Wow just wow. This research you share and your clear explanations were so helpful. While I look at international research in all of my parenting work, I had not dug into the international research on teen mental health. In the US we often only think that things affect us and our children, but this is truly an international crisis.
Thank you for this detailed analysis. With the amassing data on the role that social media plays in the mental health deterioration of youth, it is high time to take action. We cannot expect swift action from government, policy makers, or school administrators. The action needs to start around the kitchen table, and parents must take the lead in serving as role models for their children if there is to be any hope. I will be publishing an essay this weekend 'From Feeding Moloch to 'Digital Minimalism' on my substack School of the Unconformed https://schooloftheunconformed.substack.com/, for those interested in taking concrete steps toward forming a digital detox community.
as a measure of artistic support for your work... i just posted another piece, today... about our "young generation" and their relationship to digital heroin.
I wonder if, especially with adolescent girls, the world they see on social media doesn’t align with their every day reality. This dissonance causes depression due to false expectations not matching up with reality (social life, family, body image, etc).
Yeah, the underlying psychology of this phenomenon is the interesting question.
I think maybe social media is displacing or distorting some important elements of everyday reality. Historically women form tight coalitions for emotional security and collective action. Gossip and reputation management are strong elements of this, but in real life they are balanced by other moral sentiments such as loyalty, reciprocity, and fairness. Building your self image through internet dynamics looks like a dead end.
I agree. So, how, when an adolescent girl catastrophizes everything and has a social-media induced distortion of reality, can she accurately self-report mental illness? I’m concerned about the self-reported data.
Agreed. This is, of course, why they also focus on objective data like self-harm episodes and hospitalization.
But, it’s also sort of a feature of human psychology that self-report is the data, which does make it perplexingly circular. But learned “catastrophizing” is actually a psychological variable that predicts outcomes. I also sense that the group dynamics of self-reporting symptoms is somewhat underappreciated. Take the current wave of self-reported gender fluidity, explained by some academicians as a new freedom, without recognizing the harmful social contagion dynamic. Suicide can be a social contagion.
Thanks David, sorry for the late reply here. That is a good point. I will make sure to clarify the language in future posts re: school alienation.
We believe that suicide is a somewhat distinct phenomena, that needs to be addressed separately. We are going to be doing a post soon on that. Thanks for your feedback!
Also if you look directly at loneliness, you get similar results but the meaning is clearer, e.g. the fraction of lonely students in the U.S. increased from 12% in 2012 to 24% in 2018. I cover that in Real Trends in Student Loneliness section of the Improper Terminology post.
As to suicide, I forgot that adolescent it is so rare that it is difficult to identify trends in smaller countries -- so you may wish to aggregate Scandinavia when you get to suicide.
One step we could take now is increase the daily time kids spend (in school & at home) being "active" & decrease the time being "inactive". A sedentary (sitting, scrolling, watching screens) lifestyle correlates with negative outcomes: https://www.bbc.com/news/uk-wales-65188535
Just to play devil’s advocate - I’m wondering if it’s possible that the culture has normalized mental illness and mental health issues so that it is being reported more honestly now. This could also be an effect of Social Media or Media in general.
My concern is that it has gone beyond normalization. For some adolescent girls, having some sort of label of mental illness is considered cool. Saying one is depressed or anxious provides an excuse for all sorts of behaviors. As someone who is a parent of teens and is around teens a lot, I see this all the time.
I agree. I am a mental health professional and I see this all the time. My job is to see the kids that have been in the hospital or ED for mental health issues and coordinate higher levels of care. Cutting and other forms of self-harm have become normal coping skills for these kids. And there are defiantly some that feel like it makes them cool.
What an important work/research. It’s truly overwhelming to contemplate. Here’s my two-bits worth: our children are depressed and anxious because their parents are distressed. The parents are distressed because leadership and polarization have created an environment of mistrust and negativity. Our children- and they are ALL OURS- are the canaries in the coal mine. They reflect what the adults around them are feeling. ‘Nuff said.
1 Some inevitabilities: Smartphones (6.84 billion & counting) will advance technologically & dominate the market; teens (& preteens) will always want one & parents will be under constant pressure to acquiesce; schools will find it (almost) impossible to control/inhibit/forbid in-school use; social media giants will "improve" ways to increase the time users spend on their devices; kids will call parents/teachers hypocrites for the "do what say, not what I do" approach to cellphone use.
2 Some observations based on personal experience: Girls, more than boys, share feelings (esp unhappy ones) with friends; gossip (especially about other girls); are sensitive about their appearance; spend less time exercising. Boys, more than girls, suppress their feelings; spend less on-line time with social media & more with games; talk more about sports & less about their own physical appearances.
3 What can we do with a reasonable expectation of success? Parents can model appropriate behaviors for their kids from infancy to adulthood (cell phone use, exercise, diet, recreation, literacy, education, etc) Kids are mimics; they watch/listen to us & learn. Parents can seek appropriate peer groups for kids (see JR Harris/Pinker). Schools/parents focus on media literacy & cognitive skills (see Kahneman/Pinker). Parents build a trusting relationship with their kids. Parents are the key & the job is VERY, VERY HARD!
I am convinced the introduction of social media on mobile is the reason. I have worked with mobile services since early 00:
2008: Facebook mobile app introduced on IOS
2009: FB mobile app on Android
2009: PUSH NOTIFICATIONS are introduced. This is huge and gasoline on a started fire. Non-tech researchers must understand this. Before PNs, apps had to send notifications as SMS, and each cost money for the app company. PTs are free, and its use was and is still maximized. An app can now easily send a notification to a whole group for example.
2010: Instagram launches (trends like curating your bio photos emerge ” you are your bio”). Perfect use and match for push notifs.
Appreciate this work so much Zach and great points Par! I know I am very late to seeing this article but I wonder if there is any usefulness to exploring when devices, apps, push notifications where introduced into each market? For instance if there was a year or two delay when they rolled out FB or IG into a certain country, could we then see trends that are slightly delayed (ie - US rolls out IG first and then it goes to Denmark 2 years later). Just curious.
This is very compelling work. Behavioral patterns are complex and one would expect that the influences on them are multi-factorial, but it's worth thinking about what factors are compelling enough to move the needle on whole populations, or whole population sectors of multiple nations. The internet, social media and mobile devices like smart-phones are all pervasive factors in modern societies that have deeply penetrated populations, particularly younger sectors to an incredible degree in the last decade. I see this phenomenon repeatedly as I follow my teenage son around to his sporting events. Amongst the spectators in the stands, the attention of individuals (far more women than men, in my observation) is divided between what's occurring on the field and what's happening on the screen of the smart phone. Even those paying attention to the event rapidly turn to their devices during the brief intervals when play is interrupted on the field. the other day I saw several female teens sitting together and every single one was staring at a screen. What is so compelling about what's there that neither the event they were attending nor their presence with one another was adequate to break their connection with those devices? There was a time when the only image you had of yourself was what you saw in the bathroom mirror once or twice a day. Now images and selfies are collected constantly, stored in picture archives, published on social media and swapped constantly. People are acutely aware of their appearance, their behavioral gestures and are constantly judging themselves on how others may perceive them. We are bombarded by images of ourselves and others, which are then subconsciously compared to "beautiful people" whose carefully curated appearance creates an impossible standard to meet. We're doing this silent stuff in crowds, instead of paying attention to one another. The behavior is addictive and disruptive to normal interactions between people. It fosters a constant vigilance , hyper-awareness and general arousal that isn't normal. And, it is happening on a massive scale, enough to move the meter on the behavioral health of whole sectors of populations across the entire world. Scary? You betcha!
My impression is that Instagram would be more damaging than TikTok. Although that would depend what teenagers, and girls in particular are viewing. TikTok has extremely effective algorithms, better than other social media.
TikTok has a wide variety of quality, educational, and fun content, as well as being really diverse, it's not all trash or asinine influencers. But I did just remember the two most viewed creators are two young women in the US who basically don't say or do anything other than show themselves off, and overlay a few bars of music. Sadly vacuous. Don't see how that would be more damaging than Instagram, though, other than pure numbers.
It would be difficult, but possible, to measure usage and an implied correlation between the different platforms, or an implied attribution of most harm.
There’s an important variable with TikTok or instagram usage along amount of time spent on it that’s important to consider but will be harder to quantify: what are the kids watching? There’s likely a different effect on a teen from watching 2 hours a day of cute animal videos vs 2 hours of videos of teens talking about all their mental health problems or angry political videos. Then you also have to consider how most TikTok videos can now be accessed through YouTube shorts (although with YouTube’s algorithm instead of TikTok’s). Also how do you account for the teen who is not on TikTok but is immersed in a culture of teens who are and are absorbing many of the same ideas?
True, but there's never a single magic way to design research, and resources are always finite. Intricate design isn't always essential.
Teens not using social media absorb peer, family, and broader community culture, being social media adjacent couldn't be untangled or measured, and the hypothesis is that using social media is the problem, not that other people are using it.
I’ve heard that Tik Tok algorithms for western culture kids are different than eastern culture kids. Western culture gets shown more videos that dumb them down. Eastern culture gets more videos that stretch them on STEM topics, etc.
The algorithm quickly adapts to the user interests, so if I mostly look at puppies or comedy clips, I'll get more of those, but if I spend time looking at learning content, I'll get more of that content.
I expect Eastern users are seeking more edifying content, rather than the edifying content being pushed to them. No one can force a teenager to avidly watch science or maths clips, even on TikTok.
With the right resources it would be pretty easy, I would think.
We already know that teens use TikTok [slightly] more than Instagram [Pew Research: Since 2014-15, TikTok has arisen; Facebook usage has dropped; Instagram, Snapchat have grown].
Seems like it would just be a matter of identifying the kind of content that promotes the issues we're seeing, and then documenting which site is serving up more of it.
A quick and dirty would be a qualitative look at the top 20 or top 50 most popular sites each year from 2012 onwards for each platform. This would throw up trends and changes in the type of content being sought out over time. Blunt instrument, without sex or age details, but wouldl be cheapish and might be revealing.
Another pervasive factor weighing on the minds of all of us, including young people, is our environment and the ticking clock on global warming. We hear increasingly about how fundamental change in our personal and corporate behavior is necessary to avoid a global catastrophe that is coming soon, in our lifetime, if we don't change drastically. Then, when we look around ourselves, we don't see accessible ways to make fundamental change. An electric vehicle is costly. Switching our home systems from fossil fuels to electricity is costly. Adding home solar power is costly. Much of the energy consumption is commercial and industrial, environments where we have very little influence unless we are high in the leadership hierarchy. Last summer's June heatwave injured and killed mature trees on my property. Those trees are 50-120 years old. They can't be easily or quickly replaced; there's no rational reason to assume that subsequent years will be cooler, more moist than last year. My family's cars are between 10 and 35 years old, still have plenty of useful life in them. They all burn fossil fuels. The bus only runs once each way per day through my neighborhood. Alternatives to the vehicles I own are not easily accessible. The crisis is upon us and the changes needed to change my carbon footprint are expensive and substantially accessible. My child hears this stuff too. It's his future we need to worry about; mine is far shorter than his. Multiply this awareness across hundreds of millions of people and what do you get? Rising anxiety, a rising sense of hopelessness, depression?
Wow just wow. This research you share and your clear explanations were so helpful. While I look at international research in all of my parenting work, I had not dug into the international research on teen mental health. In the US we often only think that things affect us and our children, but this is truly an international crisis.
We administer the PHQ-9 and CSSRS every session
Thank you for this detailed analysis. With the amassing data on the role that social media plays in the mental health deterioration of youth, it is high time to take action. We cannot expect swift action from government, policy makers, or school administrators. The action needs to start around the kitchen table, and parents must take the lead in serving as role models for their children if there is to be any hope. I will be publishing an essay this weekend 'From Feeding Moloch to 'Digital Minimalism' on my substack School of the Unconformed https://schooloftheunconformed.substack.com/, for those interested in taking concrete steps toward forming a digital detox community.
nice comment, Ruth 🙏🏼
i'd like to put my recent post (re: digital heroin) on your radar. https://opentochange.substack.com/p/growing-up-before-digital-heroin
There is some data available about self harming https://www.julkari.fi/bitstream/handle/10024/145433/URN_ISBN_978-952-343-966-5.pdf?sequence=1&isAllowed=y This study is in Finnish and includes only COVID-19 time
Also short new from Finnish broadcasting company https://yle.fi/a/3-10659409
Thank you for this! I will add this to the google doc
nicely done, Zach & Jon — so thorough 🙏🏼
as a measure of artistic support for your work... i just posted another piece, today... about our "young generation" and their relationship to digital heroin.
https://opentochange.substack.com/p/attn-young-generation
I wonder if, especially with adolescent girls, the world they see on social media doesn’t align with their every day reality. This dissonance causes depression due to false expectations not matching up with reality (social life, family, body image, etc).
Yeah, the underlying psychology of this phenomenon is the interesting question.
I think maybe social media is displacing or distorting some important elements of everyday reality. Historically women form tight coalitions for emotional security and collective action. Gossip and reputation management are strong elements of this, but in real life they are balanced by other moral sentiments such as loyalty, reciprocity, and fairness. Building your self image through internet dynamics looks like a dead end.
I agree. So, how, when an adolescent girl catastrophizes everything and has a social-media induced distortion of reality, can she accurately self-report mental illness? I’m concerned about the self-reported data.
Agreed. This is, of course, why they also focus on objective data like self-harm episodes and hospitalization.
But, it’s also sort of a feature of human psychology that self-report is the data, which does make it perplexingly circular. But learned “catastrophizing” is actually a psychological variable that predicts outcomes. I also sense that the group dynamics of self-reporting symptoms is somewhat underappreciated. Take the current wave of self-reported gender fluidity, explained by some academicians as a new freedom, without recognizing the harmful social contagion dynamic. Suicide can be a social contagion.
Completely agree!
Is that Iceland increase number (purple) wrong in Fig 4. Seems it should be higher than 6.9%? Should be highest
Wow, thank you! I made a mistake with the graph. It is now updated. Thanks for your keen eye.
===
Very comprehensive work Zach and I appreciate the inclusion of contrary trends.
One note: your 'loneliness' measure is not loneliness but an aggregate measure of school alienation; see my critique The Perils of Improper Terminology: A Comment on The Smartphone Trap [https://theshoresofacademia.blogspot.com/2021/09/the-perils-of-improper-terminology.html].
One question: why no suicide trend data?
Thanks David, sorry for the late reply here. That is a good point. I will make sure to clarify the language in future posts re: school alienation.
We believe that suicide is a somewhat distinct phenomena, that needs to be addressed separately. We are going to be doing a post soon on that. Thanks for your feedback!
---
Also if you look directly at loneliness, you get similar results but the meaning is clearer, e.g. the fraction of lonely students in the U.S. increased from 12% in 2012 to 24% in 2018. I cover that in Real Trends in Student Loneliness section of the Improper Terminology post.
As to suicide, I forgot that adolescent it is so rare that it is difficult to identify trends in smaller countries -- so you may wish to aggregate Scandinavia when you get to suicide.
---
That's a very good idea. Thanks David.
Thank you for doing this work!
Maybe there will be one country brave enough to take action to protect the children from this, because it sure seems like too many parents just won’t
💚
One step we could take now is increase the daily time kids spend (in school & at home) being "active" & decrease the time being "inactive". A sedentary (sitting, scrolling, watching screens) lifestyle correlates with negative outcomes: https://www.bbc.com/news/uk-wales-65188535
Just to play devil’s advocate - I’m wondering if it’s possible that the culture has normalized mental illness and mental health issues so that it is being reported more honestly now. This could also be an effect of Social Media or Media in general.
My concern is that it has gone beyond normalization. For some adolescent girls, having some sort of label of mental illness is considered cool. Saying one is depressed or anxious provides an excuse for all sorts of behaviors. As someone who is a parent of teens and is around teens a lot, I see this all the time.
I agree. I am a mental health professional and I see this all the time. My job is to see the kids that have been in the hospital or ED for mental health issues and coordinate higher levels of care. Cutting and other forms of self-harm have become normal coping skills for these kids. And there are defiantly some that feel like it makes them cool.
If only this were true, I feel like the behavioral data wouldn’t back it up (and it might not, we still don’t conclusively know).
Since the data is mixed from Sweden/Denmark/Finland on self-harm and psychiatric hospital visits, I don’t know what to make of this. I
What an important work/research. It’s truly overwhelming to contemplate. Here’s my two-bits worth: our children are depressed and anxious because their parents are distressed. The parents are distressed because leadership and polarization have created an environment of mistrust and negativity. Our children- and they are ALL OURS- are the canaries in the coal mine. They reflect what the adults around them are feeling. ‘Nuff said.
1 Some inevitabilities: Smartphones (6.84 billion & counting) will advance technologically & dominate the market; teens (& preteens) will always want one & parents will be under constant pressure to acquiesce; schools will find it (almost) impossible to control/inhibit/forbid in-school use; social media giants will "improve" ways to increase the time users spend on their devices; kids will call parents/teachers hypocrites for the "do what say, not what I do" approach to cellphone use.
2 Some observations based on personal experience: Girls, more than boys, share feelings (esp unhappy ones) with friends; gossip (especially about other girls); are sensitive about their appearance; spend less time exercising. Boys, more than girls, suppress their feelings; spend less on-line time with social media & more with games; talk more about sports & less about their own physical appearances.
3 What can we do with a reasonable expectation of success? Parents can model appropriate behaviors for their kids from infancy to adulthood (cell phone use, exercise, diet, recreation, literacy, education, etc) Kids are mimics; they watch/listen to us & learn. Parents can seek appropriate peer groups for kids (see JR Harris/Pinker). Schools/parents focus on media literacy & cognitive skills (see Kahneman/Pinker). Parents build a trusting relationship with their kids. Parents are the key & the job is VERY, VERY HARD!
I am convinced the introduction of social media on mobile is the reason. I have worked with mobile services since early 00:
2008: Facebook mobile app introduced on IOS
2009: FB mobile app on Android
2009: PUSH NOTIFICATIONS are introduced. This is huge and gasoline on a started fire. Non-tech researchers must understand this. Before PNs, apps had to send notifications as SMS, and each cost money for the app company. PTs are free, and its use was and is still maximized. An app can now easily send a notification to a whole group for example.
2010: Instagram launches (trends like curating your bio photos emerge ” you are your bio”). Perfect use and match for push notifs.
great point re: push notifications!
Appreciate this work so much Zach and great points Par! I know I am very late to seeing this article but I wonder if there is any usefulness to exploring when devices, apps, push notifications where introduced into each market? For instance if there was a year or two delay when they rolled out FB or IG into a certain country, could we then see trends that are slightly delayed (ie - US rolls out IG first and then it goes to Denmark 2 years later). Just curious.
This is very compelling work. Behavioral patterns are complex and one would expect that the influences on them are multi-factorial, but it's worth thinking about what factors are compelling enough to move the needle on whole populations, or whole population sectors of multiple nations. The internet, social media and mobile devices like smart-phones are all pervasive factors in modern societies that have deeply penetrated populations, particularly younger sectors to an incredible degree in the last decade. I see this phenomenon repeatedly as I follow my teenage son around to his sporting events. Amongst the spectators in the stands, the attention of individuals (far more women than men, in my observation) is divided between what's occurring on the field and what's happening on the screen of the smart phone. Even those paying attention to the event rapidly turn to their devices during the brief intervals when play is interrupted on the field. the other day I saw several female teens sitting together and every single one was staring at a screen. What is so compelling about what's there that neither the event they were attending nor their presence with one another was adequate to break their connection with those devices? There was a time when the only image you had of yourself was what you saw in the bathroom mirror once or twice a day. Now images and selfies are collected constantly, stored in picture archives, published on social media and swapped constantly. People are acutely aware of their appearance, their behavioral gestures and are constantly judging themselves on how others may perceive them. We are bombarded by images of ourselves and others, which are then subconsciously compared to "beautiful people" whose carefully curated appearance creates an impossible standard to meet. We're doing this silent stuff in crowds, instead of paying attention to one another. The behavior is addictive and disruptive to normal interactions between people. It fosters a constant vigilance , hyper-awareness and general arousal that isn't normal. And, it is happening on a massive scale, enough to move the meter on the behavioral health of whole sectors of populations across the entire world. Scary? You betcha!
But what changed from 2017 onwards? Nothing immediately comes to mind.
"The app was launched as TikTok in the international market in September 2017"
I'm sure that was just a coincidence ;)
Ah, wow.
Yes, likely coincidence.
My impression is that Instagram would be more damaging than TikTok. Although that would depend what teenagers, and girls in particular are viewing. TikTok has extremely effective algorithms, better than other social media.
TikTok has a wide variety of quality, educational, and fun content, as well as being really diverse, it's not all trash or asinine influencers. But I did just remember the two most viewed creators are two young women in the US who basically don't say or do anything other than show themselves off, and overlay a few bars of music. Sadly vacuous. Don't see how that would be more damaging than Instagram, though, other than pure numbers.
It would be difficult, but possible, to measure usage and an implied correlation between the different platforms, or an implied attribution of most harm.
There’s an important variable with TikTok or instagram usage along amount of time spent on it that’s important to consider but will be harder to quantify: what are the kids watching? There’s likely a different effect on a teen from watching 2 hours a day of cute animal videos vs 2 hours of videos of teens talking about all their mental health problems or angry political videos. Then you also have to consider how most TikTok videos can now be accessed through YouTube shorts (although with YouTube’s algorithm instead of TikTok’s). Also how do you account for the teen who is not on TikTok but is immersed in a culture of teens who are and are absorbing many of the same ideas?
True, but there's never a single magic way to design research, and resources are always finite. Intricate design isn't always essential.
Teens not using social media absorb peer, family, and broader community culture, being social media adjacent couldn't be untangled or measured, and the hypothesis is that using social media is the problem, not that other people are using it.
Yes, the point isn’t that TikTok has other applications but rather whether teenagers use TikTok the same way they use Instagram.
Good comment
I’ve heard that Tik Tok algorithms for western culture kids are different than eastern culture kids. Western culture gets shown more videos that dumb them down. Eastern culture gets more videos that stretch them on STEM topics, etc.
The algorithm quickly adapts to the user interests, so if I mostly look at puppies or comedy clips, I'll get more of those, but if I spend time looking at learning content, I'll get more of that content.
I expect Eastern users are seeking more edifying content, rather than the edifying content being pushed to them. No one can force a teenager to avidly watch science or maths clips, even on TikTok.
With the right resources it would be pretty easy, I would think.
We already know that teens use TikTok [slightly] more than Instagram [Pew Research: Since 2014-15, TikTok has arisen; Facebook usage has dropped; Instagram, Snapchat have grown].
Seems like it would just be a matter of identifying the kind of content that promotes the issues we're seeing, and then documenting which site is serving up more of it.
Yes, it all takes dollars and good researchers.
A quick and dirty would be a qualitative look at the top 20 or top 50 most popular sites each year from 2012 onwards for each platform. This would throw up trends and changes in the type of content being sought out over time. Blunt instrument, without sex or age details, but wouldl be cheapish and might be revealing.
Another pervasive factor weighing on the minds of all of us, including young people, is our environment and the ticking clock on global warming. We hear increasingly about how fundamental change in our personal and corporate behavior is necessary to avoid a global catastrophe that is coming soon, in our lifetime, if we don't change drastically. Then, when we look around ourselves, we don't see accessible ways to make fundamental change. An electric vehicle is costly. Switching our home systems from fossil fuels to electricity is costly. Adding home solar power is costly. Much of the energy consumption is commercial and industrial, environments where we have very little influence unless we are high in the leadership hierarchy. Last summer's June heatwave injured and killed mature trees on my property. Those trees are 50-120 years old. They can't be easily or quickly replaced; there's no rational reason to assume that subsequent years will be cooler, more moist than last year. My family's cars are between 10 and 35 years old, still have plenty of useful life in them. They all burn fossil fuels. The bus only runs once each way per day through my neighborhood. Alternatives to the vehicles I own are not easily accessible. The crisis is upon us and the changes needed to change my carbon footprint are expensive and substantially accessible. My child hears this stuff too. It's his future we need to worry about; mine is far shorter than his. Multiply this awareness across hundreds of millions of people and what do you get? Rising anxiety, a rising sense of hopelessness, depression?