The physician's role in eradicating the social media epidemic

Neil Baum, MD

The health care profession has done an admirable job controlling infectious epidemics, including AIDS, and creating vaccines for COVID-19 in a record six months. Now, we need to pivot to social media epidemics, since social media can be as dangerous as infectious epidemics. The time has arrived for physicians to take an active role in recognizing the dangers of social media and having discussions with young patients and their parents about the impact of social media on the growth and development of children. This blog will review the evidence of the dangers of social media on teenagers and what role the medical profession can play in resolving the scourge of the social media epidemic.

According to surveys from the Pew Research Center, social media use among young people is nearly universal in the U.S. In 2022, up to 95% of teenagers surveyed (ages 13 to 17) reported using social media, and more than a third use it almost constantly.

Pew has also tracked which social media platforms (or "apps") teenagers use. In 2023, it found that most teens—9 out of 10 for those ages 13 to 17—use YouTube, followed by TikTok, Snapchat, and Instagram.

A report from the UK, which applies to teenagers in the U.S., has these startling facts:

• Teenagers 12-17 spend seven hours and 23 minutes a day on social media.
• The average teen receives 237 messages a day, and 90% of girls and 50% of boys receive explicit messages.
• On a typical weekday, nearly one-third of adolescents admitted to using social media beyond midnight. It is no surprise that those using social media late at night have difficulty focusing on school.

The recent Surgeon General Vivek Murthy issued a report stating that there is growing evidence that social media is harming young people's mental health. The American Psychological Association (APA) issued its health advisory in 2024, requesting that the surgeon general place a warning label similar to the label on cigarettes, warning of the dangers of smoking on social media platforms and the health hazards of excessive use of social media.

There are indicators that social media can cause profound mental health and physical harm to teens. Many children with excessive cell phone use report anxiety and panic attacks. Before initiating the study, the researchers found that one in five students spent more time on their phones than on their education. Excessive use has also been linked to sleep problems, attention problems, and feelings of exclusion.

Murthy's advice was based on a review of the available evidence. His report stresses that the brain is going through a highly sensitive period between 10 and 19 when identities and feelings of self-worth are forming. According to the report, frequent social media use may be associated with distinct changes in the developing brain, potentially affecting such functions as emotional learning and behavior, impulse control, and emotional regulation. The issue is the amount of time adolescents spend on platforms, the content they are exposed to, and how their online interactions disrupt activities essential for health, such as sleep and physical activity.

Over the last decade, increasing evidence has identified the potential negative impact of social media on adolescents. According to a research study of American teenagers 12-15, those who used social media over three hours each day faced twice the risk of having mental health issues, including depression and anxiety symptoms. Although the minimum age recommended by social media platforms in the U.S. is 13, nearly 40% of children ages 8–12 use social media. That signals how difficult it can be to enforce these rules without parental supervision.

Eating disorders are yet another concern. A review of 50 studies across 17 countries between 2016 and 2021, published in PLOS Global Public Health, suggested that excessive online exposure to largely unattainable physical ideals may trigger a distorted sense of self and eating disorders. This is a particular problem among girls.

In addition, people who target adolescents, for instance, adults seeking to sexually exploit children, to financially extort them through the threat or actual distribution of intimate images, may use social media platforms for these types of predatory behaviors.

According to Dr. Murthy's advice, excessive social media use can harm teens by disrupting important healthy behaviors. There is evidence that excessive exposure to social media can overstimulate the brain's reward center and trigger pathways comparable to addiction when the stimulation becomes excessive.

The English experience of studying cell phone usage in schools

A private school in Colchester, England, participated in a groundbreaking phone ban experiment. Over 21 days in September 2024, they monitored life without cell phone devices while researchers from the University of York monitored, minute by minute, the fluctuation in their mood, brain alertness, and cognitive abilities.

The results of the UK study of a school undergoing a digital detox for three weeks revealed that

the girls started to talk face-to-face again, no longer distracted by cell phone screens. The boys played sports during recess. The library and clubs were better attended during the cell phone ban, and the children rediscovered their passions and talents.

The study demonstrated that pupils slept an extra hour a night on average. One of the investigators commented, "I'm convinced that getting them to sleep better is one of the ways to tackle the mental health epidemic in children and young adults."

The investigators also reported that students had fewer symptoms linked to anxiety and depression. Even the children said they felt more socially connected during the phone ban. The positive impact of the ban even spilled over to the students' time outside of school. Many of the children loved having more family time. Almost every parent felt they had gotten their child back. And the teachers noticed far greater alertness in class. Teachers noted that students' eye contact skills improved in a few weeks. Typical student responses include, "I feel more sociable, I concentrate better, sleep better, and in lessons I'm more focused."

Another positive result from the English study is that students received one to two grades higher in schools with an effective cell phone ban than in schools without a cell phone ban.

The role of physicians in curbing the use of social media

The American Academy of Pediatrics offers a parental tool that can help. In addition to setting the age at which you plan to start giving your kids phones or internet access, this plan can be used to establish rules and educate children and teens about being careful about privacy settings, avoiding strangers online, not giving out personal information, and knowing how to report cyberbullying. Most pediatric experts agree that elementary school-age children should not have internet access using a device with all the social media apps.

One strategy is to make a social media plan for the child's family before their teenage years. Parents might consider starting with a "dumbphone," a cell phone that doesn't have email, an internet browser, or other features found on smartphones. The experts suggest delaying full access to smartphones for as long as possible. Go slow and start with a device that allows parents to add more apps as the child matures.

Experts suggest that we educate parents, pointing out the dangers of social media and steps that parents can take to control their children's use of social media. This includes setting age-appropriate access limits, maintaining open communication, monitoring screen time, keeping devices out of bedrooms, and discussing online safety practices. Parents should also model responsible social media behavior themselves.

The policy for my family is to ban cell phone usage during meals. I want my children to engage in conversation rather than texting at the dinner table.

Responsible parents should set limits on screen time, designated social media hours—certainly after homework is completed—and specific platforms allowed.

Parents should consider keeping phones and other devices out of the bedroom, especially at night, to promote healthy sleep habits. Research shows a relationship between social media use and poor sleep quality, reduced sleep duration, and sleep difficulties in young people. For teens, inadequate sleep is linked to emotional health issues and even a higher risk for suicide.

According to the Surgeon General's report in 2023 on a typical weekday, nearly one-third of adolescents report using screen media until midnight or later. Parents should create a culture at home where all phones are turned off at a specific time, and at least one hour before bedtime. I had a policy that phones were prohibited at the dinner table or when the family went to a restaurant.

Parents should practice responsible social media use to set a positive example for their teens. For example, parents should not use cell phones at dinner time, and if they must take a call, it is polite to walk away from the dinner table to talk.

Now, there are phones and watches such as Gabb devices, which are all built specifically for teenagers. These devices do not allow teenagers to download social media or other highly addictive apps. This is an option for parents to control safe connections without access to social media.

It is of interest that Australian Prime Minister Anthony Albanese has placed his government at the forefront of finding a solution to this worldwide epidemic. He legislated for a ban on social media for children under 16, which could be a game-changer.

What have we learned from the English study, the Australian ban on cell phones for teenagers younger than 16, and the Surgeon General's report? We have concluded that a cell phone device does not provide a human connection. We may need a multipronged approach, with tech companies, the government, parents, and schools working together. Certainly, the health care profession must participate in curtailing the use of social media, especially among teenagers.

Bottom Line: As most physicians will agree, access to tech is essential to so much of our lives now and crucial to children's future careers. However, multiple examples of technology do harm, and social media among teenagers is high on the list. The health care profession has done an admirable job controlling infectious epidemics, including the AIDS virus, and creating vaccines for COVID-19 in a record six months. Now, we need to move on to social media epidemics. The social media epidemic is every bit as dangerous as infectious epidemics. Physicians need to take an active role in identifying these issues and have discussions with teenage patients and their parents about the toxic impact of social media use.

If readers have any experience with resolving the social media epidemic, please let me hear from you: doctorwhiz@gmail.com.

Neil Baum, MD, a Professor of Clinical Urology at Tulane University in New Orleans, LA. Dr. Baum is the author of several books, including the best-selling book, Marketing Your Medical Practice-Ethically, Effectively, and Economically, which has sold over 225,000 copies and has been translated into Spanish.