Social media and youth mental health

U.S. Surgeon General Vivek Murthy, MD, called on Congress last month to require a warning on social media platforms stating that social media is associated with significant mental health harms for adolescents. Though many researchers and psychiatrists contend the evidence doesn’t support such a broad warning, there is growing concern about the impact of social media on youth mental health.

“The mental health crisis among young people is an emergency ‑ and social media has emerged as an important contributor,” Murthy wrote. “Adolescents who spend more than three hours a day on social media face double the risk of anxiety and depression symptoms, and the average daily use in this age group, as of the summer of 2023, was 4.8 hours.”

Murthy also called for legislation to shield young people from online harassment, abuse and exploitation and to prevent platforms from collecting sensitive data from children. And he said that physicians and other clinicians should raise the issue of social media with kids and parents.

Though there are associations between social media and mental health issues in adolescents, much of the evidence is mixed and nuanced. A review of literature by the National Academy of Sciences “did not support the conclusion that social media causes changes in adolescent health at the population level.” The American Psychological Association concluded that “using social media is not inherently beneficial or harmful to young people.”

There also is evidence that for some teens, particularly those from marginalized groups, social media can make them feel more accepted and connected. And some experts warn that a “moral panic” over social media can cause its own harm, due in part to a lack of mental health support for teens.

In a recent interview with the Institute of Child Psychology, MSSC member and child and adolescent psychiatrist Larry Mitnaul, MD, advised against demonizing technology. Mitnaul, who has an extensive social media presence, said social media can be a valuable tool for connecting, learning and exploring the world. However, it can become unhealthy when misused or overused, so parents need to treat it carefully and impose restrictions and safeguards.

Rather than setting a particular age threshold when a child gets a phone or goes on social media, Mitnaul recommends parents assess the maturity of their children. Do they have patterns of interpersonal behavior or emotional struggles, such as depression or generalized anxiety, that could be exacerbated by social media?

The APA issued a health advisory last year on teen use of social media, including:

• Encourage social media functions that create opportunities for social support and healthy socialization;
• Engage in ongoing review, discussion and coaching on social media contents, particularly in early adolescence;
• Screen children for signs of “problematic social media uses” that can impair a child’s ability to engage in daily roles and routines;
• Limit use of social media so as to not interfere with adolescents’ sleep and physical activity.
• Limit use of social media for social comparison, particularly around beauty-or appearance-related content;
• Train adolescents in social media literacy to ensure they have developed psychologically informed competencies and skills.

The American Academy of Pediatrics Center of Excellence on Social Media and Youth Mental Health also offers resources and recommendations for clinicians and parents at aap.org/socialmedia.

The goal for youth and adults alike, Mitnaul said, is to treat and use technology “as a tool rather than the thing to be enjoyed in and of itself.”