Social Media Poses “Profound Risk of Harm” for Teens, Says U.S. Surgeon General

May 30, 2023

Social media presents a “profound risk of harm” to children and teens, according to an advisory released by the U.S. Surgeon General this month that calls for systemic change to protect American youth and their mental health. In a 25-page report, Surgeon General Dr. Vivek Murthy identifies two main areas of concern: the exposure of teens and children to harmful content, and the risk of excessive social media use for some teens and children. “We cannot conclude that social media is sufficiently safe for children and adolescents,” the advisory states.

The advisory comes just weeks after the American Psychological Association released its first-ever guidelines on social media use for teens, stressing the need for parents to limit and monitor usage as well as provide media literacy to mitigate potential risks. In recent weeks, Utah signed into law two bills prohibiting usage of social media by minors, and senators from Connecticut, Arkansas, Hawaii, and Alabama have come together to introduce two different bipartisan bills tightening regulation of social media companies designed to protect the mental health of teens and kids.

Said Connecticut Senator Richard Blumenthal, who introduced the Kids Online Safety Act, “It’s an idea whose time has come.”

Risks of Social Media

In a single paragraph beginning the advisory, the Surgeon General explores benefits of social media for teens, including the potential to build community with others who share identities, abilities, and interests, as well as a way to access valuable information and allow for self-expression. These benefits are particularly important for marginalized communities, including racial, ethnic, and sexual and gender minorities, the advisory states.

The bulk of the report, however, focuses on exploring two areas of risk for teens who use social media: the harms associated with excessive use and with exposure to inappropriate content.

Detrimental Effects of Excessive Use

Through design features such as push notifications, autoplay, infinite scroll, and the ‘like’ function, social media platforms often encourage excessive use to maximize user engagement, the advisory warns. Excessive social media use can have detrimental effects on the physical and mental health of teens by disrupting healthy behaviors. It can also lead to a loss of sleep, lack of exercise, loss of in-person social interactions, and increased anxiety and depression.

“What we’re seeing — and I think it’s reflected in the Surgeon General’s warning — is how easily kids can get tuned out of the rest of the world and tuned into Snapchat or TikTok,” says Wes Crenshaw, Ph.D., founder of Family Psychological Services in Kansas. “Because these apps are coded to be super engaging, even addicting, it’s harder for kids to move in and out of their usage and back to the real world. And it is perfectly designed to interrupt sleep and exercise.”

The advisory shared the following recent research findings:

• 95% of teenagers use social media.¹ On average, teenagers spend 3.5 hours a day on social media.² One third of teens report using social media “almost constantly.”³
• Children and teens who spend more than 3 hours a day on social media are twice as likely to experience symptoms of depression and anxiety.⁴
• One-third or more of girls aged 11-15 say they feel “addicted” to social media platforms.⁵

Exposure to Harmful Content

The advisory warns of the potential exposure to extreme and harmful content that is spread on social media through algorithmic design, direct pushes, or unwanted content exchanges. This content may include disordered eating, self-harm and suicidal behaviors, hate-based content, as well as encounters with predatory individuals. The report shared the following data:

• 46% of teens said social media makes them feel worse about their body image.⁶
• 64% of teens are “often” or “sometimes” exposed to hate-based content.⁷
• 6 in 10 teen girls report being contacted by a stranger on social media in ways that made them feel uncomfortable.⁸

Both areas of risk are especially pronounced for teens already experiencing poor mental health, the advisory warns. The APA echoed this concern in their guidelines, which concluded that “some [young people] are more vulnerable than others to the content and features on many social media platforms.” According to a recent ADDitude survey on social media use, teens with ADHD are among those most susceptible to the risks of social media. The survey found that:

• 72% of kids aged 10 and older who have ADHD use social media.
• The incidence of negative mental health effects, including anxiety, sadness, sleep problems, and depression is roughly 70% higher among teens with ADHD who use social media than it is among teens with ADHD who don’t.
• 21% of girls with ADHD who use social media experience eating issues and nearly 18% engage in self-harm.

For teens with ADHD, emotional dysregulation, time blindness, poor impulse control, and a legacy of feeling “different” and misunderstood all contribute to increased risks of problematic use and exposure to harmful content. “It’s precisely these teens who are likely to make unhelpful and unhealthy social comparisons, especially on social media,” said Sharon Saline, Ph.D., in a recent ADDitude webinar titled Compare and Despair: Social Media & Mental Health Concerns in Teens with ADHD. Added Crenshaw, in a social media guide for teens created for ADDitude, “For teens with ADHD, social media is where impulsive thinking can lead to impulsive action.” Another area of concern for teens, Crenshaw says, is the way in which social media, “promotes problematic health ideas, including promoting self-destructive behavior or even giving out bad advice that over-pathologizes kids.”

“The Burden to Support Our Children Must Be Shared”

While concerns about the risks of social media for teens is not new, measures intended to protect kids have largely focused on parental intervention, placing the onus on caregivers to limit and monitor use. The Surgeon General’s report, however, makes clear that while these interventions are important, they are not enough, and systemic regulation is needed.

“The entire burden of mitigating the risk of harm of social media cannot be placed on the shoulders of children and parents,” the report states. “We must engage in a multifaceted effort … with actions taken by groups across the spectrum: policymakers, technology companies, researchers, families, and children and adolescents themselves.”

Lawmakers across the U.S. agree, as evidenced by newly proposed pieces of legislation that aim to regulate social media companies.

Last month, senators from Connecticut, Arkansas, Alabama, and Hawaii came together to introduce the bipartisan Protecting Kids on Social Media Act, which would prohibit kids under 13 from using social media. To ensure enforcement, the bill proposed an age-verification program created and run by the U.S. Department of Commerce. The legislation would require parent approval for teens under 18 to create an account and would prohibit social media companies from employing algorithmic recommendations for users under 18.

“I see firsthand the damage that social media companies, 100% committed to addicting our children to their screens, are doing to our society,” said Senator Chris Murphy of Connecticut, co-sponsor of the bill. “Time and time again, these companies have proven they care more about profit than preventing the well-documented harm they cause. None of this is out of Congress’s control.”

Just a few weeks earlier, a bill with similar objectives, called the Kids Online Safety Act, was introduced by senators Richard Blumenthal of Connecticut and Marsha Blackburn of Tennessee. The bill would mandate that social media companies provide minors with options to disable addictive product features, opt out of algorithmic recommendations, and protect their information, and it would provide parents with improved controls to limit and monitor their children’s usage. Yet another proposed bill, from Missouri Senator Josh Hawley, called The MATURE Act, would set 16 as the minimum age for all social media users.

Several states have already signed into law bills that limit social media use for teens and kids. Utah recently enacted a pair of laws that, in addition to requiring parental permission for minors and limiting addictive features, prohibit minors from using social media after 10:30 pm.

Though the proposed national legislation has rare bipartisan support, the bills are not yet scheduled for a vote by the Senate and House of Representatives. Their future remains uncertain, however it is clear that momentum is building among policymakers, as well as medical professionals and parents, to take action to protect teens and children from the risks posed by social media use.

“The alarm bells about social media’s devastating impact on kids have been sounding for a long time,” Murphy said. “This is a reality that we don’t have to accept.”

To limit social media usage, consider the following recommendations from the U.S. Surgeon General:

• Compose a family media plan
• Create tech free zones
• Teach kids media literacy before allowing social media usage
• Model responsible social media usage

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