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Office of the Surgeon General (OSG). Social Media and Youth Mental Health: The U.S. Surgeon General’s Advisory [Internet]. Washington (DC): US Department of Health and Human Services; 2023.

Social Media and Youth Mental Health: The U.S. Surgeon General’s Advisory [Internet].
Show detailsThe influence of social media on youth mental health is shaped by many complex factors, including, but not limited to, the amount of time children and adolescents spend on platforms, the type of content they consume or are otherwise exposed to, the activities and interactions social media affords, and the degree to which it disrupts activities that are essential for health like sleep and physical activity.6 Importantly, different children and adolescents are affected by social media in different ways, based on their individual strengths and vulnerabilities, and based on cultural, historical, and socio-economic factors.7, 8 There is broad agreement among the scientific community that social media has the potential to both benefit and harm children and adolescents.6, 9
Brain development is a critical factor to consider when assessing the risk for harm. Adolescents, ages 10 to 19, are undergoing a highly sensitive period of brain development.10, 11 This is a period when risk-taking behaviors reach their peak, when well-being experiences the greatest fluctuations, and when mental health challenges such as depression typically emerge.12, 13, 14 Furthermore, in early adolescence, when identities and sense of self-worth are forming, brain development is especially susceptible to social pressures, peer opinions, and peer comparison.11, 13 Frequent social media use may be associated with distinct changes in the developing brain in the amygdala (important for emotional learning and behavior) and the prefrontal cortex (important for impulse control, emotional regulation, and moderating social behavior), and could increase sensitivity to social rewards and punishments.15, 16 As such, adolescents may experience heightened emotional sensitivity to the communicative and interactive nature of social media.16 Adolescent social media use is predictive of a subsequent decrease in life satisfaction for certain developmental stages including for girls 11–13 years old and boys 14–15 years old.17 Because adolescence is a vulnerable period of brain development, social media exposure during this period warrants additional scrutiny.
The Potential Benefits of Social Media Use Among Children and Adolescents
Social media can provide benefits for some youth by providing positive community and connection with others who share identities, abilities, and interests. It can provide access to important information and create a space for self-expression.9 The ability to form and maintain friendships online and develop social connections are among the positive effects of social media use for youth.18, 19 These relationships can afford opportunities to have positive interactions with more diverse peer groups than are available to them offline and can provide important social support to youth.18 The buffering effects against stress that online social support from peers may provide can be especially important for youth who are often marginalized, including racial, ethnic, and sexual and gender minorities.20, 21, 22 For example, studies have shown that social media may support the mental health and well-being of lesbian, gay, bisexual, asexual, transgender, queer, intersex and other youths by enabling peer connection, identity development and management, and social support.23 Seven out of ten adolescent girls of color report encountering positive or identity-affirming content related to race across social media platforms.24 A majority of adolescents report that social media helps them feel more accepted (58%), like they have people who can support them through tough times (67%), like they have a place to show their creative side (71%), and more connected to what’s going on in their friends’ lives (80%).25 In addition, research suggests that social media-based and other digitally-based mental health interventions may also be helpful for some children and adolescents by promoting help-seeking behaviors and serving as a gateway to initiating mental health care.8, 26, 27, 28, 29
The Potential Harms of Social Media Use Among Children and Adolescents
Over the last decade, evidence has emerged identifying reasons for concern about the potential negative impact of social media on children and adolescents.
A longitudinal cohort study of U.S. adolescents aged 12–15 (n=6,595) that adjusted for baseline mental health status found that adolescents who spent more than 3 hours per day on social media faced double the risk of experiencing poor mental health outcomes including symptoms of depression and anxiety.30
As of 2021, 8th and 10th graders now spend an average of 3.5 hours per day on social media.31 In a unique natural experiment that leveraged the staggered introduction of a social media platform across U.S. colleges, the roll-out of the platform was associated with an increase in depression (9% over baseline) and anxiety (12% over baseline) among college-aged youth (n = 359,827 observations).32 The study’s co-author also noted that when applied across the entirety of the U.S. college population, the introduction of the social media platform may have contributed to more than 300,000 new cases of depression.32, 33 If such sizable effects occurred in college-aged youth, these findings raise serious concerns about the risk of harm from social media exposure for children and adolescents who are at a more vulnerable stage of brain development.
Limits on the use of social media have resulted in mental health benefits for young adults and adults. A small, randomized controlled trial in college-aged youth found that limiting social media use to 30 minutes daily over three weeks led to significant improvements in depression severity.34 This effect was particularly large for those with high baseline levels of depression who saw an improvement in depression scores by more than 35%.35 Another randomized controlled trial among young adults and adults found that deactivation of a social media platform for four weeks improved subjective well-being (i.e., self-reported happiness, life satisfaction, depression, and anxiety) by about 25–40% of the effect of psychological interventions like self-help therapy, group training, and individual therapy.36
In addition to these recent studies, correlational research on associations between social media use and mental health has indicated reason for concern and further investigation. These studies point to a higher relative concern of harm in adolescent girls and those already experiencing poor mental health,37, 38, 39 as well as for particular health outcomes like cyberbullying-related depression,40 body image and disordered eating behaviors,41 and poor sleep quality linked to social media use.42 For example, a study conducted among 14-year-olds (n = 10,904) found that greater social media use predicted poor sleep, online harassment, poor body image, low self-esteem, and higher depressive symptom scores with a larger association for girls than boys.43 A majority of parents of adolescents say they are somewhat, very, or extremely worried that their child’s use of social media could lead to problems with anxiety or depression (53%), lower self-esteem (54%), being harassed or bullied by others (54%), feeling pressured to act a certain way (59%), and exposure to explicit content (71%).44
- Social Media Has Both Positive and Negative Impacts on Children and Adolescents ...Social Media Has Both Positive and Negative Impacts on Children and Adolescents - Social Media and Youth Mental Health
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