Let's talk about social media!

Whatever your opinion on social media, it is part of the lives on the majority of children in the UK. A recent report released by OFCOM 2024 stated that 51% of children aged 3-12 use social media, despite the minimum age requirement of 13. Use increases with age, with >60% of 8-11 yr olds using social media, and >90% of 12-17yr olds. 

With high rates of mental health problems affecting young people set against the backdrop of a social media explosion, it’s not hard to see why people equate the two. 

A recent study by Nagata et al. published in JAMA May 2025 assessed the temporal association between social media use and depressive symptoms, seeking to shed light on the questions:

1. Does social media use contribute to the development of depressive symptoms?
2. Does mental distress drive increased social media consumption? 

This was a US based prospective cohort study using data obtained from the ABCD study (Adolescent Brain Cognitive Development study). The study included 11876 children and adolescents, aged 9-12 years old (9-10 years at baseline), with data collected between 2016 and 2022. They assessed depressive symptoms as reported by the caregiver using the ‘Child Behaviour Checklist’ depressive problems score, and compared this against self-reported social media use at baseline, year 1, year 2 and year 3. They controlled for sex, ethnicity, household income, parental education, ACEs and family conflict. 

They found that ‘within-person’ (i.e. the same individual) increases in social media use was associated with increasing depressive symptoms in the subsequent year (from year 1 to year 2 (β, 0.07-medium sized effect; 95% CI, 0.01-0.12; P = .01) and from year 2 to year 3 (β, 0.09-medium sized effect; 95% CI, 0.04-0.14; P < .001). The study found no link between depression and subsequent social media use. Interestingly, they did not identify any ‘between person’ associations with social media use, i.e. those who had consistently high social media use were not necessarily those with high depressive symptoms, once other factors had been considered. 

Overall, the authors conclude that findings suggest that increasing time spent on social media in early adolescence may contribute to depressive symptoms over time. 

It is important to consider that this was an observational study, subject to all the usual reporting, recall and social acceptability bias. As such we cannot draw conclusions about causation. It is also worth bearing in mind that although grouped as a whole for this study, social media use is heterogeneous and used with varying purpose (with other sources reporting benefits including accessing support and peer connections). Further, research into social media is inherently challenging as it such a rapidly evolving area, by the time studies are reporting platforms have often changed dramatically!

Although insufficient to conclude that social media causes depression, this study and the wider discourse around social media raises important points for us in general practice. Social media is a key part of children’s lives, and at a much younger age than many of us may realise. As clinicians we should be routinely asking children and adolescents about their social media use, including those presenting with mood related symptoms. As described in a helpful article from Young Minds, young people felt that social media was not spoken about enough with professionals. We should ask open questions about how and why they use social media, what aspects do they value and what worries them? Avoid being judgemental or making assumptions. 

 Consider signposting to resources that children and families may find helpful when navigating the online environment, including the NSPCC, Childline, Young Minds and parental controls tools. Overall, opening the conversation and building shared understanding is a key step towards tackling any problems together.