Note: This is written by Joseph Austerman, DO, a child and adolescent psychiatrist at Cleveland Clinic.
Youth mental health continues to be a significant challenge for our world. Approximately 30% of high school students rate their mental health as not good or struggle often with emotional concerns.2 Although there are numerous contributors to this high rate of mental health struggles, the role of social media cannot be ignored.
The past few decades have brought substantial advancements in digital technology, and more children and adolescents have their own personal screen media devices. Up to 95% of young people ages 13-17 report using a social media platform. Nearly two-thirds of teenagers report using social media every day, and one-third report using it “almost constantly.”11
The types of use and content children and adolescents are exposed to pose mental health concerns. Children and adolescents who spend more than three hours a day on social media face double the risk of mental health problems, including experiencing symptoms of depression and anxiety. This is concerning as a recent survey showed that teenagers spend an average of 3.5 hours a day on social media.
When asked about the impact of social media on their body image, 46% of adolescents ages 13-17 said social media makes them feel worse.1 That being said, social media is not inherently beneficial or harmful to young people. Adolescents’ lives online both reflect and impact their offline lives. In most cases, the effects of social media are dependent on adolescents’ own personal and psychological characteristics and social circumstances.8
We know that there are both benefits and risks of social media. Screen media use is a complex and broad construct that includes active and passive engagement with different types of devices and content. Although the use of screen media devices, particularly smartphones, can facilitate many daily activities and social interactions, we need to help guide our youths in appropriate utilization and the potential dangers of social media.4,5
There can be benefits to social media use in teens. Online social interaction can promote healthy socialization among teens, especially when they’re experiencing stress or social isolation. For youths who have anxiety or struggle in social situations, practicing conversations over social media can be an important step toward feeling more comfortable interacting with peers in person. Social media can also help kids stay in touch with their support networks. That can be especially important for kids who may be hesitant to share their thoughts or experiences with caregivers.
Even though it can be helpful in some cases there are also risks. Potential risks of social media may be especially acute during early adolescence when puberty delivers an onslaught of biological, psychological and social changes. One longitudinal analysis of data from youths in the United Kingdom found distinct developmental windows during which adolescents are especially sensitive to social media’s impact. During those windows — around ages 11-13 for girls and 14-15 for boys — more social media use predicts a decrease in life satisfaction a year later, while lower use predicts greater life satisfaction.7
The risks of social media use in youths can be broken down into emotional risks, including cyberbullying, leading to potential depression, anxiety, and self-harm or suicidal ideations. The covert exposure to curated, often unrealistic, images online can lead to feelings of inadequacy, body dissatisfaction and an increased risk of developing eating disorders. These emotional consequences can then diminish a young person’s self-worth.
Along with emotional consequences, excessive social media utilization can lead to sleep disruption and reduced physical activity, leading to long-term health consequences. It can even lead to an addiction to social media, displacing time that could be spent on homework, exercise, family activities and real-world relationships.
Finally, there can be safety and privacy risks. Children can be exposed to inappropriate violent or sexual content. In some cases, social media platforms can expose youth to dangerous individuals who may attempt to exploit, extort or harm them. Youths are also at risk of oversharing personal information, placing them at risk for data incursions, identity theft or outright monetary theft. It is also hard for anyone to decipher misinformation and biased content, which can influence their views and understanding of the world.
Other research shows that when youths are exposed to unsafe behaviors online, such as substance use or self-harm, they may be at greater risk of engaging in similar behaviors themselves. In a longitudinal study of high school students, Jacqueline Nesi, PhD, an assistant professor of psychiatry at Providence, R.I.-based Brown University, and colleagues showed that kids who saw their peers drinking alcohol on social media were more likely to start drinking and to binge drink one year later, even after controlling for demographic and developmental risk factors.6
All of these risks can be reduced by educating, moderating use, limiting access to harmful content and parental monitoring.10 Encourage youths to use social media for social support and emotional intimacy. Tailor social media use to their developmental capabilities, with adult monitoring in early adolescence. Minimize exposure to harmful content and hate. Limit social media use to avoid interference with sleep and physical activity. Provide social media literacy training and continue scientific examination of its effects on adolescent development.
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References:
1. Bickham, D.S., Hunt, E., Bediou, B., & Rich, M. (2022). Adolescent Media Use: Attitudes, Effects, and Online Experiences. Boston, MA: Boston Children’s Hospital Digital Wellness Lab. https://digitalwellnesslab.org
2. Centers for Disease Control and Prevention. Youth Risk Behavior Survey Data Summary & Trends Report: 2013–2023. U.S. Department of Health and Human Services; 2024
3. Craig, S. L., Eaton, A. D., McInroy, L. B., Leung, V. W. Y., & Krishnan, S. (2021). Can Social Media Participation Enhance LGBTQ+ Youth Well-Being? Development of the Social Media Benefits Scale. Social Media + Society, 7(1)
4. Haidt J, Allen N. Scrutinizing the effects of digital technology on mental health. Nature. 2020;578(7794):226-227.
5. K Kaye L, Orben A, A Ellis D, C Hunter S, Houghton S. The conceptual and methodological mayhem of “screen time”. Int J Environ Res Public Health. 2020;17(10):3661.
6. Nesi, Jacqueline et al. Friends’ Alcohol-Related Social Networking Site Activity Predicts Escalations in Adolescent Drinking: Mediation by Peer Norms. Journal of Adolescent Health, Volume 60, Issue 6, 641 – 647
7. Orben, A., Przybylski, A.K., Blakemore, SJ. et al. Windows of developmental sensitivity to social media. Nat Commun 13, 1649 (2022)
8. Prinstein, M. J., Nesi, J., & Telzer, E. H. (2020). Commentary: An updated agenda for the study of digital media use and adolescent development—Future directions following Odgers & Jensen (2020). Journal of Child Psychology and Psychiatry, 61(3), 349–352.
9. Rideout V, Peebles A, Mann S, Robb MB. The Common Sense Census: media use by tweens and teens, 2021. March 9, 2022. Common Sense Media
10. Sebastian Wachs,et. al. , “DNT LET ’EM H8 U!”: Applying the routine activity framework to understand cyberhate victimization among adolescents across eight countries, Computers & Education, Volume 160, 2021
11.Vogels, E. A., Gelles-Watnick, R., & Massarat, N. (2022, August 10). Teens, Social Media and Technology 2022. Pew Research Center.
12. Weir, K. (2023, September 1). Social media brings benefits and risks to teens. Here’s how psychology can help identify a path forward. Monitor on Psychology, 54(6).
