Adolescents who watch excessive TV are more likely to show signs of depression when they become young adults, according to a new study. More significantly, participants' odds of being depressed went up with each hour of TV they watched. Exposure to videocassettes, computer games or radio use had no impact on the development of depression.

[T]he time teens spend watching television replaces social activities and physical activities that are important for health ... and limits their participation in activities that are intellectually stimulating.

Using data from the National Longitudinal Study of Adolescent Health (known as Add Health), researchers from the University of North Carolina, Chapel Hill evaluated 4,142 adolescents in seventh through twelfth grades in September 1995 and reassessed them in April 2002. Using the data from that The participants were screened to be sure they did not exhibit signs of depression at the start of the study.

Depressive symptoms were assessed using a nine item standardized depression screen in the first and final years of the study.

The investigators looked at the number of hours each participant spent watching TV, videocassettes (DVDs were unavailable at the time the data was collected), playing computer games and listening to the radio. They also gathered information regarding characteristics known to contribute to depression: sex, age, race, ethnicity, socioeconomic status during the participant's adolescence, as well as marital status and level of education achieved by the participants by the end of the study.

Researchers were interested in seeing whether that television viewing could be detrimental in two ways: by the impact of programming material itself, and by replacing other developmentally critical activities of teen life.

Increasing Isolation

In terms of the impact of television and other media on life, researchers noted that the time teens spend watching television replaces social activities and physical activities that are important for health and healthful habits, and limits their participation in hobbies and activities that are intellectually stimulating. The decreased time spent interacting socially interfered with the development of a teen's social and emotional coping strategies, thus limiting those coping strategies on hand later in life to meet life's challenges.

The investigators also noted that television watching often occurs late at night, and interferes with teens' getting sufficient sleep. They noted that studies have shown that thinking skills, emotional development, and attentional and organizational capabilities are all negatively impacted by early media exposure.

The investigators also described many potential risks regarding the media content itself. When ethnic, racial, and sexual stereotypes are encountered on TV, teens compare themselves to unrealistic role models and may not have the perspective to realize the superficiality of the TV characters or the value of their own uniqueness. They may become depressed at the gap between their own life situations and the TV lives to which they aspire. TV shows which show teens engaging in risky behaviors can be exciting and enticing, and rarely portray realistic outcomes of the characters' actions. Similarly, TV advertisements tantalize teens with depressingly out of reach products.

In addition, TV news and talk shows often portray a frightening world. A teen may not have the cognitive skills or emotional maturity to recognize journalistic manipulation or to accurately assess the actual risks to themselves, their friends and family of what they are seeing. When they view disturbing information alone without the opportunity to process it with more experienced adults, it remains threatening to them, and a threatening world becomes a depressing world. Conversely, the researchers noted that a positive impact of TV could be the presentation of humor and life affirming messages, which can both help to decrease depression and offer hope. The study was published in the February issue of Archives of General Psychiatry.

Videocassette viewing was not associated with increased depression. The researchers felt this was because the viewer chose videocassettes and were aware of their content, whereas "channel surfing" exposed the TV viewer to scenes and information for which they were unprepared. Similarly, computer games were not associated with depression, nor was the radio, which the researchers felt was more often background music, not a primary focus of attention.

Girls and Boys Respond Differently

The researchers were surprised by the finding that girls were less likely than boys to be impacted by television. They postulated that the social ties of adolescent girls gave them more reserve when they internalized and ruminated disturbing thoughts, while adolescent boys reacted to depressing thoughts with distracting activities that masked their discomfort and prevented sharing them with friends and family. They further speculated that male role models on TV project idealized masculinity and sexuality that made teen boys feel inadequate.

This study is important because the onset of depression is common in adolescence and young adulthood and can manifest as poor school, job, and social functioning. Adolescence is a challenging time of physical and psychological maturation and a time when teens struggle with their emerging identities. Depression can both result from and contribute to the stresses of this developmental stage and can increase the difficulty of developing and maintaining interpersonal relationships when the need for social support is high. It is additionally concerning that early onset of depression carries an increased risk of recurrence.

The investigators did not draw conclusions as to whether increased television viewing in adolescence caused increased depression in early adulthood or whether increased teen viewing was a sign of vulnerability to develop depression later on. Teens who watched excessive TV may do so because of a predisposition toward depression, which causes them to avoid other potentially anxiety-producing experiences or to escape from their stressful, lives. Regardless of the cause and effect question, the researchers conclude that the amount and type of teen media exposure, especially those that are socially isolating, should be part of any history a teen's doctor takes, and parents should maintain an awareness of time spent in front of various screens.

The Message For Parents

Of course, when this data was collected, the availability of media was significantly less than it is now. There were no DVDs, iPhones, iPods,, Blackberries, text messaging, on demand TV programming, etc.. Some of the newer technology is isolating, and some gives a greater (although perhaps artificial) sense of connection. But this study should raise the consciousness of parents and professionals who work with teens that excessive use of media can be isolating, can limit other important experiences and social connections, and can be a red flag for a developing emotional problem.

Parents may want to consider discussing news events, frightening movies, or other potentially threatening exposures with their teens to provide some adult, reality-based perspective, rather than leaving their children to draw their own conclusions. Parents may also consider modeling responsible TV watching themselves, picking specific programs rather than having it on constantly in the background or the foreground.

Parents should be on the lookout for signs of depression in their teenagers and college-age children. In addition to isolating themselves socially, depressed individuals often sleep poorly or excessively; withdraw from previously engaging activities and friends; eat poorly; and are irritable. If parents have any sense their teen might be depressed, they should consider an evaluation by their primary care doctor or a mental health professional. These symptoms can also be signs of substance use, which itself is often an attempt by teens to self-treat their unpleasant feelings. Parents should try not to assume that their teenagers' annoying behaviors are all "typical" and should try to maintain enough involvement in their daily lives and enough awareness of their friends and social activities that they can accurately assess whether their children are in need of help.