Introduction

In September, the Wall Street Journal released an exposé about Facebook, claiming the social media company had internal evidence showing Instagram use is linked with poorer mental health, particularly among young women (Instagram is owned by Facebook).[1] The story triggered multiple responses. Some commentators called for society to recognize the dangers of social media use for youth and to treat social media in a similar way to alcohol and tobacco by recognizing that, when abused, it can have severe consequences.[2] Meanwhile, a recent New York Times op-ed discussed several anecdotal stories from high school and college-age women who said that the findings about Instagram did not surprise them, given their own interactions on Instagram had fed into feelings of negative self-image, eating disorders, and other problems.[3]

This is not the first time the issue of social media use and teen mental health has been highlighted as a cause for concern. Teen mental health in the United States has been declining for more than a decade, particularly among females, and social media is an oft-cited culprit. A growing body of research has focused on the potential negative effects of social media use on youth, and numerous news articles have reported on the link between social media and adolescent mental health. For example, a 2018 New York Times story covered parenting practices of Silicon Valley executives who see screen time and social media as “wreaking havoc” on children’s development.[4]

The findings from the September Facebook study have been debated and disputed by various sources, and ultimately do not provide conclusive evidence that Instagram use is the cause of declining teen mental health.[5] Still, the report raises questions about how social media affects teen mental health and what can be done to keep youth safe online.

 

Trends in Youth Mental Health

In recent years, mental health issues among U.S. teens have increased, particularly among young women. From 2001 to 2017, adolescent depression rates increased by 60%, with the largest increases among females (Figure 1).[6] The number of adolescent girls age 12 to 17 seeking counseling or treatment for mental health disorders including anxiety, depression, and suicidal thinking increased by 11% between 2005 and 2018.[7]

Figure 1: Percent of U.S. high school students with high depressive symptoms, by sex

^{Source: Jean M. Twenge. “Why increases in adolescent depression may be linked to the technological environment.” Current Opinion in Psychology. 32, (April 2020): 89–94. Accessed October 27, 2021. https://doi.org/10.1016/j.copsyc.2019.06.036.}

Suicide, the second leading cause of deaths for high school-age youth in 2018, increased by 62% between 2009 and 2018 among this age group.[8] While males are more likely to commit suicide, females are more likely to display suicidal behaviors such as suicidal ideation or self-harm without ending their lives.[9]

Emergency room visits for self-inflicted injuries have also been on the rise among youth.[10] From 2009 to 2015, rates of self-inflicted injuries increased by 18.8% per year among 10-14-year-old girls, and increased by 7.2% for females ages 15-19 between 2008 and 2015. The largest increase in self-inflicted harms among females was for injuries by sharp object (7% annual increase from 2001 to 2015).[11] Rates of self-inflicted injury among males remained stable over that time.[12]

Overall, more adolescent girls than boys are diagnosed with mental health issues. In 2014, for example, 17.3% of adolescent girls age 12 to 17 experienced major depressive episodes, compared to only 5.7% of adolescent boys.[13]  

Unfortunately, the consequences of increased mental health problems extend into other areas of life. Mental health problems can create challenges sustaining important relationships with family and friends, as well as lead to declining academic achievement, which can reduce job opportunities and financial well-being.[14]

 

Studies Examining Social Media Use and Teen Mental Health

Evidence suggests teen girls are, at minimum, reporting and being treated more frequently with mental health issues, but the question remains whether social media is causing or exacerbating these issues. One thing can be said for sure: numerous studies have found an association between time spent on social media and poorer teen mental health, especially among young women.

For example, one large U.S. study analyzed national survey data from more than one million youth, looking at measures of psychological well-being based on indicators such as self-esteem, life satisfaction, and happiness.[15] The researchers found that teens who spent greater amounts of time on smart phones were more likely than those who spent less time on smart phones to experience mental health problems, and adolescents who spent more time on electronic communication and less time on non-screen activities had lower well-being. Ultimately, teens who spent the least amount of time on social media were happiest.  

Another recent study by Jean M. Twenge and Gabrielle N. Martin, based on three large nationally representative surveys from the U.S. and the U.K., examined gender differences in frequency of device use as well as gender differences in psychological decline.[16] Twenge and Martin found that time spent on social media was more strongly linked to lower well-being among young women than among young men. Youth who engaged in “light media use” overall had higher well-being compared to those who used no digital media, but once media use reached one hour or more per day, well-being steadily declined.

International studies have come to similar conclusions. A 2021 study authored by Cooper McAllister et al. using a nationally representative U.K. study, relied on contemporaneous time diaries to study the effects of digital technology on teens ages 13-15.[17] They found that while 7-8% of boys exhibited clinically significant depressive symptoms or engaged in self-harm, 20% of girls exhibited depressive symptoms or engaged in self-harm. Boys also spent less time on social media than girls, even though boys spent more time on digital media overall with other online activities such as gaming. 

Digital media was consistently associated with a higher likelihood of suicidal and non-suicidal self-harm and depression among girls, but rarely among boys. Figure 2 displays the associations between time on various forms of digital media use and the likelihood of engaging in self-harm by sex.

 

Figure 2: Rates of self-harm & hours of screen time

^{Source: McAllister et al., Fig. 5, 8.}

Meanwhile, girls who spent more than two hours per day using social media were significantly more likely to engage in self-harm and more likely to suffer clinically significant depression symptoms than those using social media for less than two hours per day (Figure 3). The researchers found 29% of girls who spent three or more hours per day on social media engaged in self-harm and 31% of girls who spent five or more hours on social media were depressed. Among girls who spent less than 2 hours per day on social media, 19% engaged in self-harm and 20% experienced depression.

 

Figure 3: Rates of depressive symptoms & hours of screen time

^{Source: McAllister et al., Fig. 6, 8.}

While these studies demonstrate a sometimes alarming association between use of social media and poorer mental health among adolescent girls, the findings cannot tell us whether social media use causes poorer mental health among young women. For example, girls who are already depressed may use extended time on social media as a coping mechanism, which is a limitation these studies acknowledge.

In the Kelley et al. study, the researchers acknowledged depression might lead to poor sleep, which could lead a child to spend time on his or her phone, which could in turn aggravate trouble falling asleep. Other researchers make the case that adolescents’ time online and mental health are not closely linked, but time online may instead exacerbate problems teens already face.[18]

Another reason to interpret negative findings cautiously is because social media can also have benefits for well-being, for instance, by making it easier to connect with friends, family, or other people with similar interests. Policymaking must consider these benefits alongside negative effects.

 

Recommendations

Overall, the findings are mixed on whether the net effects of technology are positive or negative, and data limitations leave many questions about the relationship between social media use and teen mental health open-ended. However, even without conclusive evidence, it is wise for families and communities to take reasonable precautions given the potential risks.

Schools, churches, and other community organizations could help inform families about mental health problems associated with social media and technology use in the existing literature. Communities could lead campaigns similar to the “#devicefreedinner” movement spearheaded by Common Sense Media, which encourages families to put their devices away in order to be present with one another during dinner.

Communities could also lead campaigns about the importance of parents monitoring children’s social media use. Parents should be encouraged to have conversations with their children about the potential harms associated with social media use and how social media can distort reality, as well as about how to navigate the rapidly evolving world of technology. Parents could also be provided information on the signs of various depressive and suicidal behaviors in teens.

In addition, policymakers could consider funding further research on the effects of social media on children’s mental health by redirecting existing funding streams provided through the National Institute of Mental Health, the National Institutes of Health, or the U.S. Department of Health and Human Services, that provide research funding.[19]  

The plausible link between social media use and poorer mental health is cause for further research and investigation. Going forward, parents, teachers, and community leaders will continue to be some of the best sources of guidance for teens navigating the complexities of social media.    

 

Rachel Sheffield
Senior Policy Advisor

Catherine Francois
Research Assistant