Audio long read: Do smartphones and social media really harm teens’ mental health?
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Because at Verizon, whether you're already a customer or you're just joining us, we got you. Visit Verizon today. Price guarantee applies to then current base monthly rate. Additional terms and conditions apply for all offers. This is an audio long read from nature. In this episode, do smartphones and social media really harm teens' mental health? Written by Helen Pearson and read by me, Benjamin Thompson.

There's a book perched near the top of the New York Times bestseller list about what's wrong with kids today. The Anxious Generation by psychologist Jonathan Haidt argues that increasing time spent on smartphones and social media at the expense of play is rewiring the brains of children and adolescents and driving soaring rates of mental illness.

It leapt to the top of the bestseller list when it was released a year ago and has sat there ever since. The book reinforced an acute concern among many Western parents about the time that their children spend on smartphones and other screens.

In a 2024 survey, nearly half of US teenagers said they were online almost constantly, compared with 24% a decade earlier. And one third used social media sites such as YouTube almost all the time. Parents are troubled by this technology because it's new, it's different, and it's not the way they were raised, says psychologist Sarah Coyne at Brigham Young University in Provo, Utah.

Although researchers agree that adolescents are struggling with mental health, there is fierce debate about how much phones and social media are to blame. Some scientists say the copious research done so far does not show a large effect of these technologies on teenagers' psychological health.

Science to date does not support the widespread panic around social media and mental health, says Candice Odges, a psychologist at the University of California, Irvine, who has criticized Haidt's conclusions. Scientists acknowledge that smartphones and social media can potentially be harmful for some people if screen time displaces healthy activities such as sleep, or if posts encourage them to self-harm, for instance.

But these tools can also help people connect to support, advice, education and friends. The impact, quote, depends on the individual themselves and their history and their physiology, the content and the context, says Coyne.

And many researchers are concerned that parents and children are hearing the alarming message propagated by Haidt's blockbuster book and major media, rather than the more nuanced one suggested by other scientists. Some authorities, meanwhile, are moving to ban phones from schools or restrict teenagers' access to social media.

Parents and kids are very aware of the narrative and very worried, says Megan Moreno, an adolescent medicine physician at the University of Wisconsin-Madison. That sparks family battles over screens and leaves parents unsure what to do. No one denies that adolescent mental health is a huge concern. Research shows that over the past two decades, rates of mental illness have been increasing in adolescents in many countries.

For instance, surveys of US adolescents found that the share reporting symptoms of depression rose from 16% in 2010 to 21% in 2015, mostly due to increases in girls, and that rates of suicide rose from 5.4 to 7 per 100,000 in the same period.

Researchers suspect that some of these trends could be down to increased awareness and reporting of mental health concerns, but they have also searched for other causes.

Haidt, who works at the New York University Stern School of Business, points out in his book that the upswing in mental illness coincides with the widespread adoption by teenagers of smartphones. The iPhone was launched in 2007 and argues that this edged out real-world socializing, playing and sleep.

He then draws on many studies of different types to build an argument that, quote, this great rewiring of childhood is the single largest reason for the tidal wave of adolescent mental illness that began in the early 2010s, end quote. Haidt points in particular to evidence that heavy social media use by pre-teen girls is linked to depression and anxiety.

Whenever you look at anxiety, depression, you almost always find the effects are larger, he told Nature. But other researchers have criticized some of his views. Hodges published one of the most biting critiques in a review of Haidt's book.

His argument that digital technologies are driving an epidemic of mental illness, quote, is not supported by science, she wrote, suggesting that Haidt might be mistaking correlation between technology use and mental illness for causation. At the heart of the dispute is a large, complex and often conflicting body of research that different researchers interpret in different ways.

Many scientists have looked for correlations between measures of screen or social media use and mental health in cross-sectional studies, which collect data at one moment in time, or longitudinal studies, which track people over time. Although some studies have found benefits, others have reported harms.

A big weakness in such analyses is that they often rely on participants self-reporting the time they spend on screens. This is usually inaccurate, because people can't remember or are embarrassed to answer honestly. We all agree it's terrible, Heitz says. To try and make sense of the conflicting literature, researchers have done dozens of reviews analysing many studies together, again with varying results.

Many have found relatively weak associations and small effects of these technologies on mental health. One 2020 analysis of more than 80 reviews concluded that there was, on average, a, quote, negative but very small, end quote, association between adolescents' use of digital technology, and social media in particular, and psychological well-being.

A 2024 literature review by the U.S. National Academies of Sciences, Engineering and Medicine, quote, did not support the conclusion that social media causes changes in adolescent health at a population level, end quote.

It's also unclear in some studies, say Odgers and some other researchers, which comes first. Whether social media causes depression, for instance, or whether young people who are depressed are more likely to spend time on social media. We might have the arrow pointing in the wrong direction, Odgers says. The evidence from experiments in which people swear off smartphones or social media for a spell has also been somewhat equivocal.

One systematic review of 23 mostly randomised trials found some evidence that abstaining from social media improved measures of depression, says Ruth Plackett, a health researcher at University College London, who led the review. But other studies found no effect. From all this evidence, researchers have arrived at differing conclusions.

Odgers and others worry that the focus on phones risks distracting scientists and policymakers from other important but harder to tackle contributors to adolescent mental health problems, such as poverty, inequality, violence, discrimination and isolation. We have young people in crisis and part of it might be technology, says Amy Orban, who studies digital mental health at the University of Cambridge, UK.

But we also have other areas that we really, truly know influence mental health that aren't getting near the time they need, she says. Haidt takes a different view. He says that the type of small effects that scientists have found is not unusual in public health studies based on crude measures such as self-reported screen time.

He argues that the effects are often masked when researchers combine and analyse different results, such as data on boys and girls, or measures of overall wellbeing with those on depression. The links are clearer, he says, in analyses centred on depression and anxiety. Quote, So this is getting very frustrating because the evidence of harm is there. End quote.

Many scientists say the impacts of smartphones and social media depend on the individual, their family and other circumstances, and what they're doing online.

A 2021 study of nearly 400 adolescents, for example, found that 28% of participants felt worse after using social media platforms, mostly WhatsApp, Snapchat and Instagram, 26% felt better and 45% felt neither better nor worse.

Such results might help to explain why some other studies, which look at averages, find little impact, says Eina Bains, a communication researcher at the University of Amsterdam, who led the study. When you put all these effects together, of course, in the end, you have a very small effect, she says. Some researchers have observed potential benefits for certain groups.

Coyne researches underrepresented populations, including transgender and non-binary youth. And she says, quote, they're using their phones in really effective ways a lot of the time to find belonging and community, end quote.

By contrast, a small proportion of young people do use their smartphones or social media in problematic ways, researchers and physicians say, and there is debate about how to define and diagnose what constitutes pathological use.

Nothing one does for eight or nine hours a day, except for sleep, should be viewed as a healthful activity, says Dimitri Christakis, a pediatrician and researcher at the Seattle Children's Research Institute in Washington. And for some, social media use can lead to devastating consequences.

In September 2022, for instance, a London coroner's inquest found that 14-year-old Molly Russell, quote, died from an act of self-harm whilst suffering from depression and the negative effects of online content, end quote. The inquest heard that Russell had viewed content about self-harm and suicide on the platform's Instagram and Pinterest before she took her own life in November 2017.

During the inquest, a representative of Meta, which owns Instagram, defended the platform's policies. And a Pinterest representative admitted that the site was not safe when Russell used it. In response to the inquest findings, both firms pointed to ways they were improving their sites. Last year, Instagram launched teen accounts, which restrict the content young users can view.

Such cases are horrific and tragic, says Coyne, and lead to understandable fear among parents that something similar could happen to their child. But jumping from anecdotal cases to an assumption that social media is a terrible peril for all teenagers is problematic, she and other scientists say. That's a genuine fear, says Coyne, but the, quote, likelihood of that is really, really small, end quote.

One big challenge for scientists is identifying which adolescents could be at most risk of harm. I think it's often more vulnerable kids and more vulnerable families who have fewer resources, have more stresses, more mood regulation problems, that are struggling more with media, says Jenny Radesky, who studies parenting and technology at the University of Michigan, Ann Arbor. Parents and young people also worry about more common online harms.

A 2022 survey by the Pew Research Center, a think tank in Washington, D.C., found that 46% of 13 to 17-year-olds had experienced at least one form of online harassment, such as being sent unwanted explicit images.

Last October, 13 US states and the District of Columbia launched lawsuits against TikTok, alleging that its platform had addictive features and had harmed young people's mental health. TikTok said in a statement that it strongly disagreed with these claims and that it provided, quote, robust safeguards, end quote, for young people.

Researchers, including Odgers, are largely united in wanting more action from big tech firms to protect young people through, for example, less addictive app designs. A growing number of US states have enacted laws that aim to keep children safe on social media. There is less consensus and research about whether banning access to social media by children, as Australia will do later this year, will be effective.

The debate about screens leaves parents in a bind. How should they set appropriate boundaries for their children? Until 2016, the American Academy of Pediatrics, or the AAP, based in Itasca, Illinois, had simple, quote, two-by-two, end quote, guidelines, says Moreno. No screens for children under two, and no more than two hours of screen time per day for older kids.

But the Academy abandoned its blanket rules as people switched to smartphones and tablets instead of televisions. A new research emerged, says Moreno, who is one of two medical directors of the Academy's Specialist Centre on Social Media and Youth Health. The message nowadays is that families should have a conversation about what works best for them, considering their children, values and routines.

The AAP provides tools to help, such as one that allows parents to customise their own family media plan and suggests possible rules, such as keeping bedrooms or meals screen-free. Quote, a strong parent-child relationship with good communication, end quote, is key to helping children with their screen use and mental health, says Radesky, the other medical director of the AAP Centre.

Parents can still set a time limit, she says, but, quote, you can also have a discussion with your teen about what is the amount of time you want to spend on Instagram per day. Is it three hours? Is that giving you life? End quote. Odgers suggests that, rather than fighting over screen time, parents should consider whether their child is getting enough sleep and exercise, is involved in different activities, and is getting along with friends.

If so, then perhaps their screen use is a reasonable part of the mix. If your child is struggling and missing out on these things, then that's an area where you can reallocate time, she says. To resolve the scientific debate, Haidt says he would like to see larger experimental studies, such as ones in which entire schools that go phone-free are compared with control schools.

Moves by many countries to limit use of phones in schools offer an opportunity for scientists, agrees Orban. It's a natural experiment, so we should be studying that, she says. The trouble is that technology is already moving on.

Surveys show that US teenagers are increasingly using online artificial intelligence tools, such as chatbots, which is why Auburn wants to see researchers collect data now on how young people are using this technology. The crucial thing is that we should learn from this problem that we didn't have the right evidence at the right time, she says. We need to learn for the next technology.

To read more of nature's long-form journalism, head over to nature.com slash news.

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