Are screens causing a teen depression? Jean Twenge's new book shows the link : Shots - Health News A striking decline in teen mental health has coincided with the rise of smartphones and social media. Is social media causing the mental health challenges? Finally, research can answer that question.

The truth about teens, social media and the mental health crisis

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MELISSA BLOCK, HOST:

Back in 2017, Jean Twenge started a firestorm in the field of psychology. Twenge studies health metrics across generations in America. When she looked at data for the Gen Z generation, who are now teenagers and young adults, she saw signs of a mental health crisis on the horizon. Rates of depression, anxiety and loneliness were rising quickly. She had a hypothesis about the cause - smartphones and social media.

(SOUNDBITE OF ARCHIVED NPR BROADCAST)

JEAN TWENGE: Smartphones were used by the majority of Americans around 2012, and that's the same time loneliness increases. That's very suspicious.

BLOCK: That's Twenge speaking on this program back in 2017. At the time, many of her colleagues didn't agree with her. They thought she had way too little data to make such claims and that she was unnecessarily causing a panic. Well, now, six years later, Twenge is back with a new book. As NPR's Michaeleen Doucleff reports, science is finally catching up with her.

MICHAELEEN DOUCLEFF, BYLINE: Twenge's new book is called "Generations." In it, she analyzes the mental health of five generations, going all the way back to 1925. She shows quite clearly that, in the past decade for Gen Z...

TWENGE: The way teens spend their time outside of school has fundamentally changed.

DOUCLEFF: Take, for instance, hanging out with friends face-to-face. For 30 years, the time that teens spent socializing this way stayed pretty steady. But then, in 2010, it nosedived.

TWENGE: It's just like a black diamond ski slope - just straight down - these really, really big changes.

DOUCLEFF: At the same time, social media use began to soar. A poll from the Pew Research Center finds that about 95% of teens now use some social media, and about a third say they use it constantly.

TWENGE: And this is not a small number of people either. In the most recent data, 22% of 10th grade girls spent seven or more hours a day on social media.

DOUCLEFF: That's like - they're not doing anything else besides going to school, right?

TWENGE: Yep, that's correct.

DOUCLEFF: Not surprisingly, with all this screen time, Twenge finds that teens are getting much less sleep than they did a decade ago. Today, nearly half of high school seniors sleep less than seven hours a night.

TWENGE: Kids in that age group are supposed to be getting nine hours a night, and this is a really serious problem. Sleep is absolutely crucial for physical health and for mental health. Not getting enough sleep is a major risk factor for anxiety and depression and self-harm.

DOUCLEFF: And unfortunately, all those mental health problems have continued to increase.

TWENGE: Across the board, since 2010, there have been increases in anxiety, depression, loneliness. And it's not just symptoms. It's also behaviors - things like emergency room visits for self-harm, for suicide attempts and completed suicides. All of those increased for teens.

DOUCLEFF: All of these changes coincide with what may be the most rapid uptake in a new technology in human history - the uptake of smartphones and social media. Twenge has hypothesized for years now that they're connected.

Chris Said is a data scientist, with a Ph.D. in psychology from Princeton. He has also worked at Facebook and Twitter and agrees that the timing is hard to ignore.

CHRIS SAID: Social media was just, like, a nuclear bomb on teen social life. I don't think there's anything in recent memory or even distant history that has changed the way that teens socialize as much as social media.

DOUCLEFF: But the timing doesn't answer the critical question - does social media cause teens to become depressed? Scientists have published many studies addressing this question, but Said says, here's the thing people don't realize. In these studies, they haven't been using or really even had the proper tools to answer the question, so the findings have been all over the place - murky, noisy, inconclusive and confusing.

SAID: This is a very hard problem to study. And when you use tools that can't fully answer the question, you're going to get weak answers. So I think that's one reason why really strong evidence didn't show up in the data, at least early on.

DOUCLEFF: But now, scientists have better tools. Over the past few years, several high-quality studies have come out that can directly test whether or not social media causes depression. And the picture is getting clearer. Matthew Gentzkow is an economist at Stanford University. He says the best study just came out last November. It's from scientists at the Massachusetts Institute of Technology.

MATTHEW GENTZKOW: I really love that paper, and I think that paper is probably the most convincing thing I have seen.

DOUCLEFF: In the study, researchers took advantage of what was really a once-in-a-lifetime opportunity - the rollout of Facebook on college campuses way back in 2004 to 2006.

GENTZKOW: When Facebook was introduced, it exploded so quickly. You know, everybody on campus had it in a very short period of time.

DOUCLEFF: But not every campus got Facebook at the same time. The rollout was staggered, and this staggered rollout is experimental gold. It allowed scientists to measure how the mental health of students changed on a campus as many students started using social media. We're talking about hundreds of thousands of students on over 300 campuses.

GENTZKOW: You're looking at the impact of Facebook being introduced to an entire university.

DOUCLEFF: The researchers could also track students' mental health because, at the time, colleges were administering a national survey about mental health, with questions about concrete behaviors.

GENTZKOW: Things like visits to the university health system for mental health and medications and things like that.

DOUCLEFF: What they found was, almost immediately after Facebook arrives, there is an uptick in many mental health issues, like depression and anxiety. The researchers estimate that Facebook caused about 2% of college students to become depressed. That would mean more than 300,000 more young adults suffering from depression.

GENTZKOW: I think that shows clear effects. It's really credible.

DOUCLEFF: Of course, there are limitations. For starters, it's Facebook, which teens are using less and less, and it's a very early version of Facebook. There was no news feed or like button, so the version wasn't as potent as social media now. But other recent studies support these findings, including one led by Gentzkow. In that study, his team paid adults to quit Facebook for four weeks, and then they measured people's mental health changes. Across the board, people felt better on average after a break from Facebook.

GENTZKOW: You see higher happiness, life satisfaction, lower depression, lower anxiety and maybe a little bit lower loneliness.

DOUCLEFF: Gentzkow says there's still a lot to learn about social media and the mental health of teens, but a few ideas are really crystallizing. In particular, social media won't hurt everyone. Recent data suggests younger teens and preteens might be the most vulnerable to it. And while social media isn't the only cause of mental health problems in teens today, it is a cause. And it's something society, communities, parents and teens themselves should take seriously and be extremely careful with.

Michaeleen Doucleff, NPR News.

AILSA CHANG, HOST:

And Michaeleen will be reporting more on the harmful effects of social media in an upcoming series of stories called Living Better. She'll look at what types of social media are most harmful, who is more at risk and what people can do to protect themselves.

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