for girls, one comparable to the correlation between depression and substance abuse for the same age group. As such, there is continued evidence of a gendered divide, as well as evidence of some risk, particularly towards girls.     

Technology, Depression, and Gender

Early puberty has traditionally been associated with higher likelihood of negative effects for girls, including the risk of mental health issues like anxiety and depression in later adulthood (Thompson et al. 2016). In adults, women are 1.5 to 3 times at risk for depression compared to men, a trend which preliminary research in DNA methylation has suggested may be due to biological changes in brain structure from puberty onwards (Chan et al. 2022). Others have linked this increased tendency to depression to psychosocial differences such as increased use of ruminative thought patterns by girls compared to boys (Papadakis et al. 2006). 

In relation to COVID-19, researchers Liu et al. (2022) sought to investigate the effect of the pandemic on adolescent mental health, predicting that girls and youth who were lonelier would show higher resulting levels of depression. 175 participants were recruited (51% male with a mean age of 16.01, SD= 2.56) for study and received a series of questionnaires as part of the study. Questionnaires were included as part of three surveys delivered at key points, the first (T1) delivered prior to the pandemic (within an average of 2 years), the second (T2) within a range of six to twelve weeks following pandemic shutdown (average at 8 weeks), with the third (T3) being delivered an average of 8.5 months post pandemic shutdown. Depression symptoms were monitored with the Children’s Depression Inventory, while loneliness was measured using the UCLA loneliness scale. With T1 providing the baseline response, mental health symptoms, social media and video game usage, as well as social activity responses were monitored at T2 and T3. The results acquired by Liu et al. (2022) had some interesting implications. For boys, rates of depression initially stayed the same from pre-covid, but later increased as the pandemic wore on. For girls, depression increased early and remained elevated. For both genders, rates on the CDI scale eight months post-pandemic shutdown displayed depression at 5 (boys) and 6 (girls) compared to the scores that are typically acquired under normal circumstances (between 3 and 4). For girls, higher social media usage was linked to more depressive symptoms. Overall, the results showed a continued trend in gender differences in depression, similar to other researchers.

Depression and Doomscrolling

The post COVID-19 literature has shown that there is a tentative link between depression and social media, with higher use correlated with higher depressive tendencies (Liu et al. 2022, Twenge et al. 2022). In all cases, researchers stressed that this should not be considered a directional assessment. While in theory, social media could certainly cause depression, it is just as likely that those already suffering may use social media more frequently as a coping method, whether successfully or not. The presence of the pandemic as a stressor itself must also remain at the forefront. However, if directionality is assumed in relation with the pandemic, it leaves one to wonder what the influencing factors may be. One potential influencing factor for depression increases in relation to both COVID-19 and social media is the concept of problematic news consumption–something which became common in 2020 when daily news updates announced local death counts. Problematic news consumption, defined as addiction-like consumption of usually negative news (which has also been associated with the term doomscrolling), has been shown to correlate to higher instances of mental and physical illness (McLaughlin et al. 2022).

As previously mentioned, gender differences in the presentation rate of depression symptoms has been speculated to be linked to patterns of ruminative thinking for girls (Papadakis et al. 2006). Rumination during COVID-19 has been linked to increased depression symptoms in adults (Schachter et al. 2022). At this time, there appears to be no similar studies done on adolescents.

Popular depictions within media depict the use of technology and social media by teenagers as being similar to addiction or compulsion (i.e. the classic checking for texts every five minutes). With this in mind, the idea that doomscrolling may function as a short or long-term form of ruminative coping similar to the kind deployed in Obsessive Compulsive Disorders takes form. In exploring the concept of problematic news consumption, McLaughlin et al. (2022) suggest this may be the case. On its face, the repetitive act of doomscrolling looks remarkable similar to the definition of compulsions outlined in the Diagnostic and Statistical Manual of Mental Disorders (5th edition TR, American Psychological Association 2022): 1) a repetitive act and 2) that the act is driven by the desire to relieve anxiety or some other stressor. With this concept and previous research in mind, it stands to wonder whether the same drives are at play when it comes to adolescents, social media usage, and depression, especially during COVID-19. Current research following this hypothesis has shown some promise, although most studies have focused on adult populations instead of adolescents.

At least one study by Price et al. (2022) has used emerging adults (M age = 18.89) to investigate the effect of doomscrolling on mental health during the pandemic. Using a sample size of 61, participants were recruited initially based on a parent study involving the effect of childhood maltreatment on psychopathology, and grouped into control or test by their response scores on the Adverse Childhood Experiences Scale (ACEs, control < 3, test > 3) and whether they’d experienced childhood maltreatment prior to age 18. Participants conducted a daily diary study which included assessments on the  Patient Health Questionnaire – 9 (PHQ-9) and the PTSD Checklist for DSM-5 (PCL-5) as well as a question about media exposure, which included multiple options (social media such as instagram (etc.), television, newspaper, radio, etc.) with the option to pick as many as they used. The media exposure question was presumed to be a binary response in which participants had either been exposed to news or not for the purpose of tracking media exposure within the study. Interestingly, the results by Price et al. (2022) found that social media was more commonly used than traditional news media by study participants. In addition, those with stronger symptoms of psychopathologies (depression or post-traumatic stress disorder) were found to use social media more often, and that social media use was linked to increased negatives in wellbeing. Researchers subsequently recommended that at-risk individuals should try to limit their social media exposure.

Conclusion

It is imperative that the rise in adolescent mental health issues post COVID-19 is given focus in research going forward. The trends in literature that have been highlighted in this review show that there is increased risk of harm for youth going forward, especially for young women and girls. That research by McLaughlin et al. (2022) and Price et al. (2022) shows that some element of social media consumption can be considered obsessive compulsive, and subsequently harmful, is promising as there are already useful therapies which can be tweaked following more research to be beneficial in regards to digital media. More research should be done in this area to investigate the directionality of adolescent depression and other mental health issues in relation to social media and technology.

References

Chan, R. F., Copeland, W. E., Zhao, M., Xie, L. Y., Costello, J., Aberg, K. A., & van den Oord, Edwin J. C. G. (2022). A methylation study implicates the rewiring of brain neural circuits during puberty in the emergence of sex differences in depression symptoms. Journal of Child Psychology and Psychiatry, 63(7), 802-809. https://doi.org/10.1111/jcpp.13522.

Liu, S. R., Davis, E. P., Palma, A. M., Sandman, C. A., & Glynn, L. M. (2022). The acute and persisting impact of COVID-19 on trajectories of adolescent depression: Sex differences and social connectedness. Journal of Affective Disorders, 299, 246-255. https://doi.org/10.1016/j.jad.2021.11.030.

McLaughlin, B., Gotlieb, M.R. & Mills, D.J. (2022) Caught in a Dangerous World: Problematic News Consumption and Its Relationship to Mental and Physical Ill-Being, Health Communication, DOI: 10.1080/10410236.2022.2106086.

Ohannessian, C. M. (2009). Media use and adolescent psychological adjustment: An examination of gender differences. Journal of Child and Family Studies, 18(5), 582-593. https://doi.org/10.1007/s10826-009-9261-2.

Orben, A., & Przybylski, A. K. (2019). The association between adolescent well-being and digital technology use. Nature Human Behaviour. doi:10.1038/s41562-018-0506-1.

Papadakis, A. A., Prince, R. P., Jones, N. P., & Strauman, T. J. (2006). Self-regulation, rumination, and vulnerability to depression in adolescent girls. Development and Psychopathology, 18(03). doi:10.1017/s0954579406060408.

Price, M., Legrand, A. C., Brier, Z. M. F., van Stolk-Cooke, K., Peck, K., Dodds, P. S., Danforth, C. M., & Adams, Z. W. (2022). Doomscrolling during COVID-19: The negative association between daily social and traditional media consumption and mental health symptoms during the COVID-19 pandemic. Psychological Trauma: Theory, Research, Practice, and Policy, 14(8), 1338-1346. https://doi.org/10.1037/tra0001202.

Racine N, McArthur BA, Cooke JE, Eirich R, Zhu J, Madigan S. Global Prevalence of Depressive and Anxiety Symptoms in Children and Adolescents During COVID-19: A Meta-analysis. JAMA Pediatr. 2021;175(11):1142–1150. doi:10.1001/jamapediatrics.2021.2482.

Schachter, J., Ajayi, A. A., & Nguyen, P. L. (2022). The moderating and mediating roles of mindfulness and rumination on COVID-19 stress and depression: A longitudinal study of young adults. Journal of Counseling Psychology, 69(5), 732-744. https://doi.org/10.1037/cou0000626.

Thompson, S. M., Hammen, C., & Brennan, P. A. (2016). The impact of asynchronous pubertal development on depressive symptoms in adolescence and emerging adulthood among females. Journal of Youth and Adolescence, 45(3), 494-504. https://doi.org/10.1007/s10964-015-0402-1.

Toombs E., Mushquash, C.J., Mah, L. Increased screen time for children and youth during the COVID-19 pandemic. Science Briefs of the Ontario COVID-19 Science Advisory Table. 2022;3(59). https://doi.org/10.47326/ocsat.2022.03.59.1.0.

Twenge, J. M. (2019). Why increases in adolescent depression may be linked to the technological environment. Current Opinion in Psychology. doi:10.1016/j.copsyc.2019.06.036.

Twenge, J.M., Haidt, J., Lozano, J., & Cummins, K.M. (2022) Specification curve analysis shows that social media use is linked to poor mental health, especially among girls. Acta Psychologica 224, https://doi.org/10.1016/j.actpsy.2022.103512.