Social media is a double-edged sword when it comes to mental health. Over the past decade, with more technology and platforms coming out, like TikTok, it feels like there is no escaping social media these days. With so much time, availability, and exposure to digital media, there has to be some effect on the users’ mental well-being. This is especially true for children, particularly adolescents, who immerse themselves in social platforms. Too much social media and harmful platform activity have been known to cause depression, anxiety, and even suicide. The suicide rate of adolescents and young adults ages 15-24 is around 25 to 30 per 100,000 persons, increasing 8% from 2020-2021 [1]. This is the demographic with the highest rate of suicide out of any age group. There has also been an increase in emotional and behavioral problems among children 5-18 years old from 2014 to 2017 from 5.4% to 5.7% on average, and 10% of those identifying as being two or more races, nearly doubling the national average [2].
According to Statista, in the US, 16% of children ages 3 and 4 used a cell phone for the first time, with 12% of children first utilizing a cell phone before age 3. By 2020, 97% of children under 8 owned a smartphone [3]. One reason is that parents feel pressured to give their children these devices because they fear their children being isolated if they do not have one. Also, parents want their kids to stay caught up in technology, and many schools are now issuing devices to young students for learning purposes.
The subsequent article will explore several social media factors that affect children’s mental health, particularly the negative impact on children’s mental health over the last decade, and decipher how much screen time on these platforms is considered harmful. Also, it will touch on the negative impact of cyberbullying. Lastly, I’ll discuss what interventions are taking place to protect children from the negativity that social media can bring and how social media can be used to promote mental health.
The omnipresence of social media has taken its toll on the youth’s mental health, especially adolescents. Several studies have shown it leads to depression, body image and eating disorders, sleep deprivation, and behavioral issues. Harmful content is abundant, including media portraying drug use or promoting suicide. One study of over 400 recent youth hospital admits found that almost 15% were viewing suicidal content, and 16% were viewing content promoting self-harm [4]4444. Major depressive disorder (MDD) in adolescents can exacerbate the negative impact of social media. These children can display an increased impulse control issue regarding internet use and more significant sleep deprivation [5]. Those that have depression and have also been diagnosed with autistic traits fair even worse. These children tend to have worse depressive symptoms in general and are more likely to use social media excessively and be addicted to their smartphones [6]. Another paper on the misuse of social media and cell phones found a positive correlation between excessive use and other psychiatric disorders like anxiety, obsessive-compulsive disorder (OCD), and attention deficit disorder (ADHD) [7].
These studies and data are essential, but the question is, why do those that have mental health issues have more of a problem with social media usage than the average youth population? It may be a constant seeking of validation amongst all the negative, but adolescents tend to compare their real-life selves to their online peers and often feel they cannot measure up. This seems to be more apparent in young girls [8]. Further studies need to be made to determine whether there is a correlation between children with social skills difficulties and not only the excessive nature of using social media but how much of that content could be considered negative. This could mean looking up disturbing or harmful content, like promoting suicide or drug use, or the lack of successful interactions with those online either by being intentionally omitted from online social groups or cyberbullying.
As of 2019, Facebook is the most widely used social media platform. Those that suffer from depression tend to have fewer friends and fewer connections between friends. Also, emotional dependence on Facebook has been known to negatively impact a child’s sense of self-sufficiency, finding meaning in life, accepting oneself, having meaningful relationships, and ability to cope with everyday life [9]. Even with these negative mental and social states present, the addictive behavior continues, exacerbating symptoms.
The brain can physically change with excessive social media activity use, and there is a link between social media use and cortical thinning. There is a volumetric morphological change in the thalamus-prefrontal cortex-brain stem circuit that is similar to other studies that indicate volume changes in those specific regions are indicators of the early onset of alcohol abuse. Furthermore, these individuals tend to exhibit poorer impulse control, display more hostility, and are more distracted, among other externalizing behavioral issues [10]. This is disturbing, especially considering the study was not conducted on adolescents but on nine and 10-year-olds.
The link between alcohol abuse and social media is of interest in many studies. Those that binge drink tend to post more about their alcohol use, and posting alcohol-related content has been indicated in alcohol abuse later in life [9, 11]. Considering the change in brain morphology related to social media use, it would be exciting to know if it is related to the predisposition to engage in risky alcohol behaviors.
Due to privacy and consent barriers, it is hard to gather data on some of the negative impacts of social media. This is true for the potential for social media to increase self-harming behaviors and suicidal ideation. Many children and adolescents post pictures of self-harm online anonymously on websites like Tumblr or Instagram, changing hashtags to be exclusively viewed by a particular audience and avoiding direct interaction for fear of judgment [9, 12]. It is utilized as a means to vent without detection. These posts can normalize the behavior and desensitize those viewing the content [13]. This could potentially lead to others being more likely to engage in self-harming activity.
Anxiety is generally expressed in the social media landscape by the feeling of missing out or FoMO. Children and adolescents feel they must check their status and updates to feel included or “liked” [14]. This need to get positive feedback on social media may be due to a lack of emotional stability and a deficiency of a real-world support group. Consequently, the individual may unreasonably compare his/herself to others and have reoccurring negative thoughts or ruminations. The appeal of social media for those predisposed to anxiety is the ability to control the content. These children will indulge in online activities to be viewed as cool and likable and try to avoid being labeled as uninteresting or a misfit. The need for belonging can increase social anxiety and harm a child’s well-being [9].
Those diagnosed with ADHD have difficulty staying off social media platforms, and it is considered a very convenient distraction. They are more likely to have multiple accounts on the same platform, be addicted to social media, and are less likely to try to correct their excessive behaviors, especially if the symptoms are more pronounced [15, 16].
Another common theme in the study of the mental health impact of social media on children is sleep deprivation. Even toddlers are not immune to the effects of sleep deprivation and screen time, and it has been shown to prevent them from falling asleep sooner and sleeping for a shorter time [17]. In 9-10-year-old children, shorter sleep duration has been linked to more behavioral issues. Also, excessive screen time playing video games was associated with depressive symptoms, and watching movies was associated with external behavioral problems such as aggression. High social media usage in adolescents, 3-5 hours a day, contributed to late sleep onset, late waking on school days, and issues returning to sleep [18].
But how much screen time is too much? There is limited consensus on the answer to these questions. This is likely due to the study design. A notable study analyzed the responses from over 44,000 children and teens for the National Survey of Children’s Health by the US Census Bureau 2016. The short answer is more than two hours daily, with significant deleterious effects at seven or more hours. For children aged 6-17, after two hours of screen time, there is an upward trend in anxiety and depression symptoms, as well as behavioral issues, such as arguing with their caregivers excessively and not finishing chores or other tasks asked of them. The anxiety and depressive symptoms that need treatment are more pronounced in teenagers than in the younger demographic [19]. This is likely due to the adolescent age group spending significantly more time on various devices and more intensely.
A review of several reviews by Neza and Russell [20] also concluded a robust positive correlation between 2+ hours of screen time in children and depressive symptoms. There was weak evidence for a link between anxiety and screen time. Although there is little clear evidence for a correlation between low self-esteem and screen time, one review analyzed studies using the health-related quality of life (HRQOL) questionnaire and found a significant association between low HRQOL scores, indicating poorer perceived life quality, and screen time exceeding two hours. This review also noted weak evidence for excessive screen time, behavior issues, anxiety, and ADHD symptoms. No substantial evidence was found to connect screen time with eating disorders or suicidal thoughts.
Cyberbullying is a huge issue for children using social media and has gained much attention in the past decade with increasing social media use. Approximately 15% to 35% of young people have been victims of cyberbullying, and 10% to 20% have admitted to being the bully [21]. Cyberbullying is more pronounced after the age of fourteen [22]. Bullies have garnered most of the attention for preventative measures. It makes sense in many ways. If you stop the bully, you control the problem. The dynamic of cyberbullying is more complex than that. A cross-sectional study of adolescents found that victims of cyberbullying have more psychological issues than bullies. They have a lower sense of self academically, physically, socially, and about their family. The cyberbullies were likelier to have low empathy, and both groups were more prone to loneliness, depression, stress, and low life satisfaction [23]. It may be beneficial for future cyberbullying interventions to address the mental well-being of the victims and bullies instead of only chastising the bully and attempting to limit their content or access to social media, which has limited effectiveness and does not fix the root of the issue.
Social media is not all bad. It is excellent when used in moderation and for positive interactions. It allows contact with family and friends that live close or far away. It can be used to organize groups to help the community, promote school functions, or just hang out in a group and have fun. Pandora’s box of social media is wide open, and the potential positive impact that social media can have needs to be fostered and expanded more than trying to play whack-a-mole with all the negative social media can produce. What is the best way to promote healthy social media use and use social media to increase the well-being of children? That is a valid question for those responsible for children’s overall health need to ask. Non-digital interventions have a limited effect on reducing screen time. Evidence suggests that non-digital interventions may reduce sedentary behavior but not digital media use [24]. The most effective strategies for adolescents include setting goals, giving feedback, and planning screen time. Other approaches, like social comparison or attaining knowledge and understanding the consequences of excessive social media, are less effective. However, whatever strategy is employed is reduced as the sample size grows and with more extended studies [25].
There are digital media apps for smartphones and tablets to limit children’s use during specific periods of the day when focus is required or to reduce overall usage. Popular applications for parents are AirDroid Parental Control & Screen Time App, Qustodio Screen Time Control App for Android users, OurPact Parental Control Screen Time App, and FamilyTime Screen Time Control App for Apple. Although these apps deal with the issue of screen time, they are not meant to mitigate the adverse effects that social media can have on children’s mental health.
There are applications to address the stressful landscape of social media and promote the well-being of children. This year a study published an evaluation of two of these apps, Opp for children 11-16 and NetApp for adolescents 13-19. The purpose of these apps approach tackling the negativity of online use by two means: 1. Educate the user on mental health and dealing with emotions related to negativity online, as well as information on cyberbullying, and it provides resources for children to receive help. 2. They provide coping skills training and suggest ways to reduce the stress that can accumulate with negative aspects of social media. These apps could be better, but they have been noted as being effective in their purpose [26].
These apps and others present a different way of approaching the issue of distressing social media use. Reducing screen time and attempting to remove potentially harmful content is still essential. Still, it is difficult to monitor children’s online use all the time, and consistently removing distressful content from social media is impossible. Trying to police the content presented on social media can infringe on the freedom of communication it provides. What may be considered hurtful or distressing for some children may be benign to others. That is why providing education and resources to help children afflicted by the potentially upsetting material posted on social media may be a more effective strategy. This approach is relatively novel, and more research needs to be done to evaluate its effectiveness.
Social media is a wonderful communication tool. It provides an outlet for children and adults to express themselves in several ways and a connection to others that is difficult to do by other means. Protecting the well-being of children from excessive and stressful social media use is increasingly essential, with most using these platforms daily. Parents, guardians, and teachers play a central role in protecting children’s mental health. With 10-20% of children worldwide dealing with mental health issues and over 36% spending more than three hours on social media platforms, there is little doubt about the connection between the two [27, 28].
Self-harm, suicidal ideation, anxiety, substance abuse, and depression are all problems that social media can create or exacerbate. Excessive screen time and harmful content have been linked to eroding the well-being of children and adolescents. More needs to be done to combat this trend. To effectively protect children, more research needs to be done to find practical solutions for children of different backgrounds and ages. Teaching children responsible social media use needs to be instilled early, and coping mechanisms should be prepared to handle the stresses of online usage.
Research on social media use has recently garnered more attention over the past several years, particularly during and after the COVID-19 pandemic. Future research on the effectiveness of multiple strategies is critical. Using social media to increase and protect youth’s mental health may be a promising strategy. This approach is still new, and more needs to be known to utilize it effectively. Overall, the responsibility to guard the mental well-being of children falls on all of us. Using social media should be a joyous experience, and children should be free to communicate and express themselves without sacrificing their mental health.
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