When a child or teenager scrolls social media, they look at more than just photos of friends, memes and funny videos — they have access to good and bad in the world each time they log in. While the mental health impacts of social media on adolescents are still being studied, the known risks prompted a 19-page public advisory on May 23 from the U.S. surgeon general, urging parents and lawmakers to safeguard youth through social media limitations and policy changes.

While the advisory can be alarming, Tiffany Howell, Ph.D., a pediatric psychologist at Arkansas Children’s Hospital in Little Rock and associate professor of pediatrics at the University of Arkansas for Medical Sciences, shared helpful tips and warning signs for parents to keep their children safe while using social media.

Why It's Serious

Howell primarily sees chronic pain pediatric patients from the outpatient pain clinic, sickle cell, headache and Tourette Syndrome clinics. She follows up with these patients in the Dennis Developmental Center at ACH and more traditional therapy patients. Howell said she sees patients with depression, anxiety and adjustment disorders, ranging in age from 8 to 18, and social media use is “extremely prevalent.” That reality aligns with the advisory, which cited research that up to 95 percent of teens use at least one social media platform. One-third said they interact with social media “almost constantly,” with 40 percent of children 8 to 12 saying they use it despite most social media sites requiring users to be 13, as reported in a May 23 New York Times article.

Howell said social media could worsen feelings of loneliness her chronically ill patients already experience.

“Recently, I was talking with a teen who, due to her illnesses and injuries, isn’t able to participate in prom, homecoming or other typical school-related activities. But she’s scrolling through looking at her friends who are attending prom and parties, all the things she’s just unable to go to,” Howell said. “It’s hard for her. She knows it’s happening, but it’s harder when she’s looking at the pictures.”

During a patient’s first appointment, Howell said they fill out a social media assessment to evaluate how much time they spend on social media, what platforms they use and if they experience online bullying. Questions are tailored to each clinic. For example, pediatric patients with Tourette’s Syndrome, a nervous system condition causing sudden movements and twitches, are asked if they follow videos that show other people having “tics.”

“TikTok is a popular platform where people film themselves ticing. We know from research that people with Tourette’s disorder watching others tic causes their tics to exacerbate. We try to assess for that and ensure they’re not doing that,” Howell said.

Some mental health conditions that can stem from social media exposure or increase because of it in children and teenagers include depression, anxiety, body dysmorphia, eating disorders, self-harming, suicidal thoughts and other impacts stemming from racism, sexism and bullying.

The more a child interacts with a certain topic on social media, the more of that same topic will show up on their accounts. Howell explained if a teenager searches “depressing songs” when they’re having a bad day, the platform will continue to show similar content to the user.

“The more negative mood you put in, the more negative mood-related content you’ll see. It can affect brain functioning and emotions,” Howell said.

Tips and Warning Signs

Parents can keep their children safe while using social media in many ways.

The surgeon general recommended children under 13 should not use social media. Movements like “Wait Until 8th,” encourage all parents to wait until their child is in eighth grade before allowing them on social media so no child feels left out by not being active on a platform.

Waiting until they are older is particularly important because of the changes in brain function that can occur with social media use. The surgeon general’s advisory report stated that frequent interaction with social media may correlate to changes in the developing brain, specifically the amygdala, which impacts emotional learning and behavior. The report further explained it affects “the prefrontal cortex (important for impulse control, emotional regulation and moderating social behavior) and could increase sensitivity to social rewards and punishments."

Howell said she recommends these social media tips to protect adolescents:

  • Monitor a child’s social media use; Parents need to tell their children they will be monitoring their social media. Even if they are teenagers, it’s important to “trust, but verify,” Howell said. Setting parental controls or utilizing apps like Bark, which can monitor and alert parents to cyberbullying, online predators and depression, also helps.

  • Make sure the account is private; Setting a social media account to private can prevent cyberbullying and possible predatory behavior from strangers. Some platforms also allow a person to turn off direct messaging capabilities.

  • Set time limits; Parents can set time limits for apps on smartphones and tablets. The general rule is up to two hours of social media use on weekdays and three hours on the weekends.

  • Take away access to phones/tablets at night; For safety reasons, children should not be allowed access to social media at night.

  • Log off entirely; If an adolescent feels worse while scrolling, stepping away is important.

There are also common warning signs that might indicate too much exposure to social media:

  • Major meltdowns when taking social media away, obsessions

  • Significant mood changes

  • Isolating from friends, family, previously enjoyed activities

  • Eating habit changes

  • Flat affect, void of emotions in their face

  • Self-insulting statements, constant comparison to others

  • Engaging in dangerous behaviors for “likes,” followers

Howell also said children could be exposed and pressured to compete in harmful challenges, learn dangerous behaviors like tips on self-harm or suicide and fall victim to scams.

Help at Arkansas Children's Hospital

If a child is experiencing these warning signs, Howell said it’s important to seek professional mental health help as soon as possible. If a child expresses suicidal or homicidal thoughts, seek immediate medical attention.

The Child Study Center, located in the David M. Clark Center for Safe and Healthy Children at Arkansas Children’s Hospital, provides evaluation and treatment for various mental health problems in children and families. The center’s Outpatient Therapy Clinic, part of the Division of Child and Adolescent Psychiatry program at the UAMS Psychiatric Research Institute, sees patients from infancy to 18.

Howell said the center has several programs that could assist with over-exposure to social media, like cognitive behavioral therapy, dialectical behavior therapy and family therapy.

There are times, especially under the guidance of a mental health professional, when a child should be taken away from social media together for their overall health. Seeking help from a mental health expert can help parents determine what is best for their child.

“As a parent, I hope my kids can come to me for everything and that they will love and trust me with all of that. As a person who has been a teenager before, I know, realistically and developmentally, that’s not always realistic,” she said. “To speak with a mental health professional outside of friends and family, to know that is the person they can come to with issues like that, can be extremely beneficial.”

The child’s primary care provider (PCP) can send a referral to the Child Study Center at 501-364-5150, and a staff member will then contact the family to schedule an appointment. Click here for more information.