Social Media and the Rise of Mental Health Problems

Much has been said about rises in mental health problems reported by younger people over the past 20 years. It is estimated that the prevalence of anxiety for 18-to-25-year-olds was about 8% in 2008, compared with 15% in 2018¹, and it is now around 17%². These figures certainly imply an increase in psychological problems for this age group. Many explanations have been put forth concerning factors responsible – such as living in a more uncertain world³, lack of resilience among the young⁴, or copycat reporting⁵. However, a suggestion that has not been explored in detail is that there is an increase in the experience of anxiety symptoms – not anxiety in the strict sense but as a result of social media withdrawal.

It is certainly the case that the rise in reporting of anxiety by younger people over the last 20 years has been paralleled by a rise in social media use. Twenty years ago (in 2008, when the iPhone/smartphone was launched), the prevalence of social media usage among 18-to-25 year-olds was 65%⁶, and now is around 99%⁷. This increase of 50% mirrors the rise in anxiety (although, is less pronounced). Of course, this correlation fits several of the above explanations, and, although it sounds harsh, copycat reporting of psychological problems from videos posted by others on social media – for either attention or identity – cannot be ruled out. However, another factor accompanying high social media use is social media withdrawal⁸ – which can sometimes (indeed often) present like symptoms of anxiety⁹.

Excessive social media use can happen for any number of reasons. I am not speaking about the personal reasons of the individual – which are of clinical importance – but of the underlying psychological processes. At least three such processes have been noted as important in this context: habit, addiction, and adjunct behaviours^10,11. The latter are produced when there is a gap between the delivery of important reinforcers (events) in an organism’s environment, and behaviour emerges during this interval. Schedule-induced polydipsia is an example of this effect, where food is delivered to a rat at fixed intervals, and the rat comes to emit excessive drinking in between times – an effect linked with substance misuse¹². This is an interesting suggestion in the context of social media use – is it just filling time between more important things?¹¹ However, habit and addiction are better studied – both produce high levels of behaviour, but are different from one another.

Broadly speaking, addiction is accompanied by several issues for the person in its grip. It clearly has a major disruptive influence on that person’s life, and on the lives of people around them (who often notice this first, or care about it more). This is also true of a bad habit. However, addiction has two things that a habit does not – it leads to increasing usage over time to gain the same effects (tolerance); and, when the person is not using, they experience withdrawal effects. The latter is of interest in explaining part of the rise of anxiety-reporting by young people. (Social media addiction is not a current diagnosis in the DSM-5.)

The withdrawal effects experienced upon cessation of any substance of misuse, or any process addiction (behavioural addiction), are typically opposite to those which the substance or behaviour produces. So, withdrawal from a substance with analgesic properties tends to involve pain (think of heroin withdrawal)¹³; whereas, withdrawal from a sedative (such as an old-fashioned barbiturate) tends to be accompanied by an increase in tension¹⁴. Many people use social media as a timeout from a stressful life⁸ – very much like people used to use sedative drugs (the fact that, as barbiturates have declined as a drug of prescription in favour of SSRIs, which do not carry the same psychoactive effects, at the same time as world-uncertainty and social media use have increased, may be an issue worth exploring). In fact, the withdrawal effects when social media is ceased appear (for many) to be similar to those seen when withdrawing from a sedative^8,15.

Withdrawal from social media produces a range of psychological and physiological effects, which are remarkably like those seen in anxiety. Physiologically, if a person who reports heavy social media use is prevented from using their digital device, and their physiological reactions are measured, then an increase in heart rate and in blood pressure can be observed¹⁵. Also noted is an increase in galvanic skin response, which is a measure of how much people sweat⁹. All these physical effects are felt during periods of anxiety. Indeed, when asked to subjectively report what they are experiencing, people who have had their digital devices removed, say that they feel anxious^9,15. These reported anxiety symptoms increase in proportion to the time that they are without their device⁹.

Devotees of cognitive-behavioural explanations of psychological states have suggested that anxiety, even panic attacks, can result from a misreading of physiological signals, or a mis-reaction to those physiological events¹⁶. Given this, it may be that the increase in anxiety for young people has nothing to do with their living in an uncertain world – the world has always been uncertain, and that’s nothing new. It may not be that they are lacking resilience to challenge – some do, some don’t, and that’s always been the case. Rather, it may be that the alleged anxiety of young people is actually a product of social media withdrawal. Perhaps interestingly, this phenomenon of social media addiction is reported in between 10-30% of 18-to-25-year-olds, and so could explain a chunk of the increased reported anxiety^8,15.

What all this suggests is not just that social media can have many negative effects, but that it is very hard to attribute any reported effects – such as increased levels of anxiety among the young – to any particular cause. In this case, it may be that some of the alleged increase in anxiety is due, not to anxiety, as we understand it, but to the effects of withdrawal, which mimic anxiety. Discriminating between those two possibilities or states is an important task for anybody, as it can lead to being able to do something about it.