Minimizing the risks of teen social media use

Anyone who regularly interacts with children and teens has probably been concerned about the impact of social media use on young patients’ well-being. Over recent years there’s been a rise in social media apps that include algorithm-based, personally curated feeds of short-form videos. In October 2024 more than a dozen states filed lawsuits against TikTok alleging that the app is addictive to youth and harms their mental health. The lawsuits claim it’s intentionally addictive and is contributing to psychological harm by increasing anxiety, depression, and body dysmorphia, among other concerns. 

Coincidentally, new CDC data reporting on adolescent mental health was released the same day these lawsuits were filed. This data—gathered from the national Youth Risk Behavior Survey completed by high school students—included reports of high rates of sadness, hopelessness, anxiety, stress, and suicidal ideation. The results are even more concerning for adolescents from marginalized groups (ethnic and racial minorities, transgender youth, and students that have experienced racism in school). In this study, high rates of social media use were positively correlated with bullying victimization, persistent feelings of sadness/hopelessness, seriously considering attempting suicide, and making a suicide plan.  

However, the results of prior research exploring the correlation between social media use and youth mental health outcomes are highly inconsistent. Many studies have also documented benefits of social media use. Concrete conclusions cannot be drawn regarding the strength of the correlation between social media use and well-being, mechanisms that would explain the association, the precise quality or quantity of social media use which is most impactful, and which patient-specific factors predict greater susceptibility to the negative effects of social media use. 

It’s estimated that over 95% of adolescents in the U.S. have social media accounts and the majority of those use the applications multiple times per day. Knowing that adolescent and young adult patients are almost guaranteed to be using social media on a daily basis, how can clinicians best support them? 

1. In addition to asking about total time spent on social media apps, be curious about how the apps are being used (e.g. passively viewing content versus posting content or interacting with others; primarily following friends/peers versus celebrities or influencers). 

2. Remind patients and caregivers there are potential benefits of social media use but that they should be mindful of potential risks as well. 

3. Encourage patients to reflect on how they feel after they use their favorite social media app. 

4. Ask patients if they experience cyber-bullying/harassment or are exposed to content that makes them uncomfortable. If so, help them identify a trusted adult who could help navigate these challenges. 

5. Emphasize that moderation and boundaries are important, particularly if social media use is impacting sleep, academic performance, or other areas of daily life. 

6. Talk to patients and caregivers about the preponderance of misinformation on social media regarding medical and psychological conditions and health fads. 

This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.