research on the effects of social media on mental health

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Social Media Use and Its Connection to Mental Health: A Systematic Review

Fazida karim.

1 Psychology, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA

2 Business & Management, University Sultan Zainal Abidin, Terengganu, MYS

Azeezat A Oyewande

3 Family Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA

4 Family Medicine, Lagos State Health Service Commission/Alimosho General Hospital, Lagos, NGA

Lamis F Abdalla

5 Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA

Reem Chaudhry Ehsanullah

Safeera khan.

Social media are responsible for aggravating mental health problems. This systematic study summarizes the effects of social network usage on mental health. Fifty papers were shortlisted from google scholar databases, and after the application of various inclusion and exclusion criteria, 16 papers were chosen and all papers were evaluated for quality. Eight papers were cross-sectional studies, three were longitudinal studies, two were qualitative studies, and others were systematic reviews. Findings were classified into two outcomes of mental health: anxiety and depression. Social media activity such as time spent to have a positive effect on the mental health domain. However, due to the cross-sectional design and methodological limitations of sampling, there are considerable differences. The structure of social media influences on mental health needs to be further analyzed through qualitative research and vertical cohort studies.

Introduction and background

Human beings are social creatures that require the companionship of others to make progress in life. Thus, being socially connected with other people can relieve stress, anxiety, and sadness, but lack of social connection can pose serious risks to mental health [ 1 ].

Social media

Social media has recently become part of people's daily activities; many of them spend hours each day on Messenger, Instagram, Facebook, and other popular social media. Thus, many researchers and scholars study the impact of social media and applications on various aspects of people’s lives [ 2 ]. Moreover, the number of social media users worldwide in 2019 is 3.484 billion, up 9% year-on-year [ 3 - 5 ]. A statistic in Figure  1  shows the gender distribution of social media audiences worldwide as of January 2020, sorted by platform. It was found that only 38% of Twitter users were male but 61% were using Snapchat. In contrast, females were more likely to use LinkedIn and Facebook. There is no denying that social media has now become an important part of many people's lives. Social media has many positive and enjoyable benefits, but it can also lead to mental health problems. Previous research found that age did not have an effect but gender did; females were much more likely to experience mental health than males [ 6 , 7 ].

Impact on mental health

Mental health is defined as a state of well-being in which people understand their abilities, solve everyday life problems, work well, and make a significant contribution to the lives of their communities [ 8 ]. There is debated presently going on regarding the benefits and negative impacts of social media on mental health [ 9 , 10 ]. Social networking is a crucial element in protecting our mental health. Both the quantity and quality of social relationships affect mental health, health behavior, physical health, and mortality risk [ 9 ]. The Displaced Behavior Theory may help explain why social media shows a connection with mental health. According to the theory, people who spend more time in sedentary behaviors such as social media use have less time for face-to-face social interaction, both of which have been proven to be protective against mental disorders [ 11 , 12 ]. On the other hand, social theories found how social media use affects mental health by influencing how people view, maintain, and interact with their social network [ 13 ]. A number of studies have been conducted on the impacts of social media, and it has been indicated that the prolonged use of social media platforms such as Facebook may be related to negative signs and symptoms of depression, anxiety, and stress [ 10 - 15 ]. Furthermore, social media can create a lot of pressure to create the stereotype that others want to see and also being as popular as others.

The need for a systematic review

Systematic studies can quantitatively and qualitatively identify, aggregate, and evaluate all accessible data to generate a warm and accurate response to the research questions involved [ 4 ]. In addition, many existing systematic studies related to mental health studies have been conducted worldwide. However, only a limited number of studies are integrated with social media and conducted in the context of social science because the available literature heavily focused on medical science [ 6 ]. Because social media is a relatively new phenomenon, the potential links between their use and mental health have not been widely investigated.

This paper attempt to systematically review all the relevant literature with the aim of filling the gap by examining social media impact on mental health, which is sedentary behavior, which, if in excess, raises the risk of health problems [ 7 , 9 , 12 ]. This study is important because it provides information on the extent of the focus of peer review literature, which can assist the researchers in delivering a prospect with the aim of understanding the future attention related to climate change strategies that require scholarly attention. This study is very useful because it provides information on the extent to which peer review literature can assist researchers in presenting prospects with a view to understanding future concerns related to mental health strategies that require scientific attention. The development of the current systematic review is based on the main research question: how does social media affect mental health?

Research strategy

The research was conducted to identify studies analyzing the role of social media on mental health. Google Scholar was used as our main database to find the relevant articles. Keywords that were used for the search were: (1) “social media”, (2) “mental health”, (3) “social media” AND “mental health”, (4) “social networking” AND “mental health”, and (5) “social networking” OR “social media” AND “mental health” (Table  1 ).

Out of the results in Table  1 , a total of 50 articles relevant to the research question were selected. After applying the inclusion and exclusion criteria, duplicate papers were removed, and, finally, a total of 28 articles were selected for review (Figure  2 ).

PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses

Inclusion and exclusion criteria

Peer-reviewed, full-text research papers from the past five years were included in the review. All selected articles were in English language and any non-peer-reviewed and duplicate papers were excluded from finally selected articles.

Of the 16 selected research papers, there were a research focus on adults, gender, and preadolescents [ 10 - 19 ]. In the design, there were qualitative and quantitative studies [ 15 , 16 ]. There were three systematic reviews and one thematic analysis that explored the better or worse of using social media among adolescents [ 20 - 23 ]. In addition, eight were cross-sectional studies and only three were longitudinal studies [ 24 - 29 ].The meta-analyses included studies published beyond the last five years in this population. Table  2  presents a selection of studies from the review.

IGU, internet gaming disorder; PSMU, problematic social media use

This study has attempted to systematically analyze the existing literature on the effect of social media use on mental health. Although the results of the study were not completely consistent, this review found a general association between social media use and mental health issues. Although there is positive evidence for a link between social media and mental health, the opposite has been reported.

For example, a previous study found no relationship between the amount of time spent on social media and depression or between social media-related activities, such as the number of online friends and the number of “selfies”, and depression [ 29 ]. Similarly, Neira and Barber found that while higher investment in social media (e.g. active social media use) predicted adolescents’ depressive symptoms, no relationship was found between the frequency of social media use and depressed mood [ 28 ].

In the 16 studies, anxiety and depression were the most commonly measured outcome. The prominent risk factors for anxiety and depression emerging from this study comprised time spent, activity, and addiction to social media. In today's world, anxiety is one of the basic mental health problems. People liked and commented on their uploaded photos and videos. In today's age, everyone is immune to the social media context. Some teens experience anxiety from social media related to fear of loss, which causes teens to try to respond and check all their friends' messages and messages on a regular basis.

On the contrary, depression is one of the unintended significances of unnecessary use of social media. In detail, depression is limited not only to Facebooks but also to other social networking sites, which causes psychological problems. A new study found that individuals who are involved in social media, games, texts, mobile phones, etc. are more likely to experience depression.

The previous study found a 70% increase in self-reported depressive symptoms among the group using social media. The other social media influence that causes depression is sexual fun [ 12 ]. The intimacy fun happens when social media promotes putting on a facade that highlights the fun and excitement but does not tell us much about where we are struggling in our daily lives at a deeper level [ 28 ]. Another study revealed that depression and time spent on Facebook by adolescents are positively correlated [ 22 ]. More importantly, symptoms of major depression have been found among the individuals who spent most of their time in online activities and performing image management on social networking sites [ 14 ].

Another study assessed gender differences in associations between social media use and mental health. Females were found to be more addicted to social media as compared with males [ 26 ]. Passive activity in social media use such as reading posts is more strongly associated with depression than doing active use like making posts [ 23 ]. Other important findings of this review suggest that other factors such as interpersonal trust and family functioning may have a greater influence on the symptoms of depression than the frequency of social media use [ 28 , 29 ].

Limitation and suggestion

The limitations and suggestions were identified by the evidence involved in the study and review process. Previously, 7 of the 16 studies were cross-sectional and slightly failed to determine the causal relationship between the variables of interest. Given the evidence from cross-sectional studies, it is not possible to conclude that the use of social networks causes mental health problems. Only three longitudinal studies examined the causal relationship between social media and mental health, which is hard to examine if the mental health problem appeared more pronounced in those who use social media more compared with those who use it less or do not use at all [ 19 , 20 , 24 ]. Next, despite the fact that the proposed relationship between social media and mental health is complex, a few studies investigated mediating factors that may contribute or exacerbate this relationship. Further investigations are required to clarify the underlying factors that help examine why social media has a negative impact on some peoples’ mental health, whereas it has no or positive effect on others’ mental health.

Conclusions

Social media is a new study that is rapidly growing and gaining popularity. Thus, there are many unexplored and unexpected constructive answers associated with it. Lately, studies have found that using social media platforms can have a detrimental effect on the psychological health of its users. However, the extent to which the use of social media impacts the public is yet to be determined. This systematic review has found that social media envy can affect the level of anxiety and depression in individuals. In addition, other potential causes of anxiety and depression have been identified, which require further exploration.

The importance of such findings is to facilitate further research on social media and mental health. In addition, the information obtained from this study can be helpful not only to medical professionals but also to social science research. The findings of this study suggest that potential causal factors from social media can be considered when cooperating with patients who have been diagnosed with anxiety or depression. Also, if the results from this study were used to explore more relationships with another construct, this could potentially enhance the findings to reduce anxiety and depression rates and prevent suicide rates from occurring.

The content published in Cureus is the result of clinical experience and/or research by independent individuals or organizations. Cureus is not responsible for the scientific accuracy or reliability of data or conclusions published herein. All content published within Cureus is intended only for educational, research and reference purposes. Additionally, articles published within Cureus should not be deemed a suitable substitute for the advice of a qualified health care professional. Do not disregard or avoid professional medical advice due to content published within Cureus.

The authors have declared that no competing interests exist.

• Open access
• Published: 06 July 2023

Pros & cons: impacts of social media on mental health

• Ágnes Zsila 1 , 2 &
• Marc Eric S. Reyes   ORCID: orcid.org/0000-0002-5280-1315 3  

BMC Psychology volume  11 , Article number:  201 ( 2023 ) Cite this article

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The use of social media significantly impacts mental health. It can enhance connection, increase self-esteem, and improve a sense of belonging. But it can also lead to tremendous stress, pressure to compare oneself to others, and increased sadness and isolation. Mindful use is essential to social media consumption.

Social media has become integral to our daily routines: we interact with family members and friends, accept invitations to public events, and join online communities to meet people who share similar preferences using these platforms. Social media has opened a new avenue for social experiences since the early 2000s, extending the possibilities for communication. According to recent research [ 1 ], people spend 2.3 h daily on social media. YouTube, TikTok, Instagram, and Snapchat have become increasingly popular among youth in 2022, and one-third think they spend too much time on these platforms [ 2 ]. The considerable time people spend on social media worldwide has directed researchers’ attention toward the potential benefits and risks. Research shows excessive use is mainly associated with lower psychological well-being [ 3 ]. However, findings also suggest that the quality rather than the quantity of social media use can determine whether the experience will enhance or deteriorate the user’s mental health [ 4 ]. In this collection, we will explore the impact of social media use on mental health by providing comprehensive research perspectives on positive and negative effects.

Social media can provide opportunities to enhance the mental health of users by facilitating social connections and peer support [ 5 ]. Indeed, online communities can provide a space for discussions regarding health conditions, adverse life events, or everyday challenges, which may decrease the sense of stigmatization and increase belongingness and perceived emotional support. Mutual friendships, rewarding social interactions, and humor on social media also reduced stress during the COVID-19 pandemic [ 4 ].

On the other hand, several studies have pointed out the potentially detrimental effects of social media use on mental health. Concerns have been raised that social media may lead to body image dissatisfaction [ 6 ], increase the risk of addiction and cyberbullying involvement [ 5 ], contribute to phubbing behaviors [ 7 ], and negatively affects mood [ 8 ]. Excessive use has increased loneliness, fear of missing out, and decreased subjective well-being and life satisfaction [ 8 ]. Users at risk of social media addiction often report depressive symptoms and lower self-esteem [ 9 ].

Overall, findings regarding the impact of social media on mental health pointed out some essential resources for psychological well-being through rewarding online social interactions. However, there is a need to raise awareness about the possible risks associated with excessive use, which can negatively affect mental health and everyday functioning [ 9 ]. There is neither a negative nor positive consensus regarding the effects of social media on people. However, by teaching people social media literacy, we can maximize their chances of having balanced, safe, and meaningful experiences on these platforms [ 10 ].

We encourage researchers to submit their research articles and contribute to a more differentiated overview of the impact of social media on mental health. BMC Psychology welcomes submissions to its new collection, which promises to present the latest findings in the emerging field of social media research. We seek research papers using qualitative and quantitative methods, focusing on social media users’ positive and negative aspects. We believe this collection will provide a more comprehensive picture of social media’s positive and negative effects on users’ mental health.

Data Availability

Not applicable.

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Acknowledgements

Ágnes Zsila was supported by the ÚNKP-22-4 New National Excellence Program of the Ministry for Culture and Innovation from the source of the National Research, Development and Innovation Fund.

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Ágnes Zsila

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AZ conceived and drafted the Editorial. MESR wrote the abstract and revised the Editorial. All authors read and approved the final manuscript.

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Science News

Social media harms teens’ mental health, mounting evidence shows. what now.

Understanding what is going on in teens’ minds is necessary for targeted policy suggestions

Most teens use social media, often for hours on end. Some social scientists are confident that such use is harming their mental health. Now they want to pinpoint what explains the link.

Carol Yepes/Getty Images

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By Sujata Gupta

February 20, 2024 at 7:30 am

In January, Mark Zuckerberg, CEO of Facebook’s parent company Meta, appeared at a congressional hearing to answer questions about how social media potentially harms children. Zuckerberg opened by saying: “The existing body of scientific work has not shown a causal link between using social media and young people having worse mental health.”

But many social scientists would disagree with that statement. In recent years, studies have started to show a causal link between teen social media use and reduced well-being or mood disorders, chiefly depression and anxiety.

Ironically, one of the most cited studies into this link focused on Facebook.

Researchers delved into whether the platform’s introduction across college campuses in the mid 2000s increased symptoms associated with depression and anxiety. The answer was a clear yes , says MIT economist Alexey Makarin, a coauthor of the study, which appeared in the November 2022 American Economic Review . “There is still a lot to be explored,” Makarin says, but “[to say] there is no causal evidence that social media causes mental health issues, to that I definitely object.”

The concern, and the studies, come from statistics showing that social media use in teens ages 13 to 17 is now almost ubiquitous. Two-thirds of teens report using TikTok, and some 60 percent of teens report using Instagram or Snapchat, a 2022 survey found. (Only 30 percent said they used Facebook.) Another survey showed that girls, on average, allot roughly 3.4 hours per day to TikTok, Instagram and Facebook, compared with roughly 2.1 hours among boys. At the same time, more teens are showing signs of depression than ever, especially girls ( SN: 6/30/23 ).

As more studies show a strong link between these phenomena, some researchers are starting to shift their attention to possible mechanisms. Why does social media use seem to trigger mental health problems? Why are those effects unevenly distributed among different groups, such as girls or young adults? And can the positives of social media be teased out from the negatives to provide more targeted guidance to teens, their caregivers and policymakers?

“You can’t design good public policy if you don’t know why things are happening,” says Scott Cunningham, an economist at Baylor University in Waco, Texas.

Increasing rigor

Concerns over the effects of social media use in children have been circulating for years, resulting in a massive body of scientific literature. But those mostly correlational studies could not show if teen social media use was harming mental health or if teens with mental health problems were using more social media.

Moreover, the findings from such studies were often inconclusive, or the effects on mental health so small as to be inconsequential. In one study that received considerable media attention, psychologists Amy Orben and Andrew Przybylski combined data from three surveys to see if they could find a link between technology use, including social media, and reduced well-being. The duo gauged the well-being of over 355,000 teenagers by focusing on questions around depression, suicidal thinking and self-esteem.

Digital technology use was associated with a slight decrease in adolescent well-being , Orben, now of the University of Cambridge, and Przybylski, of the University of Oxford, reported in 2019 in Nature Human Behaviour . But the duo downplayed that finding, noting that researchers have observed similar drops in adolescent well-being associated with drinking milk, going to the movies or eating potatoes.

Holes have begun to appear in that narrative thanks to newer, more rigorous studies.

In one longitudinal study, researchers — including Orben and Przybylski — used survey data on social media use and well-being from over 17,400 teens and young adults to look at how individuals’ responses to a question gauging life satisfaction changed between 2011 and 2018. And they dug into how the responses varied by gender, age and time spent on social media.

Social media use was associated with a drop in well-being among teens during certain developmental periods, chiefly puberty and young adulthood, the team reported in 2022 in Nature Communications . That translated to lower well-being scores around ages 11 to 13 for girls and ages 14 to 15 for boys. Both groups also reported a drop in well-being around age 19. Moreover, among the older teens, the team found evidence for the Goldilocks Hypothesis: the idea that both too much and too little time spent on social media can harm mental health.

“There’s hardly any effect if you look over everybody. But if you look at specific age groups, at particularly what [Orben] calls ‘windows of sensitivity’ … you see these clear effects,” says L.J. Shrum, a consumer psychologist at HEC Paris who was not involved with this research. His review of studies related to teen social media use and mental health is forthcoming in the Journal of the Association for Consumer Research.

Cause and effect

That longitudinal study hints at causation, researchers say. But one of the clearest ways to pin down cause and effect is through natural or quasi-experiments. For these in-the-wild experiments, researchers must identify situations where the rollout of a societal “treatment” is staggered across space and time. They can then compare outcomes among members of the group who received the treatment to those still in the queue — the control group.

That was the approach Makarin and his team used in their study of Facebook. The researchers homed in on the staggered rollout of Facebook across 775 college campuses from 2004 to 2006. They combined that rollout data with student responses to the National College Health Assessment, a widely used survey of college students’ mental and physical health.

The team then sought to understand if those survey questions captured diagnosable mental health problems. Specifically, they had roughly 500 undergraduate students respond to questions both in the National College Health Assessment and in validated screening tools for depression and anxiety. They found that mental health scores on the assessment predicted scores on the screenings. That suggested that a drop in well-being on the college survey was a good proxy for a corresponding increase in diagnosable mental health disorders. 

Compared with campuses that had not yet gained access to Facebook, college campuses with Facebook experienced a 2 percentage point increase in the number of students who met the diagnostic criteria for anxiety or depression, the team found.

When it comes to showing a causal link between social media use in teens and worse mental health, “that study really is the crown jewel right now,” says Cunningham, who was not involved in that research.

A need for nuance

The social media landscape today is vastly different than the landscape of 20 years ago. Facebook is now optimized for maximum addiction, Shrum says, and other newer platforms, such as Snapchat, Instagram and TikTok, have since copied and built on those features. Paired with the ubiquity of social media in general, the negative effects on mental health may well be larger now.

Moreover, social media research tends to focus on young adults — an easier cohort to study than minors. That needs to change, Cunningham says. “Most of us are worried about our high school kids and younger.” 

And so, researchers must pivot accordingly. Crucially, simple comparisons of social media users and nonusers no longer make sense. As Orben and Przybylski’s 2022 work suggested, a teen not on social media might well feel worse than one who briefly logs on. 

Researchers must also dig into why, and under what circumstances, social media use can harm mental health, Cunningham says. Explanations for this link abound. For instance, social media is thought to crowd out other activities or increase people’s likelihood of comparing themselves unfavorably with others. But big data studies, with their reliance on existing surveys and statistical analyses, cannot address those deeper questions. “These kinds of papers, there’s nothing you can really ask … to find these plausible mechanisms,” Cunningham says.

One ongoing effort to understand social media use from this more nuanced vantage point is the SMART Schools project out of the University of Birmingham in England. Pedagogical expert Victoria Goodyear and her team are comparing mental and physical health outcomes among children who attend schools that have restricted cell phone use to those attending schools without such a policy. The researchers described the protocol of that study of 30 schools and over 1,000 students in the July BMJ Open.

Goodyear and colleagues are also combining that natural experiment with qualitative research. They met with 36 five-person focus groups each consisting of all students, all parents or all educators at six of those schools. The team hopes to learn how students use their phones during the day, how usage practices make students feel, and what the various parties think of restrictions on cell phone use during the school day.

Talking to teens and those in their orbit is the best way to get at the mechanisms by which social media influences well-being — for better or worse, Goodyear says. Moving beyond big data to this more personal approach, however, takes considerable time and effort. “Social media has increased in pace and momentum very, very quickly,” she says. “And research takes a long time to catch up with that process.”

Until that catch-up occurs, though, researchers cannot dole out much advice. “What guidance could we provide to young people, parents and schools to help maintain the positives of social media use?” Goodyear asks. “There’s not concrete evidence yet.”

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Social media use can be positive for mental health and well-being

January 6, 2020— Mesfin Awoke Bekalu , research scientist in the Lee Kum Sheung Center for Health and Happiness at Harvard T.H. Chan School of Public Health, discusses a new study he co-authored on associations between social media use and mental health and well-being.

What is healthy vs. potentially problematic social media use?

Our study has brought preliminary evidence to answer this question. Using a nationally representative sample, we assessed the association of two dimensions of social media use—how much it’s routinely used and how emotionally connected users are to the platforms—with three health-related outcomes: social well-being, positive mental health, and self-rated health.

We found that routine social media use—for example, using social media as part of everyday routine and responding to content that others share—is positively associated with all three health outcomes. Emotional connection to social media—for example, checking apps excessively out of fear of missing out, being disappointed about or feeling disconnected from friends when not logged into social media—is negatively associated with all three outcomes.

In more general terms, these findings suggest that as long as we are mindful users, routine use may not in itself be a problem. Indeed, it could be beneficial.

For those with unhealthy social media use, behavioral interventions may help. For example, programs that develop “effortful control” skills—the ability to self-regulate behavior—have been widely shown to be useful in dealing with problematic Internet and social media use.

We’re used to hearing that social media use is harmful to mental health and well-being, particularly for young people. Did it surprise you to find that it can have positive effects?

The findings go against what some might expect, which is intriguing. We know that having a strong social network is associated with positive mental health and well-being. Routine social media use may compensate for diminishing face-to-face social interactions in people’s busy lives. Social media may provide individuals with a platform that overcomes barriers of distance and time, allowing them to connect and reconnect with others and thereby expand and strengthen their in-person networks and interactions. Indeed, there is some empirical evidence supporting this.

On the other hand, a growing body of research has demonstrated that social media use is negatively associated with mental health and well-being, particularly among young people—for example, it may contribute to increased risk of depression and anxiety symptoms.

Our findings suggest that the ways that people are using social media may have more of an impact on their mental health and well-being than just the frequency and duration of their use.

What disparities did you find in the ways that social media use benefits and harms certain populations? What concerns does this raise?

My co-authors Rachel McCloud , Vish Viswanath , and I found that the benefits and harms associated with social media use varied across demographic, socioeconomic, and racial population sub-groups. Specifically, while the benefits were generally associated with younger age, better education, and being white, the harms were associated with older age, less education, and being a racial minority. Indeed, these findings are consistent with the body of work on communication inequalities and health disparities that our lab, the Viswanath lab , has documented over the past 15 or so years. We know that education, income, race, and ethnicity influence people’s access to, and ability to act on, health information from media, including the Internet. The concern is that social media may perpetuate those differences.

— Amy Roeder

Gen Z mental health: The impact of tech and social media

Much like many relationships a person might have between ages 18 and 24, the relationship a young person has with social media  can be complicated. No matter where they live, respondents in a new global survey said social media usage can lead to a fear of missing out (FOMO) or poor body image, but it also can help with social connections and self-expression.

McKinsey Health Institute’s (MHI’s) 2022 Global Gen Z Survey asked more than 42,000 respondents in 26 countries across continents questions based on the four dimensions of health: mental, physical, social, and spiritual. 1 Participants were surveyed on the following nine key topics: overall health and well-being, mental health in the workplace, spiritual health and religion, social determinants of health, social media and digital health services, mental health service utilization, mental health among students, attitudes toward mental health, and global current events. As with all surveys, these data reflect a moment in time and MHI makes no long-term approximations about how these results will trend over time. MHI then analyzed differences and similarities across generations and countries, with a hope of informing the broader dialogue around Gen Z mental health.

Gen Zers, on average, are more likely than other generations to cite negative feelings about social media. 2 Social media is defined here as apps to connect, potentially broadly, with other users. It does not include direct messaging apps. They are also more likely to report having poor mental health. But correlation is not causation, and our data indicates that the relationship between social media use and mental health is complex. One surprise: Older generations’ engagement with these platforms is on par with Gen Zers. For example, baby boomers in eight of the 26 countries surveyed report spending as much time on social media as Gen Zers, with millennials being the most likely to post. And while negative impacts of social media were reported across cohorts, positive effects were even more common—more than 50 percent of all groups cited self-expression and social connectivity as positives from social media.

More than 50 percent of all groups cited self-expression and social connectivity as positives from social media.

There are also signs that technology provides access to supportive mental health resources for younger people. Gen Z respondents are more likely than other generations to use digital wellness apps and digital mental health programs. 3 Digital wellness apps are defined as consumer-driven digital applications that aim to reduce stress, improve well-being and productivity, and address nonclinical conditions for consumers, focusing on topics such as meditation, sleep tracking, cognitive behavioral therapy, and fitness. Digital mental health programs are telehealth programs that offer remote appointments with a healthcare provider (for example, physician, therapist), either over video or phone. Additionally, respondents indicate that certain aspects of social media use can benefit their mental health, such as using social media for self-expression. Young refugees and asylum seekers are among those most likely to cite social media as a tool to stay connected and decrease loneliness.

Methodology

To gain a better understanding of Gen Z in comparison with other generations, the McKinsey Health Institute conducted an internet-based survey in May 2022 in ten European countries (France, Germany, Italy, the Netherlands, Poland, Spain, Sweden, Switzerland, Türkiye, and United Kingdom), with approximately 1,000 completes per country (including around 600 Gen Z). In August 2022, an additional 1,600 completes per country (including 600 Gen Z) were collected from 16 mostly non-European countries (Argentina, Australia, Brazil, China, Egypt, India, Indonesia, Ireland, Japan, Mexico, Nigeria, Saudi Arabia, South Africa, United Arab Emirates, United States, Vietnam). In total, the survey collected responses from 42,083 people, including 16,824 Gen Z individuals (mostly 18–24-year-olds and including a negligible minority of 13–17-year-old non-European respondents), 13,080 millennials (25–40 years old), 6,937 Gen Xers (41–56 years old), 5,119 baby boomers (57–75 years old), and 123 from the Silent Generation (76–93 years old).

Within each country, the survey applied weights to match the distribution of age cohorts, gender, and share of population with tertiary education in the sample to the country’s national census. The sample was drawn from populations with access to the internet, which made the samples more representative of Gen Z respondents, in which nearly all individuals with access to the internet are active technology users; however, for other generations, this is less likely to be the case. This analysis reflects self-reported results in 2022.

Considerations for cross-generational surveys

The survey focused on how respondents—mainly Gen Z—were feeling at the time they were surveyed. Therefore, we cannot determine whether differences in answers between age cohorts are caused by an intrinsic change in attitudes and behaviors or are merely induced by age differences: it is possible that Gen Z will eventually think and behave like millennials, Gen X, or baby boomers, when they reach those ages.

Considerations for surveys conducted online

The survey was conducted online. Therefore, it may not accurately reflect the behaviors or attitudes of individuals who do not have reliable online access. This can be particularly significant in various aspects of life, given that the internet can have a profound impact on the information we access and how we process it.

Considerations for cross-country surveys

Cross-country, sociocultural differences can impact perceptions, scale usage, and affect other factors that may influence responses. However, we cannot automatically conclude that these differences are objective. For instance, the variations in answers on an agreement scale may be due to the respondent’s inclination to agree or disagree and their propensity to choose extreme answers such as “strongly disagree” or “strongly agree.”

Although we relied on cultural experts and youth reviewers to ensure equivalence of meanings across languages during translations, some observed differences across countries may still be induced by the translations.

To measure country differences, we computed country averages and used them to calculate simple averages across countries. By doing so, we treated each country equally, regardless of its population size.

In the six insights below, MHI delves deeper into the ways in which mental health, technology, and social media intersect for our respondents (see sidebar “Methodology” for further detail). This survey covered additional topics such as climate change and spiritual health (for selected insights, see sidebars “Climate change is a concern for many respondents” and “Gen Z and spiritual health: Insights”).

Gen Z respondents report challenges with health across most dimensions

Although many individuals around the world are struggling with their health, there are meaningful differences within groups.

Globally, one in seven baby boomers say their mental health has declined over the past three years, compared with one in four Gen Z respondents. Female Gen Zers were almost twice as likely to report poor mental health when compared with their male counterparts (21 percent versus 13 percent, respectively).

In most surveyed countries, a higher proportion of Gen Z respondents said their mental health was poor or very poor when compared with other dimensions of health (16 percent in Gen Z and 7 percent for baby boomers). However, in China, Egypt, Nigeria, Saudi Arabia, United Arab Emirates, and Vietnam, Gen Z respondents reported that they struggled most with their social health. Overall, mental health experiences varied by region, with Gen Z participants in Saudi Arabia, Egypt, and Nigeria rating their mental health as “very good” with the highest frequencies.

While Gen Z tends to report worse mental health, the underlying cause is not clear. There are several age-specific factors that may impact Gen Z’s mental health independent of their generational cohort, including developmental stage, level of engagement with healthcare, and familial or societal attitudes.

Almost everyone is using social media, but in different ways

More than 75 percent of respondents in all age groups said they use and check social media sites at least ten minutes a day.

Younger generations tend to engage with social media regularly, in both active and passive ways. Almost half of both millennial and Gen Z respondents check social media multiple times a day. Over one-third of Gen Z respondents say they spend more than two hours each day on social media sites; however, millennials are the most active social media users, with 32 percent stating they post either daily or multiple times a day.

Whether less active social media use by Gen Z respondents could be related to greater caution and self-awareness among youth, reluctance to commit, or more comfort with passive social media use remains up for debate. Studies have shown that passive social media use (for example, scrolling) could be linked to declines in subjective well-being over time. 1 Philippe Verduyn et al., “Passive Facebook usage undermines affective well-being: Experimental and longitudinal evidence,” Journal of Experimental Psychology: General , 2015, Volume 144, Number 2.

Gen Zers and millennials are more likely than other generations to say social media affects their mental health

Studies of young adults and their social media use have shown an inverse relationship between screen time and psychological well-being, 1 Jean Twenge et al., “Associations between screen time and lower psychological well-being among children and adolescents: Evidence from a population-based study,” Preventive Medicine Reports , 2018, Volume 12. with higher utilization associated with poorer well-being. Other research indicates the nature of the relationship individuals have with social media can have a greater impact on their mental health than time spent. 2 Mesfin A. Bekalu, Rachel F. McCloud, and K. Viswanath, “Association of social media use with social well-being, positive mental health, and self-rated health: Disentangling routine use from emotional connection to use,” Health Education & Behavior , 2019, Volume 46, Number 2.

Our findings show a nuanced relationship between social media use and mental health. While around one-third of respondents across cohorts report positive impacts of social media on mental health, generations differ in reported negative impacts.

Negative effects seem to be greatest for younger generations, with particularly pronounced impacts for Gen Zers who spend more than two hours a day on social media and Gen Zers with poor mental health. Gen Z respondents from Europe and Oceania were most likely to report negative impacts from social media, and respondents from Asia were least likely (32 percent and 19 percent, respectively). 3 Participants were requested to rank 13 factors, including technology and social media, on how they perceive their impact on mental health. There is the possibility for varying interpretation of what classifies as negative or positive effects. Differences across generations and regions could be influenced in part by social media algorithms.

While the positive impact stays comparable, older generations report fewer negative effects

All generational cohorts in the survey said that social media use had the most positive impact on self-expression and social connectivity. Self-reported refugees and asylum seekers cite higher levels of positive impact than others across all aspects.

Across generations, there are more positive than negative impacts reported by respondents; however, the reported negative impact is higher for Gen Z. Respondents from high-income countries (as defined by World Bank) were twice as likely to report a negative impact of social media on their lives than respondents from lower-middle-income countries (13 percent compared with 7 percent).

When compared with their male counterparts, a higher proportion of female Gen Zers said social media had a negative impact on FOMO (32 percent versus 22 percent), body image (32 percent versus 16 percent), and self-confidence (24 percent versus 13 percent).

Positive aspects of technology may include increased access to health resources

Across generations, more than one in four respondents report using digital wellness apps as compared with one out of five using digital mental health programs (28 percent compared with 19 percent, respectively). Fifty percent more Gen Z respondents reported using digital mental health programs than Gen X or baby boomers (22 percent for Gen Z versus 15 percent for Gen X and baby boomers).

Among those respondents who report using digital mental health programs, most Gen Zers say they would likely keep using them (65 percent); other generations are even more committed, with 74 percent reporting that they would likely continue to use the programs. Four out of five respondents across all generations report that these programs benefit their mental health.

While evaluation of outcomes and effectiveness requires continued study, digital health resources may play an important role in supporting mental health globally, especially when in-person resources are limited or geographically inaccessible. For certain populations, digital health resources could be the preferred method of obtaining support.

Most find help on their own or by referral

Thirty-four percent of Gen Z respondents who use digital mental health programs and apps say they found them on their own. This proportion increases to approximately 50 percent in Brazil, Indonesia, Mexico, and South Africa. In other countries, primary care physicians and healthcare payers (insurance plans) were listed as primary access points to digital mental health programs.

No matter the geography, employers have growing  opportunities to promote workplace well-being and ensure employees have access to the evidence-based mental health resources they need.

At least a third of respondents in most countries and generational cohorts said physical, mental, social, and spiritual health resources were important or very important in choosing an employer, and Gen Z gave particular weight to mental health resources. Given that Gen Z is a growing percentage of the workforce, and that few Gen Z respondents cited employers as a primary access point for help, there may be room for employers to further  engage around mental health in the future.

Technology and social media can be a part of the solution

Climate change is a concern for many respondents.

Climate change appears to be a major concern across generations: in the McKinsey Health Institute 2022 Global Gen Z Survey, more than half of respondents across all age groups reported feeling highly distressed when asked about climate change, with females reporting a higher percentage compared with males. Many Gen Z respondents reported experiencing stress, sadness, anger, and frustration due to climate change and its related disasters. More than 50 percent of total respondents expressed fear and anxiety about the future, with Gen Z demonstrating greater concern than other generations. More than 50 percent of all respondents agree or strongly agree that “government leaders and companies have failed to take care of the planet.”

This fear is not purely existential about the fate of the world or “eco-anxiety,” but instead is often rooted in specific environmental risks that may impact their direct day-to-day livelihoods. When asked about which statements related to climate change resonated with them, 33 percent agree or strongly agree that climate change poses a threat to their family’s physical or financial security. Individuals with self-reported poor mental health are more likely to feel affected by climate change, with 67 percent of Gen Z in this group stating that the future is “frightening” when looking at climate change, compared with 47 percent of Gen Z with neutral or good mental health.

Given the complex and multifaceted nature of mental health and climate change threats and related disruptions, there are no simple answers to the challenges they pose. There is an opportunity for further understanding of how experiences and attitudes around climate change may be influenced by political and ecological factors. However, in order to help young people navigate these issues, healthcare providers, educators, and parents can take a proactive approach by exploring these topics through targeted questioning and solution-oriented discussions. By encouraging young people to think critically about mental health and climate change, the focus can become empowerment and active role-playing to promote personal well-being, climate resilience, and the health of the planet.

Social media and technology, while part of the broader dialogue around youth mental health, can be powerful tools in promoting well-being and offering scaled mental health support. For example, developers might consider embedding algorithms that make it easier for youth expressing psychological distress to find support groups, crisis hotlines, or emergency mental health services. Additionally, digital mental health companies could consider partnering with virtual and community-based providers to connect people with high-acuity needs to timely and culturally-appropriate crisis services.

Gen Z and spiritual health: Insights

According to the McKinsey Health Institute 2022 Global Gen Z survey, those between the ages of 18 and 24 report poorer spiritual health than older generations, with Gen Z respondents almost three times more likely than baby boomers to report poor or very poor spiritual health.

Spiritual health enables people to integrate meaning in their lives. Spiritually healthy people have a strong sense of purpose. While people who are experiencing poor mental health could have good spiritual health, or vice versa, Gen Z individuals who experienced poor mental health were five times more likely to report poor spiritual health than those with neutral or good mental health.

Responses varied widely by country, both in terms of overall ratings of spiritual health and in respondents’ perceived importance of spiritual health. For example, there was a 48-point range across countries in respondents indicating that spiritual health was “extremely important” to them. While 8 percent of total respondents in the Netherlands said spiritual health was “extremely important” to them, 56 percent of total respondents in Brazil said the same. Respondents in higher-income countries were half as likely to indicate spiritual health is “extremely important” to them versus lower-middle-income countries (23 percent versus 43 percent).

Respondents in Africa and South America were most likely to report that spiritual health was extremely important to them (46 percent and 41 percent, respectively); respondents in Europe were least likely (18 percent).

Given these data, it’s clear that spiritual health matters to young people around the world, and there may be important links to overall well-being. People seeking to support the mental health and psychological resilience of young people may want to inquire about how they are finding purpose in their homes, families, and at work.

Around the world, communities are struggling to provide young people with someone to call, someone to respond, or a safe place to get help during mental health, substance use, and/or suicidal crises . The availability of crisis supports globally is varied, with the majority of countries having no national suicide or mental health crisis line. In addition, communities in every geography lack adequate community mental health services infrastructure to respond to the volume of crises young people experience each year, instead relying on schools, emergency rooms, hospitals, law enforcement, or families to bridge a gap that could save lives and livelihoods. Dispatching specially trained mobile teams or providing a safe place to go in crisis is even more rare—a gap that technology could bridge.

Collaboration between technology companies, mental health professionals, educators, employers, policy makers, and the wider community is necessary. By prioritizing mental health and utilizing technology in a positive way, young people are more likely to achieve and sustain better health. Other strategies that could be considered include using social media to build supportive online communities for affinity groups and promoting youth leaders to create and disseminate content that promotes mental health. 4 Mizuko Ito, Candice Odgers, and Stephen Schueller, Social media and youth wellbeing: What we know and where we could go , Connected Learning Alliance, June 2020. Researchers and companies can explore evidence-based strategies such as mental health promotion and mindfulness programs to mitigate the negative effects of social media and to help young people use social media as a platform for authentic self-expression. 5 Julia Brailovskaia and Jürgen Margraf, “Positive mental health and mindfulness as protective factors against addictive social media use during the COVID-19 outbreak,” PLOS One , 2022, Volume 17, Number 11.

A “precision prevention” approach to talking with young people about the role of technology in their lives may help create a more informed, supportive, and healthful environment. By providing parents, educators, and healthcare professionals with these tools, they can become actively engaged in promoting the health of Gen Z and beyond. While addressing these issues may seem overwhelming, it is essential that stakeholders work together to help improve the mental health of young people.

MHI is an enduring, non-profit-generating global entity within McKinsey. MHI strives to catalyze actions across continents, sectors, and communities to achieve material improvements in health, empowering people to lead their best possible lives. MHI sees supporting youth mental health as essential to adding years to life and life to years.

If you would like to learn more about the McKinsey Health Institute (MHI) 2022 Global Gen Z survey and the additional data and insights the McKinsey Health Institute has from the survey, please submit an inquiry via the MHI “contact us” form . The McKinsey Health Institute, as a non-profit-generating entity of McKinsey, is creating avenues for further research that can catalyze action.

Erica Coe is a coleader at the McKinsey Health Institute and a partner in McKinsey’s Atlanta office. Kana Enomoto is a coleader at the McKinsey Health Institute and an associate partner in the Washington, DC, office, where Andrew Doy is a consultant and Cheryl Healy is an associate partner.

The authors wish to thank Nicolas Abi-Chacra, Lea Arora, Victoria Bennett, Abby Bloomfield, Ulrike Deetjen, Alexandru Degeratu, Martin Dewhurst, Joseph Jung, Abhishek Mahajan, Roxanne Sabbag, Emma Summerton, Pooja Tatwawadi, and Oliver Walker for their contributions to this article. They also wish to thank MHI geographical leaders Alistair Carmichael, Andira Putri, and Shriya Sethi. They also wish to thank the European Society for Child and Adolescent Psychiatry (ESCAP) affiliates and Orygen for providing their local expertise and helping shape the MHI Global Gen Z Survey (2022). They also wish to thank Megan Jones Bell, Murali Doraiswamy, Sharon Hoover, Roberta Katz, Shekhar Saxena, and Anil Thapliyal for their contributions.

This article was edited by Elizabeth Newman, an executive editor in the Chicago office.

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How Does Social Media Affect Your Mental Health?

Facebook has delayed the development of an Instagram app for children amid questions about its harmful effects on young people’s mental health. Does social media have an impact on your well-being?

By Nicole Daniels

What is your relationship with social media like? Which platforms do you spend the most time on? Which do you stay away from? How often do you log on?

What do you notice about your mental health and well-being when spending time on social networks?

In “ Facebook Delays Instagram App for Users 13 and Younger ,” Adam Satariano and Ryan Mac write about the findings of an internal study conducted by Facebook and what they mean for the Instagram Kids app that the company was developing:

Facebook said on Monday that it had paused development of an Instagram Kids service that would be tailored for children 13 years old or younger, as the social network increasingly faces questions about the app’s effect on young people’s mental health. The pullback preceded a congressional hearing this week about internal research conducted by Facebook , and reported in The Wall Street Journal , that showed the company knew of the harmful mental health effects that Instagram was having on teenage girls. The revelations have set off a public relations crisis for the Silicon Valley company and led to a fresh round of calls for new regulation. Facebook said it still wanted to build an Instagram product intended for children that would have a more “age appropriate experience,” but was postponing the plans in the face of criticism.

The article continues:

With Instagram Kids, Facebook had argued that young people were using the photo-sharing app anyway, despite age-requirement rules, so it would be better to develop a version more suitable for them. Facebook said the “kids” app was intended for ages 10 to 12 and would require parental permission to join, forgo ads and carry more age-appropriate content and features. Parents would be able to control what accounts their child followed. YouTube, which Google owns, has released a children’s version of its app. But since BuzzFeed broke the news this year that Facebook was working on the app, the company has faced scrutiny. Policymakers, regulators, child safety groups and consumer rights groups have argued that it hooks children on the app at a younger age rather than protecting them from problems with the service, including child predatory grooming, bullying and body shaming.

The article goes on to quote Adam Mosseri, the head of Instagram:

Mr. Mosseri said on Monday that the “the project leaked way before we knew what it would be” and that the company had “few answers” for the public at the time. Opposition to Facebook’s plans gained momentum this month when The Journal published articles based on leaked internal documents that showed Facebook knew about many of the harms it was causing. Facebook’s internal research showed that Instagram, in particular, had caused teen girls to feel worse about their bodies and led to increased rates of anxiety and depression, even while company executives publicly tried to minimize the app’s downsides.

But concerns about the effect of social media on young people go beyond Instagram Kids, the article notes:

A children’s version of Instagram would not fix more systemic problems, said Al Mik, a spokesman for 5Rights Foundation, a London group focused on digital rights issues for children. The group published a report in July showing that children as young as 13 were targeted within 24 hours of creating an account with harmful content, including material related to eating disorders, extreme diets, sexualized imagery, body shaming, self-harm and suicide. “Big Tobacco understood that the younger you got to someone, the easier you could get them addicted to become a lifelong user,” Doug Peterson, Nebraska’s attorney general, said in an interview. “I see some comparisons to social media platforms.” In May, attorneys general from 44 states and jurisdictions had signed a letter to Facebook’s chief executive, Mark Zuckerberg, asking him to end plans for building an Instagram app for children. American policymakers should pass tougher laws to restrict how tech platforms target children, said Josh Golin, executive director of Fairplay, a Boston-based group that was part of an international coalition of children’s and consumer groups opposed to the new app. Last year, Britain adopted an Age Appropriate Design Code , which requires added privacy protections for digital services used by people under the age of 18.

Students, read the entire article , then tell us:

Do you think Facebook made the right decision in halting the development of the Instagram Kids app? Do you think there should be social media apps for children 13 and younger? Why or why not?

What is your reaction to the research that found that Instagram can have harmful mental health effects on teenagers, particularly teenage girls? Have you experienced body image issues, anxiety or depression tied to your use of the app? How do you think social media affects your mental health?

What has your experience been on different social media apps? Are there apps that have a more positive or negative effect on your well-being? What do you think could explain these differences?

Have you ever been targeted with inappropriate or harmful content on Instagram or other social media apps? What responsibility do you think social media companies have to address these issues? Do you think there should be more protections in place for users under 18? Why or why not?

What does healthy social media engagement look like for you? What habits do you have around social media that you feel proud of? What behaviors would you like to change? How involved are your parents in your social media use? How involved do you think they should be?

If you were in charge of making Instagram, or another social media app, safer for teenagers, what changes would you make?

Want more writing prompts? You can find all of our questions in our Student Opinion column . Teachers, check out this guide to learn how you can incorporate them into your classroom.

Students 13 and older in the United States and Britain, and 16 and older elsewhere, are invited to comment. All comments are moderated by the Learning Network staff, but please keep in mind that once your comment is accepted, it will be made public.

Nicole Daniels joined The Learning Network as a staff editor in 2019 after working in museum education, curriculum writing and bilingual education. More about Nicole Daniels

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A.O. is an unpaid member of governmental and non-governmental organizations (including the UK Department for Culture, Media and Sport, and The British Academy). She has also provided unpaid and paid talks and consultancy work to organizations that will not gain or lose financially from this publication. S.-J.B. currently receives funding from Wellcome, the MRC, the Jacobs Foundation, the Wellspring Foundation and the University of Cambridge. In the past five years, S.-J.B. engaged in a paid consultancy with Cognita International Schools Group and has provided paid expert witness work for UK charities, legal organisations in the UK and USA and the UK government. S.-J.B. is the author of two books related to the brain, education and learning, for which she received an advance and royalties. S.-J.B. gives talks in schools, in the state and private sector, as well as at education conferences and for education organizations, and other public, private and third sector organizations (some talks are remunerated). S.-J.B. is a member of the Rethinking Assessment group, the Steering Committee of the Cambridge Centre of Science Policy, the Technical Advisory Group for the UK Government Department of Education 'Education and Outcomes Panel-C Study' and the Singapore Government National Research Foundation Scientific Advisory Board. She was a member of the Times Education Commission in 2021-22.

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Social media is driving teen mental health crisis, surgeon general warns

Surgeon General Vivek Murthy, long a proponent of mental health awareness, has issued a warning that social media use is a main contributor to depression, anxiety and other problems in the nation's teenagers.

The report, released Tuesday, calls attention to growing concerns about the effects of social media use on children and adolescent's mental health. The advisory urges policymakers and the companies that make the social media platforms to share with parents the burden of managing children's and adolescents’ social media use.

Murthy calls youth mental health “the defining public health issue of our time,” urging policymakers to help ensure strong safety standards to help protect adolescents and teens from exposure to harmful content and excessive use. 

Up to 95% of teens between the ages of 13 and 17 say they use a social media platform, according to the report. About a third say they're scrolling, posting or otherwise engaged with social media "almost constantly."

"At this point, we do not have enough evidence to say with confidence that social media is sufficiently safe for our kids, Murthy said in an interview. "We have to now take action to make sure that we are protecting our kids."

The report pulls together research that links social media use and poor mental health in adolescents, such as a 2019 study that found teens who spent more than three hours a day on social media "faced double the risk of experiencing poor mental health outcomes, including symptoms of depression and anxiety."

As of last year, students in grades eight and 10 who were surveyed said they spent even more time each day on these platforms: three hours and 30 minutes, on average.

Jim Steyer, founder of Common Sense Media, an organization that advocates for laws and policies to make media more child-friendly, said the advisory was "absolutely spot on" and "should be a clarion call to every parent in this country, every policymaker, that we need to put focus and resources into this effort."

The most popular social media platforms among teens are TikTok, Snapchat and Instagram, according to the Pew Research Center .

The surgeon general's warning about social media comes as the rates of teenage depression, sadness and hopelessness have skyrocketed over the past decade, especially among girls.

" Teen depression started to rise around 2012, a time that coincides with the popularity of smartphones," said Jean Twenge, a professor of psychology at San Diego State University and the author of "Generations: The Real Differences between Gen Z, Millennials, Gen X, Boomers and Silents—and What They Mean for America’s Future."

It was also a time, Twenge said, that "'likes' on posts became common, and the algorithms started to become more sophisticated to keep people on social media for longer. That's clearly not a coincidence." 

The surgeon general's report also blamed social media for perpetuating eating disorders , body dysmorphia and low self-esteem. Some evidence also suggests a possible link between excessive social media use and attention-deficit/hyperactivity disorder in teens.

Twenge said social media can a ffect mental health in a variety of ways. Both sleep and face-to-face social interaction are beneficial to mental health, she said, but if kids are online when they should be in bed or spending time with friends, that's a problem.

Feeling left out and comparing oneself to others can also be damaging.

"Even if you know on an intellectual level that they may have taken 200 selfies to get the right one," Twenge said, "at an emotional level, that's not really processed."

What can be done?

The surgeon general's report outlines recommendations for both technology companies and lawmakers.

"Policymakers need to step up and help ensure that we have strong safety standards, to help protect our kids from exposure to harmful content, and to also protect them from excessive use," Murthy said. This includes enforcing age minimums.

Companies are advised to create better tools to protect teenagers, and loosen up on features that entice kids to stay online longer.

It's parents who are on the front lines now in trying to help teens navigate the online world. The report encourages caregivers to create "tech-free" zones in the home, and to talk with kids about how social media use makes them feel.

"It's really not fair to put the onus on parents alone. Why isn't the industry held responsible for creating the platforms and making the features that much more addictive?" Steyer of Common Sense Media said. "There has to be a major national discussion."

How old should kids be before using social media?

Most tech companies require users to be at least 13 years old. But nearly 40% of kids between the ages of 8 and 12 use social media, the report said.

Murthy said he believes even 13 is too young to be on social media but said there wasn't enough data to suggest which age would be appropriate.

Twenge suggested that the age minimum should be set at 16.

"Let's get some regulations in place now to help kids who are not yet on social media," Twenge said. "Maybe we can save the next generation."

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Erika Edwards is a health and medical news writer and reporter for NBC News and "TODAY."

Hallie Jackson is senior Washington correspondent for NBC News.

Social Media Addiction and Mental Health: The Growing Concern for Youth Well-Being

• May 20, 2024
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Kenta Minamitani, Stanford LLM 2024

The Growing Mental Health Crisis and Social Media

Mental health problems have become a major public health issue in the United States, affecting a significant portion of the population. According to the National Institute of Mental Health (NIMH), nearly one in five U.S. adults is living with a mental illness, and the prevalence of mental health problems among youth is even more alarming (NIMH, 2023). The widespread use of social networking sites has been identified as a contributing factor to the growing mental health crisis, especially among younger generations.

The Link Between Social Media and Mental Health Issues

The link between social media and mental health issues has been well documented in numerous studies and research papers. A systematic review found that the use of social networking sites is associated with an increased risk of depression, anxiety, and psychological distress (Keles, et al., 2020). The associations, though not by itself proof of causation, at least some reason for concern. Additionally, this association is particularly strong in adolescents compared to younger children (Twenge & Campbell, 2018). Moreover, in the United States, the 12-month prevalence of major depressive episodes among adolescents increased from 8.7% in 2005 to 11.3% in 2014 (Mojtabai, et al., 2016). The new media screen activities have been suggested as one of the causes of the increase in adolescent depression and suicide (Twenge, et al., 2017).

Although research has not necessarily shown that the use of social media has a causal relationship with poorer mental health in young people, health professionals and policy makers are becoming increasingly wary of the use. The U.S. Department of Health and Human Services is calling for increased transparency and for companies to prioritize user wellbeing over revenue, as various studies have shown negative effects on social media use, especially on the mental health of youth. (Surgeon General, 2021). In addition, the American Academy of Pediatrics warns that “media use and screen time are associated with increased risks for children and adolescents, such as attention deficits, increased aggression, low self-esteem, and depression” (American College of Pediatricians, 2020). The American Psychological Association (APA) also highlights the correlation between high social media use and poor mental health among adolescents (APA, 2024).

New York City’s Unprecedented Action

Recognizing the severity of the problem, New York City has taken the unprecedented step of classifying social networking sites as a public health threat (Ables, 2024). The City of New York, the New York Department of Education, and the New York City Health and Hospitals Corporation have filed a lawsuit against TikTok, Meta, Snap, and YouTube to hold the companies responsible for “fueling the nationwide youth mental health crisis” (Gold, 2024).

The lawsuit filed by New York City is a significant development in the ongoing debate about the responsibility of social media companies to address the negative impact of their platforms on mental health. The U.S. Surgeon General has called on these companies to improve the safety, health, and well-being of their users (Surgeon General, 2021). This includes implementing stricter moderation policies, providing resources for mental health support, and collaborating with researchers and health professionals to better understand the impact of social media on mental health.

A Multi-Faceted Approach to Addressing the Issue

However, addressing the complex relationship between social media and mental health requires a multifaceted approach that goes beyond the actions of social media companies. From a legal perspective, this could include government regulation and individual legal action. Policymakers could consider implementing stricter rules and guidelines for social media companies to follow, such as requiring them to prioritize user well-being and mental health over engagement and profits. This could include mandating regular mental health impact assessments, providing resources for mental health support, and implementing stricter content moderation policies to reduce the spread of harmful and toxic content. However, since strong opposition is expected from users and companies on human rights grounds, including violations of freedom of expression, it is crucial to organize the evidence to date and explain convincingly that the restriction is urgently needed for public health reasons and that there are no other measures that could be taken.

Mental health professionals must adapt to the changing landscape of technology and incorporate social media literacy into their treatment plans. The NIMH emphasizes the importance of teaching individuals how to maintain a healthy relationship with social media, including setting limits on use, engaging in offline activities, and seeking support when needed (NIMH, 2023).

Educational institutions also have a critical role to play in promoting digital literacy and responsible social media use among students. Schools should incorporate digital literacy education into their curricula and teach students how to navigate social media in a healthy and productive way. Parents and caregivers must also be involved in this process by setting appropriate boundaries and modeling responsible social media use, as parental media monitoring has protective effects on a variety of academic, social, and physical outcomes for children (Gentile, et al., 2014).

As individuals, we must take responsibility for our own mental health and well-being in the digital age. This means being mindful of the time we spend on social networking sites, curating our feeds to include positive and uplifting content, and prioritizing offline activities and relationships. In this case, we can use the guidelines or recommendations published by the professionals; for example, the APA has published “Social Media Recommendations” to advocate the appropriate use of social media based on scientific evidence (APA, 2023).

Looking Ahead

As we look to the future, it is clear that the issue of social networking and mental health will continue to be a pressing concern. As technology advances and new platforms emerge, it is critical that we remain vigilant and proactive in addressing the potential risks associated with these services. Increased research and collaboration among policymakers, legal experts, social media companies, mental health professionals, and educators is needed to address this growing issue and develop effective strategies to promote healthy social media use and mitigate its potential harms.

• Ables, K. (2024, January 25). New York City designates social media a public health hazard. The Washington Post. https://www.washingtonpost.com/technology/2024/01/25/nyc-social-media-health-hazard-toxin/
• American College of Pediatricians. (2020). Media Use and Screen Time – Its Impact on Children, Adolescents, and Families. https://acpeds.org/position-statements/media-use-and-screen-time-its-impact-on-children-adolescents-and-families
• American Psychological Association. (2024). Teens are spending nearly 5 hours daily on social media. Here are the mental health outcomes. https://www.apa.org/monitor/2024/04/teen-social-use-mental-health
• American Psychological Association. (2023). Social media brings benefits and risks to teens. Here’s how psychology can help identify a path forward. https://www.apa.org/monitor/2023/09/protecting-teens-on-social-media
• Gentile DA, et al. (2014) Protective Effects of Parental Monitoring of Children’s Media Use: A Prospective Study. JAMA Pediatr. 168(5):479–484. https://doi.org/10.1001/jamapediatrics.2014.146
• Gold, A. (2024, February 14). New York City sues social media companies for negligence, public nuisance. Axios. https://www.axios.com/2024/02/14/new-york-city-sues-social-media-companies-for-negligence-public-nuisance
• Guernsey L (2014). Garbled in translation: Getting media research to the press and public. Journal of Children and Media, 8(1), 87–94. https://doi.org/10.1080/17482798.2014.863486
• Keles, B., et al. (2020). A systematic review: The influence of social media on depression, anxiety and psychological distress in adolescents. International Journal of Adolescence and Youth, 25(1), 79-93. https://doi.org/10.1080/02673843.2019.1590851
• Mojtabai R, et al. (2016). National trends in the prevalence and treatment of depression in adolescents and young adults. Pediatrics, 138(6), e20161878. https://doi.org/10.1542/peds.2016-1878
• National Institute of Mental Health. (2023). Mental illness. https://www.nimh.nih.gov/health/statistics/mental-illness
• Robinson JP, et al. (2002). The Internet and other uses of time. In Wellman B & Haythornthwaite C (Eds.), The Internet in Everyday Life (pp. 244–262). Blackwell.
• Surgeon General. (2021). Protecting youth mental health: The U.S. Surgeon General’s advisory. https://www.hhs.gov/sites/default/files/surgeon-general-youth-mental-health-advisory.pdf
• Twenge JM, et al. (2017). Increases in depressive symptoms, suicide-related outcomes, and suicide rates among US adolescents after 2010 and links to increased new media screen time. Clinical Psychological Science, 6(1), 3–17. https://doi.org/10.1177/2167702617723376
• Twenge, J. M., & Campbell, W. K. (2018). Associations between screen time and lower psychological well-being among children and adolescents: Evidence from a population-based study. Preventive medicine reports, 12, 271–283. https://doi.org/10.1016/j.pmedr.2018.10.003

How teens view social media’s impact on their mental health

Editor’s note:  If you or someone you know is struggling with suicidal thoughts or mental health matters, please call the 988 Suicide & Crisis Lifeline by dialing 988 to connect with a trained counselor, or visit the  988 Lifeline website .

A new report details the role social media plays in the lives of young people, and how they manage the various pros and cons — including in the context of being a person of color or LGBTQ+, or having depression.

Those benefits and drawbacks include valuing online platforms for social connection , self-expression and information, while also feeling the brunt of social media’s effects on their attention span, confidence and contentedness, according to the report released Tuesday by Common Sense Media and Hopelab, a social innovation lab and impact investor aiming to support the well-being of young people.

READ MORE: How to know if you have ‘phone addiction’ — and 12 ways to address it

“Most conversations and headlines surrounding social media and youth mental (health) focus solely on the harms, portraying young people as passive consumers. This research shows that it’s much more complex,” said Amy Green, head of research at Hopelab, in a news release. “If we truly want to improve the well-being of young people, we need to listen to their experiences and ensure that we do not inadvertently remove access to crucial positive benefits.”

Also driving the research is the national youth mental health crisis, the authors said, marked by increasing rates of mental disorders , such as anxiety and depression, suicidal thoughts and attempts , and antidepressant medications prescribed to youth. In conversations about these phenomena, social media has consistently been at the center, though mental health issues can have multiple contributing factors. 

Conducted by the NORC — previously called the National Opinion Research Center — at the University of Chicago, the research includes 1,274 teens (ages 14 to 17) and young adults (ages 18 to 22) recruited online between October and November 2023. The young people “provided direction and input regarding survey content” and participated in focus groups and interviews to help the research team prioritize and interpret results, according to a news release. The report is the third in a series tracking the influence of social media on well-being among youth.    

The researchers found the rate of depressive symptoms among youth is about 10% down from pandemic highs but is still high and comparable to the elevated levels of 2018. Nearly half of young people reported experiencing any severity of depression, and nearly a third (28%) said they had moderate to severe symptoms.

Additionally, about half of LGBTQ+ youth reported moderate to severe symptoms of depression, compared to nearly one-quarter of their non-LGBTQ+ peers.

Those with depression were more susceptible to social comparison and pressure to show their best selves on social media. But they were also more likely to find resources to support their well-being and curate their feeds for this purpose — done by selecting a “not interested” button on content they don’t like, flagging inappropriate or offensive content, or blocking someone whose content bothered them. These youth also positively curated feeds by “liking” and spending more time on content they did enjoy, since many social media algorithms work by giving you more content based on your level of engagement with certain topics.

This was especially important for LGBTQ+ youth who, along with Black and Latinx young people, faced more exposure to harassment and stress online.

“In focus groups, Black youth told us their experiences with in-person harassment lowered their tolerance for similar behavior on social media, and meant they were more willing to give up the benefits to protect themselves from hateful comments,” said lead researcher Amanda Lenhart, head of research at Common Sense Media, via email.

The findings confirm what many researchers have seen scientifically and anecdotally, said Dr. Mitch Prinstein, chief science officer at the American Psychological Association, via email. Prinstein wasn’t involved in the study.

Social media and mental health

Many participants also revealed the positives they gain from social media, citing online platforms as a place to seek support and advice; decompress; connect with loved ones and others who share their experiences, interests or identities; stay informed; and keep up with their favorite influencers or content creators.

“Another important finding is the importance of social media as a space of connection, creativity and professional opportunities for Black youth,” Lenhart said.

Dr. Douglas Gentile, distinguished professor of psychology at Iowa State University, encouraged being “careful about interpreting (self-reported) data like these,” he said via email.

“People are surprisingly bad at actually knowing what the effects of media use are on themselves,” Gentile, who wasn’t involved in the research, added. “I don’t mean to say that anyone is lying. Just that we only see little pieces of how the media influence us.”

Nearly one-fourth of participants reported using social media almost constantly throughout the day, up 7% from the rate the authors found in their 2018 report, the authors found. Many young people reported an inability to control their use, social media distracting from other activities and unconsciously reaching for social media when bored. To counteract these behaviors, on top of customizing their feeds, many have also taken breaks from social media to avoid the temptation or deleted their accounts permanently.

“Social media could offer (more) benefits to youth if it was designed with a primary focus on youth well-being rather than a focus on keeping kids engaged for as long as possible to make a profit from their data,” Prinstein said.

While, or after, using social media, try doing an emotional check-in, Lenhart said. “Ask yourself, ‘How am I feeling right now? Did I see anything that made me feel sad?’”

Taking a temporary or permanent break from the content causing the most distress could be helpful, Lenhart added, especially if you already struggle with depression.

If you’re a parent or guardian wondering how to best manage your teen’s social media use, one of the most important things you can do is “keep communication channels open,” Lenhart said.

Parental involvement is important, as young adults have expressed regret that their parents allowed them to use social media so young, wishing they could go back and tell their parents to not give in to their demands, Prinstein said.

Ask the teens in your life what they like about these platforms and what types of connections or activities support their mental health, Lenhart said. Let them know you’re there to help figure out a solution if social media is upsetting them or interfering with other responsibilities.

Respect “that each young person is an expert in their own lived experience,” Lenhart said. “Young people are valuable teachers in their own right.”

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5 Reasons to Unplug From Social Media for Better Mental Health

Spending time offline can help you foster better relationships IRL. Here's how to start.

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Most of us spend more time than we'd like to admit glued to our phones. In fact, nearly half of smartphone users in the US say they can't imagine life without their mobile devices . But how is the  use of technology affecting our mental health ? And what can we do to offset that dependency? 

Many have turned to digital detoxes as a way to disconnect from technology. Research links digital detoxes to the improvement of depression symptoms , among other mental health benefits. 

Ready to try a digital detox? Here's what you need to know.

Read more: Best Mental Health Apps

What is a digital detox?

A digital detox is when you completely abstain or intentionally reduce your time using electronic devices like smartphones, computers, TVs and tablets. The idea of a digital detox is to disconnect from the online world to focus more on the present moment without distractions. The most common things people avoid during a digital detox include: 

• Text messages
• Video games
• Watching TV
• Smartphones, tablets, laptops and computers

What is a social media detox?

Like a digital detox, a social media detox is when someone refrains from engaging with or using social media for a period of time or indefinitely to improve their mental health and well-being. It's one of the most popular forms of digital detox.

A quantitative study conducted on college students who underwent social media detoxes that lasted from one to seven days found that most students reported positive changes in mood, better productivity, improved sleep and reduced anxiety .

Another study published in the Journal of Social and Clinical Psychology found that limiting social media to 30 minutes a day can significantly improve one's overall well-being.

Read more :  Why You Endlessly Scroll Through Your Phone, and How to Stop

How social media affects mental health

There's no denying we benefit a lot from social media. Platforms like Facebook, Instagram, X (formerly known as Twitter) and TikTok keep us connected to friends and family, while also serving as an outlet to find inspiring people. However, the constant comparison, fear of missing out  and highly curated content we're exposed to on social media can come with some drawbacks .

A 2020 systematic review linked social media to detrimental effects on the mental health of its users. The same study found that those people's levels of anxiety and depression are affected by social media envy -- being envious of someone else's life as perceived on social media.

"Time spent scrolling through social media has the potential to promote unreasonable expectations as we see influencers posting an often filtered and edited version of their seemingly perfect lives. This can trigger feelings that others are having more fun or living better lives than you are, potentially causing a negative impact on your mental health. The increasing popularity of photo filters has also been linked to poor self-esteem and self-image as we manipulate our photos to change our reality online," says Myra Altman , who holds a PhD and is VP of Clinical Care at Modern Health . 

Benefits of a digital detox

There may be personal reasons to consider a digital detox. It could be that you feel like technology is a distraction, or you just need some time away from the stressors of the online world. Whatever the reason may be, you're sure to see many benefits from taking a break from technology.

Here are some of the most common benefits of a digital detox.

Reduced anxiety and depression

According to a recent study published in the journal Cyberpsychology, Behavior and Social Networking, a social media break of just a week can reduce anxiety and depression. The same study found causal evidence that even short breaks from social media can positively impact a person's overall well-being, life satisfaction and emotions.

Enhanced focus and increased productivity

This one should come as no surprise. When we are free from distractions, we allow ourselves to be more present. Mindless scrolling on social media, checking notifications on your phone and feeling the urge to reply immediately to emails are time consumers. When we set aside distractions, we allow more time to focus on our responsibilities. 

Improved sleep

Disconnecting from electronic devices a few hours before going to sleep can significantly improve our quality of sleep. One study found that people who used social media before bed were more likely to have anxiety, insomnia and short sleep duration on weeknights.

Avoiding screen time before bed also reduces our exposure to blue light , which has been associated with disrupted sleep.

Meaningful connections in real life

Think about the last time you were anywhere alone at the doctor's office, standing in line at the grocery store or waiting for your friend at a table in a restaurant. How much of that time was spent glued to your phone? The answer is probably a lot. 

A small 2019 study found that smartphones alter the fabric of social interactions. In the experiment, a group of strangers was put in a waiting room with or without their phones. The study found that those who had their phones present were less likely to smile at someone compared to those without a phone.

Setting your phone aside can help you stay engaged with those around you.

More time for things that bring you joy

Have you ever thought about how many times a day you pick up your phone to check your emails, respond to messages and check social media? According to a survey conducted by Asurion, a global tech care company, respondents checked their phones on average 96 times a day . To put that in perspective, that's once every 10 minutes.

"One reason to consider a social media detox is to regain authority in your life and time. Many people find themselves scrolling for hours a day and then feel unproductive, leading to anxiety and depression. A detox can help put a pause on social media consumption and allow you to regain interest in other hobbies that bring happiness. The detox can also allow you the time you need to be with those you love in real life," says Raghu Kiran Appasani , MD Psychiatry and Founder and CEO of The MINDS Foundation . 

Signs that you might need a break from technology

If you made your way to this page, chances are you're already considering a digital detox -- which is a sign itself that you might need a break from your electronic devices. The best way to know you need a digital detox is to check in with yourself and see how interacting with social media and technology makes you feel.

• If you feel any of the following when engaging with the online world, it's time to say goodbye (for now) to technology:
• Anxiety, stress or depression after checking social media
• Social withdrawal
• Urge to check your phone every few minutes
• Trouble concentrating and staying focused on the task at hand
• Imposter syndrome or feeling insecure about where you are in life
• Disrupted sleep
• Feeling obligated to respond immediately to emails and text messages

How to do a digital detox

If you're ready for a digital detox challenge but aren't sure where to start, we got you. It's important to remember why you're detoxing from your digital devices in the first place. The goal is to create boundaries that ensure you're using technology in a way that benefits and works for you. Ultimately, you want to feel good about the time you're dedicating to being online.

Set realistic goals

A digital detox can be anything you want it to be. It can be refraining from using any type of technology, disconnecting from social media or just limiting daily screen time. The most important thing to keep in mind is that whatever you want to achieve has to be realistic. For example, if your work requires you to be in front of a computer all day, it may not be wise to set a goal that won't allow you access to your computer. Instead, you can opt to set screen time limits on your free time.

Read more :  I Replaced My iPhone With a Nokia Flip Phone. It Made Me Anxious

Create healthy boundaries and limits

Sometimes disconnecting completely from electronic devices isn't possible, but setting boundaries is a great way to limit how much time we spend on electronic devices. 

Here are some ideas of other times you can create limits for:

• When working out : If you want to get the most out of your workout, try to avoid any distractions. If you like to listen to music while doing so, you can download your music beforehand and set your phone to airplane mode so that you don't get any notifications.
• Before going to sleep: Smartphones were designed to keep us alert and productive, so the last thing we want is to bombard our brains with more information. Sleep experts recommend cutting off screen time 30 minutes to 1 hour before bed .
• When waking up: You never know what you will encounter when you look at your phone. Seeing bad news as soon as you wake up can trigger your stress response and leave you feeling anxious all day. Allow yourself some time to wake up without outside distractions and enjoy the present moment.
• While enjoying a meal: If you're scrolling through your phone while you eat , you may not be aware of how much you're eating and miss your body's cue that it is full . Instead, you can practice mindful eating and savor every moment of your meal.
• When spending time with the people you love: It's good to keep your phone away or silent when socializing and spending time with people. When you limit your distractions, you can have deeper and more meaningful conversations .

Occupy yourself with things that nourish your mind and body

You've decided to do a digital detox, you put away your phone, now what? It's easy to give in to checking your phone if you're bored, so you'll want to fill in this extra time with things that make you feel good.

If you're having a hard time figuring out what to do with your extra time, here are some ideas:

• Pick up a new hobby, something you've always wanted to try.
• Go for a walk or a hike
• Call a family member you haven't talked to in a while
• Go for coffee with a friend
• Read a new book (or reread your favorite one)
• Journal about how you're feeling right now
• Volunteer at a local charity that is doing important work
• Learn to cook a new recipe
• Sign up for an exercise class like kick-boxing, yoga or pilates
• Meditate or practice mindful breathing  

Reward yourself for following through

It's easier to stay motivated when looking forward to something, so take this opportunity to celebrate your wins by rewarding yourself. It doesn't have to be something grand (though it can be if you want); it can be as simple as cooking your favorite meal or taking yourself out to the movies. Whatever you decide your reward should be, make sure it's something that excites you.

Tips for your digital detox

Some people will find it fairly easy to disconnect from digital devices, while others may find it more challenging. Luckily, there are some things you can do before you go off the grid to ensure that you have a successful digital detox.

• If you're doing a social media detox, delete the apps from your phone and sign out from your account on your computer, laptop or tablet.
• Let your friends and family know about your detox and the best ways for them to contact you and provide support.
• Schedule activities to keep you busy beforehand.
• Track your progress. You can write down how you're feeling each day, seeing tangible progress may keep you motivated.
• Mute or turn off notifications on your phone and computer
• Designate tech-free zones in your house, like your bedroom or dining room.
• Remember why you started. If you feel the need to check your phone throughout your detox, think of how you felt before starting and why you decided to take a break.

Be patient with yourself

Deciding to disconnect from the digital world can make you feel anxious or even scared of missing out on important things, and it's okay to feel that way. As the days go by, you'll start to feel better about yourself and have a deeper understanding of your relationship with technology. Take the time to enjoy being present and do things that bring you happiness.

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• Adverse childhood experiences can have long-term impacts on health, opportunity and well-being.
• Adverse childhood experiences are common and some groups experience them more than others.

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Adverse childhood experiences, or ACEs, are potentially traumatic events that occur in childhood (0-17 years). Examples include: 1

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• Witnessing violence in the home or community.
• Having a family member attempt or die by suicide.

Also included are aspects of the child’s environment that can undermine their sense of safety, stability, and bonding. Examples can include growing up in a household with: 1

• Substance use problems.
• Mental health problems.
• Instability due to parental separation.
• Instability due to household members being in jail or prison.

The examples above are not a complete list of adverse experiences. Many other traumatic experiences could impact health and well-being. This can include not having enough food to eat, experiencing homelessness or unstable housing, or experiencing discrimination. 2 3 4 5 6

Quick facts and stats

ACEs are common. About 64% of adults in the United States reported they had experienced at least one type of ACE before age 18. Nearly one in six (17.3%) adults reported they had experienced four or more types of ACEs. 7

Preventing ACEs could potentially reduce many health conditions. Estimates show up to 1.9 million heart disease cases and 21 million depression cases potentially could have been avoided by preventing ACEs. 1

Some people are at greater risk of experiencing one or more ACEs than others. While all children are at risk of ACEs, numerous studies show inequities in such experiences. These inequalities are linked to the historical, social, and economic environments in which some families live. 5 6 ACEs were highest among females, non-Hispanic American Indian or Alaska Native adults, and adults who are unemployed or unable to work. 7

ACEs are costly. ACEs-related health consequences cost an estimated economic burden of $748 billion annually in Bermuda, Canada, and the United States. 8

ACEs can have lasting effects on health and well-being in childhood and life opportunities well into adulthood. 9 Life opportunities include things like education and job potential. These experiences can increase the risks of injury, sexually transmitted infections, and involvement in sex trafficking. They can also increase risks for maternal and child health problems including teen pregnancy, pregnancy complications, and fetal death. Also included are a range of chronic diseases and leading causes of death, such as cancer, diabetes, heart disease, and suicide. 1 10 11 12 13 14 15 16 17

ACEs and associated social determinants of health, such as living in under-resourced or racially segregated neighborhoods, can cause toxic stress. Toxic stress, or extended or prolonged stress, from ACEs can negatively affect children’s brain development, immune systems, and stress-response systems. These changes can affect children’s attention, decision-making, and learning. 18

Children growing up with toxic stress may have difficulty forming healthy and stable relationships. They may also have unstable work histories as adults and struggle with finances, jobs, and depression throughout life. 18 These effects can also be passed on to their own children. 19 20 21 Some children may face further exposure to toxic stress from historical and ongoing traumas. These historical and ongoing traumas refer to experiences of racial discrimination or the impacts of poverty resulting from limited educational and economic opportunities. 1 6

Adverse childhood experiences can be prevented. Certain factors may increase or decrease the risk of experiencing adverse childhood experiences.

Preventing adverse childhood experiences requires understanding and addressing the factors that put people at risk for or protect them from violence.

Creating safe, stable, nurturing relationships and environments for all children can prevent ACEs and help all children reach their full potential. We all have a role to play.

• Merrick MT, Ford DC, Ports KA, et al. Vital Signs: Estimated Proportion of Adult Health Problems Attributable to Adverse Childhood Experiences and Implications for Prevention — 25 States, 2015–2017. MMWR Morb Mortal Wkly Rep 2019;68:999-1005. DOI: http://dx.doi.org/10.15585/mmwr.mm6844e1 .
• Cain KS, Meyer SC, Cummer E, Patel KK, Casacchia NJ, Montez K, Palakshappa D, Brown CL. Association of Food Insecurity with Mental Health Outcomes in Parents and Children. Science Direct. 2022; 22:7; 1105-1114. DOI: https://doi.org/10.1016/j.acap.2022.04.010 .
• Smith-Grant J, Kilmer G, Brener N, Robin L, Underwood M. Risk Behaviors and Experiences Among Youth Experiencing Homelessness—Youth Risk Behavior Survey, 23 U.S. States and 11 Local School Districts. Journal of Community Health. 2022; 47: 324-333.
• Experiencing discrimination: Early Childhood Adversity, Toxic Stress, and the Impacts of Racism on the Foundations of Health | Annual Review of Public Health https://doi.org/10.1146/annurev-publhealth-090419-101940 .
• Sedlak A, Mettenburg J, Basena M, et al. Fourth national incidence study of child abuse and neglect (NIS-4): Report to Congress. Executive Summary. Washington, DC: U.S. Department of Health an Human Services, Administration for Children and Families.; 2010.
• Font S, Maguire-Jack K. Pathways from childhood abuse and other adversities to adult health risks: The role of adult socioeconomic conditions. Child Abuse Negl. 2016;51:390-399.
• Swedo EA, Aslam MV, Dahlberg LL, et al. Prevalence of Adverse Childhood Experiences Among U.S. Adults — Behavioral Risk Factor Surveillance System, 2011–2020. MMWR Morb Mortal Wkly Rep 2023;72:707–715. DOI: http://dx.doi.org/10.15585/mmwr.mm7226a2 .
• Bellis, MA, et al. Life Course Health Consequences and Associated Annual Costs of Adverse Childhood Experiences Across Europe and North America: A Systematic Review and Meta-Analysis. Lancet Public Health 2019.
• Adverse Childhood Experiences During the COVID-19 Pandemic and Associations with Poor Mental Health and Suicidal Behaviors Among High School Students — Adolescent Behaviors and Experiences Survey, United States, January–June 2021 | MMWR
• Hillis SD, Anda RF, Dube SR, Felitti VJ, Marchbanks PA, Marks JS. The association between adverse childhood experiences and adolescent pregnancy, long-term psychosocial consequences, and fetal death. Pediatrics. 2004 Feb;113(2):320-7.
• Miller ES, Fleming O, Ekpe EE, Grobman WA, Heard-Garris N. Association Between Adverse Childhood Experiences and Adverse Pregnancy Outcomes. Obstetrics & Gynecology . 2021;138(5):770-776. https://doi.org/10.1097/AOG.0000000000004570 .
• Sulaiman S, Premji SS, Tavangar F, et al. Total Adverse Childhood Experiences and Preterm Birth: A Systematic Review. Matern Child Health J . 2021;25(10):1581-1594. https://doi.org/10.1007/s10995-021-03176-6 .
• Ciciolla L, Shreffler KM, Tiemeyer S. Maternal Childhood Adversity as a Risk for Perinatal Complications and NICU Hospitalization. Journal of Pediatric Psychology . 2021;46(7):801-813. https://doi.org/10.1093/jpepsy/jsab027 .
• Mersky JP, Lee CP. Adverse childhood experiences and poor birth outcomes in a diverse, low-income sample. BMC pregnancy and childbirth. 2019;19(1). https://doi.org/10.1186/s12884-019-2560-8 .
• Reid JA, Baglivio MT, Piquero AR, Greenwald MA, Epps N. No youth left behind to human trafficking: Exploring profiles of risk. American journal of orthopsychiatry. 2019;89(6):704.
• Diamond-Welch B, Kosloski AE. Adverse childhood experiences and propensity to participate in the commercialized sex market. Child Abuse & Neglect. 2020 Jun 1;104:104468.
• Shonkoff, J. P., Garner, A. S., Committee on Psychosocial Aspects of Child and Family Health, Committee on Early Childhood, Adoption, and Dependent Care, & Section on Developmental and Behavioral Pediatrics (2012). The lifelong effects of early childhood adversity and toxic stress. Pediatrics, 129(1), e232–e246. https://doi.org/10.1542/peds.2011-2663
• Narayan AJ, Kalstabakken AW, Labella MH, Nerenberg LS, Monn AR, Masten AS. Intergenerational continuity of adverse childhood experiences in homeless families: unpacking exposure to maltreatment versus family dysfunction. Am J Orthopsych. 2017;87(1):3. https://doi.org/10.1037/ort0000133 .
• Schofield TJ, Donnellan MB, Merrick MT, Ports KA, Klevens J, Leeb R. Intergenerational continuity in adverse childhood experiences and rural community environments. Am J Public Health. 2018;108(9):1148-1152. https://doi.org/10.2105/AJPH.2018.304598 .
• Schofield TJ, Lee RD, Merrick MT. Safe, stable, nurturing relationships as a moderator of intergenerational continuity of child maltreatment: a meta-analysis. J Adolesc Health. 2013;53(4 Suppl):S32-38. https://doi.org/10.1016/j.jadohealth.2013.05.004 .

Adverse Childhood Experiences (ACEs)

ACEs can have a tremendous impact on lifelong health and opportunity. CDC works to understand ACEs and prevent them.