As a parent, you might ask yourself, “What, specifically, about social media use can have a negative impact on my teen?”

Dr. Murthy’s advisory was based on what it describes as a “substantial review of the available evidence.” It raises a variety of concerns, including the amount of time adolescents spend on platforms, the type of content they consume (or are exposed to), and the degree to which their online interactions disrupt activities essential for health, such as sleep and exercise. It points out that social media can also affect young users in different ways, depending on their strengths and vulnerabilities as individuals, as well as their cultural, historical, and socio-economic backgrounds.

The report stresses that the brain is going through a highly sensitive period between the ages of 10 and 19, when identities and feelings of self-worth are forming. Frequent social media use may be associated with distinct changes in the developing brain, potentially affecting such functions as emotional learning and behavior, impulse control, and emotional regulation.

Some teenagers experience a benefit when they use social media to foster positive connections with others who share common interests or identities (if they are seeking a connection with others who are, say, members of a particular racial identity), creating a space for self-expression. Relationships formed in communities like these can create opportunities for positive interactions with more diverse peer groups than are available to them offline, according to Dr. Murthy’s report.

The advisory points to a 2022 survey of American teenagers and their parents by the Pew Research Center, which showed that a majority of respondents felt that social media helps teenagers feel more accepted (58%), like they have people who can support them through tough times (67%), that they have a place to show their creative side (71%), and that they are more connected to what’s going on in their friends’ lives (80%).

“Posting to let your friends know how you’ve been spending your time can be a positive or healthy way to connect and hear about each other’s day,” says Dr. Poncin. “It’s no different than 30 years ago when adolescents would be on the phone for three hours connecting with their friends—only now you're online with your friends, saying, ‘Meet you after school,’ or ‘Did you hear about this?’”

Over the last decade, increasing evidence has identified the potential negative impact of social media on adolescents. According to a research study of American teens ages 12-15, those who used social media over three hours each day faced twice the risk of having negative mental health outcomes, including depression and anxiety symptoms.

The advisory states that other studies "point to a higher relative concern of harm in adolescent girls and those already experiencing poor mental health, as well as for particular health outcomes, such as cyberbullying-related depression, body image and disordered eating behaviors, and poor sleep quality linked to social media use."

“What’s more, the social media algorithms are built to promote whatever you seem interested in,” says Dr. Mayes. “If a teen searches for any kind of mental health condition, such as depression or suicide, it's going to feed them information about those things, so soon they may begin to think that everyone around them is depressed or thinking about suicide, which is not necessarily good for mental health.”

Teens can easily access extreme, inappropriate, and harmful content. In certain cases, deaths have been linked to suicide- and self-harm-related content, such as “cutting,” partial asphyxiation, and risk-taking challenges on social media platforms, according to Dr. Murthy’s report. Studies also found that discussing or showing this content can normalize these behaviors.

Eating disorders are yet another concern. A review of 50 studies across 17 countries between 2016 and 2021 published in PLOS Global Public Health suggested that relentless online exposure to largely unattainable physical ideals may trigger a distorted sense of self and eating disorders. This is considered to be a particular problem among girls.

In addition, people who target adolescents—for instance, adults seeking to sexually exploit teens or financially extort them through the threat or actual distribution of intimate images—may use social media platforms for these types of predatory behaviors, according to the Surgeon General's advisory.

The excessive use of social media can harm teens by disrupting important healthy behaviors. Some researchers think that exposure to social media can overstimulate the brain's reward center and, when the stimulation becomes excessive, can trigger pathways comparable to addiction.

Excessive use has also been linked to sleep problems, attention problems, and feelings of exclusion in adolescents. And sleep is essential for the healthy development of teens, according to Dr. Murthy’s advisory.

After reading the background, as a parent, you might ask yourself, “Sure, but do kids really use social media that much?”

Social media use among young people is nearly universal now, based on surveys from the Pew Research Center. In 2022, up to 95% of teenagers surveyed (ages 13 to 17) reported using social media, and more than a third of them use it “almost constantly.”

Pew has also tracked which social media platforms (or “apps”) teenagers are using. In 2023, it found the majority of teens—9 out of 10 for those ages 13 to 17—use YouTube, followed by TikTok, Snapchat, and Instagram. (Their use of Facebook dropped dramatically; there was also a decrease in the use of Twitter, now called X, although that was not as steep.)

With that in mind, YCSC experts provide a guide for parents concerned about their teens’ social media use.

Experts are still exploring whether there is a “right age” for a child to access social media. The APA explains that adolescents mature at different rates, which makes establishing a universal age recommendation difficult.

Although the minimum age most commonly required by social media platforms in the U.S. is 13, nearly 40% of children ages 8–12 use social media, according to Dr. Murthy’s report. That signals how difficult it can be to enforce these rules without parental supervision.

One strategy is to make a social media plan for your family long before the teenage years, Dr. Poncin says. “In my opinion, elementary school-age children should not have full-on internet access using a device with all the social media apps.”

In terms of phones, they can start with a “dumbphone,” a cell phone that doesn’t have email, an internet browser, and other features found on smartphones, he adds.

For middle-schoolers who show maturity and responsibility—who can get themselves to sleep and do their homework, for example—additional access may be fine, notes Dr. Poncin. But he suggests delaying full access to smartphones for as long as possible, opting for a device allowing you to add more apps as your child matures.

Establishing a family social media plan might also be useful—the American Academy of Pediatrics offers a tool that can help. In addition to setting the age at which you plan to start giving your kids phones or internet access, this plan can be used to establish rules and educate children and teens about being careful about privacy settings, avoiding strangers online, not giving out personal information, and knowing how to report cyberbullying, Dr. Mayes says.

Research shows a relationship between social media use and poor sleep quality, reduced sleep duration, and sleep difficulties in young people, according to Dr. Murthy’s advisory. For teens, poor sleep is linked to emotional health issues and a higher risk for suicide.

According to Dr. Murthy’s report, on a typical weekday, nearly one-third of adolescents report using screen media until midnight or later. (While screen media use includes various digital activities, social media apps are the most commonly used applications by teens.)

“Knowing that, try to create a culture at home where all phones are turned off by a certain time, and make sure it's at least one hour before going to bed,” Dr. Poncin says.

However, you may find that bedtime rules don’t work as well as your kids get older. It may be necessary to ask your teen to put their phone outside the bedroom before going to bed. “But, if the response is, ‘I do my homework late and have a group chat about math, so I'm going to need the phone to group chat,’ and you suspect your teen isn’t being honest, that will be a different conversation,” Dr. Poncin says. “But having these open conversations is critical.”

It will be easier to talk to your teens about social media if you have comfortable conversations with them about other issues, the doctors say.

“I don’t believe you should monitor the content of your teen’s phone, because a teenager should have privacy,” Dr. Poncin says. “An important part of the teenage years is figuring out who you are in the world. So, it's important for them to explore and even make mistakes without you hovering around them.” The goal is to keep lines of communication open and establish some trust with your child, so they'll come to you if there are issues, he adds.

This, too, is similar to the advice given when parents were concerned about the impact of television on children, adds Dr. Mayes. “Research showed that watching TV in and of itself wasn’t bad, but it began to have potentially negative effects on kids’ behavior when it was used as a babysitter,” she says. “The message to parents was to sit beside their kids and watch TV with them, and then talk about what they’re watching.”

Neither you nor your teen will be happy if you sit beside them and scroll down your social media feeds together, but you can take the time to ask how social media is working for them, Dr. Mayes suggests. “So, you're not saying, ‘Oh no! You're on social media!’ Rather, you’re normalizing it and making it clear that you're willing to talk about what they're experiencing or learning. This sets it up for them to talk to you if they run into a problem, instead of going to their peers or looking for solutions online,” she says.

Although keeping the line of communication open matters, how you have those conversations is equally important. If you are concerned about your teen’s social media use and feel the need to intervene, you might say something like, "It seems like you're on the phone so much that I don't see you just doing homework like you used to do, so I'm just worried how healthy this is for you in terms of getting your stuff done. What do you think about that?" Dr. Poncin says.

You might even need to be more assertive, for instance, saying, "I've noticed that you're on your phone until 1 a.m. When I go to the bathroom, your light is on, and you're on your phone. That’s not healthy. So, can we come up with a plan that you're most comfortable with?"

As a parent, you are a role model and that means following all the same rules you are setting for your children—if you ask your teenager to limit their screen time, you should do so as well, says Dr. Mayes, noting that it’s not uncommon to see parents looking at their phones when they are out with their kids.

You might have a hard time resisting your social media feeds, texts, and emails. Sometimes, it helps to admit to your teenagers that you find it difficult to put down your devices, too. “This a global issue, where parents want their kids to do things differently and better than they do,” Dr. Poncin says. “So, once again, having an honest conversation is important.”

Note: Cyberbullying and online abuse or exploitation can be reported to the school or the police, or on websites such as Take It Down and CyberTipline, according to the Surgeon General report.
Source: Yale Medicine