The most important question that we can ask teens isn’t if they use social media, it’s how. Just last May, the Surgeon General’s advisory on social media use in youth exposed some shocking statistics:
Among 13 to 17-year-olds, up to 95% use social media, with 35% saying they use social media “almost constantly.”1,2
40% of 8 to 12-year-olds report using social media. 2
Youth who use social media more than 3 hours a day face double the risk of mental health problems, including depression and anxiety.3 As of 2021, 8th and 10th graders spent an average of 5 hours per day on social media.4
So, while we know that teens are spending a significant amount of time on social media, “we have to ask more of the what and the why—what they’re using, why they’re using it.”, said Jasmine Reese, MD, a REACH faculty member and director of the Adolescent and Young Adult Specialty Clinic at Johns Hopkins.
What are the effects of social media on youth mental health?
Benefits of Social Media Use:
Positive community, connection, and friendships, including increased acceptance, support, and creativity
Positive content related to race for adolescent girls of color
Potential for promoting help-seeking behaviors and initiating mental health care, including mental health support for marginalized youth
Potential Harms of Social Media Use:
Increased risk of poor mental health outcomes (depression, anxiety)
Concerns about harm during vulnerable brain development stage
Correlations with negative outcomes: cyberbullying, body image issues, disordered eating, and poor sleep quality
Exposure to misinformation
Dr. Reese shared that her hospital did a study on the effects of the COVID-19 pandemic on adolescents with eating disorders and uncovered a shocking 188% rise in admissions for ED in youth aged 10 to 21.5 She explained that “There’s a lot of body image comparison because everybody online tends to look a certain way or looks perfect in their eyes.” When asked about the impact of social media on their body image, 46% of adolescents aged 13 to 17 said social media makes them feel worse.6
Another one of Dr. Reese’s main concerns is the spread of misinformation, especially when it interferes with patients’ health. One recent trend is a sudden rush of self-diagnoses based on generic ads targeting disconnected youth. Dr. Reese has seen an increase in the number of youth believing they could be autistic based on TikTok videos and ads they saw with no clinical evidence.
What Healthcare Professionals Can Do:
Ask the “what/when/why”: What apps youth use, what they do on them, and whether they have received or sent mean messages on social media, versus focusing on hours/time spent on screens.
Engage with the youth: Dr. Reese walked in while a teen was making a TikTok and asked to see it. By showing interest, the teen opened up and shared more.
Share parent resources: Bring more transparency to social media use in families.
CommonSenseMedia.org: An organization that checks and rates movies, shows, and apps to help parents know if they’re appropriate for kids. They also support research on how media affects children and speak out for rules that protect kids when using media.
AAP’s Family Media Plan: This useful online tool helps families manage their screen time together, considering:
Use of screens and social media for parents and children
Balancing media with physical activity, sleep, schoolwork, and unplugged time, and encouraging face-to-face interactions during routines
Designating media-free areas at home and regularly reviewing and adapting the plan
Parents’ Role is Crucial
Some parents struggle with their teens spending too much time on their phones, but only some discuss the potential dangers and effects of social media or ask their teens what apps they’re using and how. Dr. Reese adds, “The other part of it is really educating the parents or caregivers and the teens of what’s safe and what’s not safe.”
We have gaps in our full understanding of the mental health impacts posed by social media but at this point cannot conclude it is sufficiently safe for children and adolescents. We must better understand the answers to key questions, such as, which types of content are most harmful and what factors can protect young people from the negative effects of social media.
Riehm, K. E., Feder, K. A., Tormohlen, K. N., Crum, R. M., Young, A. S., Green, K. M., Pacek, L. R., La Flair, L. N., & Mojtabai, R. (2019). Associations Between Time Spent Using Social Media and Internalizing and Externalizing Problems Among US Youth. JAMA psychiatry, 76(12), 1266–1273. https://doi.org/10.1001/jamapsychiatry.2019.2325
Miech, R. A., Johnston, L. D., Bachman, J. G., O’Malley, P. M., Schulenberg, J. E., and Patrick, M. E. (2022). Monitoring the Future: A Continuing Study of American Youth (8th– and 10th Grade Surveys), 2021. Inter-university Consortium for Political and Social Research [distributor]. https://www.icpsr.umich.edu/web/NAHDAP/studies/38502/versions/V1
Feldman, M. A., King, C. K., Vitale, S., Denhardt, B., Stroup, S., Reese, J., & Stromberg, S. (2023). The impact of COVID-19 on adolescents with eating disorders: Increased need for medical stabilization and decreased access to care. International Journal of Eating Disorders, 56( 1), 257– 262. https://doi.org/10.1002/eat.23788
“This course has given me valuable information all evidence-based, to help me feel more confident in managing depression, ADHD and anxiety in the office”
Ndemie Price, MD Miami, FL
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