Q&A: For Mental Health Awareness Month, how to socially thrive in technology-driven world

Key takeaways:

• The absence of social connections is a significant risk factor for mental illness, Fallon Goodman, PhD, said.
• Avoiding socializing to avoid rejection prevents you from making meaningful connections, she added.

The National Alliance on Mental Illness (NAMI) estimates that one in five U.S. adults are currently living with mental health issues. In acknowledgement and celebration of Mental Health Awareness Month, NAMI has launched the “Take the Moment” campaign, encouraging individuals to build community connection, hold conversations and act now by using available resources.

Fallon Goodman, PhD, assistant professor of psychological and brain sciences at George Washington University, has focused her research on how social interaction impacts mental health and how technology affects that relationship.

Healio spoke with Goodman about how to achieve meaningful social connections in the digital age, the impact of the COVID-19 pandemic on socialization patterns, and the role that social anxiety plays in deterring social interaction and thereby increasing a person’s risk for mental health issues.

Healio: Could you discuss the relationship between social connections and mental health and wellness?

Goodman: We know that across cultures, age groups and demographic variables, the strongest predictor of happiness and well-being is the quality of someone’s social connections. At baseline, social connections are important for our health.

Social relationships or connections provide a buffer for developing different mental illnesses, like depression. They help people climb out of different mental illnesses. If you have depression and you have a strong social network, relying on or utilizing that social network can help you engage in behaviors that are going to reduce some symptoms of depression.

Conversely, the absence of social relationships is a huge risk factor for developing mental illness. Of course, one risk factor is never entirely responsible for an outcome. No one would say that if you don’t have social relationships then you're guaranteed to develop a particular illness.

But if you lack social relationships and consequently you feel lonely, or you don’t have people to lean on, it’s going be harder when distressing life events happen. It’s one less tool you have to manage those stressors, and it’s a significant tool to be missing.

Healio: How did COVID-19 and limited in-person interactions affect the mental health of people with or without pre-existing mental health issues?

Goodman: That question is difficult to answer because the pandemic was long and evolved over time. There were also geographical differences. It’s hard to pinpoint a cause and effect of an ongoing, evolving event.

We’ve heard anecdotally that for people with social anxiety, the absence of social interactions during the initial lockdown phase provided a period of relief, because social interaction is the source of their anxiety. There was a reprieve from having to face their fears each day.

However, we know how anxiety works — the more you avoid, whether intentional or not, the harder it will be when you reengage with those stimuli. When lockdowns in various areas started being lifted and we saw more in-person interaction, people with social anxiety really struggled.

But think about a teenager who has not socially interacted for several months due to COVID-19. Not only did they not engage in that social practice, but they may have missed out on some key social developmental periods, making it even harder for them to reconnect.

We also anecdotally heard that once in-person interactions resumed, there were many differences in social norms. Do I wear a mask? Do I take it off when I go outside? Do I hug? Do I do a fist-bump or a handshake? How do I re-engage? What are people expecting of me? There was so much uncertainty and variability, which is very hard for someone with social anxiety because they prefer structured, predictable interactions.

Now there is more normalcy and a return to baseline in terms of social norms, which makes social interaction much easier. But it remains to be seen how what has happened in the past 3 years might have altered people’s social trajectory in a negative way.

Healio: What role does technology play in both encouraging and discouraging social interaction?

Goodman: I like the way you phrased this question because both are true. Let’s start with how technology is helpful. We’re more connected than ever as a society in lots of helpful ways. We can find our different communities online.

There are some data that suggest that this is particularly important for certain groups of people. For example, queer adolescents who are growing up in an area of the U.S. where it’s unsafe or unwelcome to be queer and/or they don’t have other queer youth to socialize with can make online connections.

Further, low-cost social interactions help people stay in touch with very little effort by following acquaintances and liking their posts. People may argue that those are shallow interactions because they are often brief, but that doesn’t mean that they’re not helpful or beneficial. You can still feel connected to people in this more distant way.

Social media gives people a voice and it gives people who were previously powerless a platform if they use it strategically. It helps people feel connected to the world. If you’re feeling lonely, sometimes there’s comfort in being on social media.

On the exact same token, you can feel even lonelier when you’re scrolling social media looking at what other people and friend groups are doing that you’re not a part of.

If you’re using social media as a replacement for face-to-face social interactions, we know from data in my lab and elsewhere that in-person interactions are usually more beneficial to your well-being and of higher quality than online interactions.

Online social interactions serve a purpose, but if that’s the only form of interaction you’re having, it’s probably not going to lead to strong feelings of connection.

Healio: In your TED Talk, “Why you feel anxious socializing (and what to do about it),” you discussed how social anxiety often puts people at risk for developing other mental health issues. Can early diagnosis and treatment of social anxiety prevent other mental health issues from arising?

Goodman: Absolutely. Social anxiety increases the risk for depression and suicidality. It also increases the risk for substance use disorder, particularly alcohol use disorder.

If a person is at risk for developing social anxiety, or has just started having some social anxiety symptoms, then early intervention can potentially prevent the development of the consequences of social anxiety.

Healio: During your talk you stated that, “at its core, social anxiety is about the fear of being rejected.” How does fear of rejection affect the way we navigate online social situations and relationships?

Goodman: I think there’s a lot of avoidance. For online social interactions, you might avoid posting or sharing an opinion, whether or not it’s controversial. You may be deferent or just avoid interaction entirely, which could translate as passively scrolling or liking as opposed to posting.

If a person is posting or sharing information online, there may be a lot of rumination after the post occurs. We spend a lot of time prepping the post and trying to get it just right. Once you submit the post, then you start wondering, did I bother someone? Do I look OK? What are people going think of me?

Someone with social anxiety is going to struggle with post-event processing, which for them will be frequent, intense and persist over time.

In-person interactions are similar. What you typically see are people trying to fly under the radar. They try to avoid positive and negative evaluation because either end of the pole has potential for rejection. If I sound boastful and arrogant, I might be rejected, but if I’m meek or insecure, I might also be rejected. They may want to stay neutral and be agreeable. By doing this, they limit their opportunities for rejection.

But what is harmful about interacting that way is people don’t get to know you. If you’re socially interacting and not saying anything, you’re missing opportunities for rejection, but you’re also missing opportunities for connection. And worse, if you’re not saying anything at all, you might be more likely to be rejected because people think you're disinterested, cold or feel superior.

Thus, behavior that is intended to reduce the risk for rejection actually increases the risk for rejection.

Healio: You also discussed how even though we live in a hyperconnected world due to technological advancements, we are “lonelier, more depressed and more socially anxious than ever.” Can you explain why you think this is?

Goodman: The data on this are still emerging, so at best we can speculate. Technology in many ways keeps us attached to our phones. It keeps us away and disengaged from social interactions. The fact that the more I’m on my phone, the less I’m engaged in interacting with other people is definitely a factor in the equation.

We also live in a very complicated world with a lot of stressors. We have access to plentiful global information that is negative, distressing and scary, whether that is related to war or unrest or climate change.

If you’re using technology in a way that creates continuous input of distressing imagery, it’s going to be hard to feel good about yourself and the world. That sense of doom and demoralization can really start to affect you.

The pandemic exposed a lot of vulnerabilities that we have as humans, as a country and as a world in terms of illness and human fragility.

When I talked to college students about the pandemic and some of the issues they’re dealing with it, my sense is that they feel like they’re entering a time of the world that is worse than ever. Whether it’s objectively true that their generation has it worse off than others is less relevant for their mental health than their perception that they have it bad.

Technology has thoroughly disrupted our social landscape. And you have a generation that feels like they’ve gotten the short end of the stick.

Healio: In light of Mental Health Awareness Month, is there anything else you would like to add?

Goodman: The opportunity for connection and the possibilities that it opens are often more powerful than the feeling of rejection. Sometimes people get trapped in not socializing because of the fear of rejection.

What we know is, first of all, rejection is not that likely to happen and, if it does, it’s often not as bad as anticipated. On the other side of that is an opportunity to develop social relationships that can really enhance your life. There’s always a risk-benefit calculation, but often people find that the risk is worth it.

References:

• Goodman F. “Why you feel anxious socializing (and what to do about it).” https://ed.ted.com/lessons/why-you-feel-anxious-socializing-and-what-to-do-about-it-fallon-goodman. Accessed May 23, 2024.
• Mental health by the numbers. https://www.nami.org/about-mental-illness/mental-health-by-the-numbers/. Accessed May 23, 2024.
• NAMI’s “Take the Moment” campaign celebrates Mental Health Awareness Month. https://www.nami.org/press-releases/namis-take-the-moment-campaign-celebrates-mental-health-awareness-month/. Published May 1, 2024. Accessed May 23, 2024.

For more information:

Fallon Goodman, PhD, can be reached on her website, https://www.fallongoodman.com/, or on X (Twitter): @FallonRGoodman.