With the continuation of quarantine and isolation, it’s not uncommon to rely more on social media for news and entertainment. Dr. Roger McIntyre, professor of psychiatry and pharmacology at the University of Toronto and CEO of AltMed Capital, recently conducted a study of Chinese healthcare workers that links increased social media consumption during COVID-19 to a worsened mental health state. He shared further details with WBFO's Nick Lippa.
Nick Lippa: Dr. McIntyre, you recently conducted a study regarding Chinese healthcare workers, showing that the more time people spend on social media the greater the degree of their overall distress and impairment. What did you find?
RM: We have completed a study in China involving over 3000 individuals who are healthcare providers who are frontline workers. And it's important to clarify, there's two types of healthcare providers. There's healthcare providers and then there's frontline workers, people who work in the healthcare system and are on the frontline. And I think we can agree that the latter group health care providers that are frontline are particularly at risk during this time. And we're talking normally about risk via the transmission of virus because they're coming in contact with people who have been infected with Coronavirus. But they are also at risk for a variety of other concerns and we'd like to take a history lessons approach. We learned, for example, during the SARS epidemic, of which Toronto was the city most effective like deaths due to SARS outside of Asia, we had 44 people in Toronto lose their lives because of SARS. And research conducted on the healthcare workers in the frontline at that time indicated that there was a significant increase in depression, anxiety related difficulties, post traumatic stress as well as alcohol related problems. We all are reacting with tremendous concern with the information we were hearing from Europe with respect to the mortality of this virus. And we were especially saddened to hear that frontline workers in some countries like Italy reports us and nurses committing suicide. So I think it really speaks to the stress.
So we said okay, we got to go to China. This is where the virus according to the World Health Organization, began infecting people. And we surveyed over 3000 healthcare frontline workers. What did we find? We found that these workers had staggering levels of depressive symptoms, anxiety symptoms, difficulties related to distress as a consequence of really being in that frontline. And when we dug a little deeper into the data to find out, where there's certain aspects about these individuals that perhaps increased or decreased their vulnerability, as a group, the overall anxiety, depression and stress level was increased so significantly. What we found when we looked at these later analyses, to determine moderating factors, interestingly we found that consumption of social media seemed to be a factor that increased the overall reporting rates of stress, anxiety and depression. And to be specific, those respondents to our surveys who indicated that they had been on social media for more than three hours a day are two to three times more likely to report depression, anxiety and stress. And I should perhaps contextualize that, prior to COVID-19 and during much of the past decade, there's a replicated body of scientific literature indicating that social media consumption from people who are using it many hours a day, many days a week are more likely to report negative health outcomes. That is they're more likely to report decreased well being. They're more likely to have pessimistic views of themselves in the future. They're more likely to report themselves as lonely-- just as a couple of examples. So there is something about excessive consumption of social media that does not appear to be helpful. It appears to be harmful for you. And we conjecture that is in part because of the contagion, not just of the virus app, but the fear contagion, which only amplifies many social media platforms.
What is the difference between high social media consumption before the pandemic, just in general, and now during the pandemic. A lot of people are not working, they're just at home. Social media consumption at a high level seems to be a bigger risk.
RM: It's an excellent point. We all know this is an unprecedented event that's affected the entire planet.There’s no country spared here. (It’s) unprecedented not only in terms of the impact on trade and the economy and capitalism and etc. But the notion of quarantine, social distancing, socially isolating ourselves. We've never seen anything like this. Even going back to the days of the Spanish flu, this level of quarantine globally was not in place at that time. So we as human beings are wired to be social creatures. We're not wired to be disconnected. And so by the very nature of being socially isolated, physically distanced and in many cases quarantine would stay at home borders and so on, by definition, one would expect an increase in the access of many of these types of platforms. So that's a reality of this unprecedented time.
The way to approach this however is, like many things in life-- and that is that human beings need interpersonal contacts that are substantial, that are meaningful and that are secure. And even at a time like this, where we're being asked to stay at home and distance ourselves, reaching out, particularly reaching out to people who are anonymous people who are not known to us, people who we don't have attachments to or have secure relationships with, that does not appear to be particularly therapeutic for a lot of people. And to kind of put a very brief sort of evolutionary context to this-- we are in fact, of all this as a species to be interpersonally connected. We are not species that have evolved to be connected to strangers. To be connected to uncertainty within a group environment. In fact, that actually goes against evolution. Evolution has rewarded genetics that promoted attachments to family and to close circles. So there's a larger question about social media and how in many ways it's not aligned with how we've evolved. But importantly, during times like this during a quarantine, we're not suggesting people don't reach out and make connections. What we're saying is people should reach out and make meaningful connections. So some people have said to me, ‘Well, what if it's not available?’ Many people don't have family or don't have somebody who would identify as an intimate support or an instrumental support. Our attachments can be to other types of entities. For example, many people are attached to their spirituality or to their religion or to their community groups, things of that nature. And so at a time like this, when we're all feeling fearful, the need has never been greater to have secure and safe attachments. And voluminous consumption of social media does not appear to meet that need.
And that's really interesting. What I hear from a lot of people is exactly wanting that sense of community. I talk to people who utilize groups like AA, as well as other similar services. What's a healthy way to manage looking for a community in regards to your social media habits?
RM: I think that there are some very simple and fundamental questions to reflect on whenever an individual is reaching out to another individual or to a group or to an organization or what have you. First of all, does that interaction increase or does it decrease my level of anxiety? It sounds like a very basic question, but that's an important question. Does engaging with this individual or group, does it actually enhance my well being? My quality of life, my view of myself in my world? Are there aspects about this interaction that's reducing or increasing my stress? Are there aspects about this interaction that are increasing or decreasing my sense of fear and safety? Now as I go through that, that seems like a fairly basic set of questions. But quite frankly, if you and I were to survey say prior to COVID-19, or even certainly during COVID, people who spent excessive amounts of time hours and again, social media, and they were to fill out surveys regarding those questions on to my point earlier, many people would say, ‘You know, I feel worse after spending time on social media. I feel more depressed. I feel more lonely. My quality of life goes down after social media.’
And then of course, the intuitive question is, well, if it hurts, why do you do it? That's a rather simple and linear way of considering it because the drive for human attachment is so powerful. And often people will reach out and will engage in unhealthy attachments, rather than having no attachment at all. And that's us as a species. There's plenty of examples of how that takes place in day-to-day life for people to continue their relationships, interpersonal or otherwise, that are not in their best interest, because their perception of the alternative is worse. Well, it turns out, in fact, their perception is just their perception. And the reality is that replacing or improving or replacing those types of relationships is always a preferred way to go. But again, that's where human nature kicks in. And things are much easier said than done.
One of the things I like to bring up is news consumption. One of the big usages of social media is to look for news. What would be your recommendations to somebody who says, ‘Okay, maybe I'm consuming a little bit too much here. What should I do to help myself be mentally prepared to prepare myself a little bit more healthfully now?’
RM: The advice is portion control. Portion control not just with what we eat in terms of food. Portion control with respect to alcohol. Portion control in respect with what we consume through media and social media. And again, that's the guiding principle for most things in life is portion control. But to add a bit more to it, and to use food as the metaphor, there's two guiding principles around food consumption-- portion control and to make sure that the food choices that you have are healthy. We want both portion control with respect to media and social media, but also to make sure it's healthy. Now look, a couple things we've learned from previous situations of quarantine and epidemics. What we've learned is, when people are informed, it significantly reduces their anxiety. It significantly reduces their anger, their frustration and their fear. So we highly encourage people to reach out to respectable media and be informed. It's good for you to be informed. That's sort of the fruits and vegetables of your diet so to speak, keeping that metaphor going.
A separate group of investigators in China have reported with the COVID pandemic, that too much general news media consumption can also be toxic after a while. And I'm not surprised to hear that and that also extends into social media. Again, we recognize that for many people, social media is enjoyable. It's fun. It's quality of life enhancing and in that all the good things. But for a lot of people, that's not the case. And if we look across the age bands, it's a reasonable assumption that the percentage of people over the age of 75 who are using social media is lower than the people under the age of 40. And what's interesting is people under the age of 40, who are probably using more social media, people of higher age groups, they also tell us over and over and over again that the more they use it the more lonely they feel. So I think like a lot of things in life, it has to be about portion control. And making sure that the consumption of what you're doing, the choice of the types of social media and general media are appropriate are healthy. But we really strongly encourage people to be informed. And that's to just not disconnect. The message is portion control.
Bringing this back to your recent study, it was done with frontline health care workers. But this is applicable to everyone, right?
BM: Absolutely. Absolutely. It's applicable to everybody. And what's so relevant about studying frontline workers in the healthcare system during this terrible crisis is that we all can agree that that is a very stressful situation for these people. They're working very long hours, uncomfortable working environments, hyper vigilant, a lot of stress and trauma, seeing a lot of deaths, a fear of infection and transmission to others and at the same time being quarantined. Healthcare workers are often quarantined themselves. So I don't think anyone is unaware that the frontline staff are really under a lot of stress right now. And that group especially is important for us to study, because people want them to be able to engage in activities and endeavors that are able to not just reduce their anxiety and stress but build their resiliency. And what we're finding is that overconsumption of social media is not doing well for their resiliency, probably reducing it, and it is enhancing their overall distress, anxiety and depression. And this is a significant problem.