Hooked on Screens

Maybe you’ve wondered whether your child or teenager is spending too much time on their smartphone or laptop but shrugged it off. Your initial impulse was in the right direction. A new 2025 study identifies trajectories of addictive use of social media, mobile phones, and video games from childhood to early adolescence. As use rises, the researchers found, so does the link to suicidal behaviors, suicidal ideation, and problematic mental health outcomes.

While most research focuses on total screen time, this study showed that addictive screen use was the critical link to suicidality and mental health disorders. The study followed 4,300 U.S. youths aged 9–10 for four years. The researchers used machine learning to identify trajectories of addictive screen use—characterized by compulsive behavior, distress when unable to use screens, and use to escape problems—for social media, phones, and video games.

The behaviors tracked parallel DSM-5 criteria for gambling disorder; growing research supports the classification of problematic screen use as a form of behavioral addiction. Rather than total screen time, the researchers used excessive or compulsive interaction with digital screens (e.g., smartphones, tablets, computers) that also interferes with daily functioning, well-being, or responsibilities. It is difficult to control despite the negative consequences.

Addictive use trajectories were common among young people, with one in two youths having a high addictive use of mobile phones and more than 40% having such use of video games. High and addictive use was associated with two to three times greater risks of suicidal behaviors and suicidal ideation compared with low addictive use.

By age 14, about 40% had a high addictive trajectory for video games, while 30% exhibited such trajectories with social media and 25% with phones. Youths with high or increasingly addictive trajectories had double to triple the risk of suicidal ideation and suicide attempts, as well as rates of anxiety, depression, aggression, and rule-breaking.

Interestingly, total screen time alone at baseline (age 10) was not linked to later suicidal or mental health issues. The main finding was how youths used screens. For example, compulsive, distress‑driven, loss-of-control behaviors were strongly tied to adverse outcomes. The researchers found problematic smartphone screening should emphasize behavioral patterns (impulsivity, preoccupation, withdrawal-like symptoms) rather than total screen time. Regular monitoring of use patterns in pre‑teens can identify early indicators of addictive trajectories.

Researchers also found what doesn’t work; restricting phone use at school demonstrated no reductions in existing suicidality or mental health issues. Consequently, clinicians and educators should shift focus from total screen time to assessing compulsive use indicators, such as loss of control, mood regulation through screen use, and difficulty stopping use despite negative consequences. In addition, underlying drivers—like anxiety, depression, and social stressors—should be addressed.

This study marks another departure from previous studies focusing on total screen time. In that only addictive use was strongly associated with severe mental health consequences, including suicidality, the researchers do not simply recommend imposing specific time limits on use or digital detoxes. It may be more effective for addicted users to receive strategies from addiction medicine, including cognitive-behavioral therapy, motivational interviewing, and structured support systems.

Surgeon General’s Concerns Laid the Way

In May 2023, Dr. Vivek Murthy issued a Surgeon General’s Advisory highlighting the capacity of social media to both benefit and harm youth mental health. While nearly all adolescents use social platforms—and many report positive connections—concerns have emerged regarding sleep disruption, cyberbullying, body dissatisfaction, and exposure to self-harm content. Murthy pointed out that one in three adolescents stays online until midnight, impeding their sleep and neurodevelopment.

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Problematic digital use correlates with poor sleep, attention problems, and social isolation. Murthy’s advisory suggested that parents enforce phone-free periods, especially before bedtime. “The mental health crisis among young people is an emergency—and social media has emerged as an important contributor,” he declared.

Problematic Internet Use

Marc N. Potenza, M.D., Ph.D, the Steven M. Southwick Professor of Psychiatry and Professor in the Child Study Center and of Neuroscience, directs Yale's Center of Excellence in Gambling Research and other behavioral-addiction initiatives. As early as 2015, Potenza highlighted concerns over problematic internet use, labeling it an emerging problem and suggesting mindful disconnection as a preliminary strategy.

On a panel at the International Society of Addictive Medicine, Potenza drew out the parallels between internet behaviors and traditional addictions— withdrawal, tolerance, and activation of brain reward circuits—and noted challenges in defining thresholds for pathological use. Potenza sees problematic internet/phone use as a behavioral addiction akin to gambling or gaming disorder. “I think there are people who find it very difficult to tolerate time without using digital technologies like smartphones or other ways of connecting via the internet,” he said.

In a study of 5,100 children aged 9–10, Potenza found that higher screen use predicted increased internalizing symptoms, such as anxiety and depression, two years later. He advises watching children for early signs of addictive behaviors:
Loss of control or failure to reduce screen time despite efforts to cut back.
Preoccupation or persistent thoughts about screen use or intense urges to check the device.
Tolerance or increasing screen time to achieve satisfaction or more stimulating content.
Emotional discomfort when not using the screen, such as irritability, anxiety, restlessness, or boredom, when trying to cut down, stop, or unable to use a device.
Continued screen use despite awareness of harms like poor school/work performance, disrupted sleep, strained relationships, or physical health.

I asked Jessi Gold, M.D., M.S., Chief Wellness Officer for the University of Tennessee System and associate professor of psychiatry at the University of Tennessee Health Science Center, for her impressions. She said, "I would love to say the only problem with mental health and young people is social media, but it is one of the problems and one we should be creative in addressing. I don't think the answer will ever be to take away their phones completely and never let them access social media, because it is here to stay, and that kind of action would not be realistic.” She advises teaching adolescents and young adults to handle social media before college so they don't binge-use on arrival.

Petros Levounis, M.D., M.A., professor and chair of psychiatry at Rutgers New Jersey Medical School, is a leading expert in addiction psychiatry and a key voice in technological addictions. He notes that 2% to 4% of teens meet clinical criteria for tech addictions. Kids may not be alone: Levounis highlights polling showing that 64% of all Americans feel anxious when separated from their phones.

Levounis emphasizes that problematic technology-based behaviors meet DSM-5 addiction benchmarks: tolerance, withdrawal issues (e.g., irritability, mood changes), preoccupation, loss of control, negative life impact, and continued use despite problems. “Behavioral addictions include technology—video games, online porn, internet gambling—[and] can be every bit as addictive as substances,” he said.

He recommends treatment with cognitive behavioral therapy (CBT) and motivational interviewing. He advises that families and schools recognize problematic patterns early and destigmatize those seeking help.