sad teenage girl sitting by the window

Oral Contraceptives may Increase Risk for Depressive Symptoms Among Teens

A recent study by researchers at Brigham and Women’s Hospital and University Medical Center Groningen (UMCG) and Leiden University Medical Center in the Netherlands has provided new insight into whether there is any connection between oral contraceptive use and mood.

The study published in JAMA Psychiatry included a survey of young women about depressive symptoms, such as crying, sleeping excessively, and eating issues, which can be far subtler than diagnosed clinical depression. The investigators surveyed a cohort of more than 1,000 women from age 16 through 25 years, every three years, and collected a unique set of data about these sub-clinical symptoms.

The study demonstrated that there was no association between oral contraceptive use and severity of depressive symptom in the whole population that had been investigated. However, it was found that 16-year-old girls reported higher depressive symptom severity in comparison to 16-year-old girls not consuming birth-control pills.

The corresponding author of the study, Anouk de Wit, MD, PhD said, “One of the most common concerns women have when starting the pill, and teens and their parents have when an adolescent is considering taking the pill, is about immediate depressive risks.” De Wit now a trainee in the Department of Psychiatry at UMCG, further added, “Most women first take an oral contraceptive pill as a teen. Teens have lots of challenging emotional issues to deal with so it’s especially important to monitor how they are doing.”

According to co-author Hadine Joffe, MD, MSc, vice chair for Psychiatry Research for the Brigham’s Department of Psychiatry and executive director of the Connors Center for Women’s Health and Gender Biology, theirs is the “first study of this scale to dive deep into the more subtle mood symptoms that occur much more commonly than a depression episode but impact quality of life and are worrying to girls, women and their families.”

For this study, the researchers analyzed data from Tracking Adolescents’ Individual Lives Survey (TRAILS), a longitudinal study of teens and young adults from the Netherlands. Each female participant filled out a survey with questions about depressive symptoms, such as crying, suicidal ideation, self-harm, eating, sleeping, feelings of worthlessness and guilt, energy, sadness, and lack of pleasure. A depressive symptom severity score was generated based on the responses of those participants.

It was found that the association between oral contraceptive use and depressive symptoms may be bidirectional: birth-control pill intake may contribute to severity of symptoms, more severe symptoms may prompt teens to begin taking oral contraceptives, or both. Observational studies, such as this one, cannot however confirm the direction of causality.

mother taking away tablet from the child

Is Digital-Addiction a Real Menace to Children?

More and more children these days are battling digital addiction. They are being exposed to electronic devices at much younger ages, and we often watch them spending hours gazing at cell-phone/tablet or computer screens. According to experts, digital addiction is as potent as meth and can have alarming effects on children. It is extremely important to apply moderation, when it comes to screens or screen-time and we as parents must teach our children how to use them in a healthy way.

According to Dr Dimitri A. Christakis, Director, Center for Child Health, Behavior and Development, Seattle Children’s Research Institute and professor of pediatrics at the University of Washington, children use the devices along a continuum which ranges from healthy to compulsive to addictive. “I think the phenomenon of tech addiction is quite real,” he said.

In the commentary published in JAMA, Dr Christakis suggested that the relationship between media exposure and health in adolescents might turn out to follow an “inverted U” pattern. Thus, very high exposure and very low exposure might both be associated with poorer mental health outcomes than moderate amounts of usage.

However, though technology-use is as powerful as drugs, it is not analogous to drug use at all because these devices serve important purposes in our lives, including children’s. We as well as children need technology to do the day-to-day chores and stay connected but it is pertinent, given its adverse effects, to find healthy ways to use it adequately before its takes over.

Dr Ellen Selkie, an assistant professor of adolescent medicine at the University of Michigan, who does research on adolescents’ use of social media, said, “It’s like food, it’s something we all need because of the way businesses run, because of the job market—and for teens it’s the way they socialize.”

According to Dr Selkie, there is evidence that supports limitations on the absolute amount of screen time with younger children but the situation is more complicated, with older children. This is because, it is not that simple to make out whether a teen who is always on the phone, is there due to addiction or because that is where his friends are. It is normal for a teen to always want to be talking to his or her friends rather than the family.

However, just like other aspects of life that contribute to our overall well-being, it requires daily decisions on the user’s part to keep his or her technology-usage within healthy limits. Saying that one should altogether bring it down to zero is neither sensible nor acceptable given the benefits technology provides; however, we can certainly curb before we become its slaves instead of masters.

Dr Jenny Radesky, an assistant professor of developmental behavioral pediatrics at the University of Michigan and an expert on technology use by children, equates technology to “an environment.” It is a place where all sorts of activities take place, from work to entertainment to social life. However, she cautions that it is a deliberately designed and engineered environment, with an ultimate goal of making money. “Modern technologies is purposefully habit-forming and programmed with the sort of variable rewards that keep humans engaged.” she adds. It is important to not fall prey to it because it can potentially impact our healthiness in a negative way.

Dr Radesky also emphasizes that rather than the concerned individual, or the so-called addict, the problem lies with the digital environment which is shaping the individual’s behavior, often through methods that are intentionally exploitative or subconscious.

Therefore, it is essential for children to understand the way technology works for or against them. Parents can play a significant role in imparting and demystifying information and making their children more digitally literate.

While researchers often talk about the difficulty they experience in trying to understand and quantify children’s use of devices, Dr Christakis in his commentary, points out how while the required information is routinely—and efficiently—gathered by the industry and applied to increase the charm of the devices and the programs, people in academia and research are struggling to get the data needed to put together coherent and extensive guidelines for parents and policymakers. Dr Christakis, thus, suggests that an increased cooperation between industry and researchers might help in setting up those guidelines.

According to Dr Selkie, there are ways for tech companies and even game designers to be more thoughtful about children and to discourage problematic internet use.

In the meanwhile, parents should do their part and start with asking their children to put down their cell-phones while dinner or on family outings and gradually proceed to setting limits on per day screen-time. Parents themselves should also be mindful of their own use of devices and set good examples for their children.

Also read:
8 Ways to Prevent and Address Your Child’s Addiction to Smart Devices
The 4 Personal Traits That Make It Hard to Take Criticism
Study Explains Why People Lie
Why Children Lie and What Parents Can Do to Prevent It