effect of social media on mental health research paper

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Social Media and Mental Health: Benefits, Risks, and Opportunities for Research and Practice

• Published: 20 April 2020
• Volume 5 , pages 245–257, ( 2020 )

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• John A. Naslund 1 ,
• Ameya Bondre 2 ,
• John Torous 3 &
• Kelly A. Aschbrenner 4  

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Introduction

Social media has become a prominent fixture in the lives of many individuals facing the challenges of mental illness. Social media refers broadly to web and mobile platforms that allow individuals to connect with others within a virtual network (such as Facebook, Twitter, Instagram, Snapchat, or LinkedIn), where they can share, co-create, or exchange various forms of digital content, including information, messages, photos, or videos (Ahmed et al. 2019 ). Studies have reported that individuals living with a range of mental disorders, including depression, psychotic disorders, or other severe mental illnesses, use social media platforms at comparable rates as the general population, with use ranging from about 70% among middle-age and older individuals to upwards of 97% among younger individuals (Aschbrenner et al. 2018b ; Birnbaum et al. 2017b ; Brunette et al. 2019 ; Naslund et al. 2016 ). Other exploratory studies have found that many of these individuals with mental illness appear to turn to social media to share their personal experiences, seek information about their mental health and treatment options, and give and receive support from others facing similar mental health challenges (Bucci et al. 2019 ; Naslund et al. 2016b ).

Across the USA and globally, very few people living with mental illness have access to adequate mental health services (Patel et al. 2018 ). The wide reach and near ubiquitous use of social media platforms may afford novel opportunities to address these shortfalls in existing mental health care, by enhancing the quality, availability, and reach of services. Recent studies have explored patterns of social media use, impact of social media use on mental health and wellbeing, and the potential to leverage the popularity and interactive features of social media to enhance the delivery of interventions. However, there remains uncertainty regarding the risks and potential harms of social media for mental health (Orben and Przybylski 2019 ) and how best to weigh these concerns against potential benefits.

In this commentary, we summarized current research on the use of social media among individuals with mental illness, with consideration of the impact of social media on mental wellbeing, as well as early efforts using social media for delivery of evidence-based programs for addressing mental health problems. We searched for recent peer reviewed publications in Medline and Google Scholar using the search terms “mental health” or “mental illness” and “social media,” and searched the reference lists of recent reviews and other relevant studies. We reviewed the risks, potential harms, and necessary safety precautions with using social media for mental health. Overall, our goal was to consider the role of social media as a potentially viable intervention platform for offering support to persons with mental disorders, promoting engagement and retention in care, and enhancing existing mental health services, while balancing the need for safety. Given this broad objective, we did not perform a systematic search of the literature and we did not apply specific inclusion criteria based on study design or type of mental disorder.

Social Media Use and Mental Health

In 2020, there are an estimated 3.8 billion social media users worldwide, representing half the global population (We Are Social 2020 ). Recent studies have shown that individuals with mental disorders are increasingly gaining access to and using mobile devices, such as smartphones (Firth et al. 2015 ; Glick et al. 2016 ; Torous et al. 2014a , b ). Similarly, there is mounting evidence showing high rates of social media use among individuals with mental disorders, including studies looking at engagement with these popular platforms across diverse settings and disorder types. Initial studies from 2015 found that nearly half of a sample of psychiatric patients were social media users, with greater use among younger individuals (Trefflich et al. 2015 ), while 47% of inpatients and outpatients with schizophrenia reported using social media, of which 79% reported at least once-a-week usage of social media websites (Miller et al. 2015 ). Rates of social media use among psychiatric populations have increased in recent years, as reflected in a study with data from 2017 showing comparable rates of social media use (approximately 70%) among individuals with serious mental illness in treatment as compared with low-income groups from the general population (Brunette et al. 2019 ).

Similarly, among individuals with serious mental illness receiving community-based mental health services, a recent study found equivalent rates of social media use as the general population, even exceeding 70% of participants (Naslund et al. 2016 ). Comparable findings were demonstrated among middle-age and older individuals with mental illness accessing services at peer support agencies, where 72% of respondents reported using social media (Aschbrenner et al. 2018b ). Similar results, with 68% of those with first episode psychosis using social media daily were reported in another study (Abdel-Baki et al. 2017 ).

Individuals who self-identified as having a schizophrenia spectrum disorder responded to a survey shared through the National Alliance of Mental Illness (NAMI) and reported that visiting social media sites was one of their most common activities when using digital devices, taking up roughly 2 h each day (Gay et al. 2016 ). For adolescents and young adults ages 12 to 21 with psychotic disorders and mood disorders, over 97% reported using social media, with average use exceeding 2.5 h per day (Birnbaum et al. 2017b ). Similarly, in a sample of adolescents ages 13–18 recruited from community mental health centers, 98% reported using social media, with YouTube as the most popular platform, followed by Instagram and Snapchat (Aschbrenner et al. 2019 ).

Research has also explored the motivations for using social media as well as the perceived benefits of interacting on these platforms among individuals with mental illness. In the sections that follow (see Table 1 for a summary), we consider three potentially unique features of interacting and connecting with others on social media that may offer benefits for individuals living with mental illness. These include: (1) Facilitate social interaction; (2) Access to a peer support network; and (3) Promote engagement and retention in services.

Facilitate Social Interaction

Social media platforms offer near continuous opportunities to connect and interact with others, regardless of time of day or geographic location. This on demand ease of communication may be especially important for facilitating social interaction among individuals with mental disorders experiencing difficulties interacting in face-to-face settings. For example, impaired social functioning is a common deficit in schizophrenia spectrum disorders, and social media may facilitate communication and interacting with others for these individuals (Torous and Keshavan 2016 ). This was suggested in one study where participants with schizophrenia indicated that social media helped them to interact and socialize more easily (Miller et al. 2015 ). Like other online communication, the ability to connect with others anonymously may be an important feature of social media, especially for individuals living with highly stigmatizing health conditions (Berger et al. 2005 ), such as serious mental disorders (Highton-Williamson et al. 2015 ).

Studies have found that individuals with serious mental disorders (Spinzy et al. 2012 ) as well as young adults with mental illness (Gowen et al. 2012 ) appear to form online relationships and connect with others on social media as often as social media users from the general population. This is an important observation because individuals living with serious mental disorders typically have few social contacts in the offline world and also experience high rates of loneliness (Badcock et al. 2015 ; Giacco et al. 2016 ). Among individuals receiving publicly funded mental health services who use social media, nearly half (47%) reported using these platforms at least weekly to feel less alone (Brusilovskiy et al. 2016 ). In another study of young adults with serious mental illness, most indicated that they used social media to help feel less isolated (Gowen et al. 2012 ). Interestingly, more frequent use of social media among a sample of individuals with serious mental illness was associated with greater community participation, measured as participation in shopping, work, religious activities, or visiting friends and family, as well as greater civic engagement, reflected as voting in local elections (Brusilovskiy et al. 2016 ).

Emerging research also shows that young people with moderate to severe depressive symptoms appear to prefer communicating on social media rather than in-person (Rideout and Fox 2018 ), while other studies have found that some individuals may prefer to seek help for mental health concerns online rather than through in-person encounters (Batterham and Calear 2017 ). In a qualitative study, participants with schizophrenia described greater anonymity, the ability to discover that other people have experienced similar health challenges and reducing fears through greater access to information as important motivations for using the Internet to seek mental health information (Schrank et al. 2010 ). Because social media does not require the immediate responses necessary in face-to-face communication, it may overcome deficits with social interaction due to psychotic symptoms that typically adversely affect face-to-face conversations (Docherty et al. 1996 ). Online social interactions may not require the use of non-verbal cues, particularly in the initial stages of interaction (Kiesler et al. 1984 ), with interactions being more fluid and within the control of users, thereby overcoming possible social anxieties linked to in-person interaction (Indian and Grieve 2014 ). Furthermore, many individuals with serious mental disorders can experience symptoms including passive social withdrawal, blunted affect, and attentional impairment, as well as active social avoidance due to hallucinations or other concerns (Hansen et al. 2009 ), thus potentially reinforcing the relative advantage, as perceived by users, of using social media over in person conversations.

Access to a Peer Support Network

There is growing recognition about the role that social media channels could play in enabling peer support (Bucci et al. 2019 ; Naslund et al. 2016b ), referred to as a system of mutual giving and receiving where individuals who have endured the difficulties of mental illness can offer hope, friendship, and support to others facing similar challenges (Davidson et al. 2006 ; Mead et al. 2001 ). Initial studies exploring use of online self-help forums among individuals with serious mental illnesses have found that individuals with schizophrenia appeared to use these forums for self-disclosure and sharing personal experiences, in addition to providing or requesting information, describing symptoms, or discussing medication (Haker et al. 2005 ), while users with bipolar disorder reported using these forums to ask for help from others about their illness (Vayreda and Antaki 2009 ). More recently, in a review of online social networking in people with psychosis, Highton-Williamson et al. ( 2015 ) highlight that an important purpose of such online connections was to establish new friendships, pursue romantic relationships, maintain existing relationships or reconnect with people, and seek online peer support from others with lived experience (Highton-Williamson et al. 2015 ).

Online peer support among individuals with mental illness has been further elaborated in various studies. In a content analysis of comments posted to YouTube by individuals who self-identified as having a serious mental illness, there appeared to be opportunities to feel less alone, provide hope, find support and learn through mutual reciprocity, and share coping strategies for day-to-day challenges of living with a mental illness (Naslund et al. 2014 ). In another study, Chang ( 2009 ) delineated various communication patterns in an online psychosis peer-support group (Chang 2009 ). Specifically, different forms of support emerged, including “informational support” about medication use or contacting mental health providers, “esteem support” involving positive comments for encouragement, “network support” for sharing similar experiences, and “emotional support” to express understanding of a peer’s situation and offer hope or confidence (Chang 2009 ). Bauer et al. ( 2013 ) reported that the main interest in online self-help forums for patients with bipolar disorder was to share emotions with others, allow exchange of information, and benefit by being part of an online social group (Bauer et al. 2013 ).

For individuals who openly discuss mental health problems on Twitter, a study by Berry et al. ( 2017 ) found that this served as an important opportunity to seek support and to hear about the experiences of others (Berry et al. 2017 ). In a survey of social media users with mental illness, respondents reported that sharing personal experiences about living with mental illness and opportunities to learn about strategies for coping with mental illness from others were important reasons for using social media (Naslund et al. 2017 ). A computational study of mental health awareness campaigns on Twitter provides further support with inspirational posts and tips being the most shared (Saha et al. 2019 ). Taken together, these studies offer insights about the potential for social media to facilitate access to an informal peer support network, though more research is necessary to examine how these online interactions may impact intentions to seek care, illness self-management, and clinically meaningful outcomes in offline contexts.

Promote Engagement and Retention in Services

Many individuals living with mental disorders have expressed interest in using social media platforms for seeking mental health information (Lal et al. 2018 ), connecting with mental health providers (Birnbaum et al. 2017b ), and accessing evidence-based mental health services delivered over social media specifically for coping with mental health symptoms or for promoting overall health and wellbeing (Naslund et al. 2017 ). With the widespread use of social media among individuals living with mental illness combined with the potential to facilitate social interaction and connect with supportive peers, as summarized above, it may be possible to leverage the popular features of social media to enhance existing mental health programs and services. A recent review by Biagianti et al. ( 2018 ) found that peer-to-peer support appeared to offer feasible and acceptable ways to augment digital mental health interventions for individuals with psychotic disorders by specifically improving engagement, compliance, and adherence to the interventions and may also improve perceived social support (Biagianti et al. 2018 ).

Among digital programs that have incorporated peer-to-peer social networking consistent with popular features on social media platforms, a pilot study of the HORYZONS online psychosocial intervention demonstrated significant reductions in depression among patients with first episode psychosis (Alvarez-Jimenez et al. 2013 ). Importantly, the majority of participants (95%) in this study engaged with the peer-to-peer networking feature of the program, with many reporting increases in perceived social connectedness and empowerment in their recovery process (Alvarez-Jimenez et al. 2013 ). This moderated online social therapy program is now being evaluated as part of a large randomized controlled trial for maintaining treatment effects from first episode psychosis services (Alvarez-Jimenez et al. 2019 ).

Other early efforts have demonstrated that use of digital environments with the interactive peer-to-peer features of social media can enhance social functioning and wellbeing in young people at high risk of psychosis (Alvarez-Jimenez et al. 2018 ). There has also been a recent emergence of several mobile apps to support symptom monitoring and relapse prevention in psychotic disorders. Among these apps, the development of PRIME (Personalized Real-time Intervention for Motivational Enhancement) has involved working closely with young people with schizophrenia to ensure that the design of the app has the look and feel of mainstream social media platforms, as opposed to existing clinical tools (Schlosser et al. 2016 ). This unique approach to the design of the app is aimed at promoting engagement and ensuring that the app can effectively improve motivation and functioning through goal setting and promoting better quality of life of users with schizophrenia (Schlosser et al. 2018 ).

Social media platforms could also be used to promote engagement and participation in in-person services delivered through community mental health settings. For example, the peer-based lifestyle intervention called PeerFIT targets weight loss and improved fitness among individuals living with serious mental illness through a combination of in-person lifestyle classes, exercise groups, and use of digital technologies (Aschbrenner et al. 2016b , c ). The intervention holds tremendous promise as lack of support is one of the largest barriers towards exercise in patients with serious mental illness (Firth et al. 2016 ), and it is now possible to use social media to counter such. Specifically, in PeerFIT, a private Facebook group is closely integrated into the program to offer a closed platform where participants can connect with the lifestyle coaches, access intervention content, and support or encourage each other as they work towards their lifestyle goals (Aschbrenner et al. 2016a ; Naslund et al. 2016a ). To date, this program has demonstrated preliminary effectiveness for meaningfully reducing cardiovascular risk factors that contribute to early mortality in this patient group (Aschbrenner, Naslund, Shevenell, Kinney, et al., 2016), while the Facebook component appears to have increased engagement in the program, while allowing participants who were unable to attend in-person sessions due to other health concerns or competing demands to remain connected with the program (Naslund et al. 2018 ). This lifestyle intervention is currently being evaluated in a randomized controlled trial enrolling young adults with serious mental illness from real world community mental health services settings (Aschbrenner et al. 2018a ).

These examples highlight the promise of incorporating the features of popular social media into existing programs, which may offer opportunities to safely promote engagement and program retention, while achieving improved clinical outcomes. This is an emerging area of research, as evidenced by several important effectiveness trials underway (Alvarez-Jimenez et al. 2019 ; Aschbrenner et al. 2018a ), including efforts to leverage online social networking to support family caregivers of individuals receiving first episode psychosis services (Gleeson et al. 2017 ).

Challenges with Social Media for Mental Health

The science on the role of social media for engaging persons with mental disorders needs a cautionary note on the effects of social media usage on mental health and wellbeing, particularly in adolescents and young adults. While the risks and harms of social media are frequently covered in the popular press and mainstream news reports, careful consideration of the research in this area is necessary. In a review of 43 studies in young people, many benefits of social media were cited, including increased self-esteem and opportunities for self-disclosure (Best et al. 2014 ). Yet, reported negative effects were an increased exposure to harm, social isolation, depressive symptoms, and bullying (Best et al. 2014 ). In the sections that follow (see Table 1 for a summary), we consider three major categories of risk related to use of social media and mental health. These include: (1) Impact on symptoms; (2) Facing hostile interactions; and (3) Consequences for daily life.

Impact on Symptoms

Studies consistently highlight that use of social media, especially heavy use and prolonged time spent on social media platforms, appears to contribute to increased risk for a variety of mental health symptoms and poor wellbeing, especially among young people (Andreassen et al. 2016 ; Kross et al. 2013 ; Woods and Scott 2016 ). This may partly be driven by the detrimental effects of screen time on mental health, including increased severity of anxiety and depressive symptoms, which have been well documented (Stiglic and Viner 2019 ). Recent studies have reported negative effects of social media use on mental health of young people, including social comparison pressure with others and greater feeling of social isolation after being rejected by others on social media (Rideout and Fox 2018 ). In a study of young adults, it was found that negative comparisons with others on Facebook contributed to risk of rumination and subsequent increases in depression symptoms (Feinstein et al. 2013 ). Still, the cross-sectional nature of many screen time and mental health studies makes it challenging to reach causal inferences (Orben and Przybylski 2019 ).

Quantity of social media use is also an important factor, as highlighted in a survey of young adults ages 19 to 32, where more frequent visits to social media platforms each week were correlated with greater depressive symptoms (Lin et al. 2016 ). More time spent using social media is also associated with greater symptoms of anxiety (Vannucci et al. 2017 ). The actual number of platforms accessed also appears to contribute to risk as reflected in another national survey of young adults where use of a large number of social media platforms was associated with negative impact on mental health (Primack et al. 2017 ). Among survey respondents using between 7 and 11 different social media platforms compared with respondents using only 2 or fewer platforms, there were 3 times greater odds of having high levels of depressive symptoms and a 3.2 times greater odds of having high levels of anxiety symptoms (Primack et al. 2017 ).

Many researchers have postulated that worsening mental health attributed to social media use may be because social media replaces face-to-face interactions for young people (Twenge and Campbell 2018 ) and may contribute to greater loneliness (Bucci et al. 2019 ) and negative effects on other aspects of health and wellbeing (Woods and Scott 2016 ). One nationally representative survey of US adolescents found that among respondents who reported more time accessing media such as social media platforms or smartphone devices, there were significantly greater depressive symptoms and increased risk of suicide when compared with adolescents who reported spending more time on non-screen activities, such as in-person social interaction or sports and recreation activities (Twenge et al. 2018 ). For individuals living with more severe mental illnesses, the effects of social media on psychiatric symptoms have received less attention. One study found that participation in chat rooms may contribute to worsening symptoms in young people with psychotic disorders (Mittal et al. 2007 ), while another study of patients with psychosis found that social media use appeared to predict low mood (Berry et al. 2018 ). These studies highlight a clear relationship between social media use and mental health that may not be present in general population studies (Orben and Przybylski 2019 ) and emphasize the need to explore how social media may contribute to symptom severity and whether protective factors may be identified to mitigate these risks.

Facing Hostile Interactions

Popular social media platforms can create potential situations where individuals may be victimized by negative comments or posts. Cyberbullying represents a form of online aggression directed towards specific individuals, such as peers or acquaintances, which is perceived to be most harmful when compared with random hostile comments posted online (Hamm et al. 2015 ). Importantly, cyberbullying on social media consistently shows harmful impact on mental health in the form of increased depressive symptoms as well as worsening of anxiety symptoms, as evidenced in a review of 36 studies among children and young people (Hamm et al. 2015 ). Furthermore, cyberbullying disproportionately impacts females as reflected in a national survey of adolescents in the USA, where females were twice as likely to be victims of cyberbullying compared with males (Alhajji et al. 2019 ). Most studies report cross-sectional associations between cyberbullying and symptoms of depression or anxiety (Hamm et al. 2015 ), though one longitudinal study in Switzerland found that cyberbullying contributed to significantly greater depression over time (Machmutow et al. 2012 ).

For youth ages 10 to 17 who reported major depressive symptomatology, there were over 3 times greater odds of facing online harassment in the last year compared with youth who reported mild or no depressive symptoms (Ybarra 2004 ). Similarly, in a 2018 national survey of young people, respondents ages 14 to 22 with moderate to severe depressive symptoms were more likely to have had negative experiences when using social media and, in particular, were more likely to report having faced hostile comments or being “trolled” from others when compared with respondents without depressive symptoms (31% vs. 14%) (Rideout and Fox 2018 ). As these studies depict risks for victimization on social media and the correlation with poor mental health, it is possible that individuals living with mental illness may also experience greater hostility online compared to individuals without mental illness. This would be consistent with research showing greater risk of hostility, including increased violence and discrimination, directed towards individuals living with mental illness in in-person contexts, especially targeted at those with severe mental illnesses (Goodman et al. 1999 ).

A computational study of mental health awareness campaigns on Twitter reported that while stigmatizing content was rare, it was actually the most spread (re-tweeted) demonstrating that harmful content can travel quickly on social media (Saha et al. 2019 ). Another study was able to map the spread of social media posts about the Blue Whale Challenge, an alleged game promoting suicide, over Twitter, YouTube, Reddit, Tumblr, and other forums across 127 countries (Sumner et al. 2019 ). These findings show that it is critical to monitor the actual content of social media posts, such as determining whether content is hostile or promotes harm to self or others. This is pertinent because existing research looking at duration of exposure cannot account for the impact of specific types of content on mental health and is insufficient to fully understand the effects of using these platforms on mental health.

Consequences for Daily Life

The ways in which individuals use social media can also impact their offline relationships and everyday activities. To date, reports have described risks of social media use pertaining to privacy, confidentiality, and unintended consequences of disclosing personal health information online (Torous and Keshavan 2016 ). Additionally, concerns have been raised about poor quality or misleading health information shared on social media and that social media users may not be aware of misleading information or conflicts of interest especially when the platforms promote popular content regardless of whether it is from a trustworthy source (Moorhead et al. 2013 ; Ventola 2014 ). For persons living with mental illness, there may be additional risks from using social media. A recent study that specifically explored the perspectives of social media users with serious mental illnesses, including participants with schizophrenia spectrum disorders, bipolar disorder, or major depression, found that over one third of participants expressed concerns about privacy when using social media (Naslund and Aschbrenner 2019 ). The reported risks of social media use were directly related to many aspects of everyday life, including concerns about threats to employment, fear of stigma and being judged, impact on personal relationships, and facing hostility or being hurt (Naslund and Aschbrenner 2019 ). While few studies have specifically explored the dangers of social media use from the perspectives of individuals living with mental illness, it is important to recognize that use of these platforms may contribute to risks that extend beyond worsening symptoms and that can affect different aspects of daily life.

In this commentary, we considered ways in which social media may yield benefits for individuals living with mental illness, while contrasting these with the possible harms. Studies reporting on the threats of social media for individuals with mental illness are mostly cross-sectional, making it difficult to draw conclusions about direction of causation. However, the risks are potentially serious. These risks should be carefully considered in discussions pertaining to use of social media and the broader use of digital mental health technologies, as avenues for mental health promotion or for supporting access to evidence-based programs or mental health services. At this point, it would be premature to view the benefits of social media as outweighing the possible harms, when it is clear from the studies summarized here that social media use can have negative effects on mental health symptoms, can potentially expose individuals to hurtful content and hostile interactions, and can result in serious consequences for daily life, including threats to employment and personal relationships. Despite these risks, it is also necessary to recognize that individuals with mental illness will continue to use social media given the ease of accessing these platforms and the immense popularity of online social networking. With this in mind, it may be ideal to raise awareness about these possible risks so that individuals can implement necessary safeguards, while highlighting that there could also be benefits. Being aware of the risks is an essential first step, before then recognizing that use of these popular platforms could contribute to some benefits like finding meaningful interactions with others, engaging with peer support networks, and accessing information and services.

To capitalize on the widespread use of social media and to achieve the promise that these platforms may hold for supporting the delivery of targeted mental health interventions, there is need for continued research to better understand how individuals living with mental illness use social media. Such efforts could inform safety measures and also encourage use of social media in ways that maximize potential benefits while minimizing risk of harm. It will be important to recognize how gender and race contribute to differences in use of social media for seeking mental health information or accessing interventions, as well as differences in how social media might impact mental wellbeing. For example, a national survey of 14- to 22-year olds in the USA found that female respondents were more likely to search online for information about depression or anxiety and to try to connect with other people online who share similar mental health concerns when compared with male respondents (Rideout and Fox 2018 ). In the same survey, there did not appear to be any differences between racial or ethnic groups in social media use for seeking mental health information (Rideout and Fox 2018 ). Social media use also appears to have a differential impact on mental health and emotional wellbeing between females and males (Booker et al. 2018 ), highlighting the need to explore unique experiences between gender groups to inform tailored programs and services. Research shows that lesbian, gay, bisexual, or transgender individuals frequently use social media for searching for health information and may be more likely compared with heterosexual individuals to share their own personal health experiences with others online (Rideout and Fox 2018 ). Less is known about use of social media for seeking support for mental health concerns among gender minorities, though this is an important area for further investigation as these individuals are more likely to experience mental health problems and online victimization when compared with heterosexual individuals (Mereish et al. 2019 ).

Similarly, efforts are needed to explore the relationship between social media use and mental health among ethnic and racial minorities. A recent study found that exposure to traumatic online content on social media showing violence or hateful posts directed at racial minorities contributed to increases in psychological distress, PTSD symptoms, and depression among African American and Latinx adolescents in the USA (Tynes et al. 2019 ). These concerns are contrasted by growing interest in the potential for new technologies including social media to expand the reach of services to underrepresented minority groups (Schueller et al. 2019 ). Therefore, greater attention is needed to understanding the perspectives of ethnic and racial minorities to inform effective and safe use of social media for mental health promotion efforts.

Research has found that individuals living with mental illness have expressed interest in accessing mental health services through social media platforms. A survey of social media users with mental illness found that most respondents were interested in accessing programs for mental health on social media targeting symptom management, health promotion, and support for communicating with health care providers and interacting with the health system (Naslund et al. 2017 ). Importantly, individuals with serious mental illness have also emphasized that any mental health intervention on social media would need to be moderated by someone with adequate training and credentials, would need to have ground rules and ways to promote safety and minimize risks, and importantly, would need to be free and easy to access.

An important strength with this commentary is that it combines a range of studies broadly covering the topic of social media and mental health. We have provided a summary of recent evidence in a rapidly advancing field with the goal of presenting unique ways that social media could offer benefits for individuals with mental illness, while also acknowledging the potentially serious risks and the need for further investigation. There are also several limitations with this commentary that warrant consideration. Importantly, as we aimed to address this broad objective, we did not conduct a systematic review of the literature. Therefore, the studies reported here are not exhaustive, and there may be additional relevant studies that were not included. Additionally, we only summarized published studies, and as a result, any reports from the private sector or websites from different organizations using social media or other apps containing social media–like features would have been omitted. Although, it is difficult to rigorously summarize work from the private sector, sometimes referred to as “gray literature,” because many of these projects are unpublished and are likely selective in their reporting of findings given the target audience may be shareholders or consumers.

Another notable limitation is that we did not assess risk of bias in the studies summarized in this commentary. We found many studies that highlighted risks associated with social media use for individuals living with mental illness; however, few studies of programs or interventions reported negative findings, suggesting the possibility that negative findings may go unpublished. This concern highlights the need for a future more rigorous review of the literature with careful consideration of bias and an accompanying quality assessment. Most of the studies that we described were from the USA, as well as from other higher income settings such as Australia or the UK. Despite the global reach of social media platforms, there is a dearth of research on the impact of these platforms on the mental health of individuals in diverse settings, as well as the ways in which social media could support mental health services in lower income countries where there is virtually no access to mental health providers. Future research is necessary to explore the opportunities and risks for social media to support mental health promotion in low-income and middle-income countries, especially as these countries face a disproportionate share of the global burden of mental disorders, yet account for the majority of social media users worldwide (Naslund et al. 2019 ).

Future Directions for Social Media and Mental Health

As we consider future research directions, the near ubiquitous social media use also yields new opportunities to study the onset and manifestation of mental health symptoms and illness severity earlier than traditional clinical assessments. There is an emerging field of research referred to as “digital phenotyping” aimed at capturing how individuals interact with their digital devices, including social media platforms, in order to study patterns of illness and identify optimal time points for intervention (Jain et al. 2015 ; Onnela and Rauch 2016 ). Given that most people access social media via mobile devices, digital phenotyping and social media are closely related (Torous et al. 2019 ). To date, the emergence of machine learning, a powerful computational method involving statistical and mathematical algorithms (Shatte et al. 2019 ), has made it possible to study large quantities of data captured from popular social media platforms such as Twitter or Instagram to illuminate various features of mental health (Manikonda and De Choudhury 2017 ; Reece et al. 2017 ). Specifically, conversations on Twitter have been analyzed to characterize the onset of depression (De Choudhury et al. 2013 ) as well as detecting users’ mood and affective states (De Choudhury et al. 2012 ), while photos posted to Instagram can yield insights for predicting depression (Reece and Danforth 2017 ). The intersection of social media and digital phenotyping will likely add new levels of context to social media use in the near future.

Several studies have also demonstrated that when compared with a control group, Twitter users with a self-disclosed diagnosis of schizophrenia show unique online communication patterns (Birnbaum et al. 2017a ), including more frequent discussion of tobacco use (Hswen et al. 2017 ), symptoms of depression and anxiety (Hswen et al. 2018b ), and suicide (Hswen et al. 2018a ). Another study found that online disclosures about mental illness appeared beneficial as reflected by fewer posts about symptoms following self-disclosure (Ernala et al. 2017 ). Each of these examples offers early insights into the potential to leverage widely available online data for better understanding the onset and course of mental illness. It is possible that social media data could be used to supplement additional digital data, such as continuous monitoring using smartphone apps or smart watches, to generate a more comprehensive “digital phenotype” to predict relapse and identify high-risk health behaviors among individuals living with mental illness (Torous et al. 2019 ).

With research increasingly showing the valuable insights that social media data can yield about mental health states, greater attention to the ethical concerns with using individual data in this way is necessary (Chancellor et al. 2019 ). For instance, data is typically captured from social media platforms without the consent or awareness of users (Bidargaddi et al. 2017 ), which is especially crucial when the data relates to a socially stigmatizing health condition such as mental illness (Guntuku et al. 2017 ). Precautions are needed to ensure that data is not made identifiable in ways that were not originally intended by the user who posted the content as this could place an individual at risk of harm or divulge sensitive health information (Webb et al. 2017 ; Williams et al. 2017 ). Promising approaches for minimizing these risks include supporting the participation of individuals with expertise in privacy, clinicians, and the target individuals with mental illness throughout the collection of data, development of predictive algorithms, and interpretation of findings (Chancellor et al. 2019 ).

In recognizing that many individuals living with mental illness use social media to search for information about their mental health, it is possible that they may also want to ask their clinicians about what they find online to check if the information is reliable and trustworthy. Alternatively, many individuals may feel embarrassed or reluctant to talk to their clinicians about using social media to find mental health information out of concerns of being judged or dismissed. Therefore, mental health clinicians may be ideally positioned to talk with their patients about using social media and offer recommendations to promote safe use of these sites while also respecting their patients’ autonomy and personal motivations for using these popular platforms. Given the gap in clinical knowledge about the impact of social media on mental health, clinicians should be aware of the many potential risks so that they can inform their patients while remaining open to the possibility that their patients may also experience benefits through use of these platforms. As awareness of these risks grows, it may be possible that new protections will be put in place by industry or through new policies that will make the social media environment safer. It is hard to estimate a number needed to treat or harm today given the nascent state of research, which means the patient and clinician need to weigh the choice on a personal level. Thus, offering education and information is an important first step in that process. As patients increasingly show interest in accessing mental health information or services through social media, it will be necessary for health systems to recognize social media as a potential avenue for reaching or offering support to patients. This aligns with growing emphasis on the need for greater integration of digital psychiatry, including apps, smartphones, or wearable devices, into patient care and clinical services through institution-wide initiatives and training clinical providers (Hilty et al. 2019 ). Within a learning healthcare environment where research and care are tightly intertwined and feedback between both is rapid, the integration of digital technologies into services may create new opportunities for advancing use of social media for mental health.

As highlighted in this commentary, social media has become an important part of the lives of many individuals living with mental disorders. Many of these individuals use social media to share their lived experiences with mental illness, to seek support from others, and to search for information about treatment recommendations, accessing mental health services and coping with symptoms (Bucci et al. 2019 ; Highton-Williamson et al. 2015 ; Naslund et al. 2016b ). As the field of digital mental health advances, the wide reach, ease of access, and popularity of social media platforms could be used to allow individuals in need of mental health services or facing challenges of mental illness to access evidence-based treatment and support. To achieve this end and to explore whether social media platforms can advance efforts to close the gap in available mental health services in the USA and globally, it will be essential for researchers to work closely with clinicians and with those affected by mental illness to ensure that possible benefits of using social media are carefully weighed against anticipated risks.

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Dr. Naslund is supported by a grant from the National Institute of Mental Health (U19MH113211). Dr. Aschbrenner is supported by a grant from the National Institute of Mental Health (1R01MH110965-01).

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Naslund, J.A., Bondre, A., Torous, J. et al. Social Media and Mental Health: Benefits, Risks, and Opportunities for Research and Practice. J. technol. behav. sci. 5 , 245–257 (2020). https://doi.org/10.1007/s41347-020-00134-x

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Pros & cons: impacts of social media on mental health

• Ágnes Zsila 1 , 2 &
• Marc Eric S. Reyes   ORCID: orcid.org/0000-0002-5280-1315 3  

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The use of social media significantly impacts mental health. It can enhance connection, increase self-esteem, and improve a sense of belonging. But it can also lead to tremendous stress, pressure to compare oneself to others, and increased sadness and isolation. Mindful use is essential to social media consumption.

Social media has become integral to our daily routines: we interact with family members and friends, accept invitations to public events, and join online communities to meet people who share similar preferences using these platforms. Social media has opened a new avenue for social experiences since the early 2000s, extending the possibilities for communication. According to recent research [ 1 ], people spend 2.3 h daily on social media. YouTube, TikTok, Instagram, and Snapchat have become increasingly popular among youth in 2022, and one-third think they spend too much time on these platforms [ 2 ]. The considerable time people spend on social media worldwide has directed researchers’ attention toward the potential benefits and risks. Research shows excessive use is mainly associated with lower psychological well-being [ 3 ]. However, findings also suggest that the quality rather than the quantity of social media use can determine whether the experience will enhance or deteriorate the user’s mental health [ 4 ]. In this collection, we will explore the impact of social media use on mental health by providing comprehensive research perspectives on positive and negative effects.

Social media can provide opportunities to enhance the mental health of users by facilitating social connections and peer support [ 5 ]. Indeed, online communities can provide a space for discussions regarding health conditions, adverse life events, or everyday challenges, which may decrease the sense of stigmatization and increase belongingness and perceived emotional support. Mutual friendships, rewarding social interactions, and humor on social media also reduced stress during the COVID-19 pandemic [ 4 ].

On the other hand, several studies have pointed out the potentially detrimental effects of social media use on mental health. Concerns have been raised that social media may lead to body image dissatisfaction [ 6 ], increase the risk of addiction and cyberbullying involvement [ 5 ], contribute to phubbing behaviors [ 7 ], and negatively affects mood [ 8 ]. Excessive use has increased loneliness, fear of missing out, and decreased subjective well-being and life satisfaction [ 8 ]. Users at risk of social media addiction often report depressive symptoms and lower self-esteem [ 9 ].

Overall, findings regarding the impact of social media on mental health pointed out some essential resources for psychological well-being through rewarding online social interactions. However, there is a need to raise awareness about the possible risks associated with excessive use, which can negatively affect mental health and everyday functioning [ 9 ]. There is neither a negative nor positive consensus regarding the effects of social media on people. However, by teaching people social media literacy, we can maximize their chances of having balanced, safe, and meaningful experiences on these platforms [ 10 ].

We encourage researchers to submit their research articles and contribute to a more differentiated overview of the impact of social media on mental health. BMC Psychology welcomes submissions to its new collection, which promises to present the latest findings in the emerging field of social media research. We seek research papers using qualitative and quantitative methods, focusing on social media users’ positive and negative aspects. We believe this collection will provide a more comprehensive picture of social media’s positive and negative effects on users’ mental health.

Data Availability

Not applicable.

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Acknowledgements

Ágnes Zsila was supported by the ÚNKP-22-4 New National Excellence Program of the Ministry for Culture and Innovation from the source of the National Research, Development and Innovation Fund.

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Ágnes Zsila

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Department of Psychology, College of Science, University of Santo Tomas, Manila, 1008, Philippines

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AZ conceived and drafted the Editorial. MESR wrote the abstract and revised the Editorial. All authors read and approved the final manuscript.

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Zsila, Á., Reyes, M.E.S. Pros & cons: impacts of social media on mental health. BMC Psychol 11 , 201 (2023). https://doi.org/10.1186/s40359-023-01243-x

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Social Media and Mental Health: Benefits, Risks, and Opportunities for Research and Practice

Affiliations.

• 1 Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA.
• 2 CareNX Innovations, Mumbai, India.
• 3 Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA.
• 4 Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH.
• PMID: 33415185
• PMCID: PMC7785056
• DOI: 10.1007/s41347-020-00134-x

Social media platforms are popular venues for sharing personal experiences, seeking information, and offering peer-to-peer support among individuals living with mental illness. With significant shortfalls in the availability, quality, and reach of evidence-based mental health services across the United States and globally, social media platforms may afford new opportunities to bridge this gap. However, caution is warranted, as numerous studies highlight risks of social media use for mental health. In this commentary, we consider the role of social media as a potentially viable intervention platform for offering support to persons with mental disorders, promoting engagement and retention in care, and enhancing existing mental health services. Specifically, we summarize current research on the use of social media among mental health service users, and early efforts using social media for the delivery of evidence-based programs. We also review the risks, potential harms, and necessary safety precautions with using social media for mental health. To conclude, we explore opportunities using data science and machine learning, for example by leveraging social media for detecting mental disorders and developing predictive models aimed at characterizing the aetiology and progression of mental disorders. These various efforts using social media, as summarized in this commentary, hold promise for improving the lives of individuals living with mental disorders.

Keywords: digital health; mHealth; mental health; psychiatry; safety; social media.

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Social media and mental health in students: a cross-sectional study during the Covid-19 pandemic

• Abouzar Nazari   ORCID: orcid.org/0000-0003-2155-5438 1 ,
• Maede Hosseinnia   ORCID: orcid.org/0000-0002-2248-7011 2 ,
• Samaneh Torkian 3 &
• Gholamreza Garmaroudi   ORCID: orcid.org/0000-0001-7449-227X 4  

BMC Psychiatry volume  23 , Article number:  458 ( 2023 ) Cite this article

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Social media causes increased use and problems due to their attractions. Hence, it can affect mental health, especially in students. The present study was conducted with the aim of determining the relationship between the use of social media and the mental health of students.

Materials and methods

The current cross-sectional study was conducted in 2021 on 781 university students in Lorestan province, who were selected by the Convenience Sampling method. The data was collected using a questionnaire on demographic characteristics, social media, problematic use of social media, and mental health (DASS-21). Data were analyzed in SPSS-26 software.

Shows that marital status, major, and household income are significantly associated with lower DASS21 scores (a lower DASS21 score means better mental health status). Also, problematic use of social media (β = 3.54, 95% CI: (3.23, 3.85)) was significantly associated with higher mental health scores (a higher DASS21 score means worse mental health status). Income and social media use (β = 1.02, 95% CI: 0.78, 1.25) were significantly associated with higher DASS21 scores (a higher DASS21 score means worse mental health status). Major was significantly associated with lower DASS21 scores (a lower DASS21 score means better mental health status).

This study indicated that social media had a direct relationship with mental health. Despite the large amount of evidence suggesting that social media harms mental health, more research is still necessary to determine the cause and how social media can be used without harmful effects.

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• Social media

Social media is one of the newest and most popular internet services, which has caused significant progress in the social systems of different countries in recent years [ 1 , 2 ]. The use of the Internet has become popular among people in such a way that its use has become inevitable and has made life difficult for those who use it excessively [ 3 ]. Social media has attracted the attention of millions of users around the world owing to the possibility of fast communication, access to a large amount of information, and its widespread dissemination [ 4 ]. Facebook, WhatsApp, Instagram, and Twitter are the most popular media that have attractive and diverse spaces for online communication among users, especially the young generation [ 5 , 6 ].

According to studies, at least 55% of the world’s population used social media in 2022 [ 7 ]. Iranian statistics also indicate that 78.5% of people use at least one social media. WhatsApp, with 71.1% of users, Instagram, with 49.4%, and Telegram, with 31.6% are the most popular social media among Iranians [ 8 , 9 ].

The use of social media has increased significantly in all age groups due to the origin of the COVID-19 pandemic [ 10 ] .It affected younger people, especially students, due to educational and other purposes [ 11 , 12 ]. Because of the sudden onset of the COVID-19 pandemic, educational institutions and learners had to accept e-learning as the only sustainable education option [ 13 ]. The rapid migration to E-learning has brought several challenges that can have both positive and negative consequences [ 14 ].

Unlike traditional media, where users are passive, social media enables people to create and share content; hence, they have become popular tools for social interaction [ 15 ].The freedom to choose to participate in the company of friends, anonymity, moderation, encouragement, the free exchange of feelings, and network interactions without physical presence and the constraints of the real world are some of the most significant factors that influence users’ continued activity in social media [ 16 ]. In social media, people can interact, maintain relationships, make new friends, and find out more about the people they know offline [ 17 ]. However, this popularity has resulted in significant lifestyle changes, as well as intentional or unintentional changes in various aspects of human social life [ 18 ]. Despite many advantages, the high use of social media brings negative physical, psychological, and social problems and consequences [ 19 ], but despite the use and access of more people to the Internet, its consequences and crises have been ignored [ 20 ].

Use of social media and mental health

Spending too much time on social media can easily become problematic [ 21 ]. Excessive use of social media, called problematic use, has symptoms similar to addiction [ 22 , 23 ]. Problematic use of social media represents a non-drug-related disorder in which harmful effects emerge due to preoccupation and compulsion to over-participate in social media platforms despite its highly negative consequences [ 24 , 25 , 26 ], which leads to adverse consequences of mental health, including anxiety, depression, lower well-being, and lower self-esteem [ 27 , 28 , 29 ].

Mental health & use of social media

Mental health is the main pillar of healthy human societies, which plays a vital role in ensuring the dynamism and efficiency of any society in such a way that other parts of health cannot be achieved without mental health [ 30 ]. According to World Health Organization’s (WHO) definition, mental health refers to a person’s ability to communicate with others [ 31 ]. Some researchers believe that social relationships can significantly affect mental health and improve quality of life by creating a sense of belonging and social identity [ 32 ]. It is also reported that people with higher social interactions have higher physical and mental health [ 33 ].

Scientific evidence also shows that social media affect people’s mental health [ 34 ]. Social studies and critiques often emphasize the investigation of the negative effects of Internet use [ 35 ]. For example, Kim et al. studied 1573 participants aged 18–64 years and reported that Internet addiction and social media use were associated with higher levels of depression and suicidal thoughts [ 36 ]. Zadar also studied adults and reported that excessive use of social media and the Internet was correlated with stress, sleep disturbances, and personality disorders [ 37 ]. Richards et al. reported the negative effects of the Internet and social media on the health and quality of life of adolescents [ 38 ]. There have been numerous studies that examine Internet addiction and its associated problems in young people [ 39 , 40 ], as well as reports of the effects of social media use on young people’s mental health [ 41 , 42 ].

A study on Iranian students showed that social media leads to depression, anxiety, and mental health decline [ 25 ]. A study on Iranian students showed that social media leads to depression, anxiety, and mental health decline [ 25 ]. But no study has investigated the effects of social media on the mental health of students from a more traditional province with lower individualism and higher levels of social support (where they were thought to have lower social media use and better mental health) during the COVID-19 pandemic. As social media became more and more vital to university students’ social lives during the lockdowns, students were likely at increased risk of social media addiction, which could harm their mental health. University students depended more on social media due to the limitations of face-to-face interactions. In addition, previous studies were conducted exclusively on students in specific fields. However, in our study, all fields, including medical and non-medical science fields were investigated.

The present study was conducted to determine the relationship between the use of social media and mental health in students in Lorestan Province during the COVID-19 pandemic.

Study design and participants

The current study was descriptive-analytical, cross-sectional, and conducted from February to March 2022 with a statistical population made up of students in all academic grades at universities in Lorestan Province (19 scientific and academic centers, including centers under the supervision of the Ministry of Health and the Ministry of Science).

Sample size

According to the convenience sampling method, 781 people were chosen as participants in the present study. During the sampling, a questionnaire was created and uploaded virtually on Porsline’s website, and then the questionnaire link was shared in educational and academic groups on social media for students to complete the questionnaire under inclusion criteria (being a student at the University of Lorestan and consenting to participate in the study).

The research tools included the demographic information questionnaire, the standard social media use questionnaire, and the mental health questionnaire.

Demographic information

The demographic information age, gender, ethnicity, province of residence, urban or rural, place of residence, semester, and the field of study, marital status, household income, education level, and employment status were recorded.

Psychological assessment

The students were subjected to the Persian version of the Depression Anxiety Stress Scale (DASS21). It consists of three self-report scales designed to measure different emotional states. DASS21 questions were adjusted according to their importance and the culture of Iranian students. The DASS21 scale was scored on a four-point scale to assess the extent to which participants experienced each condition over the past few weeks. The scoring method was such that each question was scored from 0 (never) to 3 (very high). Samani (2008) found that the questionnaire has a validity of 0.77 and a Cronbach’s alpha of 0.82 [ 43 ].

Use of social media questionnaire

Among the 13 questions on social media use in the questionnaire, seven were asked on a Likert scale (never, sometimes, often, almost, and always) that examined the problematic use of social media, and six were asked about how much time users spend on social media. Because some items were related to the type of social media platform, which is not available today, and users now use newer social media platforms such as WhatsApp and Instagram, the questionnaires were modified by experts and fundamentally changed, and a 22-item questionnaire was obtained that covered the frequency of using social media. Cronbach’s alpha was equal to 0.705 for the first part, 0.794 for the second part, and 0.830 for all questions [ 44 ]. Considering the importance of the problematic use of the social media, six questions about the problematic use were measured separately.

To confirm the validity of the questionnaire, a panel of experts with CVR 0.49 and CVI 0.70 was used. Its reliability was also obtained (0.784) using Cronbach’s alpha coefficient. Finally, the questionnaire was tested in a class with 30 students to check the level of difficulty and comprehension of the questionnaire. Finally, a 22-item questionnaire was obtained, of which six items were about the problematic use of social media and the remaining 16 questions were about the rate and frequency of using social media. Cronbach’s alpha was 0.705 for the first part, including questions about the problematic use of the social media, and 0.794 for the second part, including questions about the rate and frequency of using the social media. The total Cronbach’s alpha for all questions was 0.830. Six questions about the problematic use of social media were measured separately due to the importance of the problematic use of social media. Also, a separate score was considered for each question. The scores of these six questions on the problematic use of the social media were summed, and a single score was obtained for analysis.

Statistical analysis

Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 26.0 (SPSS Inc., Chicago, IL, USA). The normal distribution of continuous variables was analyzed using the Kolmogorov-Smirnov test, histogram, and P-P diagram, which showed that they are not normally distributed. Descriptive statistics were calculated for all variables. Comparison between groups was done using Mann-Whitney and Kruskal-Wallis non-parametric tests. Multiple linear regression analysis was used to investigate the relationship between mental health, problematic use of social media, and social media use (The result of merging the Frequency of using social media and Time to use social media). Generalized Linear Models (GLM) were used to assess the association between mental health with the use of social media and problematic use of social media. Due to the high correlation (r = 0.585, p = < 0.001) between the use of social media and problematic use of social media, collinearity, we run two separate GLM models. Regression coefficients (β) and adjusted β (β*) with 95% CI and P-value were reported.

A total of 781 participants completed the questionnaires, of which 64.4% were women and 71.3% were single. The minimum age of the participants was 17 years, the maximum age was 45 years, and about half of them (48.9%) were between 21 and 25 years old. A total of 53.4% of the participants had bachelor’s degrees. The income level of 23.2% of participants was less than five million Tomans (the currency of Iran), and 69.7% of the participants were unemployed. 88.1% were living with their families and 70.8% were studying in non-medical fields. 86% of the participants lived in the city, and 58.9% were in their fourth semester or higher. Considering that the research was conducted in a Lorish Province, 43.8% of participants were from the Lorish ethnicity.

The mean total score of mental health was 12.30 with a standard deviation of 30.38, and the mean total score of social media was 14.5557 with a standard deviation of 7.74140.

Table  1 presents a comparison of the mean problematic use of social media and mental health with demographic variables. Considering the non-normality of the hypothesis H0, to compare the means of the independent variables, Mann-Whitney non-parametric tests (for the variables of gender, the field of study, academic semester, employment status, province of residence, and whether it is rural or urban) and Kruskal Wallis (for the variables age, ethnicity, level of education, household income and marital status). According to the obtained results, it was found that the score of problematic use of social media is significantly higher in women, the age group less than 20 years, unemployed, non-native students, dormitory students, and students living with friends or alone, Fars students, students with a household income level of fewer than 7 million Tomans(Iranian currency), and single, divorced, and widowed students were higher than the other groups(P < 0.05).

By comparing the mean score of mental health with demographic variables using non-parametric Mann-Whitney and Kruskal Wallis tests, it was found that there is a significant difference between the variable of poor mental health and all demographic variables (except for the semester variable), residence status (rural or urban) and education level. (There was a significant relationship (P < 0.05). In such a way that the mental health condition was worse in women, age group less than 20 years old, non-medical science, unemployed, non-native, and dormitory students. Also, Fars students, divorced, widowed, and students with a household income of fewer than 5 million Tomans (Iranian currency) showed poorer mental health status. (Table  1 ).

The final model shows that marital status, field, and household income were significantly associated with lower DASS21 scores (a lower DASS21 score means better mental health status). Being single (β* = -23.03, 95% CI: (-33.10, -12.96), being married (β* = -38.78, 95% CI: -51.23, -26.33), was in Medical sciences fields (β* = -8.15, 95% CI: -11.37, -4.94), and have income 7–10 million (β* = -5.66, 95% CI: -9.62, -1.71) were significantly associated with lower DASS21 scores (a lower DASS21 score means better mental health status). Problematic use of social media (β* = 3.54, 95% CI: (3.23, 3.85) was significantly associated with higher mental health scores (a higher DASS21 score means worse mental health status). (Table  2 )

Age, income, and use of social media (β* = 1.02, 95% CI: 0.78, 1.25) were significantly associated with higher DASS21 scores (a higher DASS21 score means worse mental health status). Marital status and field were significantly associated with lower DASS21 scores (a lower DASS21 score means better mental health status). Age groups < 20 years (β* = 6.36, 95% CI: 0.78, 11.95) and income group < 5 million (β* = 6.58, 95% CI: 1.47, 11.70) increased mental health scores. Being single (β* = -34.72, 95% CI: -47.06, -38.78), being married (β* = -38.78, 95% CI: -51.23, -26.33) and in medical sciences fields (β* = -8.17, 95% CI: -12.09, -4.24) decreased DASS21 scores. (Table  3 )

The main purpose of this study was to determine the relationship between social media use and mental health among students during the COVID-19 pandemic.

University students are more reliant on social media because of the limitations of in-person interactions [ 45 ]. Since social media has become more and more vital to the social lives of university students during the pandemic, students may be at increased risk of social media addiction, which may be harmful to their mental health [ 14 ].

During non-adulthood, peer relations and approval are critical and social media seems to meet these needs. For example, connection and communication with friends make them feel better and happier, especially during the COVID-19 pandemic and national lockdowns where face-to-face communication was restricted [ 46 ]. Kele’s study showed that the COVID-19 pandemic has increased the time spent on social media, and the frequency of online activities [ 47 ].

Because of the COVID-19 pandemic, e-learning became the only sustainable option for students [ 13 ]. This abrupt transition can lead to depression, stress, or anxiety for some students due to insufficient time to adjust to the new learning environment. The role of social media is also important to some university students [ 48 ].

Staying at home, having nothing else to do, and being unable to go out and meet with friends due to the lockdown measures increased the time spent on social media and the frequency of online activities, which influenced their mental health negatively [ 49 ]. These reasons may explain the findings of previous studies that found an increase in depression and anxiety among adolescents who were healthy before the COVID-19 pandemic [ 50 ].

According to the results, there was a statistically significant relationship between social media use and mental health in students, in such a way that one Unit increase in the score of social media use enhanced the score of mental health. These two variables were directly correlated. Consistent with the current study, many studies have shown a significant relationship between higher use of social media and lower mental health in students [ 45 , 51 , 52 , 53 , 54 ].

Inconsistent with the findings of the present study, some previous studies reported the positive effect of social media use on mental health [ 55 , 56 , 57 ]. The differences in findings could be attributed to the time and location of the studies. Anderson’s study in France in 2018 found no significant relationship between social media use and mental health. This may be because of the differences between the tools for measuring the ability to detect fake news and health literacy and the scales of the research [ 4 ].

The present study showed that the impact of using social media on the mental health of students was higher than Lebni’s study, which was conducted in 2020 [ 25 ]. Also, in Dost Mohammad’s study in 2018, the effect of using social media on the mental health of students was reported to be lower than in the present study [ 58 ]. Entezari’s study in 2021, was also lower than the present study [ 59 ]. It seems that the excessive use of social media during the COVID-19 pandemic was the reason for the greater effects of social media on students’ mental health.

The use of social media has positive and negative characteristics. Social media is most useful for rapidly disseminating timely information via widely accessible platforms [ 4 ]. Among the types of studies, at least one shows an inverse relationship between the use of social media and mental health [ 53 ]. While social media can serve as a tool for fostering connection during periods of physical isolation, the mental health implications of social media being used as a news source are tenuous [ 45 ].

The results of the GLM analysis indicated that there was a statistically significant relationship between the problematic use of social media and mental health in students in such a way that one-unit increase in the score of problematic use of social media enhanced the mental health score, and it was found that the two variables had a direct relationship. Consistent with our study, Boer’s study showed that problematic use of social media may highlight the potential risk to adolescent mental health [ 60 ]. Malaeb also reported that the problematic use of social media had a positive relationship with mental health [ 61 ], but that study was conducted on adults and had a smaller sample size before the COVID-19 pandemic.

Saputri’s study found that excessive social media use likely harms the mental health of university students since students with higher social media addiction scores had a greater risk of experiencing mild depression [ 62 ]. A systematic literature review before the COVID-19 pandemic (2019) found that the time spent by adolescents on social media was associated with depression, anxiety, and psychological distress [ 63 ]. Marino’s study (2018) reported a significant correlation between the problematic use of social media by students and psychological distress [ 64 ].

Social media has become more vital for students’ social lives owing to online education during the COVID-19 pandemic. Therefore, this group is more at risk of addiction to social media and may experience more mental health problems than other groups. Lebni also indicated that students’ higher use of the Internet led to anxiety, depression, and adverse mental health, but the main purpose of the study was to investigate the effects of such factors on student’s academic performance [ 25 ]. Previous studies indicated that individuals who spent more time on social media had lower self-esteem and higher levels of anxiety and depression [ 65 , 66 ]. In the present study, students with higher social media addiction scores were at higher mental health risk. Such a finding was consistent with research by Gao et al., who found that the excessive use of social media during the pandemic had adverse effects on social health [ 14 ]. Cheng et al. indicated that using the Internet, especially for communication with people, can harm mental health by changing the quality of social relationships, face-to-face communication, and changes in social support [ 24 ].

A reason for the significant relationship between social media use and mental health in students during the COVID-19 pandemic in the present study was probably the students’ intentional or unintentional use of online communication. Unfortunately, social media published information, which might be incorrect, in this pandemic that caused public fear and threatened mental health.

During the pandemic, social media played essential roles in learning and leisure activities. Due to electronic education, staying at home, and long leisure time, students had more time, frequency, and opportunities to use social media in this pandemic. Such a high reliance on social media may threaten student’s mental health. Lee et al. conducted a study during the COVID-19 pandemic and confirmed that young people who used social media had higher symptoms of depression and loneliness than before the COVID-19 pandemic [ 67 ].

The present study showed that there was a significant positive relationship between problematic use of social media and gender, so that women were more willing to use social media, probably because they had more opportunities to use social media as they stayed at home more than men; hence, they were more exposed to problematic use of social media. Consistent with our study, Andreassen reported that being a woman was an important factor in social media addiction [ 68 ]. In contrast to our study, Azizi’s study in Iran showed that male students use social media significantly more than female students, possibly due to differences in demographic variables in each population [ 69 ].

Moreover, there was a significant relationship between age and problematic use of social media in that people younger than 20 were more willing to use social media in a problematic way. Consistent with the present study, Perrin also indicated that younger people further used social media [ 70 ].

According to the findings, unemployed students used social media more than employed ones, probably because they had more time to spend in virtual space, leading to higher use and the possibility of problematic use of social media [ 71 ].

Moreover, non-native students were more willing to use the social media probably because students who lived far away from their families used social media problematically due to the lack of family control over hours of use and higher opportunities [ 72 ] .

The results showed that rural students have a greater tendency to use social Medias than urban students. Inconsistent with this finding, Perrin reported that urban people were more willing to use the social media. The difference was probably due to different research times and places or different target groups [ 70 ].

According to the current study, people with low household income were more likely to use social media, most likely because low-income people seek free information and services due to a lack of access to facilities and equipment in the real world or because they seek assimilation with people around them. Inconsistent with our findings, Hruska et al. reported that people with high household income levels made much use of social media [ 73 ], probably because of cultural, economic, and social differences or different information measurement tools.

Furthermore, single, divorced, and widowed students used social media more than married students. This is because they spend more time on social media due to the need for more emotional attention, the search for a life partner, or a feeling of loneliness. This also led to the problematic use of social media [ 74 ].

According to the results, Fars people used social media more than other ethnic groups, but this difference was insignificant. This finding was consistent with Perrin’s study, but the population consisted of people aged 18 to 65 [ 70 ].

In the current study, there was a significant relationship between gender and mental health, so that women had lower mental health than men. The difference was in health sociology. Consistent with the present study, Ghasemi et al. indicated that it appeared necessary to pay more attention to women’s health and create an opportunity for them to use health services [ 75 ].

The findings revealed that unemployed students had lower mental health than employed students, most likely because unemployed individuals have lower mental health due to not having a job and being economically dependent on others, as well as feeling incompetent at times. Consistent with the present study, Bialowolski reported that unemployment and low income caused mental disorders and threatened mental health [ 76 ].

According to this study, non-native students have lower mental health than native students because they live far from their families. The family plays an imperative role in improving the mental health of their children, and mental health requires their support. Also, the economic, social, and support problems caused by being away from the family have endangered their mental health [ 77 ].

Another important factor of the current study was that married people had higher mental health than single people. In addition, divorced and widowed students had lower mental health [ 78 ]. Possibly due to the social pressure they suffer in Iranian society. Furthermore, they received lower emotional support than married people. Therefore, their lower mental health seemed logical [ 79 , 80 , 81 ]. A large study in a European population also reported differences in the likelihood of mood, anxiety, and personality disorders between separated/divorced and married mothers [ 82 ].

A key point confirmed in other studies is the relationship between low incomes with mental health. A meta-analysis by Lorant indicated that economic and social inequalities caused mental disorders [ 83 ]. Safran also reported that the probability of developing mental disorders in people with low socioeconomic status is up to three times higher than that of people with the highest socioeconomic status [ 84 ]. Bialowolski’s study was consistent with the current study but Bialowolski’s study examined employees [ 76 ].

The present study was conducted during the COVID-19 pandemic and therefore had limitations in accessing students. Another limitation was the use of self-reporting tools. Participants may show positive self-presentation by over- or under-reporting their social media-related behaviors and some mental health-related items, which may directly or indirectly lead to social desirability bias, information bias, and reporting bias. Small sample sizes and convenience sampling limit student population representativeness and generalizability. This study was based on cross-sectional data. Therefore, the estimation results should be seen as associative rather than causative. Future studies would need to investigate causal effects using a longitudinal or cohort design, or another causal effect research design.

The findings of this study indicated that the high use of social media affected students’ mental health. Furthermore, the problematic use of the social media had a direct relationship with mental health. Variables such as age, gender, income level, marital status, and unemployment of non-native students had significant relationships with social media use and mental health. Despite the large amount of evidence suggesting that social media harms mental health, more research is still necessary to determine the cause and how social media can be used without harmful effects. It is imperative to better understand the relationship between social media use and mental health symptoms among young people to prevent such a negative outcome.

Data Availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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The authors would like to express their gratitude to all academic officials of Lorestan universities and Mr. Mohsen Amani for their cooperation in data collection.

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Abouzar Nazari

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Maede Hosseinnia

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Abouzar Nazari and Maedeh Hossennia designed the study, collected the data and drafted the manuscript. Samaneh Torkian performed the statistical analysis and prepared the tables. Gholamreza Garmaroudi, as the responsible author, supervised the entire study. All authors reviewed and edited the draft manuscript and approved the final version.

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Nazari, A., Hosseinnia, M., Torkian, S. et al. Social media and mental health in students: a cross-sectional study during the Covid-19 pandemic. BMC Psychiatry 23 , 458 (2023). https://doi.org/10.1186/s12888-023-04859-w

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Science News

Social media harms teens’ mental health, mounting evidence shows. what now.

Understanding what is going on in teens’ minds is necessary for targeted policy suggestions

Most teens use social media, often for hours on end. Some social scientists are confident that such use is harming their mental health. Now they want to pinpoint what explains the link.

Carol Yepes/Getty Images

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By Sujata Gupta

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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Social Media Use and Mental Health: A Global Analysis

1 Department of Public Health & Prevention Science, Baldwin Wallace University, Berea, OH 44017, USA; ude.wb@61htimsj

Ajlina Karamehic-Muratovic

2 Department of Sociology and Anthropology, St Louis University, St. Louis, MO 63108, USA

Mahdi Baghbanzadeh

3 Department of Business Development, Ofogh Kourosh Chain Stores, Tehran 1433894961, Iran; [email protected]

Ateka Bashir

4 Department of Public Health, Amherst College, Amherst, MA 01002, USA; moc.liamg@68aaketa

Jacob Smith

Ubydul haque.

5 Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, North Texas, Fort Worth, TX 76107, USA; [email protected]

Associated Data

Data will be shared based upon request through the corresponding author.

Research indicates that excessive use of social media can be related to depression and anxiety. This study conducted a systematic review of social media and mental health, focusing on Facebook, Twitter, and Instagram. Based on inclusion criteria from the systematic review, a meta-analysis was conducted to explore and summarize studies from the empirical literature on the relationship between social media and mental health. Using PRISMA guidelines on PubMed and Google Scholar, a literature search from January 2010 to June 2020 was conducted to identify studies addressing the relationship between social media sites and mental health. Of the 39 studies identified, 20 were included in the meta-analysis. Results indicate that while social media can create a sense of community for the user, excessive and increased use of social media, particularly among those who are vulnerable, is correlated with depression and other mental health disorders.

1. Introduction

Mental health is defined as emotional, psychological, and social well-being [ 1 ]. It plays a role in nearly every aspect of one’s life and can determine how we think, feel, act, respond to stress, relate to others, and even make choices [ 1 ]. According to the DSM-5, mental health disorders are “characterized by clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning.” Mental health disorders are common and their etiology ranges from biological factors, such as genes or brain chemistry, to life experiences, such as trauma or a history of abuse [ 1 ]. Approximately one in five American adults have some mental health issue, one in ten young people experience a period of major depression, and one in twenty-five Americans report living with a serious mental illness, such as schizophrenia, bipolar disorder, or major depression [ 1 ].

Furthermore, mental health disorders are influenced by and affect our daily social interactions [ 1 ]. Many of our social interactions occur via social media, with individuals spending a significant amount of time on popular social media sites such as Facebook, Twitter, and Instagram, among others. As of December 2019, Facebook reported 2.5 billion monthly active users, Twitter reported 330 million monthly active users, and as of January 2020, Instagram had over 1 billion active monthly users worldwide.

Social media platforms are a great tool for individuals to interact, connect, and support one another [ 2 ]. Moreover, many individuals with mental health problems turn to social media platforms to seek support networks and aid others [ 2 ]. Social media can further promote a sense of community and assist in keeping relationships not otherwise maintained, which could improve mental health outcomes if correct information and advice are obtained [ 3 ]. At the same time, however, increased use of social media may also lead to a constant desire to be connected and can promote negative experiences, which in turn can affect the mental health of the users [ 3 ]. Negative effects of increased social media use are especially pronounced for youth; the literature suggests, for instance, that social media use has the potential to amplify the risk of alcohol and drug use among youth [ 4 , 5 ].

In this paper, a meta-analysis was performed to explore the relationship between social media use (Facebook, Instagram, and Twitter) and mental health, using a systematic review of studies from January 2010 to June 2020. The paper additionally assessed the strength of the evidence presented regarding social media and mental health and sought to determine whether a positive effect exists between social media use and mental health.

A literature search using PRISMA guidelines was conducted to explore the relationship between social media site (Facebook, Instagram, and Twitter) usage and mental health ( Figure 1 ). A multi-database search identified studies published between January 2010 and June 2020. Articles from PubMed and Google Scholar were selected to investigate the relationship of each type of social media site and mental health. While Google Scholar has wide coverage in terms of interdisciplinary scientific studies, it was supplemented and complemented by PubMed due to PubMed’s widely accessible resources and because the database has a provision of MEDLINE and other National Library of Medicine (NLM) resources. Search terms were chosen to broadly capture the various ways social media and mental health have been defined and explored in the existing literature. See Box 1 for a summary of the search strategy and selection process for the systematic review.

Literature search related to social media and mental health.

• Period search: January 2010 to June 2020.
• Source: PubMed and Google Scholar.
• Search terms: (‘mental health’) AND (‘Social Media’) AND (‘Twitter’ OR ‘Facebook’ OR ‘Instagram’) AND (‘COVID-19′).
• Inclusion criteria: Only articles that displayed use of Social Media, Twitter, Instagram, and Facebook.
• Articles found = 71; Articles included = 39.
• All age groups, male/female, publication date last ten years, all countries and origins.
• Exclusion criteria: Any articles that do not focus on either Twitter, Instagram, or Facebook.
• Articles retained for evaluation = 39.

PRISMA 2009 flowchart showing research of records.

This study followed Warton et al.’s (2011) recommendation to use GLMMs for the meta-analysis with the logit transformation in meta-analysis problems with single proportions [ 6 ]. All the statistical analyses were performed in R studio (version 3.6.1, The R Foundation, Vienna, Austria), using the meta3 and metaphor4 packages [ 6 , 7 , 8 , 9 , 10 ].

Subgroup Analyses

To identify differences among studies with different scopes, a subgroup analysis with five groups was conducted. Studies were clustered into groups depending on the social media site specified as being the focus of the study. Thus, five groups were created, including only Facebook (labeled F, n = 10), only Twitter (labeled T, n = 2), only Instagram (labeled I, n = 2), all three social media platforms (labeled FTI, n = 1), and unknown (social media platform not specified) (labeled U, n = 5).

In the subgroup analysis, the sample sizes and the year of publication of the study were also considered ( Table S1: Supplementary Materials ). For the sample size, we considered the median value of the sample sizes (600) for the cut-off, and for the year of publication studies were categorized as before 2018 and after 2018 (including 2018). To test for the existence of publication bias, we used a funnel plot.

A total of 71 articles were identified through the Google Scholar and PubMed database search. After duplicates were removed, 39 articles were retained for evaluation.

Of the 39 studies included, 14 studies focused on Facebook only [ 3 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ].

Two studies focused on both Facebook and Twitter [ 2 , 24 ], and twelve focused on exclusively Twitter [ 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 ].

Three studies included all three social media sites [ 37 , 38 , 39 ]. Furthermore, three studies focused on Instagram only [ 40 , 41 , 42 ].

Finally, in five studies, the social media platform included was unknown/not specified [ 43 , 44 , 45 , 46 , 47 ].

The literature spanned vast geographical ranges including Italy [ 3 ], Thailand [ 15 ], Poland [ 16 ], The United States [ 11 , 14 , 17 , 20 , 22 , 28 , 30 , 33 , 38 , 40 , 42 , 43 ], Germany [ 18 , 41 ], Australia [ 20 , 26 ], Korea [ 13 , 29 ]. The United Kingdom [ 21 , 24 , 35 , 36 ], Japan [ 32 ], China [ 44 , 45 ], Iraq [ 39 ], India [ 46 ], and Pakistan [ 47 ]. Of the studies included, Twitter was the social media platform most used due to its ease of collecting data by extrapolating large numbers of tweets simultaneously. Some studies were only based on Twitter posts and other studies were based on users of Facebook, Twitter, and Instagram.

The studies included in our meta-analysis employed various analysis methodologies including a study of the association of factors on social media, risk assessment, repeated-measures ANOVA, logistic regression, Poisson multilevel regression, bivariate and multivariate analysis, correlation analysis, advance sentiment analysis, multistage clustering techniques, a sample test of proportional, and statistical inference.

3.1. Facebook

Of the 39 included studies, Facebook emerged as one of the main social media sites in 14 of the studies where the relationship between social media and mental health was examined. At least seven of the studies reviewed provided support for a positive relationship between social media use and mental health. For instance, in a survey study conducted in Germany [ 18 ], it was found that Facebook users had higher values of certain reported personality traits and positive variables protecting mental health than did non-users. Similarly, while assessing mental health issues such as depression, anxiety, and PTSD, Masedu et al. (2014) reported that Facebook use among adults 25–54 years old had a positive impact on mental health and quality of life outcomes in the years following a disaster [ 3 ]. Naslund et al. (2018) found Facebook to be promising for supporting health behavior change among people with serious mental illness [ 11 ].

Three of the studies included in the analysis found a negative relationship between social media use and mental health. For example, Hanprathet et al. (2015) illustrated some risks of Facebook usage that affected the mental health status of Thai adolescents in their cross-sectional study [ 15 ]. Blachnio et al. (2015) found additional evidence that daily internet use time in minutes, gender, and age were predictive of Facebook intrusion [ 16 ].

Therefore, studies included in our analysis that focused on Facebook only indicate evidence for both a positive and negative relationship between social media usage and mental health, with slightly more studies evidencing a positive relationship.

3.2. Twitter

Of the 12 studies focusing exclusively on Twitter, it was clear that Twitter has been used to raise awareness about many different mental health issues and to help individuals connect and feel that they are not alone [ 25 , 26 ]. For instance, Cavazos-Rehg et al. (2016) reported supportive and knowledge-based awareness tweets about fighting depression to be most common, making up 40% of the tweets reported [ 27 ]. Cavazos-Rehg et al. (2016) suggest that health professionals can use Twitter to tailor and target prevention and awareness about mental health [ 27 ]. Twitter data have also been found to be useful in providing insight for mental health surveillance before and after traumatic events such as natural disasters [ 28 ].

Furthermore, Twitter has been useful in the detection and anticipation of mental health issues [ 28 ]. For example, Reece et al. (2017) built models to predict the emergence of depression and PTSD by using learning algorithms analyzing the linguistic patterns in Tweets of the sample months before a clinical diagnosis of depression [ 48 ]. The results of their study indicated that despite the limitation of 180 characters per tweet, people who were depressed showed signs of depression in their tweets significantly before the actual diagnosis, resulting in the viable option to use Twitter as a predictive depression evaluation tool for clinicians. Similarly, Berry et al. (2017) conducted a study using Text mining methods for Twitter to collect and organize tweets from the hashtag #WhyWeTweetMH [ 25 ]. Four overarching themes were derived from the tweets collected: (1) A sense of community; (2) raising awareness and combatting stigma; (3) a safe space for expression; and (4) coping and empowerment [ 25 ]. Therefore, evidence from studies focusing on Twitter seems to suggest a positive relationship between social media and mental health.

3.3. Instagram

Three of the studies included in the analysis focused on Instagram. Across these studies, the general trend was that Instagram may be a contributing factor in causing body image and self-harm issues in young people. Of the three studies focusing exclusively on Instagram, one study found a relationship between consistent Instagram usage and negative body image and self-harm [ 40 ]. This study focused on content posted on Instagram between 18 June 2014, and 30 June 2014, to evaluate the meaning, popularity, and content advisory warnings related to ambiguous non-suicidal self-injury (NSSI) hashtags on Instagram. The sample of 201 Instagram posts led to the identification of 10 ambiguous NSSI hashtags, with some common terms including #selfinjuryy and #MySecretFamily. “#MySecretFamily” was a popular term that described the broader community of NSSI and mental illness. The term #MySecretFamily had approximately 900,000 search results at the time. Content Advisory warnings were only generated by one-third of the relevant hashtags [ 40 ]. Another study discussed how image-based social media such as Instagram may become a source of mental health-related information and a tool for health communication [ 42 ]. Brown et al. (2019) pointed out in their study how although most of the study participants (80%) had come across expressions of active suicidal thoughts, activity and language use on Instagram did not predict acute suicidality [ 41 ].

It is important to add that Instagram is the newest platform of the three social media platforms included in this paper, so its lack of history makes it difficult to draw specific conclusions of mental health issues about its long-term use. Nevertheless, based on the inclusion of a limited number of studies, one can conclude that there appears to be a correlation between consistent Instagram usage and the effect on negative body image and self-harm.

3.4. Facebook, Twitter, Instagram

Analysis of three studies focusing on all three social media platforms generally indicates that social media use has the potential to influence people’s mental health and psychological well-being. For example, Lis et al. (2015) researched the opinions of psychiatrists on whether social media had adverse effects on psychosis [ 37 ]. The study found that 37% of participants believed there was an association between psychopathology and social media sites [ 37 ].

In a subsequent study, Lin et al. (2016) assessed depression and social media use across multiple social media platforms in a large and nationally representative sample of young adults [ 38 ]. It was found that social media use was significantly associated with increased depression [ 38 ]. Most recently, a quantitative survey study by Ahmad et al. (2020) obtained data from the Kurdish social media and found a statistically significant positive correlation between self-reported social media use and the spread of panic related to COVID-19 (R = 0.8701) Results from this study also showed that majority of youth aged 18–35 years are facing psychological anxiety [ 39 ]. Therefore, though the number of studies focusing on all three social media platforms included in this analysis is limited, the results of studies included show a negative relationship between social media usage and mental health.

3.5. Unknown/Not Specified

Five of the studies included in the analysis did not specify a social media platform analyzed in their respective study. These studies were more recent in terms of their respective publication date and focus on the relationship between social media use and mental health, primarily during COVID-19. For example, in Hill et al.’s (2019) study, medical students from one US allopathic medical school were asked to complete a 12-item questionnaire [ 43 ]. Questions were designed to assess students’ ability to identify, address, and counsel patients on the association between social media and mental health. Results indicated that most of the students believed there could be both a positive and negative effect of social media on mental health [ 43 ].

Gao et al. (2020) investigated the prevalence of depression, anxiety, and a combination of depression and anxiety (CDA) during the COVID-19 outbreak in Wuhan, China, by using multivariable logistic regression to identify associations between social media exposure with mental health problems after controlling for covariates [ 44 ]. They found that more than 80% of participants reported frequent exposure to social media [ 44 ]. Findings showed that there was a high prevalence of mental health problems, which were in turn positively associated with frequent social media exposure during the COVID-19 outbreak [ 44 ].

Another study conducted by Ni et al. (2020) examined risk factors, including the use of social media, for probable anxiety and depression in the community and among health professionals also in Wuhan, China [ 45 ]. A multivariable logistic regression analysis was used to examine these factors [ 45 ]. Of the 1577 community-based adults, about one-fifth of respondents reported probable anxiety and depression [ 45 ]. Similarly, of the 214 health professionals, about one-fifth of surveyed health professionals reported probable anxiety or depression [ 45 ]. Interestingly, social support was associated with less probable anxiety and depression in both health professionals and community-based adults [ 45 ]. The results of this study suggest that online platforms can be leveraged to survey community-based adults and health professionals during an epidemic and lockdown [ 45 ].

Roy et al. (2020) attempted to assess knowledge, attitude, anxiety experience, and perceived mental healthcare need among the adult Indian population during the COVID-19 pandemic [ 46 ]. An online survey was conducted using a semi-structured questionnaire using a non-probability snowball sampling technique [ 46 ]. The respondents had a moderate level of knowledge about the COVID-19 infection and adequate knowledge about its preventive aspects [ 46 ]. In addition to distress-related social media and sleep difficulties, paranoia about acquiring COVID-19 infection was also reported [ 46 ]. The perceived mental healthcare need was seen in more than 80% of participants [ 46 ]. The authors suggest that there is a need to intensify the awareness and address the mental health issues of people during this COVID-19 pandemic [ 46 ].

In Balkhi et al.’s (2020) study, a structured, self-administered questionnaire was constructed, assessing the psychological impact and behavioral changes about COVID-19 [ 47 ]. This research examined data from 400 participants residing in Karachi, Pakistan [ 47 ]. The responses were compared based on gender, age, and level of education, to find possible statistical correlations using the chi-square test [ 47 ]. The study found increased levels of anxiety due to the use of social media among people below 35 years resulted in avoidance behaviors ( p = 0.04) [ 47 ].

In sum, the five studies included in the analysis that did not specify a social media platform suggest not only that the COVID-19 pandemic has exacerbated mental health issues among social media users, but that many have used social media during the pandemic to seek social support for their mental health issues.

4. Meta-Analysis Results

Of the twenty studies, nine reported a proportion lower than 50% for a positive effect ( Figure 1 ). These results are based on the random-effects model. Confidence intervals are based on the Clopper–Pearson interval (exact binomial interval). Here, Q is distributed as a chi-square statistic with k (number of studies) minus 1. It indicates a wide range of values in the outcomes of the studies, and according to I2 = 100%, it was estimated that approximately all of the variance was due to heterogeneity ( Figure 1 ). The forest plots for the studies are found in Figure 2 . Considering the scope of the studies (Facebook, Twitter, Instagram, all three, or unknown/not specified), the year of the publication (before 2018 and after 2018), and the sample size of the studies (below 600 and above 600), a subgroup analysis was used to determine the effect of this variation on the pooled results, and the results of these analyses are reported in Table S1, Supplementary Materials . The forest plots for each scenario are illustrated in Figure 3 , Figure 4 and Figure 5 , respectively.

Forest plot of the studies.

Forest plot of the studies. Grouped by social media platforms.

Forest plot of the studies. Grouped by sample size.

Forest plot of the studies. Grouped by year of publication.

The subgroup analysis of 10 studies (those which focused only on Facebook) showed an identical pooled proportion of 0.67 (95% CI: 0.38–0.86) with a homogenous characteristic ( p -value for heterogeneity = 0.09, I2 = 100%). Two studies were sub-grouped based on only Twitter (proportion of 0.59 CI (95% CI: 0.22–0.88)) and two studies focused on Instagram (proportion 0.29 (95% CI: 0.16–0.47)). Among the studies, the studies focused on Instagram both reported a proportion lower than 50% ( Table 1 ). One study was grouped as all three platforms (proportion 0.44 (95% CI: 0.42–0.46)). Five studies were grouped as unknown (proportion 0.62 (95% CI: 0.38–0.81)). According to the groups’ Q (Qb = 7.92, df = 4, p -value = 0.09), there was no significant difference found between groups at level α = 0.05 ( Table 1 ). Furthermore, there is no significant difference between studies with sample sizes below and above 600 ( Figure 3 and Table 1 ) and no significant difference between studies before and after 2018 ( Figure 4 and Table 1 ). The funnel plot does not show any clear asymmetrical pattern in publications ( Figure 6 ).

Funnel plot for publication bias.

*: Heterogeneity of between groups.

We also conducted Egger’s regression test. The results of the test (z = −0.19, p -value = 0.85) show that there is no significant evidence of publication bias in our study ( Table 1 ).

5. Discussion

Social media sites play an important role in individuals’ mental health. In a rapidly evolving world where people experience less face-to-face interaction, understanding the relationship between social media and mental health is essential for the utilization of digital platforms to promote mental health and create a healthier world. The findings of our meta-analysis are mixed and show that social media can both support and hinder one’s mental health. The variations observed depended on the social media platform used as well as whether the study was conducted before or after the COVID-19 pandemic. In general, studies that focused on Twitter and Instagram social media platforms described the worst mental-health expression for the population that was considered in the respective study.

Facebook, the largest and the most used social media site worldwide, connects people from all over the world and enables individuals and communities to easily band together and create movement. Its’ ability for the global exchange of information is unparalleled, as it can bridge people of multiple faiths, nationalities, and orientations in one platform to pursue common goals and raise movements of reform. Facebook can also be used to bridge the worlds of numerous people in a relatively small location through the promotion of health campaigns and community activity to encourage wellness and social interaction.

In terms of mental health, our study shows that Facebook can be and is used to promote mental health through the connection to other users, mental health professionals, and organizations. Our analysis also shows that Facebook can promote mental health among its users by giving them the ability to connect and share their stories with other people who may have the same mental health challenges, making them feel less alone. Using Facebook as a social media awareness platform is an important way to promote mental health through social media. Facebook has “groups” and “pages” that can be used exclusively for mental health awareness. It can also be used to educate individuals and communities about prevention, which could be effective, provided the pages can guarantee anonymity. Facebook’s global reach is quite vast; therefore, any type of mental health intervention employed has the potential of reaching and affecting many individuals.

Likewise, our study shows that there are mental health risks associated with Facebook overuse. One study that stands out in this finding is by Park et al. (2013), which investigated overall life satisfaction before and after Facebook [ 13 ]. Results from this study indicated decreased levels of contentment with the self and life after excessive Facebook usage [ 13 ]. Therefore, the relationship between social media usage and mental health when only Facebook is considered varies, and the amount and quality of time spent on Facebook might be an important variable to consider in future studies.

Twitter is a large platform for people to engage in conversation. It has a strong and loyal audience. Introducing a hashtag and having many people retweet it creates a strong story or interest in the topic it is following. In terms of mental health, Twitter in many ways can serve as a window into users’ mental health. For example, any positive phrases or words related to mental health could be followed by a #mentallove or #mentalhealthlove, and the tweet will be placed in these categories so that any person can search the tweets that are potentially helping others.

Our study indicates that Twitter can be a useful social media platform to combat mental health issues by observing tweets that contain suggestions of depression and then targeting ads or certain pages to respective individuals where they can express their emotions or obtain the necessary help (i.e., nearby medical facilities). Mental health professionals can read and evaluate the tweets to determine if a post shows signs of a mental health issue. People can then be guided to the needed mental health service. With these interventions, professionals can use Twitter to improve the mental health outcomes of many of its users. Policymakers, as well as public health professionals, can use tweets about depression, or other mental health issues, to help find the root cause. They can also reach out to the people who tweet about depression and obtain their feedback on how they can spread awareness.

Since a survey of studies examined in our study suggests a positive relationship between its use and mental health, it is fair to conclude that Twitter may be particularly helpful in promoting an aspect of realness that is fleeting on social media as time goes on. This sense of realness in a virtual community such as Twitter can help minimize skewed mental images, blurring the lines of reality and facade. A true sense of community occurs when role models promote awareness and relate to others as well, so celebrities, policymakers, and athletes tweeting about a mental health issue can also have positive results.

Instagram is a photo-based platform that emphasizes photo and video sharing via its mobile app with over 700 million users worldwide. Our analysis of existing studies focusing on Twitter as a social media platform shows that if Twitter is not used responsibly, it has the potential to negatively influence young people’s body image and self-esteem, such as the evidence from the MacMillan et al.’s (2017) study [ 49 ] indicates.

Though the number of studies focusing on Twitter that are included in our analysis is limited to only three studies, it was clear that young women were the largest group of people that were found to be affected by the negative impact of Instagram, and mostly in terms of their mental health. Matt Kreacher, the author of the #StatusofMind report, suggests that “Instagram draws young women to compare themselves against unrealistic, largely curated, filtered and Photoshopped versions of reality.” All of this is in the palm of their hands for viewing any time of the day or night thus potentially creating a development of body image issues. Because of Instagram and the high level of mental health issues it has been associated with within the literature, the Royal Society of Mental Health proposed social media platforms place a warning on images that have been digitally enhanced or altered photos to reduce feelings of inadequacy [ 50 ]. Non-Suicidal Self Injury (NSSI) continues to be a growing and concerning trend on the social media picture-sharing app Instagram, particularly during middle school or early high school years with an estimated prevalence of approximately 7–24% [ 40 ].

Other mental health issues that have arisen with the increase in Instagram usage are anxiety, depression, bullying, fear of missing out, and disruptive sleep patterns. Studies have shown that young people who spend more than two hours a day on social media are more likely to report psychological distress [ 51 ]. The #StatusofMind report claims that Instagram users may develop a ‘compare and despair’ attitude if they spend too much time on Instagram or other social media platforms.

Other conclusions that can be drawn from our analysis are that studies examined within our parameters that focus on all three social media platforms support the powerful effect that social media has on one’s mental health. Though the number of studies included in our study to arrive at this conclusion is limited, the results of these studies are consistent in showing that increased social media usage equals lower mental health.

Moreover, the COVID-19 pandemic and social distancing have created an unprecedented setting for examining the relationship between social media usage and mental health. Studies included in our analysis, most of which did not specify a social media platform of focus, inevitably show that while social media usage increased and was rewarding to many users looking for support when the COVID-19 pandemic hit, excessive use also led to mental health issues such as depression and anxiety. Therefore, it can be argued that social media usage during the COVID-19 pandemic specifically is much like a double-edged sword; it can promote mental health, but its overuse can likewise hinder one’s mental health. Mental health consequences of the COVID-19 pandemic will likely be studied well into the future including among ethnic minorities [ 52 , 53 ].

6. Implications

Mental health professionals and others promoting psychological health can benefit from learning more about social media and its relationship with mental health. Social media campaigns can likewise promote more knowledge and awareness of specific mental health conditions. A successful advertising campaign can bring awareness to complex mental health issues such as depression and anxiety. Such a campaign has the potential to lead to policymakers flagging or possibly deactivating accounts that promote negative mental health issues. In addition to deactivating negativity, social media sites can promote and advertise positive mental health messages, which would allow the self-help promoting information to reach a wider audience. Using certain hashtags could connect people who are suffering from these issues and give them a needed virtual support group they likely would not have attended in person due to stigma. As an example, the Royal Society for Mental Health is recommending that social media platforms create a “heavy usage” notification to pop up after too much time has been spent online. Social media is not going away, so developing a safe relationship and constructively using social media may not only decrease the negative impact of social media on one’s health but may have a positive impact instead.

7. Strengths and Limitations

A major strength of this review is that it analyzes studies from areas all over the globe, including the United States, the Middle East, Asia, and several European countries. Additionally, the relationship between social media usage and mental health is a particularly important and timely topic to consider. In March of 2020, the WHO declared the COVID-19 outbreak a global pandemic. Global lockdowns required citizens to start spending more time at home, and as a result, social media usage has both increased and changed. More than ever, individuals have turned to social media for socialization, interaction, entertainment, and social support for their mental health.

A limitation of this meta-analysis is the number of databases used to conduct a systematic review, as well as limitations inherent in specifically using Google Scholar and PubMed as databases to identify highly relevant research studies. Each database is limited in its focus and scope, and neither is optimal for topical research. Ideally, multiple databases would provide the optimal and most comprehensive systematic review. Utilizing databases such as PsycINFO, MEDLINE (Ovid), Scopus, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and other educational resources should be considered in future studies. Furthermore, it is well known that most users of social media tend to be adolescents [ 40 ], limiting the generalizability of the findings to a wider and older audience. Additionally, only a few of the studies included in the review focused on Instagram only and all three platforms, limiting the conclusions that can be drawn about the relationships between Instagram specifically and mental health.

8. Conclusions

Our study shows that individuals suffering from mental health issues use social media as an outlet, and we should continue to use social media to promote wellness. Although these platforms can be a distorted reality for some, they ultimately still serve as platforms where individuals can express themselves. Such expression can be therapeutic for those experiencing mental health issues. Our analysis further shows that Facebook and Twitter have generally been used to both benefit mental health by bringing people of similar mental health situations together and creating a supportive environment. We must continue to strengthen the communities within social networks so that people will be more connected, which will in turn potentially improve their mental health.

The most important finding of this analysis, however, is that there is an untapped potential for early detection using social media platforms. Providing education and tools to navigate social media constructively in schools is a good way to promote self-esteem and mental health. The greatest suggestion to emerge from this study as we move forward into the digital age is to create forums on these social media sites used to benefit the health of the community. Finally, the way people use technology has important implications for healthcare professionals. Social media use should be closely examined from a clinical and public health perspective.

Supplementary Materials

The following are available online at https://www.mdpi.com/article/10.3390/epidemiologia3010002/s1 , Table S1: Social media use and mental health: A global analysis.

Author Contributions

Conceptualization, O.U., U.H. and J.S.; methodology, O.U., A.K.-M., U.H. and M.B.; software, M.B.; validation, O.U., A.K.-M. and J.S.; formal analysis, U.H.; investigation, A.B., J.S. and O.U.; resources, A.K.-M.; data curation, A.B.; writing—original draft preparation, O.U., A.B., A.K.-M. and J.S.; writing—review and editing, O.U., A.B., M.B., J.S. and A.K.-M.; visualization, J.S., M.B. and A.B.; supervision, U.H.; project administration, O.U. and A.K.-M. All authors have read and agreed to the published version of the manuscript.

No external funding was available for this study. U.H. was supported by the Research Council of Norway (grant # 281077).

Institutional Review Board Statement

Not applicable since we used publicly available data.

Informed Consent Statement

Patient consent was waived since we used de-identified delinked publicly available data.

Data Availability Statement

Conflicts of interest.

The authors declare no conflict of interest.

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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How Does Social Media Affect Your Mental Health?

Facebook has delayed the development of an Instagram app for children amid questions about its harmful effects on young people’s mental health. Does social media have an impact on your well-being?

By Nicole Daniels

What is your relationship with social media like? Which platforms do you spend the most time on? Which do you stay away from? How often do you log on?

What do you notice about your mental health and well-being when spending time on social networks?

In “ Facebook Delays Instagram App for Users 13 and Younger ,” Adam Satariano and Ryan Mac write about the findings of an internal study conducted by Facebook and what they mean for the Instagram Kids app that the company was developing:

Facebook said on Monday that it had paused development of an Instagram Kids service that would be tailored for children 13 years old or younger, as the social network increasingly faces questions about the app’s effect on young people’s mental health. The pullback preceded a congressional hearing this week about internal research conducted by Facebook , and reported in The Wall Street Journal , that showed the company knew of the harmful mental health effects that Instagram was having on teenage girls. The revelations have set off a public relations crisis for the Silicon Valley company and led to a fresh round of calls for new regulation. Facebook said it still wanted to build an Instagram product intended for children that would have a more “age appropriate experience,” but was postponing the plans in the face of criticism.

The article continues:

With Instagram Kids, Facebook had argued that young people were using the photo-sharing app anyway, despite age-requirement rules, so it would be better to develop a version more suitable for them. Facebook said the “kids” app was intended for ages 10 to 12 and would require parental permission to join, forgo ads and carry more age-appropriate content and features. Parents would be able to control what accounts their child followed. YouTube, which Google owns, has released a children’s version of its app. But since BuzzFeed broke the news this year that Facebook was working on the app, the company has faced scrutiny. Policymakers, regulators, child safety groups and consumer rights groups have argued that it hooks children on the app at a younger age rather than protecting them from problems with the service, including child predatory grooming, bullying and body shaming.

The article goes on to quote Adam Mosseri, the head of Instagram:

Mr. Mosseri said on Monday that the “the project leaked way before we knew what it would be” and that the company had “few answers” for the public at the time. Opposition to Facebook’s plans gained momentum this month when The Journal published articles based on leaked internal documents that showed Facebook knew about many of the harms it was causing. Facebook’s internal research showed that Instagram, in particular, had caused teen girls to feel worse about their bodies and led to increased rates of anxiety and depression, even while company executives publicly tried to minimize the app’s downsides.

But concerns about the effect of social media on young people go beyond Instagram Kids, the article notes:

A children’s version of Instagram would not fix more systemic problems, said Al Mik, a spokesman for 5Rights Foundation, a London group focused on digital rights issues for children. The group published a report in July showing that children as young as 13 were targeted within 24 hours of creating an account with harmful content, including material related to eating disorders, extreme diets, sexualized imagery, body shaming, self-harm and suicide. “Big Tobacco understood that the younger you got to someone, the easier you could get them addicted to become a lifelong user,” Doug Peterson, Nebraska’s attorney general, said in an interview. “I see some comparisons to social media platforms.” In May, attorneys general from 44 states and jurisdictions had signed a letter to Facebook’s chief executive, Mark Zuckerberg, asking him to end plans for building an Instagram app for children. American policymakers should pass tougher laws to restrict how tech platforms target children, said Josh Golin, executive director of Fairplay, a Boston-based group that was part of an international coalition of children’s and consumer groups opposed to the new app. Last year, Britain adopted an Age Appropriate Design Code , which requires added privacy protections for digital services used by people under the age of 18.

Students, read the entire article , then tell us:

Do you think Facebook made the right decision in halting the development of the Instagram Kids app? Do you think there should be social media apps for children 13 and younger? Why or why not?

What is your reaction to the research that found that Instagram can have harmful mental health effects on teenagers, particularly teenage girls? Have you experienced body image issues, anxiety or depression tied to your use of the app? How do you think social media affects your mental health?

What has your experience been on different social media apps? Are there apps that have a more positive or negative effect on your well-being? What do you think could explain these differences?

Have you ever been targeted with inappropriate or harmful content on Instagram or other social media apps? What responsibility do you think social media companies have to address these issues? Do you think there should be more protections in place for users under 18? Why or why not?

What does healthy social media engagement look like for you? What habits do you have around social media that you feel proud of? What behaviors would you like to change? How involved are your parents in your social media use? How involved do you think they should be?

If you were in charge of making Instagram, or another social media app, safer for teenagers, what changes would you make?

Want more writing prompts? You can find all of our questions in our Student Opinion column . Teachers, check out this guide to learn how you can incorporate them into your classroom.

Students 13 and older in the United States and Britain, and 16 and older elsewhere, are invited to comment. All comments are moderated by the Learning Network staff, but please keep in mind that once your comment is accepted, it will be made public.

Nicole Daniels joined The Learning Network as a staff editor in 2019 after working in museum education, curriculum writing and bilingual education. More about Nicole Daniels

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Studies highlight impact of social media use on college student mental health

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When Kyle Palmberg set out to design a research study as the capstone project for his psychology major at St. Mary’s University of M i nnesota in Winona, he knew he wanted his focus to be topical and relevant to college students.

His initial brainstorming centered around the mental health impact of poor sleep quality. 

“I wanted to look at college students specifically, to see the different ways that sleep quality can be harmed and how that can impact your mental health,” he said. As he reviewed the scientific literature, one variable kept appearing. “The topic that kept coming up was social media overuse,” he said. “It is such an important thing to my target demographic of college students.”

Palmberg, 22, grew up surrounded by social media. He’d heard plenty of warnings about the downsides of spending too much time online, and he’d seen many of his peers seemingly anchored to their phones, anxious or untethered if they had to put them down for more than a few minutes at a time.

“I think from my perspective as someone who’s been really interested in psychology as an academic discipline, social media addiction is also something I’ve been aware of personally,” Palmberg said. “I can tell within myself when things can become harmful or easy to misuse. I often see the hints of addictive behaviors in peers and coworkers.”

Palmberg found much of the published research on the topic inspiring, particularly a 2003 study on internet gambling addiction. 

“They were looking at how internet gambling addiction permeates a person’s behavior,” he said. Palmberg hypothesized that there may be behavioral similarities between people addicted to online gambling and those addicted to social media. 

“Social media provides this convenient platform for users to interact with others,” he said. “As users grow addicted, they learn that they can come back to that social platform more and more to get their needs met. The tolerance users have for gratifying that social need grows. Then they have to use social media more and more often to get those benefits.”

The negative impact of a growing dependence on social media is that time spent online takes away from real in-person interactions and reduces the time a person has available for basic personal care needs, like sleep and exercise, Palmberg said. This can ultimately have a negative impact on mental health.

“As a person builds a high tolerance for the use of social media it causes internal and external conflict,” he said. “You know it is wrong but you continue to use it. You relapse and struggle to stop using it.” Palmberg said that social media use can be a form of “mood modification. When a person is feeling down or anxious they can turn to it and feel better at least for a moment. They get a sense of withdrawal if they stop using it. Because of this negative side effect, it causes that relapse.”

Palmberg decided he wanted to survey college students about their social media use and devise a study that looked at connections between the different motivations for that use and potential for addictive behaviors. He ran his idea by his academic advisor, Molly O’Connor, associate professor of psychology at Saint Mary’s, who was intrigued by his topic’s clear connections to student life.

“We often notice social media addiction with our student population,” O’Connor said. She knew that Palmberg wouldn’t have a hard time recruiting study participants, because young people have first-hand experience and interest in the topic. “He’s looking at college students who are particularly vulnerable to that addiction. They are tuned into it and they are using it for coursework, socialization, entertainment, self-documentation.”

O’Connor said she and her colleagues at the university see signs of this addiction among many of their students. 

“They’ll be on their phones during class when they are supposed to pay attention,” she said. “They can’t help themselves from checking when a notification comes through. They say they had trouble sleeping and you’ll ask questions about why and they’ll say they were scrolling on their phone before they went to bed and just couldn’t fall asleep.”

The entertainment-addiction connection

Once his study was given the go-ahead by his advisor and approved by the university for human-subjects research, Palmberg had two months to recruit participants. 

To gather his research subjects, he visited classes and gave a short speech. Afterward, students were given an opportunity to sign up and provide their emails. Palmberg recruited 86 participants this way, and each was asked to fill out an anonymous survey about their social media habits.

Palmberg explained that the main framework of his study was to gain a deeper understanding of why college students use social media and the circumstances when it can become addictive and harmful to their mental health and well-being. He also hypothesized that perceived sleep quality issues would be connected to social media addiction.

After collecting the surveys, Palmberg said, “We essentially threw the data into a big spreadsheet. We worked with it, played with it, analyzed it.” He explained that his analysis focused on motivations for social media use, “including building social connections and self-documentation.”

What Palmberg discovered was that his subjects’ most popular motivation for social media use was for entertainment. While some participants listed other motivations, he said the most “statistically significant” motivation was entertainment.

“Not only was entertainment the most highly endorsed reason to use social media in the study,” Palmberg said, “for college students it was the only motivation we analyzed that was statistically connected to social media addiction and perceived stress. The entertainment motivation was also related to poor sleep quality.”

Mental Health & Addiction

A better way to deliver unexpected news, in her new book, ‘the rock in my throat,’ kao kalia yang shares her struggle with selective mutism, a community-based approach to suicide prevention.

He found connections between a reliance on social media for entertainment and addictive behaviors, like an inability to shut down apps or put a phone away for an extended period of time. “If a person is using social media for entertainment, they are more likely to be addicted to social media than someone who is not using it for entertainment,” Palmberg said.

The structures of popular social media platforms reinforce addictive behaviors, he said. “Current trends in social media lean more toward entertainment platforms like TikTok or Instagram. People are going on there just to pass time,” Palmberg said. These brief and repetitive formats encourage addiction, he said, because the dopamine high they create is short-lived, causing users to keep visiting to get those fleetingly positive feelings. 

O’Connor supports Palmberg’s conclusions. A reliance on social media platforms for entertainment encourages addiction, she said. This is backed up by student behavior.

“My big takeaway was the interest in the entertainment variable was the key predictor of addiction. It’s not necessarily the students that are using it to communicate with each other, but the ones that say, ‘I need to kill time between classes,’ or, ‘I’m bored before bed,’ or, ‘I am trying to relieve stress after working on homework.’” The addictive aspect comes in, O’Connor said, “because users want to be entertained more and more. They are constantly looking for the next thing to talk about with their friends.”

Palmberg said he believes that not all social media use among college students has to be addictive. “It is important for people to view social media as not only something that can be harmful but also something that can be used as a tool. I like to emphasize with my study that it’s not all negative. It is more of an emphasis on moderation. It is possible to use social media responsibly. But just like almost anything, it can be addictive.”

An emphasis on digital well-being

Twice a year, in an effort to get out ahead of digital addiction, students at Gustavus Adolphus College in St. Peter are encouraged to take a deeper look at their social media use and its impact on their mental health. Charlie Potts, the college’s interim dean of students, heads the effort: It’s a clear match with his job and his research interests.

During the semiannual event, known as “Digital Well-Being Week,” Gustavus students learn about the potentially negative impact of social media overuse — as well as strategies for expanding their social networks without the help of technology.

Potts said that event has been held four times so far, and students now tell him they anticipate it. 

“We’ve gotten to the point where we get comments from students saying, ‘It’s that time again,’” he said. Students say they appreciate the information and activities associated with Digital Well-Being Week, Potts continued, and they look forward to a week focused on spending less time with their phones.

“They remember that we put baskets on every table in the dining hall with a little card encouraging them to leave their phones there and instead focus on conversations with others,” he added. “We even include  a card in the basket with conversation starters. Students are excited about it. They know the drill. It is something they like to do that feels good.”

Potts’ own academic research has focused on mental health and belonging. Each fall, he also heads up a campus-wide student survey focused on digital well-being and how to balance phone use with other aspects of mental and physical health.

In the survey, Potts said, “We ask students, ‘How much time do you spend every day on social media? How does it make you feel?’ Students are blown away when they see the number of hours that the average Gustie spends online. The vast majority are in the 4-7 hours a day on their phone range.”

The survey, which uses a motivational style of interviewing to help participants get at the root of why altering their social media behaviors may be valuable to their overall health and well-being, focuses on small changes that might reduce participants’ reliance on technology in favor of face-to-face interaction. 

“We do a lot of conversations with students about strategies they could use,” Potts said. “Things like plugging your phone in across the room while you sleep, leaving it behind while you go to work out at the rec center, subtle changes like that. We also talk about mental health and mindfulness and how…you discern your values about what you are consuming and how that might affect you.”

Though Potts said he has encountered some resistance from students (“You roll with that and help them understand the value of that and think about how they are going to make that change,” he said), he’s also heard a lot of positive student feedback about his survey — and the twice-yearly focus on digital well-being.  

“What we found with our students is they realize deep down that their relationship with their phones and social media was not having a positive impact on their life,” Potts said. “They knew change would be good but they didn’t know how to make change or who to talk to about that or what tools were at their disposal. These options help them understand how to do that.”

Andy Steiner

Andy Steiner is a Twin Cities-based writer and editor. Before becoming a full-time freelancer, she worked as senior editor at Utne Reader and editor of the Minnesota Women’s Press. Email her at  [email protected] .

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