Intentionally using social media & technology: Stories and strategies from people managing depression
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This post summarizes the CHI 2020 paper, Emergent self-regulation practices in technology and social media use of individuals living with depression by Jordan Eschler, Eleanor Burgess, Madhu Reddy, and David Mohr (Paper link here)
Blog post written by Eleanor (Ellie) Burgess & edited by Jordan Eschler
Overview
We interviewed 30 people living with depression in a large city in the U.S. Midwest to explore their technology and social media use. We found that, over time, participants began to consider how the ways they were using technologies might be influencing their mental health, both positively and negatively. Participants described a process to monitor and creatively adjust technology use to improve their emotional, cognitive, and behavioral health. We suggest future design opportunities to better empower individuals with depression to encourage their natural inclinations to self-regulate their technology and social media use.
How do people managing depression use technologies in their day-to-day life?
Depression is the world’s leading cause of disability, affecting more than 300 million people. Depression is comprised of many symptoms, which include persistent sadness and loss of motivation. In this study, we wanted to understand how individuals managing depression made decisions about their technology use across the variety of technologies they use in everyday life. We discussed participants’ lived experiences — both positive and negative — of managing depression and technology use.
We found that people self-regulate their technology and social media use through a process of improving cognitive, emotional, and behavioral habits. Participants came to understand that managing technology use was essential to their mental hygiene and daily routines. Specifically, participants described processes of becoming more intentional with their technology use over time. This included strategies like deleting apps, limiting time of use, or seeking positive content.
In this blog post, we’ll present a couple of findings we learned, based on self-regulation, and finally we’ll share the potential ways that our research can inform the design of future technologies, as well as people’s conversations with their therapists.
I. Cognitive Self-regulation: Identifying & Breaking Negative Patterns of Technology and Social Media Use
In their daily life, participants described feeling “separate” from other people, or fundamentally different from “healthy” peers or coworkers. These feelings can be common among those experiencing depression, and can be amplified in the context of technology use.
“Passive” use (use without a specific goal) played a substantial role in problematic use of technology and social media, particularly when people were feeling fatigued or experiencing low motivation.
Participants viewed behaviors such as negative self-comparison or “getting lost in the scroll” — e.g., using one’s phone for long periods of distraction — as problematic. This use was undesirable because it could make it harder to process feelings or complete self-care routines.
For example, one participant (P19) struggled primarily with mindless Facebook use:
“I’m searching for that hedonic pleasure instead of understanding that going on Facebook for hours might feel better than exercising in the moment, but on the whole I’ll feel so much better to exercise versus go on Facebook. Sometimes it’s hard to give up this short-term pleasure for a longer-term pleasure.”
Participants described passive technology use as a distraction from negative thought patterns. Distraction is a natural response to the cognitive effects related to depression, such as rumination. However, this does not necessarily mean distraction is a healthy response to such cognitive effects, particularly if it means avoiding self-care or other important activities for staying healthy.
Over time, most participants realized a link between their mood and technology and social media habits. This led most participants — particularly those with a history of managing depression, or experiences with formal care such as seeing a therapist — to reach a point in their self-regulation where they were working to stop problematic behaviors like those described above.
Solutions: Becoming More Intentional With Technology Use Over Time
To use technology & social media to support their mental health, people created strategies to positively regulate their moods. Two main strategies to manage undesirable technology use patterns were: (1) limiting or controlling access to certain technology platforms (keeping the bad out) and (2) seeking positive content (inviting the good in).
(1) Limiting or Controlling Technology/Social Media Access
When participants realized they were using technology or social media in ways they perceived to negatively influence their mental health, they often carried out a blunt approach to solve the problem: deleting certain applications they found too distracting or time-consuming. For example, P13 deleted Snapchat after noticing her anxiety related to watching peers’ stories. Other people deleted apps from their phone, but still used the browser login, creating a situation where it was a little harder to access the social media application day-to-day.
Unfortunately, some people felt that even if they wanted to delete social media accounts or applications, the option was not always feasible. For example, college-aged participants often needed to use tools like Facebook to participate with campus groups. In these cases, participants often designed their own solutions to manage social media use, such as setting time limits per day and/or tracking use over time.
(2) Seeking positive content
Participants also curated content encountered via technology or social media use. Participants described seeking out good, positive, or helpful content and stimulation, rather than the behaviors previously described of blocking unwanted content and stimulation (i.e., inviting the good in, rather than keeping the bad out).
For example, a person could change what they saw in their Facebook feed day-to-day. P18 “liked” certain Facebook pages or groups so that he could see more positive and inspirational pictures or quotes (“You find these little gold mines. You follow them, like them, and you get postings from them on a regular basis”). Instagram and Pinterest were also general social media platforms where participants reported curating their feeds to present more positive content. Curating social media content like this helped to increase the amount of content perceived as helpful for mental health, and simultaneously helped to avoid negative comparisons with other people.
While social media and technology use could sometimes be challenging for our participants, they also described using these tools in positive ways to self-regulate both their emotion and behavior.
II. Emotional Self-Regulation: Using technology as a “mental reset”
People intentionally used social media and technology to achieve what we call a “mental reset” to distract themselves briefly in order to break negative thinking patterns. Instead of using phrases like “zoning out” (or scrolling endlessly as described in the section above), participants described their emotional reset activities as discrete tasks to prevent negative mood or halt a spiraling negative mood.
People might use streaming content, funny videos or gifs, or music when winding down after feeling stressed and also to transition from one activity to another. For example, P02 watched cat videos to re-center herself when she felt irritable at work:
“It’s also good if I’m getting frustrated or overwhelmed to just sort of like, take two minutes, take a break, look at something else — laugh at a kitten video or something, and then get back to what I was doing, because I think eight straight hours of the craziness I deal with at work, [I] would not last for very long, without the occasional break.”
Sometimes a small distraction, like a cat video or a mobile game, is enough to pull someone out of a negative emotional spiral. Perhaps you’ve noticed this yourself, pulling up a relaxing video or movie after a stressful day of work. In addition, music and connections to online and offline peer support groups were lauded for their ability to help participants reset themselves. These mental resets were seen as particularly helpful in situations where there was limited time for emotional self-regulation, especially while at work.
III. Behavioral Self-Regulation: Using a variety of “general use” technologies for planning & tracking
Participants used many different technologies to self-regulate their behavior and reach their goals. These behaviors included planning time for self-care and forging new patterns in technology use. Participants also described how they tracked activities important for mental health maintenance (e.g., frequency of eating, drinking, exercising, and hours slept), and reflected on changes in mood or responses to certain stimuli.
Creating structure and planning (e.g., scheduling social events) are often important goals for individuals living with depression. Several of our participants adapted bullet journals or used dedicated calendaring apps to plan their work, self-care time, and social lives. P19 used their calendar to motivate action to avoid procrastination or inactivity, which could exacerbate their depression:
[I routinely plan to] get a good amount of sleep, exercise, block out time for myself to do homework. I know that I’m the type of person who needs to have a pretty clear-cut schedule. So, if I have a whole day on my calendar that’s blank, I can spend that day doing nothing and then I feel shitty afterwards. So, even if it’s just drawing out a four-hour chunk where I’m like, “Go to Starbucks and do homework.”
Interestingly, some participants reported using Instagram creatively to assess their mood changes over time. These participants found Instagram to be a valuable journaling and reflection tool. P21 tracked her mood and reflected on her post history using Instagram.
“I think [I track moods] indirectly through Instagram…if I look back through Instagram because I’ve been doing it for a while now, I could probably go back and see the different moods or times in my life what was going on based on my artwork, what I posted or what I didn’t post.” (P21)
While some participants described these tracking practices, overall we observed a range of sophistication in behavioral self-regulation practices. Some participants had a better understanding of their own thought processes and self-regulation than others. We found that those who had a more clear understanding often had a history of managing depression cycles and/or clinical care (e.g., past or present sessions with a therapist).
IV. Where to go next with technology design? How to support self-regulation practices
Managing moods and emotions is an important part of mental health interventions. Among our participants, about half reported using mental health-focused applications either currently or at some point in the past (e.g., Calm, Calm Harm, and Headspace). However, our participants described using these apps as just one part of a broader strategy for using technology and social media to self-regulate their emotions. Many of the technology tools people report using in self-regulation practices are not designed specifically for mental health or mood management (e.g., apps for calendars, texting, social media). However, people are still benefiting from these tools!
To self-regulate, people employed “bundles” of technology and social media applications (e.g., combinations of apps, online streaming videos, cell phone games, and music). P21’s use of a social media application for tracking of and reflection on mood, for example, underlines the creativity of our participants in their work to understand and manage changes in mood, and subsequently to adjust behavior through reflection. Of course, it depends on the person, as different strategies work better for different people.
Based on what we learned, we believe that future design and policy work should focus on empowering individuals living with depression to self-regulate their technology and social media use. Oftentimes people managing depression are thought of as passive individuals wholly subject to the influence of technology and social media. However, in reality they can have a profound impact on their own well-being by taking action to stop negative technology use in its tracks.
Although our recommendations are not meant to replace current clinical treatment for depression, our observations point to (1) opportunities for the design of technology interventions for depression care, such as mobile applications, and (2) possibilities to enhance health care interventions with discussions of technology use. We seek to re-center individuals living with depression, who can be empowered to understand and self-regulate their own technology and social media use.
(1) Designing for Technology Use Awareness & Reflection
Drawing from our participants’ experiences, we suggest that individuals living with depression do not necessarily have a preexisting positive relationship with technology. Many current mental health applications assume that a potential user accepts that the Smartphone is a powerful, but controllable, tool for engaging in everyday life. However, participants in our study generally did not have this assumed positive attitude about technology and social media. For example, our participants often referred to their own Smartphones as a type of “temptation” or “trap.”
We advocate for technology-based, targeted mental health applications that start by helping users to both assess their own technology use and reflect on their attitudes about technology. In this way, targeted mental health applications can assist users to start thinking about their devices as powerful, personalized tools for improving mental health, augmenting self-regulatory instincts for technology use.
Technology-based, targeted mental health applications must convey a sort of self-awareness that the mode of intervention — technology — can be part of the problem and part of the solution for individuals living with depression.
Targeted mental health apps can assist users in linking causes and effects of technology use. In doing so, we believe that apps designed to support this consideration process can move toward incorporating intent and self-regulation in technology use more broadly. An example of such an assistive feature would be to have users rate the effect of apps they use on their mood, helping them to reflect on which technology or social media use has positive, versus negative, perceived effects.
Technology-based solutions could also go further in adopting the self-regulation point of view, by assisting users in setting new goals for technology use. The process of setting goals, working to meet them, and reflecting on failure and/or success is a central aspect of self-regulation theory that can assist individuals in building resilience, and changing thought patterns (e.g., ruminating less after failing to reach a goal, and reflecting on factors that led to failure).
(2) Discussing technology use within formal mental health care
A significant amount of participants’ social engagement occurred through texts, Facebook messenger, or other social media. However, participants were not routinely discussing technology use with therapists or clinicians, despite spending several hours a day engaged online.
Participants spoke at length in their interviews about the effects of technology and social media use on their mood, and the creative strategies they had developed over time to adjust their use patterns to meet their needs. However, despite the similarities between participant self-regulation practices, we found that individuals were largely designing and accomplishing these practices on their own.
There is an opportunity for clinicians to assist individuals with depression to assess their technology use from a therapeutic standpoint, perhaps through a “mindfulness” lens. For example, clinicians could ask about technology use, thought patterns, and mood, or suggest individuals with depression track technology use and feelings about it for a period of time.
If individuals’ moods are affected by technology use, this aspect of daily life should not be neglected in depression treatment. There are also opportunities for clinicians to assist individuals with establishing technology use goals, to move forward in day to day life with greater intention in use.
Conclusion
Our research shows the creative work of individuals managing depression as they reflect on and make adjustments to their technology use to manage their mental health. Over time, participants realized that passive technology use could be detrimental to their mental health, whereas active, intentional use of a diversity of technologies enabled them to reach new goals. We believe that future design and education in this area should empower people living with depression to be thoughtful about their technology and social media use, and to curate what they see and what they do across these tools as part of their mental health management.
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Thanks for reading! Here’s a link to the full paper to read for more details and a discussion of our peer support findings.
