Is Social Media Driving Young People Crazy?

A recent Surgeon General Advisory states “that we cannot conclude social media is sufficiently safe for children and adolescents.” But is this empirically correct? (Photo: U.S. Department of Health and Human Services)

Last year, Surgeon General Vivek Murthy issued a formal Advisory, “Social Media and Youth Mental Health,” warning that social media can “have a profound risk of harm to the mental health and well-being of children and adolescents.” The report called on policy-makers to "take action," and this June, Murthy published a column in The New York Times calling for the government to require social media platforms to place a label on their sites, modeled on that required of tobacco companies, warning of their danger to the mental health of young people.

Murthy's recommendation came as social psychologist Jonathan Haidt's new book, Anxious Generation, was climbing the best seller list. Haidt and fellow social psychologist Jean Twenge, the author most recently of Generations, have been at the forefront of warning against the deleterious effects of social media on young people's mental health. Haidt and Twenge applauded Murthy's proposal. New York Times columnist Pamela Paul called Murthy's proposal "an excellent first step.”

Murthy's proposal addresses what appears to be a real problem: the growing numbers of young people, especially girls, who report that they suffer from depression or anxiety. There is also clearly a problem in classrooms of young people being diverted by smart phones and social media.

Yet, in prescribing a warning label on the model of the warning labels against tobacco use, Murthy is not relying on settled science, but on a kind of moral panic. He is also fomenting Americans' worst fears about “big government.”

Murthy's argument, as spelled out briefly in his column and at greater length in the Advisory, is based on these claims:

• First, that there is a rise of mental illness among the young, especially among girls;

• Second, that the rise in mental illness came at the same as the growing use of smartphones, which allow the young to interact on social media platforms like Tik-Tok, Instagram, Twitter, and Facebook; and

• Third, that studies have shown that increased exposure to social media among the young is correlated with reports of anxiety and depression, making it likely that increased exposure to social media is causing mental illness.

In the Advisory, the surgeon general introduces a theory linking social media use to brain development among teens:

[I]n early adolescence, when identities and sense of self-worth are forming, brain development is especially susceptible to social pressures, peer opinions, and peer comparison. Frequent social media use may be associated with distinct changes in the developing brain in the amygdala (important for emotional learning and behavior) and the prefrontal cortex (important for impulse control, emotional regulation, and moderating social behavior), and could increase sensitivity to social rewards and punishments. As such, adolescents may experience heightened emotional sensitivity to the communicative and interactive nature of social media. (p. 5)

According to the Advisory, social media imperils healthy brain development by conveying “extreme” and “hate-based” content that can, among other things, raise “body image concerns” and cause eating disorders. It lowers self-esteem. In Anxious Generation, Haidt provides a more elaborate explanation of why social media can adversely affect the young, and particularly young girls who learn they can't live up to the standards of “socially-prescribed perfectionism.”

There is good reason to believe that the exposure to social media has affected how young people think and act. In earlier periods, the introduction of new media—from the printing press in the 15th century to radio and television in the last century—had a dramatic effect not just on young people but on the general population and on the course of history. However, it's one thing to say social media is affecting us and quite another to single it out as the cause of mental illness among the young and to advocate a warning label to that effect on social media platforms.

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Murthy compares his advocacy to those who succeeded in getting a warning label put on cigarettes. But that decision, made in 1965 in Congress's Federal Cigarette Labelling and Advertising Act, was based on far greater evidence than Murthy's call for a warning label on social media. From the 1920s through the early 1950s, there were medical surveys and animal studies linking tobacco to lung cancer. These medical surveys were based on reported cigarette use among lung cancer sufferers, but in 1952, two scientists from the American Cancer Institute began following the medical record of 188,000 healthy men. They found that “deaths from cancer were definitely associated with regular cigarette smoking.” In 1957, Congress held hearings on the link between cancer and smoking.

In 1959, the American Cancer Institute initiated another study that involved over a million men and women. In 1964, that study and fifteen others became the basis of a finding by an advisory committee established by President Kennedy linking smoking to lung cancer. There were no major studies by independent researchers that contradicted these findings. (It was discovered later that the tobacco industry had privately concluded that smoking was linked to cancer.) The advisory committee's report led to the 1965 act.

In the case of the effect of social media on youth mental illness, Surgeon General Murthy cites only one scientific study, authored by eight scientists, that appeared in JAMA Psychiatry in September 2019. The article, “Associations Between Time Spent Using Social Media and Internalizing and Externalizing Problems Among US Youth,” surveyed 6595 adolescents. The authors found that “increased time spent using social media...increased odds of reporting...mental health problems.” The recent Advisory also leans heavily on this article. (Other articles it cites do not strengthen their point—for instance, an experimental study involving college students who are past the relevant age.)

But there are several recent large studies that contradict or question the findings of the study that Murthy cites. These have appeared, among others, in Clinical Psychological Science in November 2019 (“Young Adolescents’ Digital Technology Use and Mental Health Symptoms: Little Evidence of Longitudinal or Daily Linkages”) and in Nature Mental Health in May 2023 (“Time Spent on Social Media Among the Least Influential Factors in Adolescent Mental Health”). There is also an "umbrella review" of the studies that appeared in Current Opinion Psychology in April 2022 (“Social Media Use and its Impact on Adolescent Mental Health”) that concludes “that most reviews interpreted the associations between social media use and mental health as 'weak' or 'inconsistent,' whereas a few qualified the same associations as 'substantial' and 'deleterious.’”

In The New York Times’s podcast, The Daily, host Sabrina Tavernise asked Murthy about his evidence linking social media to young people's mental illness. “One of my colleagues, this week,” Tavernise said, “talked to the chief science officer at the American Psychological Association, and she was asking about whether the time a child spent on social media contributed to poor mental health? And he said, and I quote, 'the results have been really mixed with probably the consensus being that, no, it’s not related.' What is your response to that?” 

Murthy replied, “Well, I think—look, it’s important to look at the research question broadly. What we’re trying to understand, first and foremost, is the answer to the question parents are asking us, which is, is social media safe for my kids?...So, there’s not evidence of safety. There is growing evidence of harm.”

In their 2018 book, The Coddling of the American Mind, Haidt and co-author Greg Lukianoff are highly critical of what they call “safetyism,” the equation of emotional with physical safety. Yet Murthy's response to questions about social media use is based precisely on “safetyism.” While the studies on the risk of smoking relied on discernible physical evidence—the existence of cancer—the studies on the risk of social media rely on self-reported descriptions of unhappiness that are, to state the obvious, highly subjective. You don't have to buy into the argument of Michel Foucault's Madness and Civilization to recognize that mental illness—particularly when we are not talking about a crippling chemical-based psychosis—is a malleable category.

Moreover, the fact that there are contrary studies undercuts Murthy's argument that “there is growing evidence of harm.” It would be more accurate to say that there is conflicting evidence of harm. By the standards that dictated the smoking warning, that doesn't justify a warning label on social media.

Haidt and Twenge use a form of eliminative reasoning to conclude that exposure to social media causes mental illness among the young. They argue that there is no other plausible explanation why the incidence of mental illness among the young took off at the same time as social media use through smart phones skyrocketed. They eliminate such alternative explanations as the rise in school shootings, fear of climate change, and diminishing economic opportunity. None of these, it would seem, are singular explanations, but they and others, such as rising pressures on school children, could have been contributing factors.

There are anomalies that Haidt and Twenge need to deal with. Studies show a sudden rise in mental illness among teens in Canada, the United Kingdom, and Australia, among others, but not a similar trend among teens in Asian countries, where smart phones are ubiquitous. In South Korea from 2005 to 2019, the incidence among adolescents of “suicidality” (suicidal thoughts and plans), which have been a prime measure of adolescent mental health, decreased rather than rose. 

In Generations, Twenge documents how “millennials” (born 1980-1994) experienced a major rise in depression beginning around 2013. That's significant because millennials have not been on social media to the same extent as "Generation Z" (born 1995 to 2012). They were in their mid-20s and even 40s when the mental health crisis is supposed to have set in. Their brains were also developed by then and not subject, as Murthy and the Advisory argues, to the same power of suggestion. That raises the possibility that something other than, or, in addition to, social media may have been at work.

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There are two additional considerations that I offer tentatively. In Robert Putnam's Our Kids, he describes the growing gap in mentality and accomplishment between lower- and higher-income families and their children. It's reflected in the difference between young Americans whose parents have only a high school education and those whose parents have graduated from college.

If you look at statistics for the incidence of depression, they are highest among the less educated and less financially secure, and children with only a single parent. These young people find themselves subject to a debilitating stress that encourages mental illness. Social media may aggravate this condition, but it's one factor among several, and can't be adequately addressed by a warning label on TikTok or Instagram.

The second consideration has to do with the prevalence of reported mental illness among upscale youth. Celebrity young comedians such as Hannah Einbinder or Taylor Tomlinson have recounted their bouts of depression or their affliction with ADHD or their being “bipolar.” Being mentally ill has become a kind of purple heart among the young. Singer-songwriter Charli XCX described a “brat”—the title of her recent album and a term widely discussed after being embraced by Kamala Harris’s campaign—as “just that girl who is a little messy and maybe says dumb things sometimes, who feels herself, but then also maybe has a breakdown but parties through it.” What is reported as mental illness among these young people may fall between performance art and genuine affliction. 

Social media probably does play an important role in this kind of reported mental illness but as a source of contagion. Haidt cites how a rash of young Germans who reported to clinics with what they believed to be Tourette's syndrome, a neurological ailment characterized by nervous tics and involuntary utterances. It turned out that none of the young Germans actually had Tourette’s syndrome but were mimicking the symptoms that a German “influencer” who had Tourette's had displayed on YouTube videos.  

Haidt suggests that a similar kind of contagion may be behind the sudden massive onset of “gender dysphoria” among teenage girls. Something is going on, but it can't simply be understood in the usual psychiatric categories, which are themselves subject to constant revision.

There are discernible harms that social media and smart phones are doing that governments can address. Several state and local governments have banned or severely restricted children's use of cell phones in school. That's all to the good. So, obviously, are restrictions on social media platforms airing what could be criminal content, whether incitements to violence or solicitations of child sex. In contrast, Murthy's overly broad proposal for a warning label could reaffirm the fears of many Americans that the federal government wants to arbitrarily interfere with their daily lives by limiting what they can read, watch, or listen to. 

A final word, though, on the social psychologists. Haidt and Twenge have not made an uncontestable case that social media plays a singular role in causing mental illness, but they have opened an important discussion about how smart phones and social media can affect our thought and actions. There is no question that the ubiquity of social media has had contributed to what is distinctive about young people who have come of age in this century—from their views about “gender fluidity” to the rash of political protests that recalls the 1960s. 

John B. Judis's latest book, written with Ruy Teixeira, is Where Have All the Democrats Gone. He is a former senior editor of The New Republic and author of 11 books.