Why So Many of Today's Teens Are Depressed

The answer might be right there in their hands: the smartphone.

Posted Aug 25, 2017

Not many research results make you sit up straight in your chair, but this one did.

Ive been tracking trends in the attitudes and behaviors of teens and young adults for many years,
primarily relying on a nationally representative survey of U.S. teens conducted every year called
Monitoring the Future (MtF) that has surveyed 1.4 million teens since the 1970s. Around 2012 to
2013, there was sudden uptick in teens saying they were experiencing symptoms of depression
feeling hopeless, not enjoying life, believing they cant do anything right. Depressive symptoms
continued to increase over the next few years, making today's teens whom I describe in my new
book, iGen significantly more depressed than teens just a few years before.

Since an excerpt of iGen ran in the Atlantic, some have wondered how I came to the conclusion
that mental health issues were on the rise among teens (and why). Now that the book has been
published with all of the graphs and analyses, I can finally explain that here, which I hope will
answer critiques that seemed to be based on an incomplete understanding of the research and
how it was done.

As I found when I dug deeper, the increase in depressive symptoms was only part of the story.
Happiness which had been increasing among teens for 20 years began to decline. Loneliness
spiked sharply, and more entering college students (in the national American Freshman survey of
9 million students) said they felt depressed and overwhelmed. Even more concerning, 50 percent
more teens in 2015 (versus 2011) demonstrated clinically diagnosable depression in the NS-DUH
national screening study. (It's important to note that all of these sources are surveys of unselected
samples of teens and not those who seek treatment thus they cannot be explained by greater
treatment-seeking). The teen suicide rate tripled among girls ages 12 to 14 and increased by 50
percent among girls ages 15 to 19. The number of children and teens hospitalized for suicidal
thoughts or self-harm doubled between 2008 and 2015. iGen'ers were experiencing a mental
health crisis. As if that werent enough, no one seemed to know why.

Economic causes seemed unlikely; the U.S. economy improved after 2011. It wasnt academic
pressure, either; in the MtF surveys, teens in the 2010s say they do fewer hours of homework than
teens reported in the 1990s, and the time college-bound high school students spend on
extracurriculars contrary to popular belief is about the same in the American Freshman
survey. There was no cataclysmic event or political shift during that time (these data predate the
presidential election). Factors such as income inequality and shifting family structure, mentioned
by some, had been building for decades, with no sudden shift in the 2010s. So what was it?

Then it hit me. In another project, Id found that teens were spending less time with their friends
in person and more time communicating electronically, with these trends accelerating after 2011.
That, I realized, was around the time that smartphones became ubiquitous when many teens
(and adults) started spending nearly every waking moment looking at the phones in their hands.
Sure enough, the Pew Center found that the percentage of Americans owning a smartphone
crossed 50 percent in late 2012. That was also around the time social media became almost
mandatory for teens. Smartphones and social media were also something that affected teens
directly a fundamental change in how they spent their time, not just an event in the news or a
trend they heard about from their parents.

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So the time sequence fit: Right when smartphones became common, and teens started spending
less time face-to-face, their psychological well-being plummeted. The next question was whether
smartphones might be linked to lower well-being among individuals. In my analyses of MtF and
the CDC's Youth Risk Surveillance System data for the book, I found they were teens who spent
more time on screens were less happy, more depressed, and had more risk factors for suicide.
Those links remained when possible confounding factors, such as gender, race, and socioeconomic
status, were taken into account.

Some wondered why I didn't include studies that found positive effects for social media. First, this
was a book excerpt, so not surprisingly I focused on the analyses I did for the book (of the
nationally representative MtF and CDC data on thousands of teens, which show correlations
between more time on social media and lower well-being). Second, the most recent meta-analysis
(of 67 studies) also found a correlation between more time on social media and lower well-being.
(For two examples, see this study of adults and this one of tweens). Overall, between the large
samples I analyzed and the meta-analysis, it seems clear that the preponderance of the evidence
points toward lower well-being with more social media use; thus, the idea that I was selective with
evidence is unfounded. Social media may have other benefits, but more psychological well-being
which was my focus does not appear to be one of them.

Of course, as I also specifically noted in the Atlantic excerpt, correlation doesnt prove causation.
For example, perhaps unhappy people use screen devices more. However, three other studies
have effectively ruled out that explanation, at least for social media. Two longitudinal studies
found that more social media use led to unhappiness, but unhappiness did not lead to more social
media use. A third study was a true experiment (which can determine causation); it randomly
assigned adults to give up Facebook for a week, or not. Those who gave up Facebook ended the
week happier, less lonely, and less depressed.

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Depression causing social media use also cant explain why depression would increase so suddenly
after 2011-12. If the increase in depression occurred first, some other, unknown factor would have
to cause depression to rise so sharply, which would then lead to more smartphone and social
media use. It seems much more likely that smartphone and social media use went up, and the
increase in depression followed. By far the biggest changes in teens day-to-day lives between
2011 and 2015 were the spread of the smartphone and the growth of social media. Nothing else
even comes close.

Not only that: No one disputes that in-person social interaction is linked to better mental health.
So even if we dismiss the correlation between social media and depression say, calling it neutral
the decline in in-person social interaction could certainly account for the increase in depression
and unhappiness. And why has in-person social interaction declined? Probably because screen
time increased.

None of this means you should yank the phone out of your teens hands. As other studies have
also documented, moderate use of smartphones around an hour a day is not harmful. In my
analyses of data from the Youth Risk Surveillance System survey administered by the CDC,
negative effects on mental health appeared only after two or more hours a day of use. Of course,
most teens (and many adults) use their smartphones much more than two hours a day (the
average is six to eight hours during leisure time), so it makes sense to consider setting limits.

After my book excerpt was published in The Atlantic, some, like Sarah Rose Cavanagh, argued that
we shouldnt draw any conclusions until we can do a controlled experiment randomly assigning
groups of teens to extensive or low smartphone use. She concluded, My suspicion is that the kids
are gonna be OK.

But it is not OK that 50 percent more teens suffered from major depression in 2015 versus just
four years before. It is not OK that the suicide rate for teen girls is at its highest level since 1975. It
is not OK that twice as many children and teens are now hospitalized for self-harm or suicidal
thoughts. It is not OK that more teens say that they are lonely and feel hopeless.

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iGen also shows many positive traits and trends, which are detailed in the book, including lower
rates of teen pregnancy and alcohol use and a stronger work ethic. Just so there is no
misunderstanding: The worrying trends in mental health do not mean there are no positive trends,
or that I ignore the positive trends. In fact, Chapter 1 of the book front and center highlights
many of these positive trends, as does the rest of the book. Nor should documenting the mental
health trends be construed as "criticism" of this generation as a psychologist, I find that idea
antithetical to the basis of my field, which is that mental health issues deserve understanding and
compassionate help, not censure.

Given the undeniably negative trends in teens' mental health and the evidence suggesting
smartphone use is at least partially behind them, it makes sense to limit kids' and teens'
smartphone use. As with any intervention, the risks of doing something versus doing nothing must
be considered. There doesn't seem to be much risk involved in limiting smartphone use to 90
minutes a day or less. However, doing nothing and having teens continue to spend six-plus hours a
day with new media risks having these negative mental health trends continue.

I would applaud a large, randomized controlled trial that directly addresses the causal link
between smartphones and depression. I hope such research will be funded and conducted, though
even if it were, it would be years before we knew the results. And if evidence emerges for another
cultural or technological trend that can explain the increase in depression, loneliness, and suicide
starting around 2012, I will push to address it. Right now, smartphone use is the most likely change
agent, so it's the one I'm addressing with my own children, and the one I think other parents
should consider. Teens and young adults are telling college counselors, survey administrators, and
therapists that they are suffering, and we need to listen.

References

Shakya, H. B., & Christakis, N. A. (2017). Association of Facebook use with compromised well-
being: A longitudinal study. American Journal of Epidemiology.
Tromholt, M. (2016). The Facebook experiment: Quitting Facebook leads to higher levels of well-
being. Cyberpsychology, Behavior, and Social Networking, 19, 661-666.

Twenge, J. M. (2017). iGen: Why Todays Super-Connected Kids Are Growing Up Less Rebellious,
More Tolerant, Less Happy and Completely Unprepared for Adulthood. New York: Atria Books.

Kross, E., Verduyn, P., Demiralp, E., Park, J., Lee, D. S., Lin, N., Shablack, H., Jonides, J., & Ybarra, O.
(2013). Facebook use predicts declines in subjective well-being in young adults. Plos One, 8,
e69841.