By Tara Bannow

The Bulletin

Advice from a psychotherapist

Carol Hopwood’s advice on making more connections with people:

1) Keep in frequent contact with old friends: Either through making visits or phone calls or sending cards to let them know you care.

2) Make meaningful conversations a goal: Try to have at least one heartfelt conversation per day — no texting!

3) Make new friends: How many new friends have you made in the past few years? Make a list of acquaintances you think you want to have as friends. Make efforts to have conversations with those people or invite them to do something with you. Most people will take this as a compliment.

4) Meet your neighbors: Get to know the people who live around you — not just on your street, but perhaps the next block over, too.

5) Get involved: Whether it’s hiking, fishing or quilting, join a club. Try several until you find one that fits you. Volunteer for an organization you admire. Take an exercise class.

Psychiatrist Dr. Alan Teo’s studies are driven primarily by what he learns from his patients, many of whom happen to be veterans in their 50s, 60s and 70s.

Teo recently took note of how much meaning those men and women seem to derive from face-to-face interactions with other people — far more so than talking on the phone or by writing emails.

His curiosity led to a study published this month in the Journal of the American Geriatrics Society that compared older adults’ use of different forms of communication with their likelihood of becoming depressed later on. The assistant professor of psychiatry at Oregon Health & Science University found the more frequent people’s in-person interactions, the less likely they were to be depressed later on. The frequency of email and other written forms of communication did not follow a consistent trend, and phone communication had little impact on the risk of depression.

Scientific literature has well established the link between today’s near-constant Internet communication and increasing rates of anxiety and depression, especially among adolescents, but Teo says his is the first to compare certain forms of communication according to their likelihood to protect against depression. What’s the best prescription doctors and therapists can give to stave off the crippling mental illness? More face-to-face communication, he said.

His message, which extends to people of all age groups, is not that social media and smartphones are bad; it’s that their use should not replace talking to real-live people.

“You need to make sure, from a depression-prevention standpoint, you have a balance and make sure that you include in-person time,” said Teo, who also is a researcher with the VA Portland Health Care System.

That might seem like a rudimentary message, but local therapists say it’s worth repeating, as many of their clients — adolescents especially — are increasingly replacing in-person communication with social media and texting — and they’re suffering severe consequences.

“I see a lot of teenage and early to mid-20-year-olds who are really disconnected and really lonely,” said Kenny Wolford, a licensed professional counselor in Bend whose clients are teens and older.

Research has shown rates of anxiety and depression are increasing among adolescents worldwide. In the U.S., one-quarter of 13- to 18-year-olds reported having anxiety in 2010, according to the National Institute of Mental Health. In 2013, nearly 11 percent of 12- to 17-year-olds reported having depression within the past year.

It affects adults, too. About 18 percent of U.S. adults reported experiencing anxiety in the past year in 2005 and 6.7 percent reported experiencing depression in the past year in 2013.

The problem with communicating through mediums such as Facebook, online gaming or texting is they can’t convey the vast majority of what is communicated when people talk to one another in person, said Carol Hopwood, a psychotherapist with Lasting Change Counseling in Bend.

“It’s not that social media or digital devices are bad,” she said, “but when we’re together in person, a lot more goes on. The vast majority of what gets communicated is not verbally.”

A crucial trait Hopwood thinks people aren’t cultivating is empathy, which is learned through deep, compassionate interactions with others.

These days, Hopwood observes groups of young people talking and notices they all glance at their phones during the conversations. They’re not truly engaged in the conversations, she said.

“Having that respectful, compassionate interaction literally changes our brain and helps us to regulate our emotions,” she said.

It’s also a huge problem between couples, Hopwood said.

“I know lots of relationships in families, it could be spouses, that the phone is a big issue,” she said, “because no matter what, if they get a message and they get a ding, they can’t get their attention away. It doesn’t matter if they’re having dinner, having sex, whatever they’re doing, there is no time that is reserved that is special for that relationship.”

Much of Wolford’s work with adolescents is actually training them to interact with other people, as many have missed out on crucial lessons in communication. Lots of people feel safer communicating through short bursts on the Internet or through text messages because it doesn’t involve asking people to commit to spending time with them, he said.

What Wolford tells his clients who are replacing in-person communication with other forms is to tell the people in their lives what they need; don’t just assume they know.

“You have to ask for time with your friends,” he said. “You have to ask for what you need. You have to say, ‘Hey, I would really like to just go for a walk together.’”

And when that walk happens, he tells them: Leave the phone in the car.

But asking for people’s time can be hard for the many who suffer from low self-confidence. If that’s the case, Wolford encourages clients to work on simply understanding they’re worth it.

Wolford also instructs on the “art of asking questions.” Lots of people think conversations mean, “I share, you share, I share, you share,” he said. What should happen is, “I share, you ask a question,” he said. He’s teaching his clients to both amplify and repeat back to people their answers to questions and then ask questions in response.

“The art of question asking and sharing as a rhythm as opposed to just sharing about yourself is something that I encourage in-person communication to look like,” he said.

Natalie Houston, a licensed professional counselor with Insight Counseling Group, LLC in Bend, said teen anxiety around face-to-face interactions with their peers has become a main focus of her practice, which she said is both fascinating and scary. Like Wolford, Houston said using social media and texting feels safer for today’s adolescents because it allows them to hide their emotions.

“And yet connecting at an emotional level is what bonds us together and contributes to the quality of human experience,” she said. “It’s really about emotional connection, and that is very hard to do with these other modes of communication.”

It’s unclear whether Teo’s study accounted for social media use; that depends on how subjects interpreted a survey question that asked about email and written contact, he said. Personally, Teo said, he would interpret a Facebook message as a form of written communication. His next study will focus specifically on social media use and depression.

The fact that depression and social isolation are so common makes them crucial topics to study, Teo said. Depression is more than just feeling blue; it’s truly debilitating.

“It really affects people’s ability to work, people’s ability to be, of course, happy and healthy, and it affects people around them — family, too,” he said. “So it’s an important health outcome.”

— Reporter: 541-383-0304,