Commentary: Social media use, depression and our need for answers
Parents, teachers, doctors and young people themselves are worried about the use of social media, but our deep dive into one study unpicks some of the issues we face when deciding what to do about it.
Social media use is in the headlines constantly, and the impact that this has on the sensitive minds of teenagers causes much agonising and worry, but is it merited?
A new study has suggested that young people who spend a lot of time on social media have more symptoms of depression than other people, but is it really as straightforward as that, and does the evidence they present really allow that conclusion to be made? This is an important consideration, especially when the decisions we make around this topic are so loaded and could affect what it is, to many teenagers, an important part of their lives.
Social media is evil?
Before I get into this, it is important to stress that to pick on one study is probably a little unfair, especially as this is not the first study to indicate that there is a link between social media use and depression. One analysis of multiple studies, known as a meta-analysis, even went so far as to suggest that the more you use social media, the more likely you are to be depressed.
Nevertheless, the study we’re talking about here, which was published by JAMA Network Open on May 21, is large, with more than 10,000 young people included, and they researchers did a good job with the tools available to them to try to account for and mitigate the many, many factors that can undermine a scientific analysis and render the results, at best, open to question or, worst, fatally flawed.
And this is crucially important when we are looking at something like the connection between social media use and the risk of developing a serious mental illness such as depression, thereby labelling a young person, perhaps for life and certainly in the short term, during a period in which many decisions about their future, and future prospects, are decided.
Anyone who is a parent, and any young person growing up in today’s world, will be concerned whether the untrammelled use of social media will have a negative impact on the developing mind; one that we all know, from personal experience and by seeing the growing pains of others, is uniquely sensitive.
Parents in particular need to know whether they should be worried about the time spent on social media by their children (and let’s stress here that this study did not look at what the participants were looking at on social media), and need good, reliable evidence before they weigh in on what their children are getting up to in their spare time.
And the problem we have today, much like trying to find an unbiased person to take part in the jury for a major and extremely public trial, is that we all, for better or for worse, have come to our own conclusions about social media. Some believe it must be evil and therefore has an undeniably pernicious influence on young minds; others think that it is all about the content and what you are exposed to; yet more people consider that it has the power for good, if used properly.
But what about the study?
Before we get started, I should warn you that we are going to get into a bit of a deep dive about how mental health studies are conducted and the nuance of how to interpret the findings, but I feel that is very important if we are to understand what we are looking at, and so use the results to influence what we do and how we address young people’s habits.
Who am I?
For the study, Jason M. Nagata, MD, Division of Adolescent and Young Adult Medicine, University of California, San Francisco, CA, and colleagues set out to examine if there is a link between social media use and the occurrence of depressive symptoms from late childhood to early adolescence.
The relied on data from the Adolescent Brain Cognitive Development Study (ABCD), which is the largest long-term study of adolescent health, brain, and cognitive (thinking or mental processing) development in the USA.
Children aged 9–10 years were recruited between October 2016 and October 2018, and were assessed when they joined the study and then each year for three years, then followed until 2022. The assessments included questions on the hours and minutes each weekday and weekend day they spent on social media. Depressive symptoms were examined using the Child Behavior Checklist, which is a widely used caregiver report form used to identify problem behaviour in children.
Other information that could affect the results—such as the sex, and race and ethnicity of the young person, their household income, and the highest level of parental educational level—was gathered, alongside the number of negative, or adverse, childhood experiences they had, their understanding of parental rule-setting, supervision, consequences and monitoring, and the degree of family conflict.
What do you want me to say?
The reason I am explaining this is that the study was therefore very thorough, and covered many aspects that could limit the ability of the researchers the draw firm conclusions. But no study is perfect, especially when trying to assess personal experiences in an objective and scientific manner.
One of the main problems, acknowledged by the researchers, is what is known in academic circles as “recall bias,” or when people forget or misremember a past event or experience when asked about it for a research study. Another problem they highlight is something they term “social desirability bias,” or the tendency for survey respondents to answer questions in a way that they believe will be viewed favourably.
These issues can have a huge impact on study results and probably don’t get quite the attention or recognition they deserve. While researchers can take steps to reduce their effects, recall and social desirability biases are difficult to fully measure or control for, leaving some uncertainty that is hard to account for in analyses.
The other problem is that the study was observational, meaning it simply gathered data on the young people and looked for patterns or outcomes. While this can yield important findings, it relies heavily on the quality and completeness of the available data; and by definition, it cannot draw conclusions about aspects that weren’t included or measured in the first place.
Social media is getting me down?
Let’s get back to the study findings. The researchers had complete information on nearly 12,000 young people, of whom almost half were female; so this is a large study, especially within the field of psychiatry. The average age of the participants was 9.9 years, and only just over half were white, meaning the researchers could meaningfully adjust for race and ethnicity.
The analysis showed that social media use was remarkably consistent over time, as was the occurrence of depressive symptoms. More importantly, the team found that, adjusting for various factors, above-average and continued social media use was significantly associated with increased levels of depression symptoms when looking at young people on an individual basis.
“These findings provide initial evidence…that social media use is a potential contributing factor to adolescent depressive symptoms rather than merely a correlate or consequence of such symptoms,” the researchers write.
The results also indicated that higher levels of depressive symptoms in the first place were not associated with later increases in social media use, suggesting that the relationship is not bidirectional; that is, high social media use may contribute to depressive symptoms, but having symptoms of depression does drive a person to high social media use.
The researchers suggest that the results should be taken into account when designing interventions for young people, with efforts to detect and improve social media use, including “reducing stress-related posting, avoiding triggering content, and using social media more intentionally to connect with supportive peers.” (Although it should be underlined again that the study didn’t look at the quality of social media use, just the time spent on it.)
They also say that doctors should consider asking about social media use in children and adolescents, “particularly those younger than the recommended age limits (the minimum age requirement for most social media platforms is 13 years).”
Is it all just a coincidence?
The question is, are we reading too much into these findings? The team themselves say that adolescents may be more susceptible than older people to the negative effects of media due to their personality or level of self-esteem, their age, and social factors. Also, the fact that high social media use and depressive symptoms occurred at the same time suggests that other coinciding factors, like negative peer interactions and family conflict, could play a role.
In other words, high social media use may not be the problem when it comes to depressive symptoms, but may be acting as a proxy, or stand-in, for another issue that wasn’t measured in the study. What that means is that something else may be contributing to the depressive symptoms and that something else typically happens while spending a lot of time on social media.
And what all that means is that, although the researchers don’t say so explicity in their paper, it could all simply be a coincidence, and there is no link at all between social media use and depressive symptoms at all.
Should I be worried?
“Contrary to the claims of the authors, this study, in fact, finds little evidence that earlier social media time is associated with later mental health,” commented Chris Ferguson, PhD, Professor of Psychology, Stetson University, DeLand, Florida, who was not involved in the study.
“The effect sizes reported are, in fact, so small, as to likely be due to statistical noise, not real effects. This is a common flaw of many correlational studies, particularly those with large samples such as this one.”
Ferguson adds: “On balance, this study provides better evidence that social media has no predictive relationship with later mental health than it does anything parents should worry about. Further, pediatricians should not waste valuable time querying patients about social media, based on the extraordinarily weak statistical results from this study.”
In the end, science always comes back to the same point: researchers try their best to provide answers to questions, and sometimes succeed more than others, but is up to us, in this case the people who use social media and the people who look after them, to come to our own conclusions. For that, we are on our own, but we can make the best decisions only when we understand what it is that we are looking at, and what that means.
The research was funded by grants from the NIH and grant 2022056 from the Doris Duke Charitable Foundation. The ABCD Study was supported by awards from the NIH and additional federal partners.
Nagata declares no relevant relationships.
Liam Andrew Davenport is a medical reporter with more than 20 years’ experience covering a wide range of specialties and topics in the field.