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When it comes to youthful mental health, social media may help as much as hurt
Traffic moves slowly on I-15 in South Salt Lake on Tuesday, Nov. 21, 2017. - photo by Lois M. Collins
Amid discussions of the negative impact that online devices and social media have on young people, a new national survey finds many teens and young adults use the internet and peer networks to gather health-related information, find community and connect with health care providers.

And thats especially true for those who have significant depressive symptoms, compared with those who dont.

The report, Digital Health Practices, Social Media Use and Mental Well-Being Among Teens and Young Adults in the U.S., paints a nuanced picture of both good and bad that young people may experience online. It was released Monday night by Hopelab and Well Being Trust.

Those surveyed, ages 14 to 22, said they curate their own social media use to follow people who inspire them, to be sure they can reach friends and to form or find a community online, said co-author Susannah Fox, an independent researcher who was chief technology officer for U.S. Department of Health and Human Services and a former director of Pew Research Centers health and technology portfolio. She wrote the survey and analyzed the results with researcher Victoria Rideout, a former director of the Kaiser Family Foundations Program for the Study of Media and Health.

The survey also looks at differences between how those who are depressed may use the internet and social media and those who are not; whether being online impacts depression, anxiety and stress, and the influence of factors such as age, gender, race and sexual orientation.

The young people surveyed also wrote about their experiences online and with social media. The report says most discussion of young people and technology has focused on the health risks but not on health promotion.

The conversation has been about them but not by them, so we wanted to add their voices to the discussion, Fox said. What emerges is frankly a much more complex picture of the relationship between social media and emotional well-being than weve seen previously discussed. Social media can be a lifeline if you feel alone; it can be a source of comfort when youre feeling down and thats among teens who share they are experiencing moderate to severe depressive symptoms, as well as teens who are not experiencing depressive symptoms.

She believes helping young people navigate their online world means acknowledging that complexity. We cannot say, Get off your phone and feel better. Thats not going to be true for some people, she said.

In February and March, using the Patient Health Questionnaire Depression Scale, which is a well-respected measure of depression, researchers assessed depressive symptoms of a nationally representative sampling of 1,337 teens and young adults. The survey asked about the symptoms they might be experiencing at the time they took the survey.

The report covers two main topics: first, how those surveyed describe their use of online information and digital health tools, and second, the associations between self-reported social media use and mental well-being among teens and young adults.

In addition, youths answered open-ended questions that allowed them to speak for themselves. Each question had between roughly 400 and 600 personal responses.

The unspoken question the study poses is how best to create policies and programs that promote the positives of social media and being online, Well Being Trusts chief strategy officer, Ben Miller, told the Deseret News.

Crisis mode

In 2015, 12.5 percent of youths 12 to 17 years old had at least one major depressive episode within the past year substantially higher than previous years, Miller said. Nearly 1 in 4 females that age experienced depression, 1 in 3 reported sadness or hopelessness and 1 in 5 had seriously considered suicide. Between 2005 and 2015, suicide rates for females ages 15-19 doubled, while they increased 30 percent among males that age.

Miller rattles off the data to explain the importance of understanding how young people experience mental health and address challenges. The researchers found young people want to hear and learn from others health experiences, and they use technology to do that.

This may well be the generation that revolutionizes the peer-to-peer health experience. Technology has afforded them the tools to seek out people who may be halfway around the world who are facing similar health challenges, to connect with and exchange information with them, to listen to those peoples personal experiences and to share their own, the report said.

Previous studies have shown many ways people seek information online, including to prepare for and recover from a doctors appointment, Fox said. Surveyed teens told of going online to get information they could discuss with their parents.

Teenagers especially really want to ask their parents when it comes to health information, Fox said. I think parents will be heartened by that.

Helps or hurts

Miller said ones relationship with social media depends on how one feels, the networks with which one engages and ones experiences while engaging.

You can find great support, inspiration, people who are willing to make you feel like this (depression) is something you can actually improve, you can get through, you can have a healthy life, he said.

Conversely, Sometimes you feel left out; you can watch your friends from afar and because you might be experiencing depression, you cant relate to it or youre not seeing why everyone is so happy when youre so down. If thats what I take away from my interactions on social media, its probably not going to help me.

But the survey found young people with moderate to severe depressive symptoms may especially benefit. As many as 90 percent said they use the internet to research mental health issues, while three-fourths say they look at health stories on blogs, videos and podcasts. Nearly 4 in 10 have used mobile apps that target well-being, and just under a third have connected with health providers using tools like texting and video chat.

That group is more likely than people who are not experiencing depressive symptoms to say that theyve researched mental health issues online, that theyve accessed other peoples health stories online," said Fox. "Theyre more apt to use apps related to well-being. Im fascinated by that because it shows theyre curious; they want to figure out whats going on. To me, thats a sign of hope.

Other highlights:

  • Among young people, 87 percent said they've looked online for health information most often fitness, nutrition, stress, anxiety and depression.
  • Close to two-thirds have used health-related mobile apps, including fitness, meditation, sleep and medication reminders.
  • One-third have found what the survey calls health peers online, and 91 percent of them said it helped.
  • Those with significant depressive symptoms were twice as likely as others to say social media helped them connect to useful support and advice during times of depression, stress or anxiety.
  • The feedback teens and young adults say they often receive is vastly more likely to be positive (32 percent) than negative (3 percent).
  • Nearly two-thirds of the young people said they hardly ever or never feel left out on social media. But those experiencing moderate to severe depressive symptoms were more likely to cite negative experience on social media.
But Miller noted not all young people are capable of putting down their devices or disconnecting from technology when its not helping them.

Young voices

The survey doesnt show what young people do with all the information they find online, although what the teens wrote helps fill in those blanks. For example:

  • A male, 14, went online for information after a loved one was diagnosed with skin cancer. I ended up finding lots of info that proved to be helpful and eased my worries.
  • "I have an app that basically gives you a bit of inspiration every morning to be you and love yourself. It helps me take time for me instead of rushing around at 6 in the morning stressing about the day. (Female, 14)
  • "Im bulimic and (my favorite health-related app) helps me try and stop bingeing and purging. (Female, 22)
  • "A friend of mine was always sleeping and sad, so I looked it up and I told her mom that I thought my friend was depressed. (Male, 17)
  • "A mood tracker and virtual diary has helped me to determine when my depression and anxiety have been bad enough to consider asking my doctor about changing my medicine. (Female, 22)
  • "I can post something and fish for people who understand what I wrote about to relate with me. (Male, 14)
  • "I find people with similar things that are making me sad and I read about how they handle it. (Female, 14)
  • "By connecting to some of the online friends Ive already met, they help support me. I use it to share music or memes that make us laugh, slowly taking the sorrow away. (Male, 21)
  • "I feel like Im not good enough compared to other people. I often look at other peoples pages and compare myself to them. (Female, 19)
Two groups stood out in the report: Teenage girls compared with boys and LGBTQ youths compared with straight youths are more likely to look online for information about mental health. In both cases, their rates of depression were higher and they were motivated and active in seeking information and helpful tools and connections online.

"Reading their responses, my heart really went out to them," Fox said. "I hope people would say, 'What can we do for them?'"

The survey sponsors and researchers believe the survey will provide insights into what young people seek from technology to boost well-being. That, in turn, could lead to new solutions. Miller said one of the goals is to figure out what they're finding that's helpful and where the gaps are so solutions can be offered, whether in the form of public policy, clinical programs, additional apps or other approaches.

He said that, too often, people suffering mentally are given casual, hurtful advice. We would never tell someone, 'Just work harder and your hypertension will go away.' Or just, 'Come on, smile more and youll lose weight.' But we do that all the time for mental health.