Teens, social media use and mental health: What you really need to know

"Hell is a teenage girl," begins the cult comedy-horror movie Jennifer's Body. Even when you look past the murder-heavy plot, it has a point. Female adolescence has always been a tough time. But this past year has brought unprecedented pressure with the combination of growing up in the age of social media and a pandemic that's disrupted all sense of normalcy.

Last week, the UK's Education Policy Institute and The Prince's Trust published a study that linked heavy social media use to negative well-being and self-esteem in teens, especially among girls. The study was widely covered by the media, featuring alarming headlines about how social media use was causing the mental health of teenagers across the UK to spiral. The message relayed by news publications left little room for nuance. But when you dig a little deeper into the science of social media's impact on well-being, the picture looks infinitely more murky. 

"Social media use is widespread, and mental health difficulties are also common, so it can easily be assumed that one causes the other, but you can't assume that is the case," says Dame Til Wykes, professor of clinical psychology and rehabilitation at King's College London and director for mental health at the National Institute for Health Research's Clinical Research Network.

The media coverage of the EPI and Prince's Trust study drew criticism from the research community, with experts in teen psychology pointing out that, among other issues, the study hadn't been peer reviewed. There was also some dismay that a conclusive stance had been presented to and then parroted back by the media -- a stance which failed to recognize the wider network of existing research that presents a far more complex picture. 

In response to the criticism, the study's author, Whitney Crenna-Jennings, senior researcher at EPI, said that though the research had identified heavy social media use in adolescence as being associated with lower well-being and lower self-esteem, in some cases the opposite was also true.

"Participants in our focus group studies did highlight both the positive and negative aspects of social media in relation to their mental and emotional health," she said. Unfortunately, this wasn't something that was acknowledged in most news reports.

The fervor over the study and response from the research community underscores the complexity of understanding the effects of social media use on mental health and the dangers of jumping to conclusions with sensational -- and overly simplistic -- headlines. Amy Orben, a research fellow at the University of Cambridge who specializes in studying teenagers and their use of technology, explained on Twitter that this area of science is still developing, with each piece of research a building block that's gradually added to our understanding of the topic. 

Those building blocks have contributed to a mixed image of what's going on. In August 2019, a study published in the journal Clinical Psychological Science showed there was little evidence to link mental health issues to digital technology use in early to mid-adolescence. Just three months earlier, a study published in PNAS said social media use wasn't a good indicator of life satisfaction among teenagers. Meanwhile, a 2020 study published in Nature said the effect of social media on well-being differed from teen to teen. 

A study also published last year by the American Economic Association, which wasn't focused specifically on teenagers but paints a different picture, said that deactivating Facebook for the four weeks preceding the US midterm elections "increased subjective well-being" among participants.

In her response, Crenna-Jennings acknowledged that the EPI study didn't tell the full story of the link between social media use and mental health. "While our findings provide insights into the relationship between social media and young people's mental health outcomes, there is still a lot that we don't know," she said. "We have called for more research to be undertaken, in order to fully understand the complexities of this relationship."

There are good reasons for wanting to interrogate a possible link here -- the documented increases in mental health problems in adolescents over the past three years, for example. The UK's Office for National Statistics estimates that 27% of young women are likely experiencing mental health problems. But proving that social media has a causal effect on the development of mental health problems is a highly contested space, according to Wykes.

"There are few high-quality scientific studies that have made these tests, and those available either show little or no effect," she said, noting that studies require large samples. 

Mixed messages from the media

One of the BBC's flagship radio shows, Woman's Hour, ran a segment on the study to talk about teen girls and social media. Rather than invite a psychologist, a third-party researcher or even a teenage girl onto the program, the BBC chose 45-year-old male author Matt Haig, who's written about his firsthand mental health struggles but has no firsthand experience of actually being a teenage girl growing up in the digital age.

Haig spoke confidently on the show about the link between mental health problems and social media usage in girls in their early teens, not citing scientific evidence, but his own observations of some girls he happened to know.

"I can think of teenage girls I know and am related who reached say 12, 13, 14, and then certain mental health issues arose and it tied either incidentally or directly to their increased use of social media," he said. Later he added that social media "qualifies as an addictive substance in that age group."

What Haig described here isn't causation, in which mental health problems are proved to be caused by social media usage, but correlation, in which they occur alongside each other but haven't been linked in a scientifically meaningful way. It's a common pitfall to make when discussing this issue, and one that's resulted in widespread confusion about exactly how concerned parents should be.

Haig's sweeping generalizations about teen girls also served to further highlight the failure of Woman's Hour to actually invite a teenage girl to talk about the issue, or at the very least someone who'd experienced growing up with a smartphone and social media notifications as constant companions. Representatives for the BBC didn't respond to a request for comment.

A radical idea: stop and listen?

Back in 2019, model Kaia Gerber, who at the time was just 17, posted Instagram selfies at least once per month for the first half of the year showing a phone case that featured a cigarette packet-style warning: "Social media seriously harms your mental health." Gerber wasn't the only famous Instagrammer to own the case -- and as such the design became popular among teens, and was a regular sight in Instagram selfies.

There was something ironic, meta even, about seeing these warnings appear on social media, and there was an undercurrent of making fun of the established narrative. But the cases also did likely serve as a reminder to their owners to put their phones down once in a while. It also spoke to a broader awareness among Gen Z about the importance of mindful social media usage.

We shouldn't overlook teenagers' own understanding of the impact social media usage has on their mental health, and we should take the time to listen to what they have to say on the matter, Orben said in an interview this week. Qualitative studies in which teens are able to talk openly about their experiences show that they tend to have a deep understanding of the role social media plays in their own personal well-being and that they often have their own strategies for self-regulation, she says.

They also show that teens have a thorough knowledge of media narratives around kids and social media -- they're able to cite the risks and scare stories, although it's rare they have personal stories of their own to back these up.

Faith Martin, a 19-year-old freelance journalist who's written about disability, believes that teenagers have a better understanding than most about the negative impacts of social media, having grown up with it. "Adults who compare everything to back in their day don't help because the world has changed so much," she said, adding that media narratives tend to focus exclusively on the lives of middle-class teenagers when talking about how social media may affect their well-being.

In August, UK telecoms and media watchdog Ofcom published a study looking at the effects of the lockdown on the digital lives of children and teenagers of different ages -- from what new spaces they were occupying to how they behaved within them. The study's findings didn't speak specifically about mental health, but they revealed a cross-section of findings, including how key socialization had moved online and was done in conjunction with other activities.

The closest it came to revealing a negative impact on mental health was in pointing to how some teenage girls felt insecure about their bodies and under pressure to exercise more due to consuming body-conscious exercise content on social media. But the study also showed that others had been motivated to start exercising for the first time during lockdown by what they'd encountered online, which had helped them to feel healthier and boost their mood.

Martin said she personally feels negatively affected by the endless striving for physical perfection she encounters on Instagram. "As a disabled woman, I often get drawn in by this and wonder where I fit in because no one with power on these platforms represent me or my life, these images have impacted the way I view myself and have left me questioning my self worth in the eyes of others," she said.

The list of variables thrown up among the study's small sample size, along with Martin's unique individual perspective, gives us some idea of what researchers trying to investigate the link between social media usage and well-being are up against. Taking into account the spectrum of responses from teens of different genders, backgrounds, ages, life experiences and personalities means that searching for one intrinsic, clearly defined link between social media use and well-being isn't necessarily possible or even desirable. 

Following the same path can lead researchers to very different conclusions -- a good reminder to teens and parents not to jump to a conclusion based on a single study.

The trouble with teens: They're all different!

Going in search of a number that can confirm that link is further complicated by the vast list of factors -- school pressure, social lives, hobbies, family difficulties, socioeconomic issues and so on -- that can all add up to impact the mental health of a teenager. Just classifying what counts as social media use is also in itself tricky. "If the one thing I could get parents to understand is that social media is many different things in one term... just that piece of information could be really valuable,"  Orben said.

The thinking behind the search for a single statistical link is that it could allow health experts to issue clear guidelines for a cap on how many hours of screen time teens should get, in the same way they issue guidelines to limit how many units of alcohol a person should drink. The four chief medical officers in the UK already ruled out such a move in 2019 after a comprehensive review of the published research, precisely because there are too many variables and definitions of social media.

It's the reason Orben is looking for ways to assess the impact of social media on the individual, rather than going in search of a general quantifiable number. For an LGBTQ+ teen living in a remote rural village, social media might mean access to a supportive community and activism resources, she said. Taking that away by applying generalized guidelines could harm rather than help. 

Another important factor to bear in mind, said Orben, is that just as social media usage has the potential to impact mental health, that relationship can be bidirectional. Mental health also has the potential to affect how people turn to social media.

"We often see social media usage as the cause of suffering, and we see that with other technologies as well," she said. "The way we feel or the way we live also impacts how we use the technology."

Moral panic about how much time teens spend glued to the TV, playing violent video games or reading magazines featuring unrealistic body shapes is nothing new, and so today's discourse around social media could easily be interpreted as the latest iteration. But Orben doesn't think it's quite that simple. "There's definitely a continuation, but that doesn't mean we shouldn't take people's concerns seriously," she said.

There are legitimate concerns about the effect of social media on the current and future mental health of teens, which is why it's being so widely investigated by researchers. But Orben says we need to be wary of press release culture in which definitive claims are made about findings and shaped into alarmist headlines. These ultimately lead to the spread of conflicting information about how seriously parents and teens should be taking the problem.

Orben says that parents need to be empowered to talk with their teenagers about what does and doesn't work for them and how it makes them feel. It's more important to look out for changes in behavior and be proactive about communicating than to focus on minutes spent on social media.

"Naturally, that's not the advice people want to hear. People want a concrete answer," she said. "Sometimes things are just really complicated, and we might not have the statistical means of understanding what something does yet."