Trending social media and mental health care

The first email was sent in the 1970s. Facebook was introduced twenty years ago. For Dutch readers: remember Hyves? Or for others: MySpace? Social media have been reshaping the social landscape ever since. 

Online interactions have grown exponentially in number, and social media is now indispensable for social exchange. Today, large parts of social life take place online. In fact, 84% of adolescents use at least one social media platform. In the Netherlands, adolescents are active on an average of five social media platforms (nationale sociale media onderzoek, 2024).

This is important because adolescence is also the period during which many mental health disorders first emerge. A crucial question is how social media use and mental health problems influence one another. 

It is often assumed that social media use contributes to mental health issues and impaired cognitive functioning. This assumption has even led to a ban on social media use for children under 16 in Australia. Recently, in the Netherlands, politicians from D66 suggested implementing a similar measure.

An important question is whether these sweeping statements about the negative impact of social media on mental health are supported by scientific research. When we dive into the literature we encounter several ways in which social media use can affect mental health. I will provide an overview below:

1. Social Media Addiction

Social media use can itself become a mental health issue when users develop an addiction. For humans, social acceptance and approval are highly rewarding. Seeking these is one of the primary motives for using social media, where rewards come instantly—through likes, comments, and shares. Research has shown that sharing self-related information activates the brain’s reward system (Da Silva et al., 2024).

The most compelling aspect of social media, is the external validation of self-related information. This validation is unpredictable—users never know when or if likes or comments will arrive. This intermittent reward pattern drives continuous checking of social media. Social media platforms are designed to capture user attention, which can interfere with cognitive processes like sustained attention. It is unsurprising, then, that social media can be addictive. A conservative estimate suggests that 5% of users are addicted to social media (Huang., 2022).

2. Social media related changes in brain functioning and cognition

Another widespread assumption is that social media use leads to brain changes and decreased cognitive functioning. This assumed cognitive decline is thought to negatively impact mental health. Preliminary evidence indeed suggests that social media use is associated with functional and structural changes in the brain, particularly in regions related to finger and thumb movement (Firth et al., 2019). However, neuroimaging studies on this topic are limited in size and scope, making it difficult to draw definitive conclusions.

In terms of cognitive outcomes, data from a large cohort of adolescents in the UK (N > 12,000; Stieger& Wunderl, 2022) found a small association between social media use and poorer overall cognitive functioning. However, the effect sizes were also very small, suggesting that social media use has a negligible impact on cognitive performance. Thus, claims about significant cognitive impairment caused by social media use appear largely unfounded.

3. Social media related risk factors for mental disorders

Social media use is also associated with several risk factors for mental health disorders, such as sedentary behavior, poor sleep quality, social isolation, and psychological processes like upward social comparison and the “fear of missing out” (FOMO). Additionally, users may become dependent on external validation, which can exacerbate mental health issues.

Consistently, studies have found a positive association between social media use and symptoms of anxiety and depression, particularly for problematic use (Kelly et al., 2018). However, these associations are typically weak, and causation is unclear due to the cross-sectional nature of most studies. Some studies even fail to find any significant association at all.

4. Impact on Mental Health Symptom Presentation

Social media also influences how mental health symptoms are presented. For instance, mental health-related content is particularly popular on platforms like TikTok. Strikingly, individuals on social media sometimes display symptoms that are rarely observed in clinical practice. For example, there are many reports of people repeating the word “Beans” as a tic (Giedinghagen., 2023). Research showed that this ‘tic’ could be linked to the content of an influential case. Another example is the online presentation of dissociative identity disorder, showing individuals who present themselves with over 30 avatars (the social media term for identities) developed over a period of only a few months (Porter et al., 2024). This behavior may be stimulated by external validation, attention and monetary gain. In summary, social media can be addictive and is associated with risk factors for mental health problems. However, the link to mental health issues is not consistently observed, and causality remains unclear. Additionally, social media platforms often contain a significant amount of inaccurate health-related information and may encourage self-diagnosis or the imitation of mental disorders.

Future directions

The potential of social media to improve mental health has remained relatively underexposed. Research has shown that social media increase awareness of mental health problems can reduce the associated stigmatization and increase mental health literacy (Zsila & Reyes, 2023). Also, risk groups that are not detected by regular mental health services can be reached via social media. Social media have the potential to facilitate their help-seeking and can increase a sense of control over this process. Moreover, many adolescents find online social support, community, and a sense of belonging, as well as a platform to experiment with new aspects of their identity.

It seems clear, in short, that social media have become an important context for social behavior, and can have both negative and positive effects on mental health. As such, the rapid evolution of social media presents challenges for psychologists, as this domain remains relatively new to many of them. This can sometimes make us—in particular, the somewhat older researchers—feel like anthropologists rather than psychologists, observing the behaviors of others from an outsider’s perspective. Despite this slightly uneasy feeling, there are many pressing questions that demand the attention of mental health professionals.

In the coming years, our research group at the Heymans Institute will shed light on this. Our ongoing work focusses for example on the impact of social media use on identity formation in adolescents with mental health problems, how users react to dissociative identity disorder related content on TikTok, and on critical appraisal of psychosis related content by young people with a psychotic disorder. While it is well-known that labeling can lead to self-stigma, for instance, what happens when adolescents label themselves online without consulting traditional mental health care? How do these online peer-to-peer exchanges influence identity formation? Furthermore, how can we encourage critical appraisal of mental health-related information in these digital spaces? In the coming years, we hope to find answers to these questions and to use these answers to integrate social media use in current mental health practices. 

 

References 

Da Silva Pinho A, Céspedes Izquierdo V, Lindström B, & van den Bos W. (2024). Youths’ sensitivity to social media feedback: A computational account. Sci Adv, 10(43).

Firth J, Torous J, Stubbs B, Firth JA, Steiner GZ, Smith L, Alvarez-Jimenez M, Gleeson J, Vancampfort D, Armitage CJ, & Sarris J. (2019). The “online brain”: how the Internet may be changing our cognition. World Psychiatry, 18(2), 119-129.

Giedinghagen A. (2023). The tic in TikTok and (where) all systems go: Mass social media induced illness and Munchausen’s by internet as explanatory models for social media associated abnormal illness behavior. Clin Child Psychol Psychiatry, 28(1), 270-278.

Huang C. (2022). A meta-analysis of the problematic social media use and mental health. Int J Soc Psychiatry, 68(1), 12-33. 

Kelly Y, Zilanawala A, Booker C, & Sacker A. (2019). Social Media Use and Adolescent Mental Health: Findings From the UK Millennium Cohort Study. EClinicalMedicine, 6, 59-68.

Porter CA, Mayanil T, Gupta T, & Horton LE. (2024). #DID: The Role of Social Media in the Presentation of Dissociative Symptoms in Adolescents. J Am Acad Child Adolesc Psychiatry, 63(2), 101-104 

Stieger, S. & Wunderl, S. (2022). Associations between social media use and cognitive abilities: Results from a large-scale study of adolescents. Computers in Human Behavior, 135.

Zsila Á, & Reyes MES. (2023). Pros & cons: impacts of social media on mental health. BMC Psychol, 11(1), 201.

 

Featured image credit

Dewangan Iti, CC BY-SA 4.0 <https://creativecommons.org/licenses/by-sa/4.0>, via Wikimedia Commons