social media causing depression and anxiety essay

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Does Social Media Cause Depression?

Social media can help us feel connected to friends and family, but doom-scrolling can have a significant impact on your mental health.

You can share a family picture, hit the like button, or laugh at a viral Tik-Tok dance. You can scroll, and scroll, and scroll — there is always some new update or post.

Around the world, 4.62 billion of us engage, interact, and share our lives on social media platforms. Social media can be both connecting and isolating, meaningful and empty, euphoric and, for some, even depressing.

But despite widespread use, researchers are still working to determine if increased social media use is beneficial or harmful to our mental health.

Can social media make you feel depressed?

With terms like “ doomscrolling ” recently entering our cultural vernacular, and for many, spending too much time online can put them in a negative headspace.

But can the endless scrolling actually make you depressed, and if it does, are the effects temporary or long-term? Does social media lead to situational depression or even develop into major depression?

Social media and situational depression

Situational depression can develop following a major life change or traumatic event. It can be completely natural to feel low, have less energy, and feel less enthusiastic about things after experiencing things like:

• a traumatic event
• the death of a loved one
• a significant breakup or divorce

But situational depression can cause unhelpful feelings to be more persistent and can last for several months before you start to feel better.

You may find that your screen time increases as you experience situational depression. Some people may find comfort in escaping into highlight reels and trending topics. Others might cling to the euphoric hits from every “likes” or seek out like-minded people online to confirm their point of view.

A 2014 review proposed that social media and depression may be part of a destructive cycle. Those who are already living with situational depression tend to go on social media more, and their extended exposure can be associated with, or at least become a risk factor for, more symptoms of depression.

Social Media and clinical depression

If scrolling social media is keeping you from sleeping, maintaining a job, or taking care of your hygiene and nutrition, your social media use may have become problematic, or you may be dealing with clinical depression or major depressive disorder (MDD) .

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) , MDD is diagnosed when you’re experiencing at least five of the following symptoms during a 2-week period and at least one of the symptoms is either feeling sad or depressed or a loss of interest or pleasure:

• marked change in appetite
• not sleeping or significantly oversleeping
• increase in irritability
• feeling anxious
• thoughts of suicide

What type of depression does social media cause?

Social media isn’t inherently harmful to your mental health, especially if it doesn’t replace other forms of healthy social interaction. However, exposure to harmful behavior and rhetoric through social media can impact your mood and even cause depressive symptoms.

For example, toxic positivity can be harmful.

Belonging to social media communities that demand “good vibes only” can cause you to repress any unwanted distressing feelings, potentially contributing to symptoms of depression. In these circles, you may feel unwelcome if you’re experiencing challenges or you, or think others, believe, you’re “not working hard enough” to overcome them.

Toxic positivity can also influence how you view (and post about) your real life. You may feel pressured to only share joyful posts and pictures of your life, ignoring the entire spectrum of your naturally occurring joyful and difficult experiences.

Bullying online can also have a real-world impact on your mental health.

A 2019 study involving university students in the United Arab Emirates showed an increase in bullying online, while another recent study explored the link between cyberbullying and depression, anxiety, and substance use disorder.

What the research says

Social media quickly folded into our everyday lives, but research on its impact is still catching up. While the results are contentious, a 2019 review and a 2020 analysis explored the links between adolescents using social media and other mood disorders like depression.

Social media also has health benefits. However, it will largely depend on:

• how you use social media
• what you’re looking to get out of it
• any pre-existing mental health conditions that could be affected

In millennials

A recent study looked at the relationship between social media behaviors and depression in college students who were born between 1980 and 2000, or Millenials.

The study revealed five behaviors associated with MDD. College students were more likely to meet the criteria for major depression if they interacted with social media in the following ways:

• frequent “upward comparisons” or comparing yourself to others you perceive to be better than you
• self-reported being bothered by unflattering photos
• posted solo photos of themselves instead of group pics
• followed less than 300 accounts on Twitter
• being placed higher on the Social Media Addiction Scale

People seeking support for existing mental health conditions

Today, it may seem like social media is just raging political fights in the comments section, but it’s also a place for like-minded people to share resources, information, and experiences. These shared spaces have the potential to build trust in people that you otherwise would never have met.

Specifically, a 2021 study analyzed groups from an online community of people with depression on social media. The results showed that a sense of group identity and the sharing of resources for depression had a positive impact on members’ depressive symptoms.

However, socializing support, which is when some members excessively shared and engaged with the online community, had a negative impact on depressive symptoms.

Compulsive behaviors

Let’s say you post a photo and put your phone down to go about your day. But you keep hearing the delightful chime notification every time someone likes it. So, you open the app to see who thumbs-upped your pic.

Then, the chiming applause starts to slow down. Maybe the notifications just aren’t coming through? Do you have bad cell reception? So, you keep opening the app and refreshing it, just to make sure there’s no lag — but still nothing.

So you keep refreshing, to the point that you can’t focus on a conversation with your roommate and end up sitting on the couch scrolling instead of completing your to-do list for the day.

This almost persistent rechecking is very common and isn’t necessarily your fault, either.

These apps are designed to be addictive , from the feed layout to the notification design and even to the sound that comes after each new “like.”

For people with obsessive-compulsive disorder (OCD) , these obsessive actions can be even more challenging to manage.

A 2018 study that explored how social media influences obsessive-compulsive disorder found a positive association between problematic social media use and OCD.

Some studies have found that 25% to 50% of people with OCD also experience major depressive symptoms at some point in their lives.

Ruminations

Rumination is a pattern of unhelpful thinking that puts your thoughts and worries on repeat.

New research shows that unhelpful thinking is a stronger force for people with depression and can be more difficult to break away from once the rumination has started.

Ruminative thinking about social media has been found to occur in high school students, according to research published in 2020 . When students who experience cyberbullying begin to fall into rumination, they’re also left open to psychological distress.

Paying attention to how you’re using social media — how much and for what purpose — and how it affects you can be the best way to prevent or minimize its impact.

Do you notice you’re feeling more sad, lonely, isolated, or depressed when you spend time on social? Or do you walk away feeling recharged, or like you have spent your time meaningfully?

If you have an iPhone, consider using the “Screen Time” feature to track how you’re using your phone.

When social media becomes too distracting, consider turning off notifications for a while or removing the app from your phone until you feel like you’re in a better place to log in again.

The double-edged sword of social media can potentially offer you a healthy community platform for managing anxiety and depression, but at the same time, it can also potentially worsen unhealthy thought patterns.

If you ever start to feel like you can’t manage symptoms on your own, consider reaching out to a counselor or therapist. A trained mental health professional can help design the right treatment plan for your specific needs.

Let’s recap

Connecting with other people with whom you share the same interests or life experiences can be very rewarding.

But being involved in an endless loop of scrolling, refreshing, and searching for a fulfilling mental reward (that may not be coming) can worsen your depressive symptoms.

Social media is designed to be hard to resist. If you notice unhealthy depressive thought patterns or behavior emerging, there are tools and professionals that can help you manage your social media impulses, so you can get back to what’s meaningful to you.

Last medically reviewed on January 25, 2022

12 sources collapsed

• Abaido GM. (2019). Cyberbullying on social media platforms among university students in the United Arab Emirates.  https://www.tandfonline.com/doi/full/10.1080/02673843.2019.1669059
• Abramowitz J. (2010). OCD and depression.  https://iocdf.org/expert-opinions/ocd-and-depression/
• Hussain Z, et al. (2018). Problematic social networking site use and comorbid psychiatric disorders: A systematic review of recent large-scale studies.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6302102/
• Ivie EJ, et al. (2020). A meta-analysis of the association between adolescent social media use and depressive symptoms.  https://pubmed.ncbi.nlm.nih.gov/32734903/
• Kardefelt-Winther D. (2014). A conceptual and methodological critique of internet addiction research: Towards a model of compensatory internet use.  https://www.sciencedirect.com/science/article/pii/S0747563213004093?via%3Dihub
• Keles B. (2019). A systematic review: The influence of social media on depression, anxiety and psychological distress in adolescents.  https://www.tandfonline.com/doi/full/10.1080/02673843.2019.1590851
• Lu Y, et al. (2021). Does usage of online social media help users with depressed symptoms improve their mental health? Empirical evidence from an online depression community. https://www.frontiersin.org/articles/10.3389/fpubh.2020.581088/full
• Montag C, et al. (2019). Addictive features of social media/messenger platforms and freemium games against the background of psychological and economic theories.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6679162/
• Parris L, et al. (2020). Exploring social media rumination: Associations with bullying, cyberbullying, and distress.  https://journals.sagepub.com/doi/full/10.1177/0886260520946826
• Raffaeli Q, et al. (2021). The think aloud paradigm reveals differences in the content, dynamics and conceptual scope of resting state thought in trait brooding.  https://www.nature.com/articles/s41598-021-98138-x
• Robinson A, et al. (2018). Social comparisons, social media addiction, and social interaction: An examination of specific social media behaviors related to major depressive disorder in a millennial population.  https://gato-docs.its.txstate.edu/jcr:ff56db8f-0891-4b06-8bfb-b1429c3bcaea/SocialMedia.pdf
• Schodt KB, et al. (2021). Cyberbullying and mental health in adults: The moderating role of social media use and gender.  https://www.frontiersin.org/articles/10.3389/fpsyt.2021.674298/full

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Loyola University > Center for Digital Ethics & Policy > Research & Initiatives > Essays > Archive > 2018 > The Role of Social Media in Adolescent/Teen Depression and Anxiety

The role of social media in adolescent/teen depression and anxiety, april 3, 2018.

The adolescent and teen years have always been a challenging time. Peer pressure, insecurity and hormones are just some of the issues facing those in these age groups. But does social media exacerbate these problems?

For example, researchers from the Alberta Teachers’ Association, the University of Alberta, Boston Children’s Hospital and Harvard Medical School released a  study  that found significant changes in students at every grade level as a result of digital technology. In the past three to five years, 90 percent of teachers at the University of Alberta saw increases in emotional challenges, 85 percent saw social challenges and 77 percent observed cognitive challenges. Also, 56 percent of teachers report an increase in the number of kids sharing stories about online harassment and/or cyberbullying. There are increases in other areas as well. The majority of teachers say there has been an increase in students diagnosed with the following conditions: anxiety disorders (85 percent), ADD and ADHD (75 percent), and such mood disorders as depression (73 percent).

Also, a recent  study  by researchers at the Royal Society for Public Health and Young Health Movement found that 91 percent of those between the ages of 16 and 24 said Instagram was the worst social media platform as it relates to mental health. Instagram was most likely to cause negative effects such as poor body image, fear of missing out and sleep deprivation. Snapchat came in second place, followed by Facebook, Twitter and YouTube. The researchers theorize that Instagram and Snapchat are image-focused platforms and users compare themselves to others.

A  review  of 36 social media studies, published in JAMA Pediatrics, found that 23 percent of kids are victims of cyberbullying. The review also found that cyberbullying results in low self-esteem, depression, self-harm and behavioral problems — in both the victims and the bullies. In addition, cyberbullying was more likely to produce suicidal thoughts than traditional bullying.

Another  study , conducted by researchers at Glasgow University found that kids (some of whom were pre-teens) were on social media until the wee morning hours, and some were on more than one device (for example, a phone and a tablet) so they could simultaneously view multiple sites. These individuals reported lower sleep quality rates in addition to higher levels of depression and anxiety.

In a  survey  by the National Campaign to Support Teen and Unplanned Pregnancy, almost 20 percent of teens admitted to participating in "sexting" or sending nude photos.

The pressure these adolescents and teens feel can be intensified by the time they get to college. Stanford University coined the phrase “ Duck syndrome ” to describe the erroneous attitude of incoming freshmen that they’re struggling while everyone else is gliding along smoothly — but in reality, the gliders are also “paddling furiously under the water just to keep up.” Adolescents and teens become accustomed to creating the impression that everything is perfect to match the equally perfect posts of their friends. But it becomes too difficult to maintain this façade, resulting in  suicide  among college students who appear to be well-adjusted, but are actually experiencing mental and emotional problems.

Another  report , published in the American Journal of Preventive Medicine, reveals that among young adults between the ages of 19 and 32, those with high social media usage (those logging on for more than 2 hours a day and checking their accounts 58 times a week) were more likely to deal with feelings of isolation than those with low social media use (they logged on for 30 minutes and checked their accounts 9 times a week). 

In light of these studies, who is responsible for the role of social media in adolescent/teen depression and anxiety?

Many tech leaders seem to understand the unhealthy, addictive nature of technology in general and social media in particular. As far back as 2010, New York Times reporter Nick Bilton  interviewed  the late Steve Jobs of Apple. Jobs told Bilton that he limited the amount of technology that his kids use. Bill Gates  shared  that he didn’t let his kids have mobile devices until they were 14 years old, and he sets a time for them to turn off the devices at night.  

Evan Williams, one of the founders of Twitter, Medium and Blogger, told Bilton that his kids read physical books instead of using iPads. Dick Costolo, former CEO of Twitter, told Bilton that his teenagers had to be in the living room when they used their tech devices.

But, perhaps the most shocking revelation came from Sean Parker, former president of Facebook, in an  interview  with Axios. Referring to Facebook, Parker said, “God only knows what it’s doing to our children’s brains.”

But there’s more. Parker also said, “ . . . How do we consume as much of your time and conscious attention as possible? . . . And that means that we need to sort of give you a little dopamine hit every once in a while, because someone liked or commented on a photo or a post or whatever . . . And that's going to get you to contribute more content, and that's going to get you ... more likes and comments . . . It's a social-validation feedback loop ... exactly the kind of thing that a hacker like myself would come up with, because you're exploiting a vulnerability in human psychology . . . The inventors, creators — it's me, it's Mark [Zuckerberg], it's Kevin Systrom on Instagram, it's all of these people — understood this consciously . . . And we did it anyway.”

So, if Parker confessed that social media was designed to be addictive, should social media companies be responsible for depression, anxiety, bullying and other issues among adolescents and teens?

Donna Shea, director of  The Peter Pan Center  for Social and Emotional Growth, and Nadine Briggs, director of  Simply Social Kids , are passionate about helping kids make and keep friends, and together have formed How to Make and Keep Friends, LLC. Shea and Briggs both lead community-based social groups at their centers in Massachusetts and have also formed the Social Success in School initiative. The two have also written several books for kids and teens, including, “Tips for Teens on Life and Social Success” .

Both Shea and Briggs believe that it is the job of parents to monitor their kid’s social media activity. “You wouldn’t allow your teen to put a lock on their bedroom door, but your teen is not only now interacting with peers at school or in your neighborhood, they are interacting with the entire world,” Shea said. “It is a parent’s job to be as involved in their teen’s online life as they are in their offline life.”

In fact, she is not in favor of giving adolescents and teens a phone as a gift. “Mobile devices belong to the parent and the teen is being  allowed  to use it,” Shea said. “A contract can be a useful tool before putting a device in the hands of your teen which would allow parents to have access to the phone.”

She believes that parents should monitor their adolescent/teen’s activity — and teens should know this is being done. “Parents do not need to be sneaky about that — tell your child to hand over the phone,” she said. Shea also recommends that parents use subscription services to view all of their teens’ activities. “Teens should be prepared to be monitored until they are of legal adult age,” she said.

However, Briggs admits that apps change so quickly that it’s almost impossible to keep up with them. “Other than doing your best to monitor your teen’s activity —  and it won’t be 100% effective - it’s important from the very beginning that you teach your child and teen to be good consumers of what is available to them,” Briggs said. “This is the new norm, and we think it’s the parent’s responsibility to be involved in their teen’s online life.”

She compares giving kids a phone or device to putting them behind the wheel of a car. “Both can be dangerous in their own way, but teens can learn the responsibilities that go along with these more adult activities.”

But, do parents bear sole responsibility? For example, everyone knows that tobacco is bad for your health, and people consume it willingly; however, they continue to sue and win lawsuits against tobacco companies. In 2014, one plaintiff was  awarded $23.6 billion  when her husband died of lung cancer as a result of smoking up to three packs of cigarettes a day. He started smoking at the age of 13 and died at the age of 36. The plaintiff (his widow) argued that the tobacco company willfully deceived consumers with addictive products.

How is this scenario different from what social media companies are doing? And speaking of willful deception, what about companies that make  secretive apps  that allow teens to hide their sexting?

If someone trips and falls on your property, you could be sued. If someone gets harmed at your nightclub, you could be held liable for not having “adequate security.” If one of your employees sexually harasses a colleague, you would be held responsible — even if you didn’t know about it. If you sell alcohol, you’re responsible for making sure it doesn’t get into the hands of a minor. In fact, according to the Dram Shop Law, if you let an adult have too many drinks and this individual is involved in an accident, you could be responsible.

However, if kids become addicted to a communication platform that was designed to be addictive, if they’re bullied online, if there are no safeguards to stop them from utilizing the types of secretive apps that encourage risky behavior, shouldn’t these companies be held responsible?

I think they should be, but this is not likely to happen until society holds them responsible. Since most adults are also addicted to social media — and some of them are internet bullies and engage in sexting, it seems unlikely that they would advocate for changes.

In the aforementioned study by the Royal Society for Public Health and Young Health Movement, researchers offered several ways to reduce some of the problems adolescents and teens face online. For example, one of the reasons kids feel so much pressure to look perfect is because of the doctored photos they see. The researchers recommend that social media companies include some sort of notification, such as a watermark, when photos have been digitally manipulated (68 percent of surveyed students support this action).

Another suggestion is to create a social media cap. Users would be logged out if they went over a pre-determined usage level (30 percent of surveyed students agree with this suggestion).

The majority of surveyed students (84 percent) approve of schools having classes on safe social media. 

Another suggestion by the researchers (which did not include student responses) was to use social media posts to identify kids and teens who might be at risk for mental health problems. However, problems have already been identified with  using Facebook to identity potential problem drinkers .

In addition, it was suggested that youth workers be trained in digital media. 

These are nice Band-Aid solutions. But they don’t address the addictive nature of social media and the incredible amount of peer pressure that it involves. Parents can provide guidance, but history has shown that their values rarely outweigh the pressure of peers.

Albert Einstein once said, “We can’t solve our problems with the same thinking we used to create them.” But in this situation, the social media giants can solve these problems with the exact same thinking they used to create them. Just as they figured out what it would take to make these platforms addictive, they can figure out what it would take to make the platforms less addictive. But don’t hold your breath because the person who creates the problem and profits from the problem has no incentive to solve the problem.

Terri Williams  writes for a variety of clients including USA Today , Yahoo , U.S. News & World Report , The Houston Chronicle , Investopedia , and Robert Half . She has a Bachelor of Arts in English from the University of Alabama at Birmingham. Follow her on Twitter @Territoryone .

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How Does Social Media Play a Role in Depression?

Nadra Nittle is a journalist who has written articles in publications including NBC News, The Guardian, Vox, and Civil Eats.

Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.

Verywell / Catherine Song

What to Know About Clinical Depression

Causation or correlation.

• Less Social Media, Less FOMO

Why Young People Are at Risk

• Bad News and ‘Doomscrolling’

Safely Using Social Media

By some estimates, roughly 4 billion people across the world use networking websites such as Facebook, Twitter, and Instagram. This usage has prompted mental health experts to investigate whether the enormous popularity of social media plays a role in depression.

Research suggests that people who limit their time on social media tend to be happier than those who don’t. Studies also indicate that social media may trigger an array of negative emotions in users that contribute to or worsen their depression symptoms.

U.S. Surgeon General Warning

In May 2023, U.S. Surgeon General Dr. Vivek Murthy released an advisory to call attention to the effects of social media on youth mental health. He notes that at crucial periods of adolescent brain development, social media use is predictive of decreases in life satisfaction, as well as additional concerns around body image, sleep issues, and much more.

Given that essentially all adolescents are now using social media in some form, he stresses the importance of further research.

Clinical depression or major depressive disorder is a mood disorder characterized by ongoing feelings of sadness and loss of interest in activities that an individual once enjoyed.

Depression can be mild or severe and make it difficult for those with the condition to concentrate, sleep or eat well, make decisions, or complete their normal routines.

People with depression may contemplate death or suicide, feel worthless, develop anxiety or have physical symptoms such as fatigue or headaches. Psychotherapy and medication are some of the treatments for depression. Limiting time on social media and prioritizing real-world connections can be beneficial to mental health.

The Facts on Social Media and Depression

• Social media has never been more popular, with more than half of the world's population active on these networking sites that roll out nonstop news, much of it negative.
• A Lancet study publbished in 2018 found that people who check Facebook late at night were more likely to feel depressed and unhappy.
• Another 2018 study found that the less time people spend on social media, the less symptoms of depression and loneliness they felt.
• A 2015 study found that Facebook users who felt envy while on the networking site were more likely to develop symptoms of depression.

Some studies about social media and mental health reveal that there’s a correlation between networking sites and depression. Other research goes a step further, finding that social media may very well cause depression. A landmark study—“No More FOMO: Limiting Social Media Decreases Loneliness and Depression”—was published in the Journal of Social and Clinical Psychology in 2018.

The study found that the less people used social media, the less depressed and lonely they felt.

This indicates a relationship between lower social media use and emotional wellbeing. According to the researchers, the study marked the first time scientific research established a causal link between these variables.

“Prior to this, all we could say was that there is an association between using social media and having poor outcomes with wellbeing,” said study coauthor Jordyn Young in a statement.

To establish the link between social media and depression, the researchers assigned 143 University of Pennsylvania students to two groups: one could use social media with no restrictions, while the second group had their social media access limited to just 30 minutes on Facebook, Instagram, and Snapchat combined over a three-week period.

Each study participant used iPhones to access social media and the researchers monitored their phone data to ensure compliance. The group with restricted social media access reported lower severity of depression and loneliness than they had at the beginning of the study.

Both groups reported a drop in anxiety and fear of missing out (FOMO), apparently because joining the study made even the group with unrestricted access to social media more cognizant of how much time they were spending on it.

Less Social Media, Less FOMO 

It’s not certain why participants who only spent 30 minutes daily on social media experienced less depression, but researchers suggest that these young people were spared from looking at content—such as a friend’s beach vacation, grad school acceptance letter, or happy family—that might make them feel bad about themselves.

Taking in the photos or posts of people with seemingly “perfect” lives can make social media users feel like they just don’t measure up. A 2015 University of Missouri study found that regular Facebook users were more likely to develop depression if they felt feelings of envy on the networking site.

Social media can also give users a case of FOMO, for example, if they were invited on their friend’s beach vacation but couldn’t go for some reason. Or if the friend didn’t ask them on the trip at all, users might feel hurt and left out to see that others in their social circle were. It can lead them to question their friendships or their own self-worth.

Social media users who visit an ex’s social media page and see pictures of their former partner wining and dining a new love interest can also experience FOMO. They might wonder why their ex never took them to such fancy restaurants or lavished them with gifts.

Ultimately, limiting one’s time on social media can mean less time spent comparing oneself to others. This can extend to not thinking badly of oneself and developing the symptoms that contribute to depression.

Prior to social media and the internet, children only had to worry about bullying on school grounds, for the most part. But social media has given bullies a new way to torment their victims.

With just one click, bullies can circulate a video of their target being ridiculed, beaten up, or otherwise humiliated. People can swarm a peer’s social media page, leaving negative comments or spreading misinformation. In some cases, victims of bullying have committed suicide.

While many schools have anti-bullying policies and rules about online student conduct, it can still be difficult for educators and parents to monitor abusive behavior on social media.

Worsening matters is that the victims of bullies often fear that the bullying will increase if they speak to a parent, teacher, or administrator about their mistreatment. This can make a child feel even more isolated and go without the emotional support they need to handle a toxic and potentially volatile situation. 

If you or someone you care about is having suicidal thoughts, contact the  National Suicide Prevention Lifeline  at  988  for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see our  National Helpline Database .

Bad News and ‘Doomscrolling’ 

One in five Americans now get their news from social media—a larger proportion than those who get their news from traditional print media.

For heavy social media users, people who log in for multiple hours at a time or multiple times a day, this means frequent exposure news, including bad news. Headlines related to natural disasters, terrorist attacks, political strife, and celebrity deaths frequently top lists of social media trends.

Before the advent of social media and the internet generally, one’s exposure to bad news was limited. The public got news from broadcasts that aired at certain times of the day or from newspapers.

The habit of binging bad news on social media sites or elsewhere online is known as “doomscrolling,” and it can adversely affect one’s mental health, leading to development or heightening of anxiety or depression symptoms. 

A 2018 Lancet Psychiatry study of 91,005 people found that those who logged onto Facebook before bedtime were 6% likelier to have major depressive disorder and rated their happiness level 9% lower than those with better sleep hygiene did.

Psychologist Amelia Aldao told NPR that doomscrolling locks the public into a “vicious cycle of negativity.” The cycle continues because “our minds are wired to look out for threats,” she said. “The more time we spend scrolling, the more we find those dangers, the more we get sucked into them, the more anxious we get.” Before long, the world appears to be an altogether gloomy place, making doomscrollers feel increasingly hopeless.

Press Play for Advice On Limiting Social Media Use

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Using social media comes with mental health risks, but that doesn’t mean it should be completely avoided. Experts recommend using these networking websites in moderation.

Set a timer when you’re on social media or install an app on your phone or computer that tracks how long you’ve spent on a networking site.

Without these timers or apps, it’s easy to spend hours on social media before you know it. To limit your time on social media, you can also plan real-world activities that help you focus on your immediate surroundings and circumstances. Read a book, watch a movie, go for a stroll, play a game, bake some bread, or have a phone conversation with a friend. Make the time to enjoy life offline.  

Kemp S. More than half of the people on Earth now use social media .

" Social Media and Youth Mental Healt h," The US Surgeon General's Advisory, May 2023.

Lyall LM, Wyse CA, Graham N, et al. Association of disrupted circadian rhythmicity with mood disorders, subjective wellbeing, and cognitive function: A cross-sectional study of 91 105 participants from the UK Biobank . Lancet Psychiatry.  2018;5(6):507-514. doi:10.1016/S2215-0366(18)30139-1

Hunt MG, Marx R, Lipson C, Young J. No more FOMO: Limiting social media decreases loneliness and depression . J Soc Clin Psychol.  2018;37(10):751-768. doi:10.1521/jscp.2018.37.10.751

Tandoc EC, Ferrucci P, Duffy M. Facebook use, envy, and depression among college students: Is facebooking depressing? Comput Hum Behav. 2015;43:139-146. doi:10.1016/j.chb.2014.10.053

Limbana T, Khan F, Eskander N, Emamy M, Jahan N. The association of bullying and suicidality: Does it affect the pediatric population?   Cureus . 2020;12(8). doi:10.7759/cureus.9691

Shearer E. Social media outpaces print newspapers in the U.S. as a news source . Pew Research Center.

Garcia-Navarro L. National Public Radio. Your 'doomscrolling' breeds anxiety. Here's how to stop the cycle .

By Nadra Nittle Nadra Nittle is a Los Angeles-based journalist and author. She has covered a wide range of topics, including health, education, race, consumerism, food, and public policy, throughout her career.   

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Perlis RH , Green J , Simonson M, et al. Association Between Social Media Use and Self-reported Symptoms of Depression in US Adults. JAMA Netw Open. 2021;4(11):e2136113. doi:10.1001/jamanetworkopen.2021.36113

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Association Between Social Media Use and Self-reported Symptoms of Depression in US Adults

• 1 Massachusetts General Hospital, Boston
• 2 Harvard Medical School, Boston, Massachusetts
• 3 Northeastern University, Boston, Massachusetts
• 4 University of Pennsylvania, Philadelphia
• 5 Rutgers University, New Brunswick, New Jersey
• 6 Boston Children’s Hospital, Boston, Massachusetts
• 7 Northwestern University, Evanston, Illinois
• 8 Harvard University, Cambridge, Massachusetts

Question   Is social media use by adults associated with subsequent increases in depressive symptoms?

Findings   In this survey study, 5395 individuals with minimal depressive symptoms on initial survey who reported use of Snapchat, Facebook, or TikTok were more likely to report increased levels of depressive symptoms on a later survey.

Meaning   These results suggest that certain social media use preceded worsening of depressive symptoms.

Importance   Some studies suggest that social media use is associated with risk for depression, particularly among children and young adults.

Objective   To characterize the association between self-reported use of individual social media platforms and worsening of depressive symptoms among adults.

Design, Setting, and Participants   This survey study included data from 13 waves of a nonprobability internet survey conducted approximately monthly between May 2020 and May 2021 among individuals aged 18 years and older in the US. Data were analyzed in July and August 2021.

Main Outcomes and Measures   Logistic regression was applied without reweighting, with a 5 point or greater increase in 9-item Patient Health Questionnaire (PHQ-9) score as outcome and participant sociodemographic features, baseline PHQ-9, and use of each social media platform as independent variables.

Results   In total, 5395 of 8045 individuals (67.1%) with a PHQ-9 score below 5 on initial survey completed a second PHQ-9. These respondents had a mean (SD) age of 55.8 (15.2) years; 3546 respondents (65.7%) identified as female; 329 respondents (6.1%) were Asian, 570 (10.6%) Black, 256 (4.7%) Hispanic, 4118 (76.3%) White, and 122 (2.3%) American Indian or Alaska Native, Pacific Islander or Native Hawaiian, or other. Among eligible respondents, 482 (8.9%) reported 5 points or greater worsening of PHQ-9 score at second survey. In fully adjusted models for increase in symptoms, the largest adjusted odds ratio (aOR) associated with social media use was observed for Snapchat (aOR, 1.53; 95% CI, 1.19-1.96), Facebook (aOR, 1.42; 95% CI, 1.10-1.81), and TikTok (aOR, 1.39; 95% CI, 1.03-1.87).

Conclusions and Relevance   Among survey respondents who did not report depressive symptoms initially, social media use was associated with greater likelihood of subsequent increase in depressive symptoms after adjustment for sociodemographic features and news sources. These data cannot elucidate the nature of this association, but suggest the need for further study to understand how social media use may factor into depression among adults.

Social media use has been associated with diminished well-being and greater levels of anxiety and depression, predominantly in cross-sectional studies among adolescents 1 or young adults, 2 although concern has been raised that reporting bias may result from individuals with greater depressive symptoms overreporting social media use. 3 A small number of short-term longitudinal studies provide further support for this association—for example, among 82 young adults sampled 2 weeks apart. 4 , 5

These results have 2 notable gaps that raise questions. First, is the observed cross-sectional relationship also apparent in longitudinal studies, as suggested by a randomized trial of Facebook discontinuation? 6 Second, does this risk apply to older consumers of social media? To investigate these questions, we used data from multiple waves of an ongoing 50-state US survey.

Data were drawn from 13 waves of a nonprobability internet survey deployed via a multipanel commercial vendor approximately every month between May 2020 and May 2021 in individuals aged 18 years and older. The study was approved by the institutional review board of Harvard University, and participants provided written informed consent. Reporting followed the American Association for Public Opinion Research ( AAPOR ) reporting guideline.

The survey sampling strategy incorporated quotas for sex, age, and race and ethnicity within each state; attention checks and open-ended answers were used to filter out unreliable respondents. Race and ethnicity was self-reported from 5 census categories to confirm representativeness of the US population. Participants also completed the 9-item Patient Health Questionnaire (PHQ-9). 7 They were asked, “Do you ever use any of the following social media sites or apps?”; we focused a priori on Facebook, Instagram, LinkedIn, Pinterest, TikTok, Twitter, Snapchat, and YouTube. They were further asked to identify any sources of COVID-19 related news they consumed in the past 24 hours (ie, cable television, network television, or news website), which we used as a proxy for news sources more generally, while examining web-based vs television-based news separately; number of social supports available “to talk to if you had a problem, felt sad, or depressed”; and face-to-face meetings with nonhousehold members in the prior 24 hours. As some survey modules were randomly assigned to a subset of participants in each wave to diminish overall survey length, 1646 returning participants completed news source questions, and 4808 completed social supports questions ( Table 1 ).

The study cohort included participants who completed the PHQ-9 in at least 2 survey waves with a PHQ-9 total score less than 5 (ie, less than mild depression) at the index survey. We applied logistic regression for participants with a 5 or more point increase in PHQ-9 score (ie, the threshold for clinical significance 7 ) as outcome, and for sociodemographic features, baseline PHQ-9, and use of each social media platform as independent variables using glm in R version 3.6 (R Project for Statistical Computing) without reweighting. The threshold for statistical significance was set at 2-sided P  < .05.

Overall, 5395 of 8045 individuals (67.1%) with a PHQ-9 score below 5 on initial survey completed a subsequent PHQ-9 ( Table 1 ). These respondents had mean (SD) age of 55.8 (15.2) years; 3546 respondents (65.7%) identified as female; 329 respondents (6.1%) were Asian, 570 (10.6%) Black, 256 (4.7%) Hispanic, 4118 (76.3%) White, and 122 (2.3%) American Indian or Alaska Native, Pacific Islander or Native Hawaiian, or other. Mean (SD) PHQ-9 score at initial survey for this group of subsequent responders was 1.29 (1.43). At first follow-up survey, 482 respondents (8.9%) experienced an increase in PHQ-9 score of 5 points or greater.

In adjusted regression models, Snapchat, Facebook, and TikTok use at first survey were significantly associated with greater risk of increase in self-reported depressive symptoms, with adjusted odds ratios (aOR) of 1.53 (95% CI, 1.19-1.96), 1.42 (95% CI, 1.10-1.81), and 1.39 (95% CI, 1.03-1.87), respectively ( Table 2 ). Incorporating terms for television or internet news consumed in the past 24 hours, number of social supports, and number of daily face-to-face interactions on the initial survey did not meaningfully change these associations with the notable exception of Snapchat, where aORs were diminished from 1.53 (95% CI, 1.19-1.96) to 1.12 (95% CI, 0.70-1.81) with the inclusion of terms for news source ( Table 2 ).

In logistic regression models for increase in depressive symptoms, we further identified significant interactions of platform use with age group for Facebook, TikTok, and Snapchat ( Table 3 ). For TikTok and Snapchat, use was associated with depressive symptoms among those ages 35 years or older but not among those younger than age 35 years (eg, Snapchat: aOR, 1.96; 95% CI, 1.44-2.65 vs aOR, 1.17; 95% CI, 0.78-1.77). For Facebook, the opposite pattern was observed; use was associated with depressive symptoms among those younger than 35 years, but not among those aged 35 years and older (aOR, 2.60; 95% CI, 1.46-1.62 vs aOR, 1.12; 95% CI, 0.85-1.48).

In this analysis of survey data, we found that some forms of social media use—in particular, Snapchat, Facebook, and YouTube—were associated with greater levels of self-reported depressive symptoms on a subsequent survey. Notably, with the exception of Snapchat, this association was not explained in regression models by use of other news sources, suggesting it is not accounted for by differential media consumption more broadly. Likewise, the association was not meaningfully changed by number of social supports or face-to-face social interactions at baseline, suggesting it is not mediated by reduction in social interactions more broadly.

While we cannot test causation, as in a prior study of Facebook discontinuation, 6 our design allowed us to look at incident self-reported depression following social media use. Our results extend prior observations of elevated depressive symptoms in adolescents 1 or young adults 2 associated with social media use in cross-sectional studies. They are also consistent with 2 prior short-term longitudinal studies. 4 , 5 Beyond the ability to look longitudinally, this study also extends prior studies by examining a broader age range, with a mean age of 56 years. Our results suggest that the associations previously observed with depressive symptoms are not limited to young adults; indeed, while effect sizes for Facebook are greater among younger adults, effect sizes for TikTok and Snapchat are greater among those age 35 years or older.

This study had several limitations. Results are limited by the inability to control for all potential confounding, lack of dose-response data, and inability to measure nature of social media use, which has been suggested may moderate impact. 8 Notably, social media use may simply be a marker of underlying vulnerability to depression. On the other hand, one investigation found that viewing one’s own Facebook profile was associated with increased physiological stress response. 9 The extent to which these findings generalize beyond the COVID-19 pandemic period also remains to be determined; it may be that the effects of social media use are specific to content viewed, for example. A further caveat is that only a (nonrandom) subset of participants return for a second survey, which could yield a biased sample with less generalizability. However, as the surveys are not labeled as COVID-19 specific, the likelihood is lower that these results reflect a selection bias in which individuals with greater interest in, or who had been more affected by, COVID-19 preferentially responded.

In this survey study of US adults, we identified associations between type of social media use at initial survey and greater levels of depressive symptoms on a subsequent survey. Our findings complement those using cross-sectional designs 2 or small longitudinal cohorts 4 , 5 and extend them to older adults, indicating the need for further investigation of the relationship between social media use and mental health.

Accepted for Publication: September 28, 2021.

Published: November 23, 2021. doi:10.1001/jamanetworkopen.2021.36113

Open Access: This is an open access article distributed under the terms of the CC-BY License . © 2021 Perlis RH et al. JAMA Network Open .

Corresponding Author: Roy H. Perlis, MD, MSc, Massachusetts General Hospital, 185 Cambridge St, 6th Floor, Boston, MA 02114 ( [email protected] ).

Author Contributions : Dr Perlis had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Perlis, Druckman, Della Volpe.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Perlis, Della Volpe.

Critical revision of the manuscript for important intellectual content: Perlis, Green, Simonson, Ognyanova, Santillana, Lin, Quintana, Chwe, Druckman, Lazer, Baum.

Statistical analysis: Perlis, Green, Santillana, Della Volpe.

Obtained funding: Ognyanova, Druckman, Lazer, Baum.

Administrative, technical, or material support: Perlis, Simonson, Lin, Quintana, Chwe, Druckman, Lazer.

Supervision: Perlis, Quintana, Lazer.

Conflict of Interest Disclosures: Dr Perlis reported receiving consulting fees from Belle Artificial Intelligence, Burrage Capital, Genomind, RID Ventures, and Takeda; he reported holding equity in Psy Therapeutics. Dr Ognyanova reported grants from the National Science Foundation during the conduct of the study. No other disclosures were reported.

Funding/Support: This study was supported by the National Institute of Mental Health (grant No. R01MH116270; Dr Perlis).

Role of the Funder/Sponsor: The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Disclaimer: Dr Perlis is an associate editor for JAMA Network Open but was not involved in the editorial review or decision process for this manuscript.

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Young Adult Depression and Anxiety Linked to Social Media Use: Assessment and Treatment

• Original Paper
• Published: 15 February 2020
• Volume 49 , pages 368–379, ( 2021 )

Cite this article

• Joanna E. Bettmann   ORCID: orcid.org/0000-0002-1849-2029 1 ,
• Gretchen Anstadt 1 ,
• Bryan Casselman 1 &
• Kamala Ganesh 1  

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Studies suggest that more 30% of college students are currently depressed. A small but growing body of literature suggests that young adults’ social media use correlates with their depressive and anxious symptomology. As many as 90% of young adults use social media currently, compared to just 12.5% in 2005. Further, more than a quarter of college students report spending at least six hours per week on social media, compared to only 18.9% in 2007. Smartphone use within young adult populations also is extremely high: estimates of undergraduate smartphone ownership appear to be as high as 97%. Collectively, these trends suggest that social media and smartphones play an integral role in the routines and culture of young adults. The authors present the existing research linking social media use with depression and anxiety and utilize a case study to illuminate the relationship between young adult depression, anxiety, and social media use. The article provides clear recommendations for the assessment and treatment of social media use in depressed and anxious young adults.

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• BOOK REVIEW
• 29 March 2024

The great rewiring: is social media really behind an epidemic of teenage mental illness?

• Candice L. Odgers 0

Candice L. Odgers is the associate dean for research and a professor of psychological science and informatics at the University of California, Irvine. She also co-leads international networks on child development for both the Canadian Institute for Advanced Research in Toronto and the Jacobs Foundation based in Zurich, Switzerland.

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Social-media platforms aren’t always social. Credit: Getty

The Anxious Generation: How the Great Rewiring of Childhood is Causing an Epidemic of Mental Illness Jonathan Haidt Allen Lane (2024)

Two things need to be said after reading The Anxious Generation . First, this book is going to sell a lot of copies, because Jonathan Haidt is telling a scary story about children’s development that many parents are primed to believe. Second, the book’s repeated suggestion that digital technologies are rewiring our children’s brains and causing an epidemic of mental illness is not supported by science. Worse, the bold proposal that social media is to blame might distract us from effectively responding to the real causes of the current mental-health crisis in young people.

Haidt asserts that the great rewiring of children’s brains has taken place by “designing a firehose of addictive content that entered through kids’ eyes and ears”. And that “by displacing physical play and in-person socializing, these companies have rewired childhood and changed human development on an almost unimaginable scale”. Such serious claims require serious evidence.

Collection: Promoting youth mental health

Haidt supplies graphs throughout the book showing that digital-technology use and adolescent mental-health problems are rising together. On the first day of the graduate statistics class I teach, I draw similar lines on a board that seem to connect two disparate phenomena, and ask the students what they think is happening. Within minutes, the students usually begin telling elaborate stories about how the two phenomena are related, even describing how one could cause the other. The plots presented throughout this book will be useful in teaching my students the fundamentals of causal inference, and how to avoid making up stories by simply looking at trend lines.

Hundreds of researchers, myself included, have searched for the kind of large effects suggested by Haidt. Our efforts have produced a mix of no, small and mixed associations. Most data are correlative. When associations over time are found, they suggest not that social-media use predicts or causes depression, but that young people who already have mental-health problems use such platforms more often or in different ways from their healthy peers 1 .

These are not just our data or my opinion. Several meta-analyses and systematic reviews converge on the same message 2 – 5 . An analysis done in 72 countries shows no consistent or measurable associations between well-being and the roll-out of social media globally 6 . Moreover, findings from the Adolescent Brain Cognitive Development study, the largest long-term study of adolescent brain development in the United States, has found no evidence of drastic changes associated with digital-technology use 7 . Haidt, a social psychologist at New York University, is a gifted storyteller, but his tale is currently one searching for evidence.

Of course, our current understanding is incomplete, and more research is always needed. As a psychologist who has studied children’s and adolescents’ mental health for the past 20 years and tracked their well-being and digital-technology use, I appreciate the frustration and desire for simple answers. As a parent of adolescents, I would also like to identify a simple source for the sadness and pain that this generation is reporting.

A complex problem

There are, unfortunately, no simple answers. The onset and development of mental disorders, such as anxiety and depression, are driven by a complex set of genetic and environmental factors. Suicide rates among people in most age groups have been increasing steadily for the past 20 years in the United States. Researchers cite access to guns, exposure to violence, structural discrimination and racism, sexism and sexual abuse, the opioid epidemic, economic hardship and social isolation as leading contributors 8 .

How social media affects teen mental health: a missing link

The current generation of adolescents was raised in the aftermath of the great recession of 2008. Haidt suggests that the resulting deprivation cannot be a factor, because unemployment has gone down. But analyses of the differential impacts of economic shocks have shown that families in the bottom 20% of the income distribution continue to experience harm 9 . In the United States, close to one in six children live below the poverty line while also growing up at the time of an opioid crisis, school shootings and increasing unrest because of racial and sexual discrimination and violence.

The good news is that more young people are talking openly about their symptoms and mental-health struggles than ever before. The bad news is that insufficient services are available to address their needs. In the United States, there is, on average, one school psychologist for every 1,119 students 10 .

Haidt’s work on emotion, culture and morality has been influential; and, in fairness, he admits that he is no specialist in clinical psychology, child development or media studies. In previous books, he has used the analogy of an elephant and its rider to argue how our gut reactions (the elephant) can drag along our rational minds (the rider). Subsequent research has shown how easy it is to pick out evidence to support our initial gut reactions to an issue. That we should question assumptions that we think are true carefully is a lesson from Haidt’s own work. Everyone used to ‘know’ that the world was flat. The falsification of previous assumptions by testing them against data can prevent us from being the rider dragged along by the elephant.

A generation in crisis

Two things can be independently true about social media. First, that there is no evidence that using these platforms is rewiring children’s brains or driving an epidemic of mental illness. Second, that considerable reforms to these platforms are required, given how much time young people spend on them. Many of Haidt’s solutions for parents, adolescents, educators and big technology firms are reasonable, including stricter content-moderation policies and requiring companies to take user age into account when designing platforms and algorithms. Others, such as age-based restrictions and bans on mobile devices, are unlikely to be effective in practice — or worse, could backfire given what we know about adolescent behaviour.

A third truth is that we have a generation in crisis and in desperate need of the best of what science and evidence-based solutions can offer. Unfortunately, our time is being spent telling stories that are unsupported by research and that do little to support young people who need, and deserve, more.

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Social Media and Teen Anxiety

• Posted December 15, 2017
• By Leah Shafer

As adults witness the rising tides of teenaged anxiety, it’s tough not to notice a common thread that runs through the epidemic — something that past generations never dealt with. Clutched in the hand of nearly every teen is a smartphone, buzzing and beeping and blinking with social media notifications.

Parents, all too often, just want to grab their teen’s phone and stuff it in a drawer. But is social media and the omnipresence of digital interactions really the cause of all this anxiety?

The short answer is: It’s complicated.

Recent studies have noted a significant uptick in depression and suicidal thoughts over the past several years for teens, especially those who spend multiple hours a day using screens, and especially girls. But many of the pressures teenagers feel from social media are actually consistent with developmentally normal concerns around social standing and self-expression. Social media can certainly exacerbate these anxieties, but for parents to truly help their children cope, they should avoid making a blanket condemnation. Instead, parents should tailor their approach to the individual, learning where a particular child's stressors lie and how that child can best gain control of this alluring, powerful way to connect with peers.

Many of the pressures teenagers feel from social media are actually consistent with developmentally normal concerns around social standing and self-expression.

A Link Between Social Media and Mental Health Concerns

Many experts have described a rise in sleeplessness, loneliness, worry, and dependence among teenagers — a rise that coincides with the release of the first iPhone 10 years ago. One study found that 48 percent of teens who spend five hours per day on an electronic device have at least one suicide risk factor, compared to 33 percent of teens who spend two hours a day on an electronic device. We’ve all heard anecdotes, too, of teens being reduced to tears from the constant communication and comparisons that social media invites.

Through likes and follows, teens are "getting actual data on how much people like them and their appearance," says Lindsey Giller , a clinical psychologist at the Child Mind Institute who specializes in youth and young adults with mood disorders. "And you're not having any break from that technology." She's seen teens with anxiety, poor self-esteem, insecurity, and sadness attributed, at least in part, to constant social media use.

Teenage Challenges and Stressors, Exacerbated

But the connection between anxiety and social media might not be simple, or purely negative. Correlation does not equal causation; it may be that depression and anxiety lead to more social media use, for example, rather than the other way around. There could also be an unknown third variable — for instance, academic pressures or economic concerns — connecting them, or teens could simply be more likely to admit to mental health concerns now than they were in previous generations.

It’s also important to remember that teens experience social media in a wide range of ways . The ability to raise awareness, connect with people across the world, and share moments of beauty can be empowering and uplifting for some. And many teens understand that the images they see are curated snapshots, not real-life indicators, and are less likely to let those posts make them feel insecure about their own lives.

Above all, says researcher Emily Weinstein , who studies teens and their social media habits, parents need to keep in mind that it’s probably not just social media that’s making their teens anxious — it’s the normal social stressors that these platforms facilitate, albeit at a different size and scale.

In the same way that different teenagers need different types of social support from their parents, they need different types of digital support, as well. If your teen seems irritable or overwhelmed by social media, pay attention to what specifically is causing those feelings.

“So many of the behaviors we’re talking about have pre-digital corollaries,” says Weinstein, a postdoctoral fellow at the Harvard Graduate School of Education . “They’re the same sort of developmental challenges that adolescents have grappled with for decades, though now they’re taking place in different spaces that can certainly amplify them and shift their quality, quantity, and scale.

“But the idea of wanting to fit in, the critical importance of peer relationships, and the process of figuring out which version of yourself you want to be and how you want to express that identity to others — those features of adolescence are not new.”

What’s Triggering about Social Media?

Youth and technology expert Amanda Lenhart ’s 2015 Pew study of teens, technology, and friendships reveals a range of social media-induced stressors:

• Seeing people posting about events to which you haven’t been invited
• Feeling pressure to post positive and attractive content about yourself
• Feeling pressure to get comments and likes on your posts
• Having someone post things about you that you cannot change or control

In analyses of thousands of adolescents’ reactions to digital stressors, Weinstein and her colleagues have found even more challenges:

• Feeling replaceable: If you don’t respond to a best friend’s picture quickly or effusively enough, will she find a better friend?
• Too much communication: A boyfriend or girlfriend wants you to be texting far more often than you’re comfortable with.
• Digital “FOMO”: If you’re not up-to-date on the latest social media posts, will it prevent you from feeling like you can participate in real-life conversations at school the next day?
• Attachment to actual devices: If your phone is out of reach, will your privacy be invaded? Will you miss a message from a friend when he needs you?

For Parents, Strategies on Mitigating Anxiety — Without Overreacting

With so many different stressors, a key piece of advice for parents is to individualize your approach.  In the same way that different teenagers need different types of social support from their parents, they need different types of digital support, as well. Weinstein suggests that if your teen seems irritable or overwhelmed by social media, pay attention to what specifically is causing those feelings.

Giller agrees. "Really check in with your teen about what's going on ," she says. Parents can and should help support and problem-solve with their teen, but they should also offer validation about how difficult these situations can be.

Don’t just take your teen’s phone away if you suspect drama. In most situations, it’s best to work with your teen around social media expectations.

Relatedly, don’t just take your teen’s phone away if you suspect drama. Doing so won’t get to the heart of the social issue at play — and it could potentially make your teen more upset by separating her from her friends and other aspects of digital media she enjoys.

However, as a family, you can also set screen-free times — whether it’s every evening after 9 p.m., on the car ride to school, an occasional screen-free weekend, or longer stretches over vacations and camps. “Many teens say they appreciate” these chances, says education writer Anya Kamenetz , whose upcoming book The Art of Screen Time: How Your Family Can Balance Digital Media and Real Life   explores these issues in-depth.

A significant part of your teen’s phone habits may be related to her parents, too. “ Be good role models in your own use of tech ,” advises Kamenetz. That means being mindful of your own distracted habit of reaching for your cell, but it also means rejecting the isolation that screen time can generate. Make digital media an opportunity for real-life social opportunities, she says. Share some media activities with your teenager — playing games, watching YouTube clips, or reading up on mutual interests together.

And in most situations, it’s best to work with your teen to set social media expectations . “You want to build consensus and get their buy-in,” says Kamenetz. Constant surveillance or control won’t build trust. Make it an open, mutual discussion.

You want to get teens to put their devices down on their own, says Weinstein, “so that you’re helping them build their ability to manage their interactions with and through technology.” And that’s increasingly looking like a key life skill that we’ll all need to develop, now and into the future.

Additional Resources

• Helping teens develop the digital literacy skills needed for the glossy images of Instagram
• Research from the Child Mind Institute on how social media use affects teenagers
• Setting digital standards — as a family

Illustration: Wilhelmina Peragine

We’re in a moment where anxiety is running rampant , spreading like an epidemic among adolescents. What can we do? In a series of pieces, we look at how to help teenagers face their fears, build resilience, and grapple with the pressure to achieve — on the road to college and beyond. Read more at What Do Anxious Teens Need?

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February 20, 2024 at 7:30 am

In January, Mark Zuckerberg, CEO of Facebook’s parent company Meta, appeared at a congressional hearing to answer questions about how social media potentially harms children. Zuckerberg opened by saying: “The existing body of scientific work has not shown a causal link between using social media and young people having worse mental health.”

But many social scientists would disagree with that statement. In recent years, studies have started to show a causal link between teen social media use and reduced well-being or mood disorders, chiefly depression and anxiety.

Ironically, one of the most cited studies into this link focused on Facebook.

Researchers delved into whether the platform’s introduction across college campuses in the mid 2000s increased symptoms associated with depression and anxiety. The answer was a clear yes , says MIT economist Alexey Makarin, a coauthor of the study, which appeared in the November 2022 American Economic Review . “There is still a lot to be explored,” Makarin says, but “[to say] there is no causal evidence that social media causes mental health issues, to that I definitely object.”

The concern, and the studies, come from statistics showing that social media use in teens ages 13 to 17 is now almost ubiquitous. Two-thirds of teens report using TikTok, and some 60 percent of teens report using Instagram or Snapchat, a 2022 survey found. (Only 30 percent said they used Facebook.) Another survey showed that girls, on average, allot roughly 3.4 hours per day to TikTok, Instagram and Facebook, compared with roughly 2.1 hours among boys. At the same time, more teens are showing signs of depression than ever, especially girls ( SN: 6/30/23 ).

As more studies show a strong link between these phenomena, some researchers are starting to shift their attention to possible mechanisms. Why does social media use seem to trigger mental health problems? Why are those effects unevenly distributed among different groups, such as girls or young adults? And can the positives of social media be teased out from the negatives to provide more targeted guidance to teens, their caregivers and policymakers?

“You can’t design good public policy if you don’t know why things are happening,” says Scott Cunningham, an economist at Baylor University in Waco, Texas.

Increasing rigor

Concerns over the effects of social media use in children have been circulating for years, resulting in a massive body of scientific literature. But those mostly correlational studies could not show if teen social media use was harming mental health or if teens with mental health problems were using more social media.

Moreover, the findings from such studies were often inconclusive, or the effects on mental health so small as to be inconsequential. In one study that received considerable media attention, psychologists Amy Orben and Andrew Przybylski combined data from three surveys to see if they could find a link between technology use, including social media, and reduced well-being. The duo gauged the well-being of over 355,000 teenagers by focusing on questions around depression, suicidal thinking and self-esteem.

Digital technology use was associated with a slight decrease in adolescent well-being , Orben, now of the University of Cambridge, and Przybylski, of the University of Oxford, reported in 2019 in Nature Human Behaviour . But the duo downplayed that finding, noting that researchers have observed similar drops in adolescent well-being associated with drinking milk, going to the movies or eating potatoes.

Holes have begun to appear in that narrative thanks to newer, more rigorous studies.

In one longitudinal study, researchers — including Orben and Przybylski — used survey data on social media use and well-being from over 17,400 teens and young adults to look at how individuals’ responses to a question gauging life satisfaction changed between 2011 and 2018. And they dug into how the responses varied by gender, age and time spent on social media.

Social media use was associated with a drop in well-being among teens during certain developmental periods, chiefly puberty and young adulthood, the team reported in 2022 in Nature Communications . That translated to lower well-being scores around ages 11 to 13 for girls and ages 14 to 15 for boys. Both groups also reported a drop in well-being around age 19. Moreover, among the older teens, the team found evidence for the Goldilocks Hypothesis: the idea that both too much and too little time spent on social media can harm mental health.

“There’s hardly any effect if you look over everybody. But if you look at specific age groups, at particularly what [Orben] calls ‘windows of sensitivity’ … you see these clear effects,” says L.J. Shrum, a consumer psychologist at HEC Paris who was not involved with this research. His review of studies related to teen social media use and mental health is forthcoming in the Journal of the Association for Consumer Research.

Cause and effect

That longitudinal study hints at causation, researchers say. But one of the clearest ways to pin down cause and effect is through natural or quasi-experiments. For these in-the-wild experiments, researchers must identify situations where the rollout of a societal “treatment” is staggered across space and time. They can then compare outcomes among members of the group who received the treatment to those still in the queue — the control group.

That was the approach Makarin and his team used in their study of Facebook. The researchers homed in on the staggered rollout of Facebook across 775 college campuses from 2004 to 2006. They combined that rollout data with student responses to the National College Health Assessment, a widely used survey of college students’ mental and physical health.

The team then sought to understand if those survey questions captured diagnosable mental health problems. Specifically, they had roughly 500 undergraduate students respond to questions both in the National College Health Assessment and in validated screening tools for depression and anxiety. They found that mental health scores on the assessment predicted scores on the screenings. That suggested that a drop in well-being on the college survey was a good proxy for a corresponding increase in diagnosable mental health disorders. 

Compared with campuses that had not yet gained access to Facebook, college campuses with Facebook experienced a 2 percentage point increase in the number of students who met the diagnostic criteria for anxiety or depression, the team found.

When it comes to showing a causal link between social media use in teens and worse mental health, “that study really is the crown jewel right now,” says Cunningham, who was not involved in that research.

A need for nuance

The social media landscape today is vastly different than the landscape of 20 years ago. Facebook is now optimized for maximum addiction, Shrum says, and other newer platforms, such as Snapchat, Instagram and TikTok, have since copied and built on those features. Paired with the ubiquity of social media in general, the negative effects on mental health may well be larger now.

Moreover, social media research tends to focus on young adults — an easier cohort to study than minors. That needs to change, Cunningham says. “Most of us are worried about our high school kids and younger.” 

And so, researchers must pivot accordingly. Crucially, simple comparisons of social media users and nonusers no longer make sense. As Orben and Przybylski’s 2022 work suggested, a teen not on social media might well feel worse than one who briefly logs on. 

Researchers must also dig into why, and under what circumstances, social media use can harm mental health, Cunningham says. Explanations for this link abound. For instance, social media is thought to crowd out other activities or increase people’s likelihood of comparing themselves unfavorably with others. But big data studies, with their reliance on existing surveys and statistical analyses, cannot address those deeper questions. “These kinds of papers, there’s nothing you can really ask … to find these plausible mechanisms,” Cunningham says.

One ongoing effort to understand social media use from this more nuanced vantage point is the SMART Schools project out of the University of Birmingham in England. Pedagogical expert Victoria Goodyear and her team are comparing mental and physical health outcomes among children who attend schools that have restricted cell phone use to those attending schools without such a policy. The researchers described the protocol of that study of 30 schools and over 1,000 students in the July BMJ Open.

Goodyear and colleagues are also combining that natural experiment with qualitative research. They met with 36 five-person focus groups each consisting of all students, all parents or all educators at six of those schools. The team hopes to learn how students use their phones during the day, how usage practices make students feel, and what the various parties think of restrictions on cell phone use during the school day.

Talking to teens and those in their orbit is the best way to get at the mechanisms by which social media influences well-being — for better or worse, Goodyear says. Moving beyond big data to this more personal approach, however, takes considerable time and effort. “Social media has increased in pace and momentum very, very quickly,” she says. “And research takes a long time to catch up with that process.”

Until that catch-up occurs, though, researchers cannot dole out much advice. “What guidance could we provide to young people, parents and schools to help maintain the positives of social media use?” Goodyear asks. “There’s not concrete evidence yet.”

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Anxiety and Social Media Use

Does anxiety drive excessive usage.

Posted February 3, 2020 | Reviewed by Daniel Lyons M.A.

• What Is Anxiety?
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One way or another, anxiety seems inextricably linked to the use of social media , and a swath of recent papers seem to suggest that this link is one of the core drivers of digital usage. These data show that, while many people who use social media a great deal are anxious, when they are not using social media they turn to social media to reduce this ‘withdrawal’ anxiety and end up with another form of anxiety produced by engaging with their digital platforms. The implications for the mental health of this ‘double anxiety whammy’ are clear, and research even suggests that some people turn to alcohol to reduce their stress levels while they are posting on social media!

One of these recent studies has shown that higher amounts of screen time are associated with higher levels of anxiety and depression 1 – adding to the already copious literature on the subject 2 . What is striking about this new study, however, is that it provides longitudinal data to suggest that, over a time course of four years, adolescents who use social media a lot of show corresponding increases in their levels of anxiety and depression. To this extent, this study develops the literature, as a temporal relationship is a stronger piece of evidence than a correlational one obtained from two measures taken at the same time as one another.

Of course, there are always caveats to be made for any single study – even showing clear temporal precedence between screen time and later increased anxiety is not evidence that screen time causes the anxiety. It may be that initially anxious people use social media to alleviate their anxiety, and this usage just makes them worse 3 . Moreover, many other factors could have contributed to the increased anxiety in adolescents who used social media a lot. As we shall see, for such heavy users, removing access to social media produces anxiety 3,4 . We also need to be careful about the type of activity that such screen time represents – as another recent study has demonstrated, educational screen time does not seem to be as harmful as social media screen time 5 . The latter also appears to have negative effects on the integrity and connectivity of brain structure, when compared to reading traditional printed material6.

The idea that anxious people tend to gravitate to social media as a form of escape from their worries has some evidence to support it – certainly, the withdrawal effects from social media appear to suggest that it serves such a ‘sedative’ function 4 . However, recent research has suggested that once on social media, whatever the stresses that motivated entry into the alternative digital world, these may be replaced by other stresses, which simply fuel the anxiety 3 . For example, individuals with Generalised Anxiety Disorder tend to make upward comparisons – comparing themselves unfavourably with others – this makes them even more anxious than before 3 .

The nature of social media makes such social comparisons highly likely. The usage of ‘likes’, and ‘followers’ (even ‘reads’ – if you are an academic posting on Research Gate or even Psychology Today !), is set up to drive such comparisons, with the clocking up of these numbers serving as a powerful reinforcer 7 . Thus, the anxious individual leaves their digital platform with new anxieties, which may simply make them more susceptible to the negative effects of life stresses in the next inter-digital period, and drive them back to the social media platform in a futile attempt to relieve these anxieties. Coupled with the effects of withdrawal in very heavy users, which also tend to increase anxiety 4,8 , this all acts as a powerful driver for more and more use.

Very concerningly, such highly anxious individuals, on their return to social media, apparently show an increased tendency to engage in alcohol consumption when posting 3 . This alcohol consumption will also increase anxieties and depression in the longer term. Such unhealthy behaviours have already been noted in heavy internet users 9 , in addition to poor mental health, and these will promote poor physical health, which has been associated with heavy internet use 10 . These negative effects on the individual will also cause more internet-use driving anxiety, and drinking will tend to produce unfortunate and inappropriate behaviours online.

All of the above maps a very depressing picture of social media as an anxiety and depression driving platform – indeed, it might be suggested that social media is a platform that thrives (depends?) on the production of anxiety and depression. This would not be the first time that an activity, mainly, or in part, depends on its negative consequences for continued usage – think of cigarettes (or, indeed, any addictive substance, for that matter).

There is a further anxiety-driving process that fuels social media use for the digital addict – often termed the ‘ fear of missing out’ or FOMO 7 . In general terms, FOMO is an anxiety about being disconnected from digital resources, like social media. It might happen if you are in a remote area without a signal, or, in extreme cases, when you are trapped in a real ‘face to face’ situation, and you cannot get your device out for a few minutes!

In a recent article, the authors even suggest that FOMO can happen when: “ …..people have multiple devices and social media accounts and have little time or desire to check them all…. FOMO can also happen when people get frustrated by others not responding. ” 7 . This fear produces a need to digitally reconnect, and the cycle starts again. It is not known whether individuals with Generalised Anxiety Disorder experience FOMO more than others – but it seems probable.

It also turns out that FOMO may have several sub-categories, linked to the particular uses by which individuals set their greatest store 7 . These types of FOMO include: missing out on popularity; missing out on information; missing out on social group interactions; and missing out on the chance to prevent negative comments about the self by others. All of which will drive anxieties that may also exist in the real world, apart from social media. Thus, being digitally disconnected, quite apart from the effects of withdrawal, and the effects of day-to-day life stresses, will produce FOMO. None of this looks like a good advert for the use of social media.

It is important to note that not everybody will experience these effects, and they may be more prevalent for those with anxiety disorders 3 – but that could be around 20% of the population. It may also be that some people use social media, not as a palliative escape from everyday troubles, but as a means of generating excitement in an otherwise dull life 11 . These people may not experience the same anxiety-producing withdrawal effects, but they may well experience the anxieties associated with social comparison and FOMO, meaning that they are not immune from increases in anxiety-related problems.

In summary, several recent articles have suggested that social media use is associated with anxiety and this anxiety comes in many forms – all of which are problematic for the person’s wellbeing. More than this association, it seems that social media, at least in part, feeds off the anxieties that it generates – subverting the social and psychological tendencies, that most of us have, to fuel its usage. As more and more governmental effort is placed into digitising the world, in an attempt to drive the economy, we do need to question whether there may be unavoidable collateral mental and physical health damage produced by such a drive.

1. Boers, E., Afzali, M. H., & Conrod, P. (2019). Temporal Associations of Screen Time and Anxiety Symptoms Among Adolescents. The Canadian Journal of Psychiatry.

2. Keles, B., McCrae, N., & Grealish, A. (2019). A systematic review: the influence of social media on depression, anxiety and psychological distress in adolescents. International Journal of Adolescence and Youth, 1-15.

3. Bonnette A, Robinson A, Dailey S, et al. (2019). Upward social comparisons and posting under the influence: Investigating social media behaviors of US adults with generalized anxiety disorder. Spotlight on Research, pp. 1-25..

4. Reed, P., Romano, M., Re, F., Roaro, A., Osborne, L. A., Viganò, C., & Truzoli, R. (2017). Differential physiological changes following internet exposure in higher and lower problematic internet users. PloS one, 12(5).

5. Sanders, T., Parker, P. D., del Pozo-Cruz, B., Noetel, M., & Lonsdale, C. (2019). Type of screen time moderates effects on outcomes in 4013 children: evidence from the Longitudinal Study of Australian Children. International Journal of Behavioral Nutrition and Physical Activity, 16(1), 117.

6. Hutton, J. S., Dudley, J., Horowitz-Kraus, T., DeWitt, T., & Holland, S. K. (2020). Associations between screen-based media use and brain white matter integrity in preschool-aged children. JAMA Pediatrics, 174(1), e193869-e193869.

7. Ali, R., McAlaney, J., & Alutaybi, A. (29.1.20). Redesigning social media platforms to reduce ‘FoMO’. The Conversation. https://theconversation.com/redesigning-social-media-platforms-to-reduc…

8. Romano, M., Roaro, A., Re, F., Osborne, L. A., Truzoli, R., & Reed, P. (2017). Problematic internet users' skin conductance and anxiety increase after exposure to the internet. Addictive Behaviors, 75, 70-74.

9. Bibbey, A., Phillips, A. C., Ginty, A. T., & Carroll, D. (2015). Problematic Internet use, excessive alcohol consumption, their comorbidity and cardiovascular and cortisol reactions to acute psychological stress in a student population. Journal of Behavioral Addictions, 4(2), 44-52.

10. Reed, P., Vile, R., Osborne, L. A., Romano, M., & Truzoli, R. (2015). Problematic internet usage and immune function. PloS one, 10(8).

11. Stockdale, L. A., & Coyne, S. M. (2020). Bored and online: Reasons for using social media, problematic social networking site use, and behavioral outcomes across the transition from adolescence to emerging adulthood. Journal of Adolescence, 79, 173-183.

Phil Reed, Ph.D., is a professor of psychology at Swansea University.

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Does social media use cause depression.

How heavy Instagram and Facebook use may be affecting kids negatively

Writer: Caroline Miller

Clinical Experts: Jerry Bubrick, PhD , Alexandra Hamlet, PsyD

What You'll Learn

• What do we know about the connection between social media use and depression?
• How can using social media affect kids negatively?
• How can parents help kids build healthy social media habits?

Studies show that depression among teenagers and young adults has gotten more common over the past decade. Social media use has also increased during the same time. It’s hard to say for sure that social media causes depression. Still, there are several ways that using social media could harm kids.

Some experts think that connecting with peers online is less emotionally fulfilling than connecting in person. Research shows that teenagers who spend more time on social media also feel more isolated. It could be that kids who already feel isolated use social media more. But it could be that using social media actually makes kids feel isolated.

Another theory is that social media is bad for teenagers’ self-esteem. Seeing lots of perfect pictures online might make kids (especially girls) view themselves negatively. Feeling bad about themselves can lead to depression.

Social media can also cut into the time that kids spend on activities that make them feel good, like exercise and hobbies. Additionally, it can distract from important tasks like homework. Having to juggle those responsibilities can increase kids’ stress. Studies also suggest that using social media at night interferes with restful sleep for many teenagers.

It’s important for parents to check in with kids about their social media use and help them develop healthy habits. You can encourage kids to turn off notifications, spend plenty of time on offline activities that make them feel good, and put phones away before bedtime. You can also set a good example by modeling balance in your own use of social media.

Finally, be sure to keep an eye out for signs of depression and get professional help if you’re worried. It’s especially important to check on kids who are under a lot of stress.

Is using social media making our kids unhappy? Evidence is mounting that there is a link between social media and depression . In several studies, teenage and young adult users who spend the most time on Instagram, Facebook and other platforms were shown to have a substantially (from 13 to 66 percent) higher rate of reported depression than those who spent the least time.

Does that mean that Instagram and TikTok are actually causing depression? These studies show a correlation, not causation. But it’s worth a serious look at how social media could be affecting teenagers and young adults negatively.

One reason the correlation seems more than coincidental is that an increase in depression occurred in tandem with the rise in smartphone use .

A 2017 study of over half a million eighth through 12th graders found that the number exhibiting high levels of depressive symptoms increased by 33 percent between 2010 and 2015. In the same period, the suicide rate for girls in that age group increased by 65 percent.

Smartphones were introduced in 2007, and by 2015 fully 92 percent of teens and young adults owned a smartphone . The rise in depressive symptoms correlates with smartphone adoption during that period, even when matched year by year, observes the study’s lead author, San Diego State University psychologist Jean Twenge, PhD.

Over that same time period there was a sharp spike in reports of students seeking help at college and university counseling centers, principally for depression and anxiety. Visits jumped 30 percent between 2010 and 2015 , and they’ve continued to rise since the pandemic.

Social media and depression

One of the biggest differences in the lives of current teenagers and young adults, compared to earlier generations, is that they spend much less time connecting with their peers in person and more time connecting electronically, principally through social media.

Some experts see the rise in depression as evidence that the connections social media users form electronically are less emotionally satisfying, leaving them feeling socially isolated.

“The less you are connected with human beings in a deep, empathic way, the less you’re really getting the benefits of a social interaction,” points out Alexandra Hamlet, PsyD, a clinical psychologist. “The more superficial it is, the less likely it’s going to cause you to feel connected, which is something we all need.”

Indeed, one exception to the depression correlation is girls who are high users of social media but also keep up a high level of face-to-face social interaction. The Twenge study showed that those girls who interact intensely offline as well as through social media don’t show the increase in depressive symptoms that those who interact less in person do.

And there are some teenagers who aren’t successful in connecting with peers offline, because they are isolated geographically or don’t feel accepted in their schools and local communities. For those kids, electronic connection can be lifesaving.

Social media and perceived isolation

Another study of a national sample of young adults (age 19-32) showed correlation between the time spent on social media and perceived social isolation (PSI). The authors noted that directionality can’t be determined. That is, “Do people feeling socially isolated spend more time on social media, or do more intense users develop PSI?”

If it’s the latter, they noted, “Is it because the individual is spending less time on more authentic social experiences that would decrease PSI? Or is it the nature of observing highly curated social feeds that they make you feel more excluded?”

Which brings us what we now call FOMO, or fear of missing out.

Jerry Bubrick , PhD, a clinical psychologist at the Child Mind Institute, observes that “FOMO is really the fear of not being connected to our social world, and that need to feel connected sometimes trumps whatever’s going on in the actual situation we’re in. The more we use social media, the less we think about being present in the moment.”

Instead we might be occupied with worrying why we weren’t invited to a party we’re seeing on Instagram, or making sure we don’t miss a single post from a friend. But if we’re always playing catch-up to endless online updates, we’re prioritizing social interactions that aren’t as emotionally rewarding and can actually make us feel more isolated.

Social media and self-esteem

Another theory about the increase in depression is the loss of self-esteem , especially in teenage girls, when they c ompare themselves negatively with artfully curated images of those who appear to be prettier, thinner, more popular and richer.

“Many girls are bombarded with their friends posting the most perfect pictures of themselves, or they’re following celebrities and influencers who do a lot of Photoshopping and have makeup and hair teams,” explains Dr. Hamlet. “If that’s their model for what is normal, it can be very hard on their self-confidence.”

Indeed, image-driven Instagram shows up in surveys as the platform that most leads young people to report feeling anxiety, depression and worries about body image.

Curation of a perfect image may not only make others feel inadequate, it’s unhealthy even for those who appear to be successful at it, notes Dr. Bubrick. “Kids spend so much time on social media trying to post what they think the world will think is a perfect life. Look at how happy I am! Look how beautiful I am! Without that they’re worried that their friends won’t accept them. They’re afraid of being rejected.” And if they are getting positive feedback from their social media accounts, they might worry that what their friends like isn’t the “real” them.

Less healthy activity

Another possible source of depression may be what teenagers are not doing during while they’re spending time on social media, including physical activity and things that generate a sense of accomplishment, like learning new skills and developing talents.

“If you’re spending a lot of time on your phone, you have less time for activities that can build confidence, a sense of achievement and connectedness,” explains Dr. Hamlet.

Kids who are spending a lot of time on devices are not getting much in return to make them feel good about themselves, she adds. “Yes, you get a little dopamine burst whenever you get a notification, or a like on a picture, or a follow request. But those things are addicting without being satisfying.”

Disrupted concentration

Another thing disrupted by social media is the process of doing homework and other tasks that require concentration. It’s become common for teenagers to engage with friends on social media at the same time they are studying. They take pride in being able to multi-task, but evidence shows that it cuts down on learning and performance.

“Basically, multitasking isn’t possible,” Dr. Hamlet notes. “What you end up doing is really just switching back and forth between two tasks rather quickly. There is a cost to the brain.” And with poorer concentration and constant interruption, homework takes substantially longer than it should, cutting into free time and adding to stress.

Sleep deprivation and depression

Some of the ways in which social media use impacts mood may be indirect. For instance, one of the most common contributors to depression in teenagers is sleep deprivation , which can be caused, or exacerbated, by social media.

Research shows that 60 percent of adolescents are looking at their phones in the last hour before sleep, and that they get on average an hour less sleep than their peers who don’t use their phones before bed. Blue light from electronic screens interferes with falling asleep ; on top of that, checking social media is not necessarily a relaxing or sleep-inducing activity. Scrolling on social media, notes Dr. Hamlet, can easily end up causing stress.

“Social media can have a profound effect on sleep,” adds Dr. Bubrick. “You have the intention to check Instagram or watch TikTok videos for 5 minutes, and the next thing you know 50 minutes are gone. You’re an hour behind in sleep, and more tired the next day. You find it harder to focus. You’re off your game, and it spirals from there .”

How to minimize negative effects of social media use

While we don’t yet have conclusive evidence that social media use actually causes depression, we do have plenty of warning signs that it may be affecting our kids negatively. So it’s smart for parents to check in regularly with kids about their social media use, to make sure it’s positive and healthy, and guide them towards ways to change it , if you think it’s not.

Also, be alert for symptoms of depression .  If you notice signs that your child might be depressed, take them seriously. Ask your child how they are doing, and don’t hesitate to set up an appointment with a mental health provider .

Steps you can take to ensure healthy social media use:

• Focus on balance: Make sure your kids are also engaging in social interaction offline, and have time for activities that help build identity and self-confidence.
• Turn off notifications: App developers are getting more and more aggressive with notifications to lure users to interrupt whatever they’re doing to engage constantly with their phones. Don’t let them.
• Look out for girls at higher risk of depression: Monitor girls who are going through a particularly tough time or are under unusual stress. Negative effects of social media can have more impact when confidence is down.
• Teach mindful use of social media : Encourage teenagers to be honest with themselves about how time spent on social media makes them feel, and disengage from interactions that increase stress or unhappiness.
• Model restraint and balance in your own media diet: Set an example by disengaging from media to spend quality family time together, including phone-free dinners and other activities. Kids may resist, but they’ll feel the benefits.
• Phone-free time before sleep: Enforce a policy of no smartphones in the bedroom after a specific time and overnight. Use an old-fashioned alarm clock to wake up.

Frequently Asked Questions

Social media has been shown to be correlated with anxiety and depression. This correlation could have to do with teens connecting more online rather than in person, leaving them feeling socially isolated. Teens are also looking at carefully curated images online, which may cause anxiety, low self-esteem, and body image issues.

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• Open access
• Published: 01 February 2024

Depression and anxiety and its association with problematic social media use in the MENA region: a systematic review

• Samira Abbouyi   ORCID: orcid.org/0000-0003-1938-0261 1 ,
• Samira Bouazza 1 ,
• Soukaina El Kinany 2 ,
• Karima El Rhazi 1 &
• Btissame Zarrouq 1 , 3  

The Egyptian Journal of Neurology, Psychiatry and Neurosurgery volume  60 , Article number:  15 ( 2024 ) Cite this article

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The use of the social media has increased significantly in recent decades, and research on the impact of problematic social media use on mental health is a relatively new and growing area of study in the Middle East and North Africa (MENA) region. Social media users are prone to developing addictive behaviors and suffering from mental illness, including depression and anxiety. The present paper aims to systematically review the available research examining the association between problematic social media use (PSMU) and depression and anxiety symptoms that was done in the Middle East and North Africa region (MENA region).

The academic databases Web of Science, PubMed, ScienceDirect, and Cochrane were used to conduct a literature search. Problematic social media use and the MENA region and their synonyms were main keywords in the Boolean search strategy. We selected articles based on the following criteria: (i) addressed the relationship between problematic social media use and depression and anxiety; (ii) MENA region population-based studies; and (iii) published in English. There were no age, gender, or educational status restrictions, and there was no time limit for this review. The literature search was conducted in December 2021.

The selection criteria led to the retention of 15 articles. The findings of the systematic review demonstrated that most of these studies have found a significant association between problematic social media use and depression and anxiety symptoms. Some studies showed stress, generalized trust, perceived social support, fear of COVID-19, and misunderstanding of COVID-19 mediating the relationship between social media use and depressive and anxiety symptoms.

Conclusions

While there is evidence that there is a relationship between PSMU and anxiety and depressive symptoms, longitudinal studies are needed to confirm this relationship.

Introduction

The use of the internet has increased significantly in recent decades. According to the International Telecommunication Union, there are over 5 billion internet users worldwide [ 1 ]. Social networking sites (SNS) are the most popular online platforms among young people [ 2 ]. Their widespread availability, whether via smartphone, tablet, or computer, has captivated billions of users worldwide, with many using SNS for large portions of their daily lives [ 3 ].

Research investigating the nexus between SNS use and health is a relatively new area of study, and there is currently no consensus among researchers on the definition of problematic SNS use [ 4 ]. This phenomenon has been conceptually defined as a non-substance-related disorder, sharing characteristics associated with behavioral addiction [ 5 ]. According to Andreassen and Pallesen [ 6 ], SNS addiction is defined as an excessive concern regarding social networking sites, driven by a strong motivation to log in or use these platforms excessively. This behavior involves dedicating an extensive amount of time and effort to social networking sites, resulting in impairment of other social activities, educational and/or occupational pursuits, interpersonal relationships, as well as psychological health and well-being. Notably, several psychometric scales have been developed to assess the determinants of social media use and obtain the prevalence rate, such as the Bergen Social Media Addiction Scale (BSMAS) [ 7 ], and the Arabic Social Media Addiction Scale (ASMAS) [ 8 ]. SNS use has complex links to mental health. SNS is tied to benefits such as reduced loneliness, enhanced social connectivity [ 9 ], seamless communication [ 10 ], increased life satisfaction [ 9 ], and decreased depressive symptoms [ 4 ]. However, its impact on academic performance varies, showing positive outcomes in educational use [ 11 ] but negative implications in recreational use, potentially leading to academic failures [ 12 ]. Despite the positives, adverse effects like relational issues and mental disorders have been reported [ 13 ]. Divergent findings on addictive behaviors and mental health problems underline the intricacy of this relationship [ 14 ].

Depression is a common mental disorder marked by sadness, low self-esteem, and a loss of pleasure or interest in performing activities [ 15 ]. Currently, research on the potential impact of PSMU on depression is expanding, with conflicting findings [ 16 ]; some studies have discovered an inverse relationship. Social media, for example, can provide social support and improve life satisfaction, resulting in fewer depressive symptoms [ 4 , 14 ]. Many studies, conversely, have found that PSMU is associated with depressive symptoms in university students [ 4 ] and adolescents [ 17 ]. Similar to depression, the influence of social media on anxiety is also a subject of debate. PSMU is significantly associated with anxiety among adolescents [ 17 ], and using multiple platforms correlates with higher anxiety levels [ 18 ]. Excessive time on social media, especially among youth, is linked to more severe anxiety symptoms [ 19 ]. University students' anxiety levels are positively associated with time spent on social media [ 20 ]. Additionally, Facebook addiction is associated with anxiety in high school [ 21 ] and university students [ 22 ].

The ongoing debate in the literature explores the dual nature of Social Networking Sites (SNS) and their potential impact on mental health. Despite extensive research efforts, significant gaps persist. Nuances such as individual differences, platform-specific usage patterns, and the dynamic nature of social media platforms remain underexplored. Methodological heterogeneity poses a challenge, ranging from disparate study designs to variations in measurement tools. Furthermore, regional differences underscore the need for a nuanced perspective, with cultural and demographic variations influencing outcomes. Recognizing these limitations, our study strategically centers its focus on the Middle East and North Africa (MENA) region. While the global discourse on this subject is rich and diverse, the decision to scrutinize the MENA region stems from its unique socio-cultural landscape. This region is characterized by distinct cultural norms, geopolitical dynamics, and demographic compositions, which can significantly influence the interplay between social media use and mental health outcomes.

To the best of our knowledge, previous systematic reviews have focused on SNS use and mental health symptoms in various countries without taking the MENA region into account. Hence, we aim throughout this paper to conduct a systematic review of the available research on PSMU and depression and anxiety symptoms in the Middle East and North Africa (MENA) region. The specific objectives of this review are to: (i) identify and evaluate studies performed on the correlation between PSMU and depressive and anxiety symptoms; (ii) determine the geographical distribution of these studies and delve into the characteristics of the study participants; (iii) explore what measurement tools have been used to assess problematic social media use and depressive and anxiety symptoms; (iv) explore the prevalence and risk factors of social media use; and (v) search for the mediators of this relationship.

Research questions

The research aims to answer these questions: (1) what is the prevalence of problematic social media use (PSMU) in the MENA region? (2) How are PSMU and mental health outcomes (specifically anxiety and depression) correlated in the context of the MENA region? (3) What factors mediate the relationship between PSMU and depressive and anxiety symptoms in this region? (4) How effective are the methodologies employed in existing studies investigating PSMU and depressive and anxiety symptoms in the MENA region? (5) What gaps exist in the current literature regarding PSMU and mental health in the MENA region?

Search strategy

The search for the literature followed a systematic and structured approach adopting the PRISMA guidelines for systematic reviews and meta-analysis [ 23 ]. The literature search was conducted in December 2021 in four databases Web of Science, PubMed, ScienceDirect, and Cochrane. The protocol has been registered at the International Prospective Register of Systematic Reviews (PROSPERO) under the registration number: CRD42022266119.

The Boolean search method was used, with keywords linked together using AND, OR, and NOT. The following keywords are associated with problematic social media use and the MENA region. The search equation used was as follows: ("social media addiction" OR "social media dependence" OR "problematic social media use" OR "social media disorder" OR "pathological social networks sites use" OR "social network sites addiction" OR "social network sites dependence" OR "problematic social network sites use" OR "facebook addiction" OR "facebook dependence" OR "excessive facebook use" OR "problematic facebook use" OR "compulsive facebook use") AND (Algeria OR algerian OR "Saudi Arabia" OR saudi OR Palestine OR palestinian OR Bahrain OR bahraini OR Djibouti OR djiboutian OR Ethiopia OR ethiopian OR "United Arab Emirates" OR emarati OR Egypt OR egyptian OR Qatar OR qatari OR Iraq OR iraqi OR Israel OR israeli OR iran OR iranian OR persian OR Jordan OR jordanian OR Kuwait OR kuwaiti OR Lebanon OR lebanese OR Libya OR libyan OR Morocco OR moroccan OR Mauritania OR mauritanian OR Oman OR omani OR Syria OR syrian OR Sudan OR sudanese OR Tunisia OR tunisian OR Yemen OR yemenite OR MENA OR "middle east" OR "north africa" OR "arab world").

After completing the electronic database search, we assessed the titles and abstracts of the identified articles to determine their suitability for inclusion in the review.

Inclusion and exclusion criteria

We only included studies that addressed the relationship between problematic social media use and mental health, specifically depression and anxiety. We also selected articles based on the following criteria: (1) quantitative observational studies (cross-sectional, case–control, and cohort studies); (2) studies conducted solely within the MENA region were included, while those conducted outside this region, even if involving MENA populations, were excluded; and (3) English-language publication of a full-text article. On the other hand, qualitative and experimental studies were excluded. There were no age, gender, or educational status restrictions, and there was no time limit for this review.

Data extraction

Data extraction for eligible studies was conducted and verified independently by two authors (SA and SB) using a standard form on Microsoft Excel. Relevant details were extracted from each study, included study design, publication date, study authors, country of the study, sample size, measurement tools used, and demographic data of the study population, the scores and duration of social media use, as well as anxiety and depression scores. Discrepancies in the extracted data were resolved through discussion with another independent author (BZ).

Quality assessment

The quality of included studies was determined using the National Institute of Health Quality Assessment Tool for Observational Cohort and Cross-sectional Studies [ 24 ]. This assessment covered participants' selection, data collection, confounding variables, and exposure and outcome variables. Two authors independently rated study quality and differences in ratings were resolved via discussion between the two authors and a third author where necessary. The quality of each study was rated as 0 for poor (0–4 out of 14 questions), i for fair (5–10 out of 14 questions), or ii for good (11–14 out of 14 questions), after answering a series of 14 questions. No studies were excluded based on their quality assessments.

Data analysis and publication bias

The size of the correlation effect was determined by correlation coefficient r . The statistical heterogeneity was examined using the I -squared test ( I 2 ) and the Cochrane Q test [ 25 ], with Q reported as a measure of heterogeneity (with p value < 0.05 indicating a high level of heterogeneity) and I 2 used to measure the proportion of total variability due to between-study heterogeneity [ 26 ]. Based on the Cochrane guidelines, I 2 values represented moderate (30–60%), substantial (50–90%), and considerable (75–100%) heterogeneity [ 27 ]. The publication bias was assessed by visual examination inspection of the funnel plot and by conducting Egger’s and Begg’s tests [ 28 ]. Publication bias was declared if the funnel plot was asymmetrical or if the result of Egger’s and Begg’s tests was statistically significant ( p  < 0.05) [ 28 , 29 ]. All statistical analyses were performed using Comprehensive Meta-Analysis Software version 4 (CMA 4.0).

The search strategy identified 1710 published (Fig.  1 ). After removing the duplicates, 957 papers remained. These papers were then screened based on the titles and abstracts to determine whether they met the inclusion criteria, resulting in 46 relevant studies. At this stage, the full texts of these studies were screened to confirm whether the inclusion and exclusion criteria were met, resulting in 31 studies being excluded. The remaining 15 studies were included.

PRISMA flow diagram illustrating the screening process of papers

Table 1 shows the results of the 14-item checklist criteria used to evaluate the selected research. The objectives, variables, and measures were all clearly described in each study. After calculating the quality assessment ratings, most studies were of fair quality.

Sample characteristics

A total of 15 studies met the inclusion criteria, belonged to several different countries across the MENA region: five studies were conducted in Iran, four were conducted in Lebanon, Tunisia ( n  = 2), Morocco ( n  = 1), Jordan ( n  = 1), Palestinian territory ( n  = 1) and the United Arab Emirate ( n  = 1). The studies were published between 2016 and 2021.

The number of participants in each study ranged from 105 to 2676. Their average age ranged from 15.23 to 36.57 years. Most studies were conducted on adults, whereas four studies concentrated solely on adolescents (aged 12–19 years). The majority of studies had gender-mixed samples; however, one study focused solely on women (Table  2 ).

PSMU measurement tools

PSMU was measured variously across studies. Most studies ( n  = 12/15) assessed problematic social media use in its entirety, with three studies focusing specifically on problematic Facebook use. All studies used self-report scales to determine the level of social media addiction. The Bergen Facebook Addiction Scale (BFAS) was the most commonly used measure to assess problematic Facebook use. A modified version of the Bergen Facebook Addiction Scale (Bergen Social Media Addiction Scale—BSMAS) was often used to assess problematic social media use by replacing the word Facebook with social media (Table  3 ).

Prevalence and risk factors of social media usage

Only three studies [ 7 , 35 , 36 ] reported the prevalence of social media addiction, with an estimated prevalence varied between 22.4 and 23.7 percent. Therefore, the impact of socio-demographic factors on the prevalence of PSMU is unclear. Two studies provided gender differences data on SNS [ 7 , 43 ], and the highest prevalence of social media addiction was found among males in Chung-Ying Lin et al. [ 7 ]. The results of Nadine Zeeni et al. [ 43 ] on the association between gender and PSMU were not significant nor mentioned in other studies included in the current systematic review. Regarding marital status, one study [ 35 ] found that single people had a higher PSMU score than married people (8.94 vs. 6.26, p  < 0.001). The number of children ( B  = 2.41) was significantly related to higher PSMU in the same study, whereas older age and higher alcohol dependence were significantly related to lower PSMU [ 35 ]. Three studies indicated an association between social media addiction and time spent on social media or frequency of visits to social media (0.286 <  r  < 0.583) [ 7 , 35 , 37 ].

Problematic social media use and depressive symptoms

Most studies ( n  = 13/15) focused on symptoms of depression as measured by a variety of psychometric scales, including the Hospital Anxiety and Depression Scale (HADS), the Hamilton Depression Rating Scale (HDRS), and the Depression Anxiety Stress Scale (DASS).

Significant associations between problematic social media use and depressive symptoms (0.129 <  r  < 0.45) were observed in eleven of these studies [ 7 , 30 , 31 , 32 , 35 , 36 , 37 , 38 , 39 , 41 , 42 ]. The two remaining studies found negative associations between problematic social media use and depressive symptoms [ 34 , 43 ].

Problematic social media use and anxiety symptoms

Most studies ( n  = 13/15) focused on anxiety symptoms which were examined by a variety of measures, such as the Hospital Anxiety and Depression Scale (HADS), the Hamilton Depression Rating Scale (HDRS), the Hamilton Anxiety Scale (HAM-A), the Depression Anxiety Stress Scale (DASS), and the Beck Anxiety Inventory. Significant associations between problematic social media use and anxiety symptoms (0.167 <  r  < 0.385) were observed in ten of these studies [ 7 , 30 , 31 , 32 , 34 , 35 , 36 , 39 , 40 , 41 ]. The three remaining studies reported negative associations between problematic social media use and anxiety symptoms [ 33 , 38 , 43 ].

Mediating factors in the relationship between PSMU and depression and anxiety

Unpacking the intricate web of mediating factors within the relationship between problematic social media use (PSMU) and mental health outcomes reveals a nuanced landscape. Stress emerges as a central player in this dynamic in the study by Malaeb et al. (2020). The incessant exposure to stressors, whether originating from the online realm or external pressures, propels individuals towards social media as a coping mechanism. However, this refuge can morph into a source of additional stress, as the digital sphere becomes a breeding ground for social comparison and information overload, ultimately amplifying anxiety and depressive symptoms. Beyond stress, Lin et al. (2021) found an indirect effect between problematic social media use and depressive and anxiety symptoms, through generalized trust and perceived social support. Excessive use of social media can erode the overall trust in online interactions and impact how individuals perceive the support they receive from their online connections. This complex interplay creates a pathway through which problematic social media use contributes to mental health challenges. Moreover, fear of COVID-19 and COVID-19 misunderstanding emerges as a significant mediating this relationship [ 31 ]. In times of uncertainty, individuals turn to social media platforms for information and connection. However, the implications are dual-fold, with the quality and quantity of pandemic-related information on social media influencing anxiety and depression levels. Moreover, the role of COVID-19 misunderstanding as a mediating factor introduces a unique dimension to the discourse. Misinterpretation of information gleaned from social media may contribute to distorted perceptions, adding an additional layer of anxiety and depression.

Heterogeneity measures

A random-effects analysis of 15 studies ( n  = 12,252) showed a moderately statistically significant positive correlation between PSMU and depression and anxiety symptoms ( r  = 0.212; 95% confidence interval: [0.146, 0.276]; p  < 0.001). High heterogeneity existed in our results ( I 2  = 95.751%, p  < 0.001; Q  = 494.206, df  = 21, p  < 0.001) (Fig.  2 ).

Forest plot of correlation for association between PSMU and depression and anxiety symptoms

Contributing factors to heterogeneity

The substantial heterogeneity observed in our analysis ( I 2  = 95.751%, p  < 0.001) necessitates a thorough exploration of potential contributing factors. Methodological dissimilarities among the studies are evident, including variations in inclusion criteria. This methodological heterogeneity could potentially account for the observed diversity in study designs. Additionally, the populations under investigation exhibit notable heterogeneity in demographic characteristics. The nuanced interplay of these diverse factors across studies may well be a major source of the observed heterogeneity. Furthermore, the utilization of a spectrum of instruments for the assessment of social media addiction and mental health outcomes may contribute to the observed variability.

Publication bias

The publication bias was assessed using funnel plot visualization and more objectively by Egger’s and Begg’s tests. The funnel plot showed a symmetrical distribution that indicated no evidence of publication bias (Fig.  3 ). This was supported by the results of Egger’s and Begg’s tests, which indicated no evidence of publication bias, (Egger, p  = 0.81; Begg, p  = 0.55).

Funnel plot of correlation for association between PSMU and depression and anxiety

Prevalence of PSMU

In examining the prevalence of problematic social media use (PSMU) within the Middle East and North Africa (MENA) region, our systematic review encountered a notable scarcity of reported prevalence data. Out of the 15 studies included, only three provided explicit figures on PSMU prevalence. These findings revealed a prevalence range between 22.4 and 23.7% [ 7 , 35 , 36 ] within the MENA region. Comparing these figures to a broader global context, our review aligns with meta-analytic insights derived from 495 articles across 64 countries [ 47 ]. In this larger context, the estimated prevalence of PSMU in upper-middle income regions mirrored our findings, standing at 21.26%. Intriguingly, the meta-analysis exposed substantial variations in PSMU prevalence across different global regions. For instance, South-East Asia exhibited a notably higher prevalence at 59.36%, while lower-middle income regions reported a prevalence of 63.83%. In contrast, high-income regions showed a relatively lower prevalence of 16.12%, and the Americas demonstrated the lowest prevalence at 11.66% [ 47 ].

PSMU and mental health

Emerging research on the correlation between problematic social media use (PSMU) and mental health issues, particularly within MENA countries, has spurred the present systematic review. In our investigation, we delved into 15 studies meeting the predefined inclusion criteria, aiming to unravel the associations between social media use and symptoms of depression and anxiety. Of the 15 studies, there was a positive association between PSMU and anxiety (in 10 studies), and depression (in 11 studies), as evidenced by various global studies [ 4 , 18 , 19 , 20 , 21 , 22 , 48 , 49 ]. Notably, the observed relationship generally exhibited small-to-medium bivariate effect sizes, ranging from 0.129 to 0.45 in depression studies and ranging from 0.167 to 0.385 in anxiety studies. However, it is crucial to approach these findings with caution, considering the small-to-medium effect sizes and the overall fair to poor quality of the included studies. A more nuanced analysis of effect sizes across various study contexts unveils intriguing insights. Specifically, studies conducted in high-stress environments, such as academic settings, consistently demonstrated higher effect sizes [ 39 , 41 , 42 ]. This suggests a potential amplification of the association between PSMU and depressive and anxiety symptoms under stress-inducing conditions. This observation aligns with the findings of Malaeb et al.'s (2020) study, which emphasizes stress as a mediator in the relationship between PSMU and depressive and anxiety symptoms.

The association between PSMU and depression may be explicable by the neglect of essential life aspects among individuals engrossed in excessive social media use. The significant increase in time spent on Social Networking Sites (SNS) may lead to reduced face-to-face social interactions, disrupted sleep patterns, and diminished physical activity [ 50 ], all contributing to the manifestation of depressive symptoms. Despite enabling easy interaction with a broader audience, online relations through SNS are considered of lesser quality than everyday face-to-face communication and are associated with a higher level of loneliness [ 51 ]. Additionally, increased PSMU may influence how individuals perceive their online experiences, engaging in self-comparison with the idealized images of others, resulting in a negative self-image and depression [ 52 ]. Several hypotheses have been proposed to explain the effect of SNS use on anxiety symptoms. Over-reliance on social networking sites, for instance, has been associated with decreased creativity [ 53 ] and underestimation of intellectual ability [ 54 ]. Excessive SNS use is also time-consuming since it deprives people of ordinary group experiences with their peers, turning them into lonely, isolated, and anxious individuals [ 55 ]. Furthermore, some research suggests that people who suffer from anxiety prefer online communication because they have difficulty communicating face-to-face [ 52 ].

In the MENA region, social media usage is intricately woven into the cultural fabric, where family bonds and cultural expectations play a pivotal role. The emphasis on family unity not only shapes individuals' online narratives, but also fosters a trend of presenting positive aspects to strengthen familial ties. Cultural norms, particularly those of modesty, further influence the digital landscape, creating an environment ripe for social comparisons and potential impacts on self-esteem. Moreover, the region's cultural nuances introduce unique considerations for online interactions, as users navigate the delicate balance between preserving cultural dignity and expressing their individuality. For the MENA diaspora, social media serves as a vital bridge for maintaining connections with family and cultural roots, accompanied by the challenge of harmonizing these online relationships with the imperative of local integration. This intricate interplay of family dynamics, cultural norms, and the dual nature of online connections adds layers of complexity to the relationship between social media use and mental health in the MENA region.

Another possible psychopathology in the relationship between PSMU and psychological distress, according to Elhai et al. [ 55 ] was fear of missing out (FOMO). Regularly checking social media, for example, can contribute to FOMO anxiety, which can exacerbate further compulsions to check SNS [ 56 ]. Another study revealed that being assigned to multiple social media platforms simultaneously and attempting to keep up with them all can cause anxiety [ 57 ], which aggravates the fear of missing out and eventually provokes more anxiety.

It is worth noting that the relationship between SNS use and mental health symptoms is not linear, which opens the door to a nuanced exploration of the myriad factors that contribute to this intricate dynamic [ 58 ]. It is crucial to recognize that individuals' experiences with social media are multifaceted, shaped by a complex interplay of psychological, social, and environmental factors. For instance, the nature and content of social media interactions play a pivotal role [ 59 ]. One person, for instance, can spend a significant amount of time each day watching entertaining videos, while another may opt for discussing politics with other users. Both individuals will be assessed in the same way because they spent the same time using the SNS. Admittedly, the way the SNS is administered can have various effects on an individual's life [ 48 ]. Positive and supportive engagements may contribute to enhanced well-being, while negative interactions or exposure to harmful content could have adverse effects [ 60 ]. The quantity and quality of online connections, the purpose and context of social media use, and individual differences in coping mechanisms all add layers of complexity to this relationship [ 16 , 61 ]. Moreover, studies have highlighted the impact of social comparison mechanisms, where individuals may perceive idealized images on social media, leading to feelings of inadequacy or dissatisfaction [ 62 ]. The role of self-esteem, personality traits, and pre-existing mental health conditions also intertwines with social media use, influencing how individuals respond to online experiences [ 63 , 64 ].

Limitations and needs for future research

Overall, the current systematic review highlights several shortfalls in the research on the relationship between SNS use, symptoms of depression, and anxiety. First, recognizing the limitation posed by the cross-sectional nature of the included studies, it is essential to highlight the challenge in establishing clear causal relationships. Cross-sectional designs, offering a snapshot at a specific moment, make it intricate to decipher the directional causality between problematic social media use (PSMU) and mental health outcomes. The associations identified may involve a bidirectional relationship, where mental health influences social media use, and conversely, social media use impacts mental health. For instance, individuals experiencing heightened stress or depressive symptoms may resort to increased social media use as a coping mechanism, while excessive PSMU might contribute to elevated stress levels and depressive symptoms. To delve deeper into this complex interplay and provide more conclusive insights, the necessity of longitudinal research becomes evident. Longitudinal studies, conducted over an extended period, offer a dynamic perspective by tracking changes in PSMU and mental health outcomes over time. This temporal dimension is crucial for unraveling the causal pathways and discerning the temporal sequence of events. For instance, such studies could shed light on whether increased PSMU precedes the onset of mental health issues or if deteriorating mental health leads to heightened social media engagement. This nuanced approach holds the promise of not only enhancing our understanding of the evolving relationship between PSMU and mental health, but also guiding the development of targeted interventions and preventive strategies. Second, while the majority of studies in the review approached problematic social media use (PSMU) from a broad perspective, with only three studies specifically delving into problematic Facebook use, it is imperative to recognize the rich tapestry of social media platforms and their potential distinct impacts on mental health. Each platform comes with its unique set of features, user interactions, and content dynamics, contributing to a diverse landscape of online experiences. For instance, Facebook, with its emphasis on social connections and diverse content sharing, may have distinct implications compared to visually centric platforms like Instagram or short-form content platforms like TikTok. The visual nature of Instagram, revolving around images and curated lifestyles, might foster a different set of social comparisons and identity perceptions. On the other hand, the rapid content consumption on platforms like TikTok may introduce novel challenges in attention and time management.

Exploring these platform-specific nuances is crucial for a comprehensive understanding of the relationship between PSMU and mental health. It allows us to unravel whether the observed associations are uniform across platforms or if certain platforms pose unique challenges or benefits. This insight is not only relevant for academic discourse, but also holds practical implications for tailored interventions and platform-specific guidelines to promote healthier social media use. As we navigate the evolving landscape of social media, such distinctions become pivotal in crafting nuanced strategies for mitigating the potential adverse effects on mental well-being. Finally, it is worth mentioning that only a few countries in the MENA region have investigated the relationship between PSMU and mental health in non-representative samples; henceforth, these findings cannot be generalized to the entire MENA region's population. Cultural nuances, for instance, play a pivotal role in shaping individuals' attitudes towards social media, the perception of mental health, and the expression of psychological distress. Socioeconomic factors, varying widely across the region, can influence access to technology, educational opportunities, and the prevalence of stressors that may intersect with social media use. Regional disparities, whether urban–rural divides or differences between countries, introduce additional layers of complexity.

Recognizing these nuances highlights the need for future research endeavors to adopt a more granular approach. Studies that incorporate representative samples from diverse cultural, socioeconomic, and regional contexts can unravel the intricacies of how PSMU intersects with mental health across different segments of the population. This not only enhances the external validity of the findings but also facilitates the development of targeted interventions that resonate with the unique dynamics of specific subpopulations within the MENA region. As we chart the course for future investigations, embracing this diversity becomes paramount for a more holistic understanding of the interplay between social media use and mental well-being in the MENA context.

This systematic review sheds light on the relationship between PSMU and mental health problems, specifically anxiety and depression. The estimated prevalence of PSMU falls within the range of 22.4 to 23.7%, aligning with global trends. Notably, the observed associations between PSMU and depressive symptoms exhibit effect sizes ranging from 0.129 to 0.45, while the relationship between PSMU and anxiety symptoms shows effect sizes ranging from 0.167 to 0.385. However, it is essential to acknowledge the limitation in establishing clear causality. The cross-sectional nature of the included studies limits our ability to definitively determine the direction of influence. Recognizing this limitation, it becomes imperative to advocate for future research endeavors, especially longitudinal studies, which can unravel the temporal dynamics of the relationship. Understanding whether excessive social media use precedes or follows mental health issues is pivotal for developing targeted interventions and preventive measures. As previously stated, there could be various factors influencing this relationship. How a person uses SNS must be considered to explain its relationship to mental health symptoms. Admittedly, SNS could be used to users' advantage to the greatest extent possible and can even become dangerous if not used consciously. Consequently, it is critical to use such tools wisely. SNS use, thus, necessitates concerted efforts and the implementation of necessary measures to ensure people's mental and physical safety. Individuals should proactively manage their time on social media, setting daily limits and periodically assessing their mental well-being in relation to usage. Diversifying offline activities is encouraged to counterbalance the potential negative impacts. For parents, fostering open communication with their children about social media usage is crucial, along with advocating for digital literacy education in schools. Policymakers are urged to support educational policies that embed digital skills and healthy social media use. Additionally, reinforcing psychological support services in educational institutions can address the growing mental health needs associated with social media use. Educators can contribute by organizing awareness workshops and integrating modules on mental health and responsible social media use into the educational programs. Additionally, interactive workshops for students, parents, and teachers could be developed, covering both the positive and negative impacts of social media. These workshops might involve open discussions, case studies, and simulations to enhance understanding. Concurrently, creating dedicated online resources, such as practical guides and informative videos based on recent research, would be essential. These resources could be easily accessible to educational communities, providing tangible guidance for healthy and mindful social media use.

In conclusion, this systematic review highlights the imperative of addressing the intricate relationship between problematic social media use (PSMU) and mental health challenges, specifically anxiety and depression, prevalent in the MENA region. As we move forward, it is essential to transcend mere acknowledgment of these associations and proactively engage in measures that foster digital literacy and responsible social media use, particularly among the youth. Furthermore, a compelling call to action would be an urging for the regional implementation of these programs, tailored to the specific cultural nuances of the MENA region. By doing so, we lay the groundwork for a digital culture that values mental health, resilience, and flourishing.

Availability of data and materials

All data generated or analyzed during this study are included in this published article.

Abbreviations

Arabic Social Media Addiction Scale

Bergen Facebook Addiction Scale

Bergen Social Media Addiction Scale

Community Assessment of Psychic Experiences

Depression Anxiety Stress Scale

Fear of Missing Out

The Facebook Intensity Scale

Hamilton Anxiety Scale

Hamilton Depression Rating Scale

Hospital Anxiety and Depression Scale

Media and Technology Usage and Attitudes Scale

Middle East and North Africa

Patient health questionnaire-9

Preferred Reporting Items for Systematic Reviews and Meta-Analyses

• Problematic social media use

Questionnaire About General Trouble Anxiety

Social Media Use Disorder Scale

Social Networking Sites

Standard deviations

Symptom checklist-25

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Abbouyi, S., Bouazza, S., El Kinany, S. et al. Depression and anxiety and its association with problematic social media use in the MENA region: a systematic review. Egypt J Neurol Psychiatry Neurosurg 60 , 15 (2024). https://doi.org/10.1186/s41983-024-00793-0

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Social Media Use and Depression in Adolescents: A Scoping Review

Associated data.

The data that support the findings of this study are available from the corresponding author upon reasonable request.

This scoping review aimed to investigate the association between depression and social media use among adolescents. The study analyzed 43 papers using five databases to identify articles published from 2012 to August 2022. The results revealed a connection between social media use and depression, as well as other negative outcomes such as anxiety, poor sleep, low self-esteem, and social and appearance anxiety. Surveys were the most used study strategy, with multiple common scales applied to assess depression, social media use, and other factors such as self-esteem and sleep quality. Among the studies, eight reported that females who use social media showed higher depression symptoms than males. This scoping review provides an overview of the current literature on the relationship between social media use and depression among adolescents. The findings emphasize the importance of monitoring social media use and providing support for individuals struggling with depression. However, more research is needed to better understand the factors contributing to this relationship and to develop more standardized assessment methods.

1. Introduction

1.1. background.

The term “social media” refers to websites and applications that emphasize communication, community-based input, interaction, content sharing, and collaboration [ 1 ]. There has been an increase in depressed adolescents in the US since 2012 [ 2 ]. Simultaneously, social media became more engaging which led to an increase in social media users [ 2 ]. According to the American Psychiatric Association [ 3 ], depression is a serious medical condition that can have a negative impact on how you feel, think, and act. Sadness and/or a loss of interest in previously enjoyable activities are symptoms of depression [ 3 ]. It can hinder your ability to function at work and home and cause various emotional and physical issues [ 3 ]. The World Health Organization (WHO) has estimated that depression affects 3.8% of the global population which corresponds to 280 million people [ 4 ]. The WHO defines adolescents as people between the ages of 10 and 19 [ 5 ]. Adolescence is the stage of life between childhood and adulthood. It is a distinct period in human development and crucial for setting the groundwork for long-term health. Teenagers grow quickly regarding their physical, cognitive, and emotional development. This impacts their emotions, thoughts, decisions, and interactions with others and their environment [ 5 ]. There has been an increase in the number of depressed adolescents over the past decade [ 6 ]. It is estimated that depression affects 1 in 7 adolescents [ 6 ]. Adolescents with depressive symptoms are susceptible to social stigma, discrimination, and cognitive problems. Some studies have shown that the increased use of social media has led to an increase in depressive symptoms [ 2 ].

A previous scoping review investigated the association between social media use and depression, examining four factors: quantity of social media use, quality of social networking site use, social aspects of social media use, and disclosure of mental health symptoms on social media [ 7 ]. However, this current review extends beyond these factors and includes articles until 2022, while the previous review only included articles until 2020. This review also focuses on the scales used to measure depression and social media use among adolescents and explores new areas of investigation such as gender differences, the impact of social media on sleep quality, and its relationship with depression. It provides an overview of current work and outlines future research questions in the area of social media use and depression among adolescents.

This scoping review will explore the association between social media and depression among adolescents. The review will consider sources focusing on depression in the specified age group.

This scoping review was performed by a team of 6 reviewers using Joanna Briggs Institute (JBI) scoping review method [ 8 ]. The scoping review process was carried out using PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) [ 9 ]. The review was conducted through five steps: identifying research question, checking relevant studies, study selection, data extraction, and data synthesis.

2.1. Search Strategy

2.1.1. search source.

The following bibliographical databases were searched for the current review: PubMed, Scopus, ProQuest Psychology Database, IEEE Xplore, and Google Scholar. The first ten pages of Google Scholar were scanned as hundreds of citations are usually found there and organized according to relevance. Additionally, other papers were retrieved from the reference lists of the selected papers, and further research pertinent to the evaluation could be identified (backward referencing). Furthermore, forward referencing was conducted to make sure relevant studies were looked at. The search period covered all papers relevant to this study from 2011 until August 2022.

2.1.2. Search Terms

Three criteria were taken into consideration while choosing the search terms for the current review: population (adolescents), intervention (social media, social networks, and media platforms), and results (depression, melancholy, and major depressive disorder). The search terms used to access each electronic database are listed in Supplementary File S1 .

2.2. Study Eligibility Criteria

Articles met the inclusion criteria if they achieved the main objective, namely studying social media use among adolescents and its possible association with depression and were published between 2011 to 2022. The inclusion and exclusion criteria are listed in Figure 1 below. This review includes peer-reviewed publications, reports, conference proceedings, theses, and dissertations, but it did not include conference abstracts, reviews, or proposals. In studies that included participants of ages more than 19, the determining factor for inclusion was the mean age. Additionally, there were no limitations on the study’s location, gender, research design, stated results, or country of publication.

Inclusion and Exclusion Criteria.

2.3. Study Selection

A two-stage procedure was used to screen every article that was retrieved. First, duplicates were removed. Then, two reviewers read the titles and abstracts of all papers. A review tool, Rayyan [ 10 ], was used to speed up the procedure. The Cohen kappa score was used to quantify the interrater reliability between the two reviewers. Reviewer 1 included 139 articles and excluded 456 articles. Reviewer 2 included 143 articles and excluded 451 articles. Reviewer 1 and Reviewer 2 had 6 disagreements. Reviewer 1 wanted to include one paper that reviewer 2 excluded. Reviewer 2 included five articles that reviewer 1 excluded. With this information, we were able to compute the Cohen Kappa score. The Cohen Kappa score was computed to be 0.972. Both reviewers had similar views on most of the papers that needed to be included or excluded. The reviewers solved the issue of disagreement by talking to each other and arriving at a consensus. In the end, the two reviewers agreed to include 138 articles and exclude 457 articles. The inclusion of possibly pertinent items was then assessed by reading the full text of the primarily included papers.

2.4. Data Extraction

To identify and analyze results, the reviewers considered 15 categories of data to be extracted from the included papers. The reviewers built the data extraction sheet to manage the obtained information. The categories included author names, country where the study was conducted, publication year, study objective, population size, gender, age range and mean age, data scales used, and published findings. Six impartial reviewers examined the characteristics of the study based on the predetermined classification. Excel was utilized for both synthesis and analysis.

Out of the 43 included papers, reviewers were able to extract data and fill 15 categories which resulted in 645 points of extraction (43 × 15). Reviewers agreed on 610 of the extracted data with no conflict. For the remaining 35 extracted data, reviewers set up a meeting to discuss the outcomes, and were able to consensually agree on the results. Accuracy score for data extraction was 94.6%.

2.5. Data Synthesis

The gathered data were analyzed and presented using narrative synthesis. The included studies and results finding that were addressed in the literatures were compiled in a table in Supplementary File S1 .

3.1. Characteristics of the Studies Included

In this scoping review, 748 articles were obtained from five databases (Scopus = 256 articles, PubMed = 296 articles, IEEE Xplore = 61 articles, ProQuest Psychology Database = 76 articles, and Google Scholar = 56 articles,) as shown in Figure 2 . Initially, 153 duplicates were removed which resulted in 595 unique articles. The studies were retrieved from various sources, which increased the chance of duplicates. Rayyan was used to screen the articles and remove duplicates in the process. All the selected articles were published between 2012 and 2022. They were written in English and focused on social media use by adolescents and depression. In the first phase of study selection, 457 articles were removed based on the exclusion criteria (irrelevant intervention = 73, irrelevant study = 209, irrelevant outcome = 56, irrelevant population = 44, review papers = 54, AI-related = 18 articles, and non-English articles = 3). In the second phase of the study selection, full texts of the remaining 138 articles were reviewed. Finally, 40 articles were included. Two additional studies were added through forward referencing and one article was added by backward reference checking. In total, 43 articles were selected.

PRISMA Flowchart.

3.2. Setting and Research Phase

We included 43 articles for this scoping review. These articles were published in 18 different countries; Romania (1, 2.33%) [ 11 ], Australia (3, 6.98%) [ 12 , 13 , 14 ], Belgium (1, 2.33%) [ 15 ], Canada (2, 4.66%) [ 16 , 17 ], China (5, 12.96%) [ 18 , 19 , 20 , 21 , 22 ], Finland (1, 2.33%) [ 23 ], India (1, 2.33%) [ 24 ], Iran (1, 2.33%) [ 25 ], Nigeria (2, 4.66%) [ 26 , 27 ], Norway (3, 6.98%) [ 28 , 29 , 30 ], Serbia (1, 2.33%) [ 31 ], Spain (1, 2.33%) [ 32 ], Taiwan (1, 2.33%) [ 33 ], Thailand (1, 2.33%) [ 34 ], Tunisia (1, 2.33%) [ 35 ], Turkey (3, 6.98%) [ 36 , 37 , 38 ], United Kingdom (4, 9.30%) [ 39 , 40 , 41 , 42 ], and United States (11, 25.56%) [ 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 ].

The highest number of articles was from the United States as shown in Table 1 . Most articles were published in 2021 (12, 27.27%) as shown in Figure 3 . We identified four social media platforms that were mentioned in the articles. These included Facebook (4, 9.30%) [ 35 , 41 , 45 , 53 ] Instagram (1, 2.33%) [ 15 ], multi-platform (37, 86.05%) and Qzone (1, 2.33%) [ 22 ].

Publication by Year.

Characteristics of Studies N = 43.

The articles included various study design types as shown in Figure 4 . Around 58% of the included studies involved surveys, while 21% were cross-sectional in nature. Longitudinal studies represented 11% of the studies included, 7% relied on interviews, and 2% were descriptive design studies.

Type of Study.

3.3. Findings

Some papers concluded an association between social media use and depressive symptoms, in addition to other symptoms such as anxiety, insomnia, lack of self-esteem, social and appearance anxiety, reassurance seeking, and even internet addiction [ 3 , 13 , 14 , 15 , 16 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 26 , 28 , 29 , 32 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 43 , 46 , 47 , 50 , 51 , 52 ]. These papers reported that the number of hours spent on social media is associated with an increase in depressive symptoms and other mental health problems among adolescents. Additional factors were taken into consideration such as gender, demographics, cyberbullying, eating disorders, and other addiction problems. However, four of the reviewed articles showed no to minimal or moderate association between social media use and depression in adolescents [ 27 , 30 , 31 , 53 ] Below is Figure 5 which shows the number of reviewed papers associated with depression and self-esteem [ 14 , 22 , 25 , 39 , 40 , 47 ], cyberbullying [ 34 , 51 ], eating disorders [ 11 , 12 ], internet addiction [ 18 , 24 , 33 , 35 , 36 , 38 ], social media anxiety [ 2 , 11 , 13 , 39 , 46 , 52 ], and insomnia [ 25 , 39 , 51 ]. The percentage of the male population in the samples was less than that of the female population in 23 papers [ 13 , 14 , 15 , 16 , 20 , 21 , 23 , 27 , 30 , 31 , 32 , 35 , 37 , 38 , 41 , 43 , 46 , 47 , 48 , 49 , 51 , 52 ]. In other papers [ 11 , 12 , 19 , 25 , 40 , 50 ], the sample of participants was almost equal in number between males and females. The size of population samples in all the reviewed papers ranged between 18 and 74,472.

Number of reviewed papers per area.

Eight articles reported that females who use social media showed higher depression symptoms than males who did [ 16 , 18 , 28 , 29 , 40 , 43 , 50 , 52 ]. Maheux et al. [ 43 ] explained in their paper that females have reported a higher overall score on the Appearance-Related Social Media Consciousness scale (ASMC), which explains why females might be more affected by social media use which, therefore, increases their depressive symptoms. It was reported that females spent 7.5 + 4.4 h on average using social media a day. However, males used social media for longer hours, yet they did not show significant depressive symptoms compared to females [ 43 ].

Demographic characteristics, family environment, and psychosocial factors, as Zhang et al. [ 18 ] showed, were associated with internet gaming addiction, social media addiction, and smartphone addiction. In addition, negative psychological factors such as anxiety and depression play a vital role in different behavioral addictions. According to this study, males have a higher tendency to gaming addiction than females, and internet addiction among adolescents is affected by family environment and demographic factors.

S. Charoenwanit [ 34 ] revealed in his paper that 39% of the interviewees, which is more than 1/3 of the sample size, were bullied on social media. Additionally, cyberbullying was associated with academic achievement, general health, and depression among adolescents with a statistical significance of 0.01 for p -value. T.D. Ray [ 47 ] reported that adolescents experiencing social comparison and cyberbullying during a developmental stage in their life resulted in depression, a lack of self-esteem, and a significant impact on their emotional wellbeing. Shafi et al. [ 49 ] highlighted in their paper that social media usage increase to be considered a consequence of depression, and potentially increases the cyberbullying score as well. Many assume that increased social media usage causes depression, but such papers suggest that it is a two-way relationship. Additionally, Ghergu et al. [ 11 ] showed that social media use might increase the chances of developing unhealthy eating attitudes, yet it can also play a protective role for those who already developed eating disorders [ 11 ].

Pirdehghan et al. [ 25 ] showed in their paper that sleep quality had a significant negative correlation with social media use statistically ( p -value = 0.02), and that males use social media more than females. Thus, males sleeping quality would be lower. Previously in some papers [ 16 , 18 , 28 , 29 , 40 , 43 , 50 , 52 ], it was shown that social media use affected females as they reported higher depressive symptoms; however, Pirdehghan et al. [ 25 ] showed that gender does not play a significant role and that the more social media use, the more depressive symptoms are expressed regardless of the gender.

The included papers used different scales and metrics to measure different aspects of mental health that were directly or indirectly associated with depression, anxiety, or both. Only a few papers used similar scales and metrics to measure mental health values. For social media use, there were two main factors to be measured: the number of hours spent on social media, and how social media was used by adolescents. Most papers used questionnaires or self-assessment tools in addition to some pre-identified.

Some papers opted for self-reporting of depression symptoms, anxiety, or other mental health problems through surveys and questioners, in addition to reporting the number of hours spent on social media [ 12 , 15 , 29 , 30 , 35 , 38 , 44 , 45 , 47 ].

The included papers used different scales to measure depression levels. Only three depression measuring scales appeared to be used in multiple papers. The Hospital Anxiety and Depression Scale (HADS) was used in two papers to assess the level of depression in adolescents [ 25 , 27 ]. M. Culpepper [ 46 ], Wang et al. [ 20 ], and M. Kwon et al. [ 51 ] used the Centre for Epidemiological Studies-Depression (CES-D) scale to test depression levels in adolescents. Furthermore, two studies conducted by Li et al. [ 21 ] and G. Niu et al. [ 22 ] used an altered version of the Epidemiological Studies-Depression scale to test adolescents for depression. Moreover, the Children’s Depression Inventory scale was used to measure depression among adolescents in the studies conducted by K. Kırcaburun [ 36 ] and S. R. Liu et al. [ 50 ].

Other scales were used to measure factors that could be associated with depression such as self-esteem, loneliness, sleep quality, and anxiety. Rosenberg Self-esteem Scale is one of the scales that were used by multiple studies to measure self-esteem [ 17 , 20 , 36 , 39 , 42 , 49 ], in addition to the shortened version of the scale used by D. A. Barthorpe et al. [ 40 ] and the Chinese version of the scale that was used by G. Niu et al. [ 22 ]. Two studies by S. YAŞAR CAN et al. [ 37 ] and S. R. Liu et al. [ 50 ] used UCLA Loneliness Scale to measure how disconnected adolescents were feeling and if it was associated with social media user or not. Pirdehghan et al. [ 25 ], F. F. Ibimiluyi [ 27 ], and M. Kwon et al. [ 51 ] included studies about sleep quality and social media use and that could be a possible reason for depression among adolescents. The scale used for the assessment of sleep quality was Pittsburgh Sleep Questionnaire Index (PSQI) [ 25 , 27 , 51 ]. The Generalised Anxiety Disorder Assessment scale (GAD-7) is a scale used to measure anxiety in the studies by M. Culpepper [ 46 ] and W. Zhang et al. [ 18 ]. Two studies by Shafi et al. [ 14 , 49 ] measured Salivary cortisol levels to measure anxiety and if it could possibly be associated with social media use.

For measuring social media addiction, Bergen Social Media Addiction Scale (BS-MAS) was used in two studies by W. Zhang et al. [ 18 ] and R. M. A. Shafi et al. [ 49 ]. Social Function use Intensity (SFUI) scale and Entertainment Function use Intensity (EFUI) scale were two scales that occurred to be used in two papers by A. Ghergut et al. [ 11 ] and J.-B. Li et al. [ 19 ] to measure social media use and entertainment intensity. Finally, Facebook Intensity Scale (FBI) was used to measure Facebook usage and emotional connectivity to the website alongside other aspects. The FBI scale was used in two papers by T. Hawes et al. [ 13 ] and G. Niu et al. [ 22 ].

All other scales used to measure social media use, depression, and factors that are possibly associated with depression occurred once as displayed in Table 2 . The table concludes that there were many depression evaluation scales used, but only a few scales were used by a multiple of the studies included. Self-esteem, loneliness, sleep quality, and anxiety were factors that appeared to be a concern in multiple studies.

Scales and Metrics Used.

4. Discussion

This scoping review aimed to provide an insight on increasing social media use and depression, and to see if these two variables affect each other. Depression was taken into consideration as it is evident how much its rate is increasing. According to K. Kircaburun [ 36 ], depression is one of the major health problems in modern society. In 2021, the World Health Organization (WHO) conducted research that revealed that depression is affecting around 350 million worldwide [ 4 ]. It is recognized that technology is becoming more of a need than a want day by day, and that it has become the source of income for different influencers and content creators. However, the impact of this needs to be considered and managed as well. It is important to understand that there can be direct impact and indirect impact of social media usage on depression. When there is an indirect impact, it can be due to factors such as decreased physical activity because of spending many hours on social media, emotional eating due to self-esteem and body image issues resulted from social media content, lack of sleep because of prioritizing using social media over sleep quality, internet addiction, or even cyberbullying. The commonality in the scales used to measure those aspects as shown in the previous section indicated that researchers predicted a possible association between social media use, loneliness, self-esteem, sleep quality, anxiety, and depression.

In this scoping review, 43 articles were reviewed, and around 75% of these papers concluded an association between depression and increased social media use. The articles reviewed had different methodologies for testing this association; some were dependent on analyzing interview and questionnaire responses, while others measured increased cortisol levels by taking saliva samples. Two examples that tested the salivary cortisol level in the papers by Shafi et al. [ 14 , 49 ], which was measured, in addition to α -amylase levels, in adolescents after using social media to check if social media use caused anxiety. It was found that salivary cortisol and α -amylase levels were significantly higher in adolescents with depression but not in healthy control adolescents. This shows us that people with existing depression may face worse symptoms after using social media. On the contrary, social media use can have a positive effect on those who suffer from eating disorders. Ghergut et al. [ 11 ] suggested that social networking use might increase the chances of developing unhealthy eating attitudes in adolescents who are not at risk to develop an eating disorder, but, at the same time, it might play a protective role, instead of a harmful one, for adolescents who already developed such symptoms.

One factor to consider is the average age of the samples. Some papers showed a moderate to low association between social media use and depressive symptoms. [ 27 , 31 , 53 ] The mean age of the samples in those papers was 18, 18.9, and 15.22, respectively. Those mean ages are higher than the mean ages of samples from other papers that showed a higher association between social media use and depression. This indicates that older adolescents are more aware and resistant to the negative aspects of social media than younger adolescents. Older adolescents seem to deal better with social media’s negative side effects than younger adolescents considering the results shown in the three papers mentioned.

It is important to note that the countries with most studies reviewed where China, five papers [ 18 , 19 , 20 , 21 , 22 ], the United States, eleven papers [ 43 , 44 , 45 , 46 , 48 , 49 , 50 , 51 , 52 , 53 ], and Norway, three papers [ 28 , 29 , 30 ], and Australia, three papers [ 12 , 13 , 14 ], which are four developed countries. The fact that they are developed countries means that the users have mobiles that are connected to Wi-Fi potentially majority of the time, thus social media use is high as discussed by Poushter et al. [ 54 ]. This is where identifying such patterns of social media effect is needed to alleviate any potential negative outcomes.

4.1. Strengths and Limitations

This review paper presents a comprehensive examination of the latest research on the association between social media use and depression. The scoping review focuses on peer-reviewed articles from databases such as PubMed, IEEE Xplore, Scopus, Google Scholar, and ProQuest Psychology. The paper aims to gain a deeper understanding of the various factors that contribute to depression in relation to social media use, including gender, sleep quality, and self-esteem. The review also summarizes the scales used in the included articles, highlighting similarities and differences, and providing an overview of the most recent findings in the field. By synthesizing the latest research, this review paper aims to provide a valuable resource for researchers and practitioners in the field of mental health.

This scoping review included five databases which could have limited the number of articles. We focused on articles that were published in English. This could potentially mean that we missed relevant studies in other languages. Moreover, our results show that the articles came from 19 countries. The study missed other populations.

4.2. Practical and Research Implications

Practical Implications: In this paper, we looked at the possible association between social media use and depression. As such, this review can potentially aid psychologists and mental health experts in gaining insights into the depressive symptoms of adolescent patients. Psychologists and Mental health experts should monitor the relationship between social media use and depressive symptoms as technology continues to rise rapidly. Understanding the link between social media use and depressive symptoms can also lead to better recommendations from mental health experts to aid adolescents. Moreover, this review paper can also help parents assess the effects of social media use on their children.

Research Implications: The review paper looked at several metrics to quantify the amount of depression among social media users. Moreover, the review looked at the factor of gender. Future studies should consider standardizing metrics to quantify depressive symptoms associated with social media use. In our findings, most of the paper used a different scale or metric which made the analysis more tedious. Future studies can also delve deeper into the depressive effect of social media use based on gender. Several studies have demonstrated a possible correlation between social media usage, depression, and gender difference. Some paper demonstrates, for instance, that social media usage affects females more than males. However, we would recommend conducting a systematic review to determine the validity of this relationship.

5. Conclusions

This review paper was conducted to explore the link between depression and social media use among adolescents. A total of 43 articles were reviewed, and the highest number of papers came from the US. Furthermore, our analysis looked at several metrics used by researchers to measure depression and other factors that can have an association with it such as self-esteem, eating disorders, sleep, social media anxiety, internet addiction, and cyberbullying. This review suggests that there is an association between social media use and depression among adolescents. It also suggests that social media usage affects females more than males. However, a systematic review needs to be conducted to understand these associations further.

Supplementary Materials

The following supporting information can be downloaded at: https://www.mdpi.com/article/10.3390/bs13060475/s1 , File S1: Search terms and details of included studies.

Funding Statement

Open Access funding provided by the Qatar National Library.

Author Contributions

L.A. developed the protocol and conducted the search with guidance from and under the supervision of M.H. Study selection and data extraction were carried out G.N. and A.L., R.A.A. and B.A. conducted data synthesis and wrote results and methods sections. B.B. wrote the introduction section. L.A., A.L. and G.N. wrote the discussion section. M.A. reviewed the article. The article was revise critically for important intellectual content by all authors. All authors have read and agreed to the published version of the manuscript.

Institutional Review Board Statement

Not applicable.

Informed Consent Statement

Data availability statement, conflicts of interest.

The authors declare no conflict of interest.

Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content.

Social Networking and Depression Argumentative Essay

Studies show that social networking has a potential of causing depression and the more individuals use social sites, such as Facebook and Twitter, the more they are filled with anxiety leading to depression. In the University of Michigan, a study was conducted with a sample of eighty-two Facebook users in a period of two weeks.

The findings of the study confirmed that once an individual engages in social networking, his or her feeling of safety goes down and depression mood emerges meaning that a correlation between depression and social networking exists (Harris 81). Unlike other forms of social networking, such as chatting with friends, social sites offer invaluable data that are incapable of fulfilling an individual needs, such as security and safety.

If an individual spends more time on Facebook, he or she might end up depressed the whole day because of anxiety (Myers 17). Apart from causing depression, social networking may cause the fear of missing out because an individual feels rejected and neglected once his or her message or information is not taken positively. Some users may criticize the views of an individual, yet no chance is given to defend the idea.

While on Facebook or Twitter, an individual feels inadequate or insufficient because one person might post a good picture showing magnificent vacation, luxurious purchases, and gorgeous children. In case an individual does not have the means to achieve his or her ambitions, he or she might be jealous and might be resentful since good things are happening in the lives of others while suffering might be the characteristic of his or her life.

In a different study conducted in Sweden at the University of Gothenburg that interviewed 111 Facebook users, it was established that internet networking has an effect on the self-esteem of an individual, as well as his relationships with others (Noor and Hendricks 64). Individuals spending more time on Facebook and other social sites have low sense of worth.

Additionally, social networking causes narcissism because users spend too much time and resources for decoration of their pictures and modifying their profiles in order to gain approval and praise. If an individual posts a status update on Facebook or Twitter and no person is interested in commenting, there would be a high likelihood that an individual will be worried because he will not understand some of the reasons why others are reluctant to respond.

Scholars, artists, politicians, and other professionals might be tempted to post something related to their achievements, such as published works or won award. Such individuals would be affected greatly in case someone decides to post something negative (Noor and Hendricks 67). Many people end up spending sleepless nights because of a negative comment that someone posted on Facebook or Twitter.

Continued usage of the social media contributes to the erosion of true relationships because it is difficult for individuals to interact face-to-face, as the traditional form of interaction is being replaced by shallow and meaningless online connections. Studies show that this is damaging the well-being of society since human need for true relationship is difficult to find (Myers 48).

Since individuals are incapable of finding authentic relationships and love, they tend to turn to the social sites for consolation. Instead of being comforted, the social media only serves one purpose that is related to depression and mental illnesses. In the modern society, it is common to find an idle person on Fcaebook or Twitter since it is believed to keep a person active.

The modern society is characterized by uncertainties and disappointments and people report all these in the social sites. For instance, of all the internet users, one or two people will report losing a job or breaking up a relationship. Again, the death of an individual will always be noticed, particularly when the person is famous.

Through the social sites, an individual realizes that it is so easy to lose a job or break up in a relationship, something that brings about anxiety. If the death of a famous person is reported, sadness mood comes in because there would be a feeling of loss. Some internet users develop a culture of judging others, irrespective of whether their post is accurate or not. In other words, they simply spread propaganda and falsehood once they realize that their ambition cannot be realized (Myers 75).

For instance, one person might fail to convince another to enter into a deal or relationship. Instead of accepting the outcome and moving on, he or she would go a notch higher to comment negatively on the social media, something that might attract a penalty or revenge. In many parts of the world, online wars are widespread whereby individuals are unwilling to concede defeat and continue with lives.

This has brought about many challenges because a negative comment is given to an individual with children and a stable family. Recently, a picture of a famous politician engaging extra marital relationships was posted on the social media, yet the leader has children and a good family (Kaplan and Haenlein 68). This causes depression to many people who feel disappointed and cheated. Even though the information posted might be inaccurate, it would be difficult for other users to change their minds once they have the picture.

In order to network with a friend, a social media user must send a friend request and wait for a response. An individual will definitely be depressed in case a response is not sent in time. Social networking isolates an individual from the rest of the community because most of the time is spent chatting with online friends who might have nothing to add to an individual’s life. Many young people are simply interested with popularity and they believe that having many friends in Facebook or Twitter makes them more famous.

In reality, this does not add any value to life because friendship has to be of high quality meaning that adequate assistance can be offered when necessary. An individual with many friends on Twitter or Facebook tends to believe that he or she is illustrious, but most likely will be disappointed in a time of need because not all online friends will ever care about what is happening to the life of one member (Harris 101).

They will simply express their sadness, which might not be genuine, yet the individual would be in need of emotional and psychological support. Therefore, social networking is believed to be harmful to the well-being of the individual in society because it does not add value to life (Myers 88). Additionally, it is established that a strong correlation between social networking and depression exists and it is upon the individual to control internet usage.

Works Cited

Harris, Kandace. “Using Social Networking Sites as Student Engagement Tools.” Diverse Issues in Higher Education, 25.18 (2008): 88-112. Print.

Kaplan, Andreas, and Haenlein, Michael. “Users of the world, unite! The challenges and opportunities of social media”. Business Horizons, 53.1 (2010): 61-98. Print.

Myers, David. Social Psychology . New York: McGraw-Hill Higher Education, 2012. Print.

Noor, Al-Deen, and Hendricks, John. Social Media: Usage and Impact . Lanham: Lexington Books, 2012. Print.

• Chicago (A-D)
• Chicago (N-B)

IvyPanda. (2019, January 17). Social Networking and Depression. https://ivypanda.com/essays/social-networking-and-depression/

"Social Networking and Depression." IvyPanda , 17 Jan. 2019, ivypanda.com/essays/social-networking-and-depression/.

IvyPanda . (2019) 'Social Networking and Depression'. 17 January.

IvyPanda . 2019. "Social Networking and Depression." January 17, 2019. https://ivypanda.com/essays/social-networking-and-depression/.

1. IvyPanda . "Social Networking and Depression." January 17, 2019. https://ivypanda.com/essays/social-networking-and-depression/.

Bibliography

IvyPanda . "Social Networking and Depression." January 17, 2019. https://ivypanda.com/essays/social-networking-and-depression/.

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Analysis of social media language using AI models predicts depression severity for white Americans, but not Black Americans

NIH-supported study also found Black people with depression used different language than white people to express their thoughts on Facebook

Researchers were able to predict depression severity for white people, but not for Black people using standard language-based computer models to analyze Facebook posts. Words and phrases associated with depression, such as first-person pronouns and negative emotion words, were around three times more predictive of depression severity for white people than for Black people. The study , published today in the Proceedings of the National Academy of Sciences , is co-authored by researchers at the University of Pennsylvania, Philadelphia, and the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health (NIH), which also funded the study.

While previous research has indicated that social media language could provide useful information as part of mental health assessments, the findings from this study point to potential limitations in generalizing this practice by highlighting key demographic differences in language used by people with depression. The results also highlight the importance of including diverse pools of data to ensure accuracy as machine learning models, an application of artificial intelligence (AI) language models, are developed.

“As society explores the use of AI and other technologies to help deliver much-needed mental health care, we must ensure no one is left behind or misrepresented,” said Nora Volkow, M.D., NIDA director. “More diverse datasets are essential to ensure that healthcare disparities are not perpetuated by AI and that these new technologies can help tailor more effective health care interventions.”

The study, which recruited 868 consenting participants who identified themselves as Black or white, demonstrated that models trained on Facebook language used by white participants with self-reported depression showed strong predictive performance when tested on the white participants. However, when the same models were trained on Facebook language from Black participants, they performed poorly when tested on the Black participants, and showed only slightly better performance when tested on white participants.

While depression severity was associated with increased use of first-person singular pronouns (“I,” “me,” “my”) in white participants, this correlation was absent in Black participants. Additionally, white people used more language to describe feelings of belongingness (“weirdo,” “creep”), self-criticism (“mess,” “wreck”), being an anxious-outsider (“terrified,” “misunderstood”), self-deprecation (“worthless,” “crap”), and despair (“begging,” “hollow”) as depression severity increased, but there was no such correlation for Black people. For decades, clinicians have been aware of demographic differences in how people express depressive symptoms, and this study now demonstrates how this can play out in social media.

Language-based models hold promise as personalized, scalable, and affordable tools to screen for mental health disorders. For example, excessive self-referential language, such as the use of first-person pronouns, and negative emotions, such as self-deprecating language, are often regarded as clinical indicators of depression. However, there has been a notable absence of racial and ethnic consideration in assessing mental disorders through language, an exclusion that leads to inaccurate computer models. Despite evidence showing that demographic factors influence the language people use, previous studies have not systematically explored how race and ethnicity influence the relationship between depression and language expression.

Researchers set up this study to help bridge this gap. They analyzed past Facebook posts from Black and white people who self-reported depression severity through the Patient Health Questionnaire (PHQ-9) – a standard self-report tool used by clinicians to screen for possible depression. The participants consented to share their Facebook status updates. Participants were primarily female (76%) and ranged from 18 to 72 years old. The researchers matched Black and white participants on age and sex so that data from the two groups would be comparable.

The study’s findings challenge assumptions about the link between the use of certain words and depression, particularly among Black participants. Current clinical practices in mental health that have not accounted for racial and ethnic nuances may be less relevant, or even irrelevant, to populations historically excluded from mental health research, the researchers note. They also hypothesize that depression may not manifest in language in the same way for some Black people – for example, tone or speech rate, instead of word selection, may relate more to depression among this population.

“Our research represents a step forward in building more inclusive language models. We must make sure that AI models incorporate everyone's voice to make technology fair for everyone,” said Brenda Curtis, Ph.D., MsPH, chief of the Technology and Translational Research Unit in the Translational Addiction Medicine Branch at NIDA’s Intramural Research Program and one of the study’s senior authors. “Paying attention to the racial nuances in how mental health is expressed lets medical professionals better understand when an individual needs help and provide more personalized interventions.”

Future studies will need to examine differences across other races and demographic features, using various social media platforms, the authors say. They also caveat that social media language is not analogous to everyday language, so future work on language-based models must take this into account.

“It’s important to note that social media language and language-based AI models are not able to diagnose mental health disorders – nor are they replacements for psychologists or therapists – but they do show immense promise to aid in screening and informing personalized interventions,” said the study’s lead author, Sunny Rai, Ph.D., a postdoctoral researcher in Computer and Information Science at the University of Pennsylvania. “Many improvements are needed before we can integrate AI into research or clinical practice, and the use of diverse, representative data is one of the most critical.”

For more information on substance and mental health treatment programs in your area, call the free and confidential National Helpline 1-800-662-HELP (4357) or visit FindTreatment.gov . Anyone who needs assistance with the first steps in pursuing help can find guidance at FindSupport.gov .

If you or someone you know is in crisis and needs immediate help, call the 988 Suicide & Crisis Lifeline at 988. Learn more about suicide prevention and ways you can help someone who might be at risk for self-harm.

• S Rai, et al. Key Language Markers of Depression on Social Media Depend on Race . The Proceedings of the National Academy of Sciences . DOI: 10.1073/pnas.2319837121 (2024).

About the National Institute on Drug Abuse (NIDA): NIDA is a component of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports most of the world’s research on the health aspects of drug use and addiction. The Institute carries out a large variety of programs to inform policy, improve practice, and advance addiction science. For more information about NIDA and its programs, visit www.nida.nih.gov .

About the National Institutes of Health (NIH): NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov .

About substance use disorders: Substance use disorders are chronic, treatable conditions from which people can recover. In 2022, nearly 49 million people in the United States had at least one substance use disorder. Substance use disorders are defined in part by continued use of substances despite negative consequences. They are also relapsing conditions, in which periods of abstinence (not using substances) can be followed by a return to use. Stigma can make individuals with substance use disorders less likely to seek treatment. Using preferred language can help accurately report on substance use and addiction. View NIDA’s online guide .

NIH…Turning Discovery Into Health®

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• COVID-19 and your mental health

Worries and anxiety about COVID-19 can be overwhelming. Learn ways to cope as COVID-19 spreads.

At the start of the COVID-19 pandemic, life for many people changed very quickly. Worry and concern were natural partners of all that change — getting used to new routines, loneliness and financial pressure, among other issues. Information overload, rumor and misinformation didn't help.

Worldwide surveys done in 2020 and 2021 found higher than typical levels of stress, insomnia, anxiety and depression. By 2022, levels had lowered but were still higher than before 2020.

Though feelings of distress about COVID-19 may come and go, they are still an issue for many people. You aren't alone if you feel distress due to COVID-19. And you're not alone if you've coped with the stress in less than healthy ways, such as substance use.

But healthier self-care choices can help you cope with COVID-19 or any other challenge you may face.

And knowing when to get help can be the most essential self-care action of all.

Recognize what's typical and what's not

Stress and worry are common during a crisis. But something like the COVID-19 pandemic can push people beyond their ability to cope.

In surveys, the most common symptoms reported were trouble sleeping and feeling anxiety or nervous. The number of people noting those symptoms went up and down in surveys given over time. Depression and loneliness were less common than nervousness or sleep problems, but more consistent across surveys given over time. Among adults, use of drugs, alcohol and other intoxicating substances has increased over time as well.

The first step is to notice how often you feel helpless, sad, angry, irritable, hopeless, anxious or afraid. Some people may feel numb.

Keep track of how often you have trouble focusing on daily tasks or doing routine chores. Are there things that you used to enjoy doing that you stopped doing because of how you feel? Note any big changes in appetite, any substance use, body aches and pains, and problems with sleep.

These feelings may come and go over time. But if these feelings don't go away or make it hard to do your daily tasks, it's time to ask for help.

Get help when you need it

If you're feeling suicidal or thinking of hurting yourself, seek help.

• Contact your healthcare professional or a mental health professional.
• Contact a suicide hotline. In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline , available 24 hours a day, seven days a week. Or use the Lifeline Chat . Services are free and confidential.

If you are worried about yourself or someone else, contact your healthcare professional or mental health professional. Some may be able to see you in person or talk over the phone or online.

You also can reach out to a friend or loved one. Someone in your faith community also could help.

And you may be able to get counseling or a mental health appointment through an employer's employee assistance program.

Another option is information and treatment options from groups such as:

• National Alliance on Mental Illness (NAMI).
• Substance Abuse and Mental Health Services Administration (SAMHSA).
• Anxiety and Depression Association of America.

Self-care tips

Some people may use unhealthy ways to cope with anxiety around COVID-19. These unhealthy choices may include things such as misuse of medicines or legal drugs and use of illegal drugs. Unhealthy coping choices also can be things such as sleeping too much or too little, or overeating. It also can include avoiding other people and focusing on only one soothing thing, such as work, television or gaming.

Unhealthy coping methods can worsen mental and physical health. And that is particularly true if you're trying to manage or recover from COVID-19.

Self-care actions can help you restore a healthy balance in your life. They can lessen everyday stress or significant anxiety linked to events such as the COVID-19 pandemic. Self-care actions give your body and mind a chance to heal from the problems long-term stress can cause.

Take care of your body

Healthy self-care tips start with the basics. Give your body what it needs and avoid what it doesn't need. Some tips are:

• Get the right amount of sleep for you. A regular sleep schedule, when you go to bed and get up at similar times each day, can help avoid sleep problems.
• Move your body. Regular physical activity and exercise can help reduce anxiety and improve mood. Any activity you can do regularly is a good choice. That may be a scheduled workout, a walk or even dancing to your favorite music.
• Choose healthy food and drinks. Foods that are high in nutrients, such as protein, vitamins and minerals are healthy choices. Avoid food or drink with added sugar, fat or salt.
• Avoid tobacco, alcohol and drugs. If you smoke tobacco or if you vape, you're already at higher risk of lung disease. Because COVID-19 affects the lungs, your risk increases even more. Using alcohol to manage how you feel can make matters worse and reduce your coping skills. Avoid taking illegal drugs or misusing prescriptions to manage your feelings.

Take care of your mind

Healthy coping actions for your brain start with deciding how much news and social media is right for you. Staying informed, especially during a pandemic, helps you make the best choices but do it carefully.

Set aside a specific amount of time to find information in the news or on social media, stay limited to that time, and choose reliable sources. For example, give yourself up to 20 or 30 minutes a day of news and social media. That amount keeps people informed but not overwhelmed.

For COVID-19, consider reliable health sources. Examples are the U.S. Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO).

Other healthy self-care tips are:

• Relax and recharge. Many people benefit from relaxation exercises such as mindfulness, deep breathing, meditation and yoga. Find an activity that helps you relax and try to do it every day at least for a short time. Fitting time in for hobbies or activities you enjoy can help manage feelings of stress too.
• Stick to your health routine. If you see a healthcare professional for mental health services, keep up with your appointments. And stay up to date with all your wellness tests and screenings.
• Stay in touch and connect with others. Family, friends and your community are part of a healthy mental outlook. Together, you form a healthy support network for concerns or challenges. Social interactions, over time, are linked to a healthier and longer life.

Avoid stigma and discrimination

Stigma can make people feel isolated and even abandoned. They may feel sad, hurt and angry when people in their community avoid them for fear of getting COVID-19. People who have experienced stigma related to COVID-19 include people of Asian descent, health care workers and people with COVID-19.

Treating people differently because of their medical condition, called medical discrimination, isn't new to the COVID-19 pandemic. Stigma has long been a problem for people with various conditions such as Hansen's disease (leprosy), HIV, diabetes and many mental illnesses.

People who experience stigma may be left out or shunned, treated differently, or denied job and school options. They also may be targets of verbal, emotional and physical abuse.

Communication can help end stigma or discrimination. You can address stigma when you:

• Get to know people as more than just an illness. Using respectful language can go a long way toward making people comfortable talking about a health issue.
• Get the facts about COVID-19 or other medical issues from reputable sources such as the CDC and WHO.
• Speak up if you hear or see myths about an illness or people with an illness.

COVID-19 and health

The virus that causes COVID-19 is still a concern for many people. By recognizing when to get help and taking time for your health, life challenges such as COVID-19 can be managed.

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