The toll of social media and smartphones on teen mental health : Short Wave This week, the American Psychological Association issued its first-of-kind guidelines for parents to increase protection for children online. It comes at a time of rising rates of depression and anxiety among teens.

This episode, NPR science correspondent Michaeleen Doucleff looks into the data on how that seismic change has shifted the mental health of teenagers. In her reporting, she found that the seismic shift of smartphones and social media has re-defined how teens socialize, communicate and even sleep.

We need to talk about teens, social media and mental health

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EMILY KWONG, BYLINE: You're listening to SHORT WAVE...

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KWONG: ...From NPR.

REGINA BARBER, HOST:

Hey SHORT WAVErs. Regina Barber here with NPR science correspondent Michaeleen Doucleff. Hey.

MICHAELEEN DOUCLEFF, BYLINE: Hi, Regina.

BARBER: So, Michaeleen, we've brought you on to talk about something that's been on my mind these days, especially having a daughter about to start high school. It's social media and mental health.

DOUCLEFF: Oh, gosh, me too, Regina. I have a daughter. She's a little bit younger, but I still worry about it because, for me, personally, social media has not been very healthy. You know, it makes me feel bad. So I pretty much got off of it a while ago. And I have to say, I feel better.

BARBER: Right. Of course. But sometimes it feels like social media runs our lives. It's such a, like, powerful force.

DOUCLEFF: Yes. But I think the question is, especially for teens and kids, is, is it a negative force? And, you know, the American Psychological Association weighed in on this for the first time ever. They issued guidance for teens and social media.

BARBER: Wow.

DOUCLEFF: But the alarm bells aren't new, right? Back in 2017, a psychologist at San Diego State University - her name is Jean Twenge - set off this firestorm in psychology. She studies trends across generations, and she looks at data going all the way back to the 1930s.

BARBER: Wow.

DOUCLEFF: And when she looked at mental health data for teens starting around 2011 or so, she was shocked.

BARBER: Oh, no. What shocked her?

DOUCLEFF: Well, across the board, she could see rates of depression, anxiety, loneliness. They were all rising right around 2011, 2012. And she had this hypothesis that the reason for this mental health crisis that she saw coming was smartphones.

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

DOUCLEFF: That's Jean back in 2017 on All Things Considered. And, at the time, some of her colleagues were upset. They said her data was too weak to make these big claims and that she was worrying parents for no reason. Well, six years later, Jean is back. She has a new book and a lot more data. And after doing a lot of research myself, I can see that the science is finally catching up with her.

BARBER: So today on the show, how that data stacks up. Years later, we have a fraught relationship with social media, but should we finally call it quits? You're listening to SHORT WAVE from NPR.

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BARBER: OK, Michaeleen, I've tried to make a whole mystery earlier to kind of intrigue listeners. But I think social media is generally pretty bad, right?

DOUCLEFF: I mean, I think a lot of people feel that way. But what I didn't realize was that, in the past century, psychologists and society has often blamed new technologies for kids' problems, even their mental health problems. And they do this even with no data or shady data. One example is that, back in the 1940s, psychologists blamed radio crime stories for kids' mental health problems, and then they blamed comic books and then television.

BARBER: Yep, I remember.

DOUCLEFF: So as a scientist, I started wondering, like, what does the science, what does the data actually say about social media and teen mental health? And is social media like a radio crime drama that maybe we shouldn't worry too much about?

BARBER: (Laughter).

DOUCLEFF: Or is it really like, you know, smoking and cigarettes? Like, is the worry warranted?

BARBER: OK. So let's dive into the science. What has Jean found since she last sounded that alarm?

DOUCLEFF: Yeah. So Jean's new book, it's called "Generations." She really shows something quite profound. She shows that, in the past decade, for the Gen Z generation...

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

DOUCLEFF: So take, for instance, hanging out with friends face to face, without your parents. Jean looked at data going, like, all the way back to the 1970s, and she found that the time that teens spend, you know, doing this, hanging out with friends, really stayed pretty constant until about 2004. And then it starts to decline a little bit. But then, in 2010, it takes a nosedive.

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

BARBER: This is something I've actually talked to my daughter about. I'm like, why don't you just walk over to your friend's house and knock on the door like I used to when I was a kid? And she's like, people don't do that anymore.

DOUCLEFF: It's like this seismic shift. And then, at the same time, she shows that social media use has begun to soar, right? So in 2009, only about half of teens said they were using social media every day. And then last year, 95% of teens said they 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.

BARBER: This is alarming. That's so much time. That can't be healthy.

DOUCLEFF: You know, for one thing, all this screen time is cutting into kids' sleep. So Jean also found that, between 2010 and 2021, the percentage of 10th and 12th graders sleeping seven or less hours a night rose from a third to nearly a half.

TWENGE: Kids in that age group are supposed to be getting nine hours a night. So 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.

BARBER: So things have really escalated in the last decade.

DOUCLEFF: Yes, unfortunately, that's the case.

TWENGE: Across the board since 2010, there have been increases in anxiety, depression, in 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: And what Jean shows is that all these big rapid changes in socializing, sleeping, communication, they all coincide with what may be the most rapid uptake in a new technology in human history, which has allowed people to have nearly nonstop engagement with social media apps. Apple introduced the iPhone in 2007, and by about 2012, 50% of American adults owned a smartphone.

BARBER: Well, now it's almost everyone, right?

DOUCLEFF: Yeah, absolutely. I mean, to me, sometimes it feels like people have their phones, like, attached to their hands.

BARBER: You feel naked without it.

DOUCLEFF: Right. And the consensus among the researchers I talked to say this timing - right? So we see this big change in mental health right at the time that smartphones are exploding. This timing is really hard to ignore. One of them is Chris Said. He's a data scientist. He also has a Ph.D. in psychology. He's also worked at Facebook and Twitter.

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.

BARBER: But correlation is not causation, as they say. Just because X and Y happened doesn't mean that X caused Y.

DOUCLEFF: Exactly. Right? I mean, just because the rise in depression is in these years doesn't necessarily mean social media is causing depression.

BARBER: But how are they going to study that? I mean, you have other factors, like what's happening in reaction to the society we live in, cultural movements.

DOUCLEFF: Absolutely. This has just been a really hard problem to solve. And what has happened is that scientists have published many studies trying to answer that question - does social media cause depression? But Said says what people don't realize is that, in these studies, scientists haven't been using or really even had the right tools to answer that question. They've been using what are called correlation studies, where they look to see how depression or life satisfaction varies with social media use. And so the findings have been all over the place. They've been noisy and murky, 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.

BARBER: So, Michaeleen, do they now have strong studies that can look at causation?

DOUCLEFF: Yes. So in the past several years, a couple of high-quality studies have come out directly measuring causation. And when I was interviewing scientists for this story, they kept bringing up one study in particular that actually came out last November. One of those scientists is Matthew Gentzkow. He's an economist at Stanford University. And in this study, he says researchers took advantage of really what was a once-in-a-lifetime opportunity - the rollout of Facebook on college campuses back in 2004, 2006.

MATTHEW 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 right at the same time. So the rollout was staggered. And if you think about this, having a staggered rollout like this is experimental gold because it allows the researchers to directly measure students' mental health before and after Facebook was introduced. And we're talking about hundreds of thousands of students on hundreds of campuses. So the data - it's a big data set.

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

DOUCLEFF: Luckily, the researchers could also track students' mental health at the time because colleges were administering a national survey about mental health with a bunch of questions not just about how students felt but also about concrete behaviors.

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

BARBER: After collecting all this data, what did they find?

DOUCLEFF: Almost immediately after Facebook arrives on a campus, the researchers can detect this uptick in mental health issues. With this data, they could estimate that Facebook caused about 2% of college students to become clinically depressed. And at the time, you know, there were 17 million college students. So we're talking about 300,000 more students suffering from depression.

BARBER: OK. So what does this look like for a given person during that time?

DOUCLEFF: Yeah. So they tried to estimate that, too. They look at how other bad events in people's life affect one's mental health. Say, for instance, like, if you lost your job, how would that impact your mental health? And they find that engaging with Facebook decreases a person's mental health by roughly about 22%. Now, of course, Regina, there's a lot of limits to this study, right? First of all, it's Facebook, which, you know, a lot of teens are using less and less. It's also a very old version of Facebook. This was a bare-bones version of social media. There was no like button. There was no newsfeed. So, possibly, this study underestimates the effect of Facebook.

BARBER: OK. So what are the more recent studies dealing with current social media usage?

DOUCLEFF: Yeah. So Matt Gentzkow at Stanford and his team did an experiment in 2018, and in it, they recruited about 2,700 adults, and they paid half of them to deactivate their Facebook account for four weeks. And then they looked at how that affected these people's mental health. This is called, you know, a randomized experiment, which is typically the best way to estimate whether something is causing a problem or not. But, again, there are limitations. This is a very short experiment. Nevertheless, they found that people, on average, felt better after leaving Facebook.

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

BARBER: Wow. OK. So it seems like the headline we're, like, kind of wrapping around here - quit social media yesterday if you haven't already.

DOUCLEFF: I think what is becoming clear is that social media is a cause for depression. It is not the only cause. But I think also what is clear is that social media doesn't hurt every teen or hurt every teen by the same amount. The higher usage, so the more hours kids spend on it, the higher their risk is for depression, anxiety and other mental health problems.

BARBER: Michaeleen, thank you so much for bringing us this reporting and for reinforcing my personal and parenting instincts to really limit usage.

DOUCLEFF: You're welcome. Thank you for having me.

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BARBER: This episode was produced by Jane Greenhalgh with Liz Metzger. It was edited by Jane and our managing producer, Rebecca Ramirez. Michaeleen Doucleff checked the facts. Our engineers were Neisha Heinis and Hans Copeland. Beth Donovan is our senior director, and Anya Grundmann is our senior vice president of programming. I'm Regina Barber. Thanks for listening to SHORT WAVE from NPR.

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