COMMENTARY

Will Better Science Quell Social Media's Effects on Mental Health?

Kali Cyrus, MD, MPH

Disclosures

July 13, 2022

Every day, another news article shines an alarming spotlight on worsening mental health problems faced by kids and teens. In my work as a psychiatrist, I've unfortunately witnessed this reality as rates of hopelessness, increased suicidal thinking, and anxiety increase. While I do what I can in my own practice to help kids and teens, more must be done. I support all the medical professionals across the country who have called on Meta, Facebook's parent company and one of the main contributors to growing anxiety among teens, to make reforms to protect young people's health.

CEO Mark Zuckerberg stubbornly refuses to do anything. In response, the National Academies of Sciences, Engineering, and Medicine is launching an expansive research study analyzing the impact of social media on the health of teens and children that should compel policymakers to get off the sidelines and act. The research will examine social media companies' use of consumer data and how this breach of privacy impacts the health and safety of kids and teens. The study should lay the groundwork for future social media research to help protect our youth, and recommend ways for parents, social media companies, and public officials to minimize potential harms from social media use.

This research is desperately needed.

Teens already struggle with the issues we commonly think of at that age: their sexuality, their ability to fit in at school, making their parents happy. Against the backdrop of a world that's more challenging, from the existential dread of the climate crisis to changing COVID-19 protocols to financial hurdles their parents may face, anxiety, depression, self-harm, and suicides are more common today than ever.

While suicide rates among young Americans have risen across the board, alarmingly, girls of color are becoming a larger share of these children. About 15% of Black female students in high school attempted suicide in 2018. Most of these alarming increases — at least in my experience, but supported by a growing body of research — appear to be connected in some way to social media platforms such as Instagram and Facebook.

I've seen patients who obsess over comparing themselves to their friends based on what their friends share on Instagram and WhatsApp. I've seen patients who worried so much about fitting in with their circle of virtual friends that they neglected the real people in their real lives. I've listened to patients describe the creation of the perfect digital persona, the ideal avatar, so that their lives would finally have meaning because the only thing that counts are likes, hearts, shares, and smiley emojis.

What mattered deeply for these young patients was affirmation from the mostly anonymous metaverse, not coincidentally the inspiration of the name Zuckerberg chose to rename Facebook after The Wall Street Journal published leaked internal documents that illustrated the corporation's negligence, if not complicity, in failing to stem its platforms' toxic effects on teens' mental health.

Meta's own research into Instagram's negative effects on teen girls' mental well-being shows that (and the quotes are the company's): "We make body image issues worse for one in three teen girls." And "Among teens who reported suicidal thoughts, 13 percent of British users and 6 percent of American users traced the desire to kill themselves to Instagram."

Predictably, Facebook minimized the research and denied its culpability. About a month after the leak, Facebook changed its name to Meta.

The National Academies of Sciences, Engineering, and Medicine's new project should give us the one thing that has been missing from the conversation around social media and its impact on mental health: rigorous amounts of science. Social media is addictive, especially to a teenage brain still in the process of maturing. With every heart, share, or smiley emoji, the brain sends a signal that over-reinforces the value of trying to fit in with virtual friends, rather than real people in real life. When this doesn't happen, you can imagine the withdrawal, much like from alcohol or cocaine, where desperate attempts are made to get more attention or face the depression that comes with rejection. We know that the adolescent age group is already more sensitive to rejection.

Studies already show that social media use is consistently linked to negative body image and that this link strengthens over time. The more women saw thin-body images on Instagram, the more dissatisfied they were with their bodies. I hear these stories in my practice. Even Olivia Rodrigo addresses the link between teen girls' self-esteem and social media when she sings, in "jealousy, jealousy": "Co-comparison is killing me slowly; I think I think too much about kids who don't know me."

We shouldn't shrug away the demonstrable link between social media sites and their effects on people's mental well-being as the cost of doing business in a free market. Just as other products must undergo procedures to validate proper use and safety before they go to market, the same rules should apply to Meta and its apps, Facebook and Instagram in particular.

Social media isn't going away. The challenge for us is to make social media a safer space for everyone who uses it.

At Meta's annual General Meeting in May, Zuckerberg refused to listen to shareholders who asked for meaningful reform to better protect people's health and safety. Soon, policymakers will have the necessary information they need to protect children and youth — and force Zuckerberg to put people's health ahead of his profits.

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