The public and experts alike have blamed social media for a long list of mental health issues, including rising rates of depression, anxiety and suicidal behavior among America’s youth. But research on the subject is conflicting. One study published this spring, for example, found that social media use likely doesn’t have a terribly large impact on teenagers’ life satisfaction, despite all those expert warnings.
A new study published in the Lancet Child & Adolescent Health suggests the issue is even more nuanced. Social media is associated with mental health issues, the research says—but only under certain circumstances, and only for certain people. In girls, frequent social-media use seemed to harm health when it led to either cyberbullying and/or inadequate sleep and exercise. But these factors did not seem to have the same effect on boys, and the study didn’t pick up on specific ways that social networks could be harming them.
“The message, really, is that it’s not social-media use, per se, that causes harm,” says study co-author Dasha Nicholls, who leads the Child and Adolescent Mental Health research team at Imperial College London. “It’s about getting a balance between social-media use and other age-appropriate activities, and ensuring that there aren’t specific negative things happening online.”
Researchers analyzed data from the Our Futures study, which tracked about 10,000 U.K. teenagers over three years. Starting in 2013, the teens—then aged 13-14—answered questions about the frequency of their social-media use and in-person social interaction, as well as their health and demographic profiles. In subsequent years, the same teenagers provided updated information about their social-media use, and responded to other questions about their mental health, sleep habits, physical activity and brushes with cyberbullying.
In 2013, only about 43% of the teens in the study said they regularly checked social media multiple times per day. That rose to 59% in year two, and 68.5% in year three. Over time, frequent social-media use was associated with decreased mental health and well-being, as measured by responses to questions about psychological distress, life satisfaction, happiness and anxiety. Social media seemed to have a stronger impact on girls, but the relationship was present for boys as well.
The picture grew more complicated when researchers examined which habitual social-media users also reported cyberbullying, lack of sleep and lack of exercise, which they thought could be responsible for much of the problem. They found that those three factors could almost completely predict whether frequent social-media use would harm a teenage girl’s well-being. Cyberbullying appeared to be the most damaging to girls, followed by lack of sleep and lack of exercise.
In boys, however, these factors only explained 12% of the relationship between social media and poor mental health. There are a few reasons that may be true. For one thing, girls tend to be more susceptible than boys to mental health conditions such as depression and anxiety regardless of screen time. Girls also experience more cyberbullying than boys, and Nicholls says they may be uniquely bothered by certain aspects of it, including comments about appearance and negative comparisons with others.
It’s perhaps more surprising that lack of rest and exercise stemming from online activity did not seem to affect boys, since both sleep quality and physical activity are strongly associated with mental health, regardless of gender. The discrepancy may boil down to use patterns, the study suggests. Since girls reported more frequent use of social media overall, it may be that boys are not sacrificing sleep and exercise to the same extent that girls are. The study, like most on this topic, was observational, meaning it could only look at patterns within its dataset, rather than designing a lab study that would dictate how much social media different kids used. It also couldn’t fully assess the duration of teens’ social-media use, only how many times per day they checked various apps and sites. But Nicholls says despite these limitations, the study can help guide teens toward healthier lifestyles, as one of the first to look into specific ways that social media may harm mental health over time.
“The key messages to young people are: Get enough sleep; don’t lose contact with your friends in real life; and physical activity is important for mental health and well-being,” Nicholls says. “If you look after yourself in those ways, you don’t have to worry about the impact of social media.”
Takeaways for parents of teens are similar, she says. They should encourage teenagers to stay active and turn off their phones at night—and perhaps more importantly, they should specifically ask about cyberbullying, since that seems to be a primary source of harm, Nicholls says.
“The emphasis needs to now be on the mechanisms and the content,” she says, “rather than just black-balling social media.”
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Write to Jamie Ducharme at jamie.ducharme@time.com