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The Complicated Relationship Between Screen Time and Depression
Blaming smartphones and social media for mental health issues in teens distracts from deeper problems
Much has been written about Palo Alto’s teen suicides, which is four or five times the national average. My daughter was 13 in 2009, attending Terman Middle School in Palo Alto, when her friend Natalie (name changed) ended her life. “Nat was gone forever,” my daughter wrote in an essay she shared with me recently. “She and I had been talking all summer. I had taken her emotions in our correspondence lightly. Too lightly.”
Depression and anxiety among youth are rising. A nationwide study found that adolescents reporting symptoms of clinical depression increased by 37% between 2005 and 2014, and the suicide rate of youth aged 10–19 years rose by a devastating 56% between 2007 and 2016.
California parallels the nationwide trend. The number of youth hospitalizations for mental health reasons has been rising since 2007, according to the Office of Statewide Health Planning and Development. There were 34,176 youth patients hospitalized for mental health episodes in 2007, and 48,258 in 2016 — a 41% increase.
Some experts think that the rise in mental health problems in youth can be tied to an event in 2007: The introduction of the iPhone. Psychologist and author Jean M. Twenge wants us to believe that the “iGen”, the generation shaped by smartphones and social media use, born between 1995 and 2012 is “on the brink of the worst mental-health crisis in decades.” Much of this deterioration, she writes, can be traced to their phones. Twenge drew evidence from a nationwide study examining the relationship between screen time and psychological health among 40,000 children and adolescents in 2016.
Twenge’s theories and analyses have been widely criticized, most insistently, by psychologist Sarah Rose Cavanagh on Medium, as being too alarmist, too biased, not contextual enough, and too correlational. “These studies leave open the possibilities that such associations are due to smartphones causing depression, depression symptoms causing greater use of smartphones, or a third variable, such as the number of extracurricular activities, causing both to rise and fall together,” Cavanagh writes.
To put it plainly: Does social media use go up among depressed youth because they remove themselves from real-life interactions and only connect to others online? Or does social media interaction cause depression?
Twenge’s and other surveys have found a link between the amount of screen time and mental issues like anxiety and depression, and conversely, a positive correlation between face-to-face interactions and a stronger sense of social well-being. It seems reasonable to believe that online interactions could lead to less healthy outcomes since more screen time implies less face-to-face time.
But Twenge’s hypothesis that depression is closely related to smartphone oversimplifies the problem. Peer competitiveness, academic loads, parental college goals, weight concerns, and relationship dynamics all play a role in shaping teenagers’ mental health.
Screen time may even be beneficial. Research published in Sage Journals indicates that “moderate use of digital technology is not intrinsically harmful and may be advantageous in a connected world.”
“I think we need to focus less on the social media part of it. There are many kids who are isolated and are able to get support through social media.”
Dr. Ramsey Khasho, chief clinical officer at Children’s Health Council in Palo Alto, who works with youth in crisis, argues that it’s reductive to begin and end discussions of mental illness among youth by talking about smartphones and social media. According to Khasho, one of the reasons we see a rise in youth hospitalizations for mental health is because we’ve increased awareness of mental illnesses, making it more acceptable for parents to access treatment for their children.
“I think we need to focus less on the social media part of it,” he says. “There are many kids who are isolated and are able to get support through social media.”
Pew Research published a study in 2015 confirming that “57% of teens have met a new friend online,” and that teen friendships are “strengthened and challenged” within social media environments.
Khasho suggests that mental health discussions should revolve around how to increase knowledge of mental illness symptoms, removing barriers to treatment, and eliminating stigma. Overemphasizing the link between technology and mental illness draws attention away from these critical conversations.
“We need teenagers to understand what’s going on in their brains,” says Khasho, and that includes teaching children healthy ways to channel emotions and to put their struggles into perspective. Youth, he believes, should be trained “directly and explicitly about mental health, at least in middle school.”
Doug Styles, director of Huckleberry Youth Programs, a flagship youth services program in San Francisco, claims that social media lacks the means to drive meaningful relationships, but he doesn’t believe that social media is the main problem. Pinning the rise in behavioral issues among youth squarely on social alienation, with and without the use of smartphones, Styles recommends looking at the problem holistically.
The first step to helping youth in crisis is to establish a connection with them, to help troubled youth feel a sense of belonging. “And that’s before we deal with all of the other things that may be going on in their families or in their schools that maybe creating this,” Styles says.
Ultimately, there are far too many variables affecting the mental well-being of youth. Isolating smartphone use and social media as a significant cause for declining mental health among teenagers minimizes other equally or even more relevant factors with the potential to socially alienate teens.
As a parent, navigating my teenagers’ triggers during high school was like holding on to the wing of an airplane in turbulence. While I wanted them to develop a solid work ethic, get good grades and take part in various extracurriculars, I also wanted them to be happy, surround themselves with good friends, and find ways to connect with the community. Together, these often seemed like irreconcilable objectives.
During their tween and early teen years, I closely monitored my twins’ screen behavior and realized that some screen time was necessary for forming their social identity. In the new digital era, social media accounts opened up new avenues for friendship and interconnection. Smartphone prowess was becoming as important as playground adaptability. It was excessive screen use that I kept in check. Or at least tried to keep in check.