Is social media bad for your health? - Part 1
The social media landscape
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Social media has transformed the way we communicate with each other over the past 15 years. There are 3.2 billion social media users worldwide, which equates to about 42% of the population. In the US, 69% of all adults use at least one social media site, while the average internet user has 7.1 social media accounts. Social media use is extensive adolescents. Research drawn from interviews with almost 11,000 14-year-olds found that two in five girls are on social media for at least three hours a day, and one in five boys.
Table of social media use in children and adolescents:
Facebook remains the most used social media platform in children and adults, although there are many other contenders: Twitter; gaming sites and virtual worlds such as Club Penguin, Second Life, and the Sims; video sites such as YouTube; and thousands of blogs. Gaming can have a strong social element; close to two in five online gamers aged 8-11s (38%) and three in five aged 12-15s (58%) say they use online chat features within the game to talk to others. Then we have the ever more sophisticated Instagram interface, and the emergence of “Insta-lives”.
While Facebook is used by 72% of 12-15s with a social media profile, 12-15s are more likely than in 2017 to use Instagram (65% vs. 47%) and WhatsApp (43% vs. 32%). In addition, fewer nominate Facebook as their main site or app (31% vs. 40%). Close to a quarter (23%) nominate Instagram as their main site or app, up from 14% in 2017.
Paul’s recommended reading:
Online Social Networking and Mental Health - Igor Pantic, MD, PhD.
Social Media Use and Adolescent Mental Health: Findings From the UK
Millennium Cohort Study - Yvonne Kelly, Afshin Zilanawala, Cara Booker, Amanda Sacker.
The benefits and possible harms of social media
There are many potential benefits to joining the on-line community: it’s a great place for sharing ideas, creating interest groups and organising social events in the real world. It helps us to keep in touch with our friends across the globe and facilitates some progressive political movements. In adolescents, social media participation can “offer deeper benefits that extend into their view of self, community, and the world”(*1), including:
Opportunities for community engagement through raising money for charity and volunteering for local events, including political and philanthropic events;
Enhancement of individual and collective creativity through development and sharing of artistic and musical endeavours;
Growth of ideas from the creation of blogs, podcasts, videos, and gaming sites;
Expansion of one’s online connections through shared interests to include others from more diverse backgrounds (such communication is an important step for all adolescents and affords the opportunity for respect, tolerance, and in- creased discourse about personal and global issues); and
Fostering of one’s individual identity and unique social skills.
Facebook and other platforms have developed powerful algorithms to keep us engaged, which can of course run the risk of unhealthy levels of screen use. Passive scrolling of the news feed often draws us in to the most controversial posts, because the number of comments moves them up the hierarchy. Badge icons cause spikes in our dopamine with the lure of yet more approval of our posts, or the opposite. It’s easy to see how vulnerable individuals can become addicted and use social media to the exclusion of more healthy pursuits, such as creative hobbies or sports.
And there are dark forces residing there, such as trolls and bullies, pressures to conform with unrealistic body images, and preened, illusory, curated updates from peers that might make all but the more secure individuals feel inadequate. Over time, this might chip away at someone’s self-esteem, even if they believe themselves to be immune.
Although Facebook use is supposedly restricted to teens over the age of 13, it is not strictly regulated, and some other platforms have no age restriction. Children and adolescents have limited capacity for self-regulation and increased susceptibility to peer pressure. In addition, adolescence is a normally a narcissistic period of development, perfectly aligned to the “like me” elements of social media. It is not surprising that the American Academy of Paediatrics reports “frequent online expressions of offline behaviours, such as bullying, clique-forming, and sexual experimentation, that have introduced problems such as cyberbullying, privacy issues, and “sexting.” Other problems that merit awareness include Internet addiction and concurrent sleep deprivation.”
Of these various behaviours, cyberbullying arguably has the most pernicious effect on adolescent mental health. Unlike bullying IRL (In the Real world), it is a 24/7 phenomenon, and its effects can be more enduring. False and defamatory posts – statements, doctored images, leaked intimate images – can stay on line forever. Moderation is far from exhaustive: posts can spread virally through a network, screenshots can be taken, and so on. The “right to be forgotten” is a pipe dream.
Serious consequences of cyberbullying include enduring low self-esteem, anxiety, depression and suicide. More than a third of depressed girls have experienced online harassment(*2). About half of affected girls have suffered disrupted sleep, and 20% of depressed boys. Children’s charities and clinicians have long highlighted cyberbullying and issues around self-esteem, often linked to anxieties around attractiveness and sexuality, particularly among girls. As with offline depression, preadolescents and adolescents who suffer from “Facebook depression” are at risk for social isolation and sometimes turn to risky Internet sites and blogs for “help” that may promote substance abuse, unsafe sexual practices, or aggressive or self- destructive behaviours.
“Facebook Depression”: Chicken and egg
There is a clear link between heavy social media use (particularly Facebook use) and depression., but the direction of effect is up for debate. Surveys suggest that depressed individuals tend to spend more time on social media than non-depressed people. There are many reasons posited, including the idea that if you have social anxiety it is more comfortable to have conversations at your own pace, without the pressure to be witty or funny, or fit in with peer dynamics that feel threatening to someone lacking confidence. Another theory is the depressed people would rather build a happier fantasy life on line, to escape from real world stresses. Some have suggested that platforms like Facebook might actually be therapeutic, but there is no evidence to back this up.
However, follow-up studies suggest that heavy social media use is linked to more depression and increased risk of suicide. In other words, the more children were using social media at age 10 the more depression they experienced age 14. The effect might be stronger in girls, and the link with suicide might be mediated by the progressive chipping away of self-esteem – again, more so in females.
In 2018, the University of Pennsylvania conducted a controlled study over 3 weeks where social media use was restricted to 10 minutes per day (compared to normal use)(*3). There were big reductions in depression and loneliness in the group who restricted their use, but the effect was particularly pronounced for those who were more depressed coming in to the study. As the lead researcher put it, "When you're not busy getting sucked into clickbait social media, you're actually spending more time on things that are more likely to make you feel better about your life."
Although more research needs to be done, a reasonable conclusion from the research is that both theories are likely to be true: depression causes more social media use, and social media will cause depression. It is perfectly possible that the wrong type of social media use could make a depressed person even more depressed. Arguably, depressed people should stay away from social media altogether, even if it feels more comfortable to engage with on-line conversations as opposed to chats IRL.
(*1) Clinical Report—The Impact of Social Media on Children, Adolescents, and Families. PEDIATRICS Volume 127, Number 4, April 2011.
(*2) The Guardian view on children and social media: a safeguarding failure by the state. Fri 4 Jan 2019.
(*3) Melissa G. Hunt, Rachel Marx, Courtney Lipson, Jordyn Young. No More FOMO: Limiting Social Media Decreases Loneliness and Depression. Journal of Social and Clinical Psychology, 2018.
Dr Paul Keedwell asserts his rights as author of this article.