“Whether it’s appearance, whether it’s a profession, whether it’s money, whether it’s social life, social media is having an impact. And people that continuously scroll often feel like they can’t measure up or it makes them feel like they’re not good enough.” While the advent of research focused purely on the links between social media and youth suicide is a fairly new phenomenon, a 2021 BYU study published in the Journal of Youth and Adolescence found a link between screen time and elevated suicide risk. Within that study, cyberbullying was a noted as of significant concern. For Dr. Alyssa Lucker, DO, the influence of social media is also something she sees in almost every appointment with adolescent patients at the Eating Recovery Center’s Pathlight Program. For her, the ongoing pandemic has only complicated how youth perceive social media and its effects on mental health.“Social media became these people’s pretty much only human contact for a year, maybe year and a half, and their perception on how they were so connected and how it was great. And now that concern of feeling so connected online has really disengaged them from the actual world and their actual people in their community." Research published last month by The Lancet, found that suicide rates in teens increased during the pandemic and were still higher than pre-pandemic.
The Warning Signs
Dr. Don Grant, PhD is a media psychologist who works as the executive director of outpatient services at Newport Healthcare. He says his first exposure to how social media can severely affect the mental health of young people was when he gave his daughter a cell phone. That decision, he says, led to bullying via Facebook. “And I realized I’d handed my child a weapon that I didn’t understand. You wouldn’t give a kid power tools and not understand it. And I thought, ‘Oh, my goodness, what have I done?’”Grant says that at the core of social media’s harm, and where he feels it can connect to increased thoughts of suicide, include unhealthy comparison, fear of missing out (FOMO), doom scrolling, cyberbullying, and online reputational sabotage. He says his advice to parents is to be proactive and practice healthy device management.“I tell parents and caregivers, you want to explain to your children [that[ the expectation is that they behave online the same as you would expect them to behave IRL [in real life]. And whatever your family values are, and whatever you believe.” Angela Caldwell, LMFT and founder of the Caldwell Family Institute (and formerly, the Self Injury Institute), is a practitioner who is also urging parents to become digitally aware as depression and anxiety can transition into suicidal ideation.“It’s imperative that parents get back to being one or two steps ahead of their kids. Kids are ahead of us right now and look what’s happening, they’re disintegrating…You no longer have the option of not being digitally savvy if you want to protect your child.” Caldwell says part of disrupting these issues with young people is by approaching mental health concerns with the same level of reverence usually reserved for obvious physical illness. “We don’t panic at the sign of a cough, or a tummy ache. But what do we do? We keep an eye on our kid. ‘That sounds like a wet cough, that sounds like it might turn into something,’ and we keep listening. Okay, well, irritability, feeling down, not wanting to go to school, these are all signs. These are all signs of depression. You don’t have to run to a therapist’s office, but you do have to respond the same way you would respond to a tummy ache.”
Perspectives on Reducing Harm
Lucker’s colleague, chief medical officer Dr. Howard Weeks, MD, says that part of the challenge with tackling social media when it comes to suicidal ideation in youth is that extensive social media use can mirror addiction. He and Lucker both say that poor diagnostic criteria means that clinicians are between a rock and a hard place. Over pathologizing social media use could lead to what Weeks calls “scope creep” while Lucker says that not having clear diagnostic criteria for something like internet use disorder means that insurance may not cover a patient’s much-needed treatment. Weeks also says that being able to identify the criteria could drive much-needed research. “But one of the advantages of trying to define this stuff is you start to get actual real research that goes beyond just the diagnosis and you get into imaging. and genetics. and trying to understand Pathways because maybe they’re [harmful long-term internet use and offline addiction] the same thing. Maybe they’re different. We don’t know.” Grant says that one potential positive when it comes to social media and those in mental health distress is the online disinhibition effect, where being in a digital space means users are more willing to share and find community where they otherwise might not. He says that he most often sees these benefits in people who are dipping their toe into support groups for social anxiety and addiction, but that a close eye needs to be maintained when youth are participating online in this way. “There are some cool things about the online disinhibition effect if it’s monitored, if it’s safe and if it’s guided, where it can be used. But mostly it’s used in a bad way and those are the trolls, and the cyberbullying, and all these things we see.” Another area of concern is whether social media has an outsized effect on suicidality in young girls. Those who spoke to Verywell Mind were largely on the side of anecdotal evidence that points to an even gender split in their waiting room when it comes to these concerns. Some pointed to the stigmatization of mental health in men as well as how depression can present differently between genders as possible reasons for underreporting. For all, however, one message is clear: keep the dialogue open with the youth in your life when it comes to social media, as Weeks put it, moderation and awareness are the two touchstones when it comes to preventative care. “I think we have to be careful to not villainize social media, that it has some positives, it has some potential negatives, and it’s always kind of an individual approach… I think that parents need to be aware of what their children and adolescents are doing so that they can help curate and make sure that [they’re] keeping an open dialogue with their kids so that if they are having some issues or starting to get exposed to things that they can reach out and talk with their parents so they can be aware of what’s happening,” says weeks.
