The truth about tweens and screens

We're in the middle of a mental health crisis, and it's hitting the younger generation hard. First, the stats: Worldwide, 10 to 20 percent of children and adolescents experience mental disorders. Depression is one of the leading causes of illness and disability among adolescents, and suicide is the third leading cause of death in 15- to 19-year-olds.

Mental illness is complex, with many potential biological, psychological, and environmental factors. In an ideal world, we'd be able to point to one thing — like screen time or social media use — and say, "that's the problem, right there." We don't live in an ideal world, but that's pretty much what's been happening, particularly when it comes to adolescent mental health. A 2011 paper published by the American Academy of Pediatrics warned doctors about "Facebook depression" (defined as "depression that develops when preteens and teens spend a great deal of time on social media sites, such as Facebook, and then begin to exhibit classic symptoms of depression"), and it basically snowballed from there.

However, not all research supports this hypothesis. One recent study by two psychology professors, Candice L. Odgers from the University of California, Irvine, and Michaeline R. Jensen from the University of North Carolina, Greensborough, published in the Journal of Child Psychology and Psychiatry, analyzed about 40 studies examining the link between social media use and anxiety and depression during adolescence. Their verdict? The link is small and inconsistent.

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Diana Graber, the author of Raising Humans in a Digital World: Helping Kids Build a Healthy Relationshipwith Technology, agrees that it's not accurate or fair to blame technology for a rise in teenage depression and anxiety. She points out that there are numerous other factors that could be contributing to adolescent angst: climate change, school gun violence, and college acceptance rates, for starters. "It's possible that the devices young people are constantly connected to are delivering a steady stream of information about these depressing topics, but that's hardly a reason to blame the messenger," Graber says. "Those same devices can offer solace too."

Children's therapist Katie Lear says it's important to be aware that not all screen time is created equal. "Some online activities appear more likely to put children at risk of depression, such as communicating with strangers, which makes exposure to predators more likely," she says. "But other activities may be more supportive and positive outlets for kids, like talking to peers on social media. They may feel more connected and more able to share personal information with people who can validate their experience." By leading to increased social support, there's a valid argument that smartphone use can actually protect against depression.

Lear adds that when we're evaluating a child's screen time, we should be looking not just at quantity but at quality. "Technology is an inevitable part of modern life, and children need to feel included in their peer group," she says. "On the other hand, monitoring a child's internet use can ensure that the activities they engage in online are positive, fulfilling, and not likely to put them at risk."

Odger and Jensen's study isn't without its flaws, points out Linda Charmaraman, Ph.D., a senior research scientist who studies the link between social media use and teens' wellbeing at the Wellesley Centers for Women. "This study's capacity to determine whether social media causes depression, or whether those who are depressed gravitate more toward social media, is limited because it relies heavily on reviewing cross-sectional studies — in other words, studies that observe data at a single point in time — or survey-based studies," she explains. One problem is that retrospective data is subject to recall bias or under-reporting. Plus, it doesn't look at how teens use screen time. Because these studies monitor small effects with different methodologies, we can't rely on them to firmly establish social media as a culprit that single-handedly influences teen mental health.

But can any study do that? If we want a definitive answer, we need a study that shows causation, not simply correlation. "To understand if screen time use causes teen anxiety or depression, we need a large sample that follows adolescents through a forward time period," explains pediatrician Nerissa Bauer, M.D. It would also have to measure various other variables that are also known to contribute to anxiety and depression, such as bullying, trauma, and family history of mental illness.

It's also crucial to remember that our kids aren't just test subjects. They bring their own unique characters, experiences. and proclivities to their screens. "All kids have different susceptibility to the positive and negative effects of social media, depending on who they are," Charmaraman, says. "For example, can they self-regulate? Can they counteract the social anxiety of 'fear of missing out'?" How kids use social media is crucial, she adds. Are they connecting with others, or passively viewing others' lives?

The biggest takeaway from the recent study isn't that social media doesn't cause or contribute to poor mental health in adolescents. It's that we need more research, better research, to get a definitive answer. And in the meantime, what's more important than debating the issue is taking the right steps to ensure kids get more of the positives — and less of the negatives — from smartphones.

As per Odgers and Jensen's conclusion, strategies for supporting children's mental health offline are just as applicable in online situations. "For parents, these findings bring us back to basic good practices of parenting," says child development expert Chris Drew, Ph.D. Parents' priorities should be making sure their kids have a balanced, healthy friendship circle, take part in active exercise, and have plenty of face-to-face social interaction.

While Drew says the review "seems sound," he points out that it's important to differentiate between statistical trendlines and individual experiences. "Even if statistically there appears to be negligible links between social media and anxiety, that doesn't mean that there aren't countless individual case studies where links are evident," he says. "Screen time could still cause anxiety on a case-by-case basis."

In other words, don't walk away from this study thinking that there's no need to worry and your kid can use Instagram 20 hours a day. It may — and should — mitigate any moral panic over the issue, but it doesn't take away parents' responsibility to ensure their child's relationship with their smartphone is a healthy one.

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