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If you are playing on a laptop then make sure not to double-click the PLAY-button in Steam but to click on it only once. If you have a mouse pad then you could also try connecting an actual mouse to your laptop or you can try starting the game directly from the Steam folder.
There is also an alternative launcher, Bilago's Configuration Tool. Next to being a tweaking tool for the game's .ini-files can it also launch the game (or SKSE) and even allows for a custom background so you can have a personalised Fallout 4 launcher.
The better solution is to not alt-tab.
Have you tried windowed mode? That works for me.