Television, the drug of the nation

The title of this post is, of course, stolen from the 1992 track of the same name by The Disposable Heroes of Hiphoprisy.  Yes, that’s right, they did have a startlingly naff name, but they were a good act, and also released what’s still, 17 years later, one of the very few rap tracks that directly tackles homophobia within US black culture, ‘Language of Violence‘.  Anyway, that’s not what this post is about – an opportunity for me to wax nostalgic for the days when rap was still a predominantly political genre, and not a cartoonish freak-show obsessed with money, material possessions, and misogyny.*

No, what this post is actually about is this piece of research, which I found out about via the Mad World blog.  Some medical researchers with quite a lot of time on their hands carried out a longitudinal study (one in which the same group of participants are followed over a lengthy period of time) in order to investigate a possible link between adolescent watching of television, and the risk of subsequently developing depression.  Although the research seems to have been well designed, I do still have a few problems with it.  Let’s face it, I wouldn’t be me if I didn’t…

First of all, it seems to be a very outdated concern.  As I understand it, today’s adolescents watch a lot less TV than my generation did, and are much more likely to spend their time online or playing games.  The researchers specifically state that

We did not find a consistent relationship between development of depressive symptoms and exposure to videocassettes, computer games, or radio

so it would seem there’s comparatively little of contemporary concern here.

One of the very impressive things about the research is that the researchers didn’t simply impose an arbitrary limit which they considered to mark the threshold between ‘normal’ and ‘excessive’ TV watching, and analyse the prevalence of depression in each group.  Such an approach would have led to questions about whether there was some other difference besides TV habits between the two groups that had not been taken into account by the researchers.  Instead, the researchers have analysed their data in such a way that they have been able to demonstrate that, across the group of participants as a whole, the likelihood of developing depression increases for each additional hour of television watched per day during adolescence.  The clarity provided by this method of analysing the results, together with the large size of the study sample (results from 4142 participants were included in the analysis), are the main reasons that I describe this study as well designed.

Other aspects of the study were of greater concern for me.  Judging by the information contained in the abstract (unfortunately I don’t have access to the whole paper), it would appear as though the participants were only tested for the symptoms of depression twice – once at the very beginning of the study, and again 7 years later.  Participants who tested positive for depression at the first test were apparently excluded from the analysis of the results.  There are really two concerns here.

Firstly, the researchers were clearly concerned that pre-existing depression would complicate the results from their study, since they excluded those who tested positive at the start.  However, some of the participants who appeared free from depression when the study began may have simply been having a good day when they were tested.  With no background information on how depressed they were in general before the study began, it is impossible to know for certain whether an individual participant has developed depression over the course of the study, or if they were pre-existing sufferers.  This in turn makes it difficult to be sure whether watching more TV in adolescence was a symptom of pre-existing depression, or if it was the cause of an emerging depression.  (Many of us who sufferer from depression would say that we are more likely to pursue ‘passive’ activities like watching TV when we are depressed.)

Secondly, and more significantly, with no intermediate testing of depression over the course of the 7 year period, the researchers have missed an opportunity to establish if there is an association between the presence of depressive symptoms and watching more TV.  This is significant, because it means that the researchers are unable to exclude the possibility that adolescents who began by watching very little TV later developed depression, and that this caused them to watch more TV.  If the researchers had tested the participants for depression at more frequent intervals (and I realise that logistical problems would have been encountered in arranging this, especially given the numbers of people participating in the study), it might have been possible to establish whether the change in behaviour preceded or followed the onset of depression.  This would have enabled the researchers to take a more definite view as to whether increased TV watching was a symptom or cause of depression.  Opportunities to shed light on the symptom/ cause debate regarding factors in mental illness are very rare, and as such it’s a shame that this study didn’t do that.

Instead, in their conclusion the researchers fall back on the old cliche of asserting that there is ‘an association’ between watching more TV in adolescence and developing depression in young adulthood.  Such ‘associations’ may be very clear, but they don’t necessarily tell us anything useful – as I’ve mentioned before, there’s a clear ‘association’ between broken legs and plaster casts, but that doesn’t mean that plaster casts cause broken legs.  The scientifically precise use of the word ‘association’ also leads to frustration because it’s often wrongly described as a ‘link’, and this is in turn misinterpreted as meaning that a ’cause’ has been discovered.  In fact, the first stage of this process is in evidence when the study is reported on Mad World – the article is headed ‘Link between watching TV in adolescence and depression‘, where the original research is entitled ‘Association Between Media Use in Adolescence and Depression in Young Adulthood‘.

I’m certain that the author of the blog had no intention to mislead, and just used the word ‘link’ because it was shorter, and is so often used in media reports about scientific studies which show an association that most people now assume the terms are synonymous anyway.  Certainly he doesn’t unthinkingly endorse the conclusions made by the researchers.  Instead, he points out that someone who is watching a lot of TV is likely to be socialising and exercising less than their counterparts who don’t watch as much TV, and that the researchers may have simply ‘rediscovered’ by other means the already acknowledged association between social isolation and/or lack of exercise and depression.

I certainly agree with that take on things, but would also want to take it one stage further.  The ‘associations’ between social isolation and lack of exercise and poor mental health are just that – associations.  Some lonely and unfit people will just be lonely and unfit, and won’t go on to develop depression.  Conversely, some people who take regular exercise and have positive social connections will nonetheless develop depression.  One usual way round this difficulty is to speak in terms of ‘risk factors’, and to say lack of exercise increases the risk of developing depression, in the same way that smoking increases the risk of developing heart disease.  Unfortunately, the association between depression and lack of exercise (or social contact) isn’t as clear and straightforward as the association between smoking and heart disease, because, unlike the latter, the former argument can be reversed.

When looking at the association between smoking and heart disease, it isn’t reasonable to speculate as to whether smoking causes heart disease, or heart disease causes smoking.  That’s partly because the decision to smoke is a conscious one – people who have never smoked before will not find themselves spontaneously puffing their way through a packet of 20 in the aftermath of their first angina attack.  But it’s also because of an accumulation of data which shows that people without pre-existing heart problems who smoke are significantly more likely to develop heart disease than people who don’t.  In other words, we can say with confidence that, for many individuals, a smoking habit comes before heart disease.  That is, of course, not the same as categorically proving that smoking causes heart disease – but it is a stage closer to that than merely being able to say that smoking and heart disease co-exist within many individuals.

By contrast, this is all that can be said with regard to depression and its associated ‘risk factors’ – that they co-exist within many individuals.  As I’ve already mentioned, this study, because it failed to measure depression and behavioural changes more frequently, represents a wasted opportunity to have looked at whether or not an increased TV habit preceded or followed the onset of depression.  However, even if the researchers had undertaken to do this, and had demonstrated that in most cases increased watching of TV preceded the onset of depression, they would not have been able to conclusively prove that watching TV causes depression.

It is possible, for example, that symptoms such as lack of energy and listlessness, before they became clinically significant enough to be classed as depression, may cause an increased desire for passive and undemanding leisure activities.  In this case, it would be more accurate to describe increased TV watching as an ‘early warning sign’ for depression, rather than its cause.  Certainly – and this is of course purely anecdotal evidence which taken on its own has absolutely no scientific significance – my own sensation of ‘falling into’ depression is that it begins with a gradual loss of energy, and that this eventually (or sometimes rapidly) becomes pronounced enough to justify calling it depression.

What all of this means is that, for the foreseeable future, it’s going to be very difficult to prove whether or not lifestyle factors like watching TV are the cause of mental illnesses like depression.  The main reason for this difficulty is that there’s no objective test for depression – just a subjective judgement of mood and behaviour made (usually) by a doctor.  Until it’s possible for science or medicine to come up with a physiological test for depression – a characteristic pattern of brain activity, perhaps, or a particular balance of substances in the bloodstream – it will never be possible to say whether a particular form of behaviour is an early symptom of underlying problems, or whether it is the cause of problems which will emerge later.

And what that means is that, while it’s very interesting to look at these questions, and we should never exclude the possibility that something truly significant will emerge from one of these studies, they are really nothing but distractions.  From the perspective of people with mental illnesses, and the people who treat them, it would be far more beneficial to concentrate on symptoms, and how to relieve them, than it is causes, and how to avoid them.  I’m a big supporter of scientific research for its own sake – it is always better to try and understand than it is to flounder along in ignorance – but I do think that, until science has learned a lot more about the brain and the mind than it currently knows, it’s a mistake for clinicians and patients to focus on causes and cures at the expense of symptoms and symptom management.


* – I am aware this is only a fair criticism if we’re talking about mainstream rap.

This entry was posted in About me, Depression, Psychology, Stuff I've read. Bookmark the permalink.

20 Responses to Television, the drug of the nation

  1. Zoe says:

    Aethelread? Your posts are WAY too long! And did I perchance see the magical hieroglyphs ‘No Comments’ at the top of your blog? I can’t blog at all at the moment. Not that I lack the will. Have an impossibly-indecipherable password issue with WordPress, due to previous well-documented senior moment that caused me to forget my original one. Any advice for me, with your geek’s hat on? Lots of love as always, and go on, pluck up the courage to email me. Oh OK don’t then. Either way is fine. But I don’t bite, even if I am a maneater… Love, Zoe.

  2. aethelreadtheunread says:

    Zoe – thanks for the comment.

    About your password issue. You don’t have to keep using the long one that WordPress sent you. You will need to use it once to log in, but then you can go to My Account, click on Edit My Profile, and if you scroll down that page there’s an option to set up a new password. I don’t know if you’ll be able to re-use your old password – some sites stop you doing that – but you’ll certainly be able to use something that you find easy to remember.

    Good luck!

  3. lsnduck says:

    Working at a Higher Education institution, I have access to the full article, so if there are any details you want me to check for you, say the word. Although I suspect it may be illegal for me to make that offer.

    As an aside (anecdote != evidence), the period of my life at which my issues were developing most rapidly and severely also happens to be the period when I was most socially and physically active. Yay for being a isolated couch potato!

    Suffice to say it is all very complicated, and as you say we need to be very cautious, especially with trying to guess at single factor causation.

  4. Alex says:

    Television makes me depressed, but only in the sense of throwing things and shouting whenever the news or Kris Marshall are on. I suspect that’s less mental-health related and more me-being-a-cynical-bastard related, though.
    Incidentally, I hadn’t heard of the Disposable Heroes, but any band that covers the Dead Kennedys’ ‘Holiday In Cambodia’ is alright by me. Being the precursor to Michael Franti And Spearhead helps, too.

  5. cellar_door says:

    See, TV has the opposite effect on me…it makes me feel more connected with the rest of the world and less isolated when I’m down. I know that sounds a bit counter-intuitive, but it lets me see a world outside my living room! I find when I listen to music when I’m down, it isn’t so good for me…I disappear inside my head. The urge is to stick on the headphones and retreat, but I feel less maudlin if I wack on some comedy. Particularly if it’s Big Bang Theory and I can have some weird lusting over Sheldon….

  6. Simeon says:

    Hi, I can’t disagree with most of what you have said. Yes, I have often conflated “association” and “link” but I’ll be more wary about that in the future! However, I think it’s a bit fatalistic to think that all we can do is focus on alleviating symptoms – I think there are good examples of prevention work out there and emerging evidence that things like exercise can have an impact on mental health.

  7. Lucy McGough says:

    I tend to watch more television when I’m depressed. Unfortunately, most of the programmes increase my depression so it becomes a vicious circle.

    On the other hand, anything with David Attenborough in is excellent for banishing the blues. And Dr Who rocks my socks.

  8. aethelreadtheunread says:

    Thanks for the comments.

    lsnduck – thanks for the kind offer regarding checking the full text. My guess is it would only be illegal if you reproduced the whole text, or a very large chunk of it – i’d expect brief quotations, or the reporting of a small detail, to be classed as fair use. But i only really know about these kinds of issues with regard to books rather than journals. I wouldn’t want to get you into trouble, anyway!

    we need to be very cautious, especially with trying to guess at single factor causation.

    Thank you – that’s exactly the point i was trying to make, but just couldn’t get out in so many words. :o)

    Alex – Television makes me depressed, but only in the sense of throwing things and shouting whenever the news or Kris Marshall are on.

    Ah, well, you just need to learn to be more selective about what you watch! I usually find the news ok, provided there aren’t any interviews with politicians/ thinktank speokesmen etc – i’ve never understood the point of listening to somebody say exactly what i knew they’d say before the interview started. And Kris Marshall’s BT ads are infuriating.

    I’d like to like Micheal Franti’s Spearhead stuff, but i’m afraid i just can’t get past the words ‘jazz’ and ‘reggae’. As far as i’m concerned, jazz is nothing but random noises for people who can’t tell the difference between melodic progression and flatulence… ;o) And reggae is just watered-down ska. I’m a big fan of ska (the old Jamaican stuff, not so much the 70s/80s white-boy imitations – although some of them are ok too).

    Hmmm… i think i may have just insulted the music-tastes of about half the planet there – sorry, everyone, it’s only my opinion. Please feel free to tell me i’m wrong. :o)

    cellar_door – you point up something weird about my post. I went through the whole thing without once saying what my own attitude to tv is. Basically, i agree with you that it’s a way of feeling less isolated, but i do also recognise that it can be (depending on what i’m watching) very passive and disengaging. I usually try to watch a sprinkling of documentaries, if i can, just to try and keep my mind a bit switched on, but if i’m honest, comedy and US soapy-ish drama (e.g. Brothers & Sisters) are much more my level… ;o)

    Simeon – thanks for not taking offence! I was debating with myself whether or not to include the link/ association stuff, because i didn’t want to upset you, and it is really a very minor point.

    I should have probably been a bit clearer about what i mean by alleviating symptoms. I’d include things like taking regular exercise and trying to maintain good social and personal relationships as part of alleviating symptoms. I don’t think, personally, that the lack of those things is what makes someone ill, but i do think having those things can help someone who’s depressed feel better about things.

    Lucy McGough – I agree, watching TV is a very easy option when i’m feeling depressed. I’m not sure it makes me more depressed, though. I tend to find that, if i’m depressed whatever i do makes me feel crap. But maybe i just don’t want to admit that my TV addictions is doing me harm… ;o)

  9. Lucy McGough says:

    By the way, I posted a link to your Daily Fail post on my blog. I hope you don’t mind.

  10. aethelreadtheunread says:

    Not in the least! :o)

  11. …breeding ignorance and feeding radiation!

    Not to mention “bail out the banks, loan art to the churches… satanic reverses”

    You’ve inspired me to dig out that album and listen to it. It’s GREAT.

  12. beetrootsoup says:

    Thanks, A, for the geeky advice. I do have a conveniently geeky boyfriend coming over to sort out all my petty problems tomorrow in any case, but you both appear to have been pre-empted by the Magical Force that just let me into my blog without even entering a password! Check out the latest entry. I truly am feeling a lot more chilled and happier now that I find myself transmogrified into a human robot. I also find myself baffling everyone with ever-longer words…a little bit like you, I guess, baffling the world with ever-longer blog entries…

    Oh hon. Isn’t it time to go and grab yourself just a little bit of a life? To think you not only post these gargantuan pieces, but they are actually drafted and edited ahead of time! You are one hell of a busy guy in that nice, tastefully-decorated flat in that ‘Notown’, ‘Somewhere in England’.

    Here I am gonna give you a piece of advice you might not lie. Feel free to spurn it if so. Going as close to vegetarian as you can manage is EXCELLENT for paranoia.

    Need I explain? Well you see like, (and I say this less for you, A, than any readers who might be a little less intellectually gifted) animals are very much like us. They don’t like dying and they feel scared stiff when they sense their imminent deaths approaching. Then people eat them. Then they wonder why they are full of fear and paranoia!!!

    Further handy tip: get into the habit of checking all the ingredients on every packet you pick up in that local grocer’s of yours. C’mon, it ain’t beyond the wit of either man or woman, and YES, it is important. Listen to your BODY! Give your head a rest!

    And OK, just to take the piss and push the envelope still further: VEGAN FOR THE PLANET, VEGAN FOR THE ANIMALS!

    And I’m only just a teensy weeny bit of a hypocrite. Tons of love and healing thoughts A. And well done. Your very good bloggie friend, Zoe.

  13. Lucy McGough says:

    On the other hand, roast beef and Yorkshire pudding is excellent for the morale…


  14. cellar_door says:

    I second Lucy’s morale boosting idea…

    And yup, TV is passive and disengaging…certainly doesn’t come high on the list of theapeutic activites for depression beating, as you point out…but sometimes we all need to be passive and disengage :o) I think my level might be slightly lower than yours, given my general aversion to documentaries! Although I’ve taped that Terry Pratchett one that was on t’other day…

  15. Lucy McGough says:

    That was a good one – although, annoyingly, there were no spoilers for his next book. Don’t forget part two is on next week.

  16. aethelreadtheunread says:

    Thanks for the extra comments.

    DeeDee Ramona – glad to have been of service in reminding of you of a good album. :o)

    beetroot soup – I truly am feeling a lot more chilled and happier now

    I’m glad to hear it! Oh, and you’ll have to use words a lot longer than ‘transmogrified’ to confuse me… ;o)

    Oh hon. Isn’t it time to go and grab yourself just a little bit of a life?

    Why break the habit of a ‘life’time…? ;o)

    cellar_door – sometimes we all need to be passive and disengage Indeed. I’ve more or less got past the stage of beating myself up for not climbing a mountain or taking up crochet instead of settling down with a cup of tea in front of ‘Countdown’… ;o)

    Lucy McGough – i second your recommendation for the Pratchett documentary. There are bits of it that are rather horrible to watch – the section where he’s trying to read aloud, most notably – but by and large it’s worth watching, and the Prachettian sense of humour is well in evidence. For example, the opening line of the narration: “My name is Terry Pratchett. At least, I think it is…” :o)

  17. beetrootsoup says:

    Hah! You’re all lightweights, A, Seaneen, etc. (Why are you the only two bloggers I continue to pester regularly with unwarranted and frankly rude comments?)

    Your blogs are tapering off. Mine is still going strong, and my hits are slowly but steadily climbing…

    Remember the story of the Tortoise and the Hare?

    Talking of lifetimes, A, mine has well and truly been lived in the Slow Lane. I’ve watched various ex-boyfriends and friends become ridiculously successful, my frustration levels growing ever more unbearable. Oh how I longed to hear of their downfall! Yet still their popularity grew!

    Now I sense the Time of Sweet Revenge has come. Not so much the Revenge of the Geek, but at any rate the Revenge of the Offbeat, Weird, Slightly Unpopular Girl at school who was mocked for being into ‘Women’s Lib’ aged fourteen…

    I was so uncool, A, that I was the only one at the all-girl disco of my grammar school in Folkestone (the seaside town they forgot to close down/bomb, ta Morrissey) who hit the dancefloor when ‘I Will Survive’ came on!!! I clearly remember the withering looks I got from the popular, cheerleader clique.

    I had about two friends, both of whom failed O level maths!!! And me, I fecking passed it! Like pretty much every other exam I’ve ever taken!

    Now I am simply addicted to passing everything with flying colours. Well bollocks to it. If this world can’t come up with something a little more challenging, I guess I’ll have to set myself a slightly more interesting exam…

    Tailing off enigmatically (always leave them gagging for more), with lots of love as ever, Zoe xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

    Oh and ps, by the way thank you for your sincerely expressed pleasure in my happiness. I’m getting there!

  18. Sister Y says:

    This may not be the proper forum for it but:




    Why are all British pejorative better than American pejoratives?

  19. beetrootsoup says:

    Have to agree with you there Sister Y. The UK is a cool country and London the official capital of the world. Tho’ no-one in their right mind would ever call me a patriot.

    And I have a whacking great map of the US on my living rom wall. The colour of the different states match my decor wonderfully well and plus, the bf likes to give it penetrating stares now and then. He even admitted to liking it the other day…

    Aethelread you are now turning out to be more unready than unread. It’s almost as if I’ve just moved into your flat and taken over your blog among other things ain’t it?

    Sorry for that. I feel guilty when I find you lost for words babe. Take care in this nasty world hon. Love, Zoe.

  20. Lucy McGough says:

    Hey, Aethelread, I put you on my blog list. I’m telling you in case the news makes you happy.

    And I second what Zoe said – take care in this nasty world. Sage advice which everyone should follow.

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