When my daughter Tessa started having depression symptoms, I was at a loss about what to do, and I felt such sadness for her. How she got to the other side, and how I learned about how to support her better, is one of the many stories of resilience in Screenagers NEXT CHAPTER.  

Headlines often tell us the unfortunate news that there is a higher percentage of tweens and teens reporting depression symptoms than in the past — and the question is why? (I recently wrote all about depression in teens). Depression symptoms started going down for teen boys and girls throughout the ‘90s, and then leveled off, and then around 2011 started going up again.

Today I want to talk about all the reasons why we might be seeing this rise, and I hope you will discuss these ideas with kids and students in your lives. They get all sorts of headlines with quick answers — but the reality is more complex.

I start by considering possible non-screen time reasons, then I go into screen time reasons. *I will use the word “teens” to refer to teens and tweens.

Non-screen time possible reasons

1. Could it be that teens are more likely to report their feelings on surveys?

In the U.S before the late 1980s, teen depression was not widely talked about in our society — in part because the medical world paid relatively little attention to it. The wonderful comedian Gary Gulman who had depression in his youth remarked that the treatments, "...in the ‘70s and ‘80s pretty much were 'Snap out of it,' and 'What have you got to be depressed about?’ "

2. Could it be as society talks more about depression that teens are more in touch with and more comfortable indicating symptoms on surveys?

In addition, over the past decade, many celebrities have opened up about their mental health struggles – such as Lady Gaga, Serena Williams, and Prince Harry, to name just a few. Also, famous Youtubers, who are particularly relatable to teens, sometimes talk about their depression. Since teens are exposed to media much more than in the past, opportunities to hear these experiences have multiplied. When I made a film about global mental health, I was shocked that it was nearly impossible to find in India or China a single celebrity being open about a mental health issue.

3. Could it be that overall, things are harder now for teens than in the past?

One example is that teens often talk about the stress of "not being good enough." The level of competition teens feel at school and in sports is much higher than when we were growing up. Meanwhile, academic loads can be daunting. It utterly astounds me the number of academically successful teens who tell me all the cool things they love to do in and out of school, and yet they say "Oh, no, no, I am not going to apply to such or such college, I would NEVER get in."

Other societal stressors are important to factor in, such as the stress families experience with rising health and housing costs, decreasing relative wages, job losses, worsening anti-immigration sentiments, climate issues, and funding shortages for social support programs to name a few. There are many ways things feel worse now, but it is important to remember there were plenty of intense stressors in the past as well.

Screen time possible reasons

Because the rise of reported depression symptoms started in 2011 correlates with the increase in screen time and smartphone ownership, everyone wants to know if social media and overall screen time is causing the rise in depression.

Researchers have hypothesized that if social media is a risk factor for low mood, then a teen who spends more time on screens should have a higher chance of reporting depression symptoms.

Indeed when researchers have analyzed surveys that asked teens questions about depression symptoms, and time on social media and screen time, they have often found that more time on screens correlates with a higher chance of reporting depression symptoms (or other markers of low psychological well being.) The correlation often starts after about 2 hours a day of social media. Some studies do not show a relationship, but more do than not.  

These correlation studies do not prove that social media, or lots of time on screens, cause depression. To establish causation, with say social media, researchers would have to randomize thousands of teens into two distinct groups. One group that would be allowed to use social media and one group that could not and then to follow them for many months — and the researchers would record whether the "using" group was more likely to develop depression symptoms. But wait, what about the group that is feeling sad about being left out of social media? You see all the complexities and impossibilities of trying to do such studies.

Why the correlation of social media and increased chance of depression symptoms?  

1. Could it be due to negative experiences on social media?

Negative feelings and experiences happen on social media at times. In Screenagers NEXT CHAPTER, we hear teens say:

“If you post something, someone comments something mean or rude on it, makes me upset.”
“Oh, I'm not as skinny as her. I can't afford to go on that trip.”
“You can see if they've opened your Snapchat or if they haven't opened it, and I know that they've opened someone else's, just feels so bad.”
“Guys asking for pictures. They don't want anything to do with me, otherwise. It hurt me”.
“I see people doing fun things, and then my anxiety just kind of takes over.”

There are many other possible reasons. Of interest, middle school counselors tell me how students more commonly come to them feeling upset because they keep seeing on social media how they are being left out of things — much more often than because of cyberbullying (of course, being excluded can indeed be a form of bullying.)

2.  Could it be due to the fact that time on social media can displace things needed for well being?

Time on screens and social media can usurp things that are known to foster well-being.  One of the big ones is the fact that many more teens report getting insufficient sleep than ever before, and some research has found that this lack in sleep can explain a lot of the rise in depression symptoms.

Other examples of crucial things being displaced include less in-person time, reduced chances for a person to challenge themself in ways that help them gain feelings of self-worth, fewer positive mentor opportunities due to less after-school jobs, and less physical activity.

3. Could it be that teens who are feeling depressed already (due to genetic wiring along with events at home, school, etc.) are more likely to spend longer amounts of time on social media?

Teens with depression generally experience a loss of energy and find it really hard to do things that they used to take pleasure from. Screen time is low energy.  In addition, with all the YouTube videos on social media and other things, teens can distract themselves from hard feelings.

So what do I make of all of this?

I believe all those questions and responses I wrote above, both non-screen and screen-related, are all contributing to the increases we are seeing in teens reporting depression symptoms. As a physician, educator, researcher, mom, and being out in the world with the Screenagers films, I have heard all of these reasons from teens.

Time on screens, and social media, are important risk factors.  So as parents, we want to work with youth to help them make smart choices on screens, help them have plenty of time off screens, and help them obtain skills to be able to effectively work through hard emotions — all the things covered in Screenagers NEXT CHAPTER.

Two final points when talking with kids and students about all of this-

1. To get teens to engage more fully in these conversations it is vital to validate the fact that we understand that social media and screen time are a big source of their positive emotions. This also increases the chance that they will come to us with any feelings of sadness or other hard emotions because they will not feel like we will automatically cut them off from all screen time.  
2. Depression symptoms usually stem from a complex intersection of environment, events, genetic wiring, and more. It is far too simplistic to say that this recent rise in reported symptoms is caused solely by screen time.

Here are a few questions for a discussion:

1. Go through the possible reasons I explored in this TTT. What thoughts does each of you have? *Also, I could not cover all possible explanations in this TTT, so I encourage you to go to our FB page and add other thoughts.
2. What screen time activities can help improve mood — such as Skype with a good friend?
3. In what ways can social media issues lead to more depression symptoms?

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