This week Surgeon General Vivek H. Murthy released a warning about the risks that social media presents to the mental health of children and teenagers. Adolescent mental health has been declining for years, and an increasing amount of research suggests that social media platforms could be partially to blame. But experts continue to debate just how much impact they have—and whether new and proposed laws will actually improve the situation or will end up infringing on free speech without addressing the root of the problem.

Numerous studies demonstrate that adolescent rates of depression, anxiety, loneliness, self-harm and suicide have skyrocketed in the U.S. and elsewhere since around the time that smartphones and social media became ubiquitous. In fact, in the U.S., suicide is now the leading cause of death for people aged 13 to 14 and the second-leading cause of death for those aged 15 to 24. In October 2021 the American Academy of Pediatrics declared a “national state of emergency in children’s mental health,” stating that the COVID pandemic had intensified an already existing crisis. The U.S. Centers for Disease Control and Prevention issued a similar warning in 2022, after the agency found that nearly half of high school students reported feeling persistently “sad or hopeless” during the previous year. According to the CDC, LGBTQ and female teens appear to be suffering particularly poor mental health.

Yet the role social media plays has been widely debated. Some researchers, including Jean Twenge of San Diego State University and Jonathan Haidt of New York University, have sounded the alarm, arguing that social media provides the most plausible explanation for problems such as enhanced teen loneliness. Other researchers have been more muted. In 2019 Jeff Hancock, founding director of the Social Media Lab at Stanford University, and his colleagues completed a meta-analysis of 226 scientific papers dating back to 2006 (the year Facebook became available to the public). They concluded that social media use was associated with a slight increase in depression and anxiety but also commensurate improvements in feelings of belonging and connectedness.

“At that time, I thought of them as small effects that could balance each other out,” Hancock says. Since then, however, additional studies have poured in—and he has grown a bit more concerned.  Hancock still believes that, for most people most of the time, the effects of social media are minor. He says that sleep, diet, exercise and social support, on the whole, impact psychological health more than social media use. Nevertheless, he notes, social media can be “psychologically very detrimental” when it’s used in negative ways—for instance, to cyberstalk former romantic partners. “You see this with a lot of other addictive behaviors like gambling, for example,” Hancock says. “Many people can gamble, and it’s not a problem. But for a certain subset, it’s really problematic.”

Some recent studies have attempted to clarify the link between social media and mental health, asking, for instance, whether social media use is causing depression or whether people are being more active on social media because they’re depressed. In an attempt to present causal evidence, Massachusetts Institute of Technology economist Alexey Makarin and two of his colleagues compared the staggered rollout of Facebook across various U.S. colleges from 2004 to 2006 with mental health surveys taken by students at that time. Their study, published in 2022, found that swollen rates of depression and anxiety, as well as diminished academic performance, followed Facebook’s arrival. Makarin says much of the harm they documented came from social comparisons: students viewed the online profiles of their peers and believed them to “[have] nicer lives, party more often, have more friends and look better than them.” Facebook’s parent company Meta did not responded to requests for comment by press time.

Other studies have obtained similar results. In one paper, participants were paid to deactivate Facebook for four weeks prior to the 2018 U.S. midterm elections and reported experiencing improved happiness and life satisfaction when they weren’t on the platform. And in February 2023 researchers at Swansea University in Wales found likely physical health benefits, including a boost to the functioning of the immune system, when social media use was reduced by as little as 15 minutes per day.

“In total, there’s a more and more coherent picture that, indeed, social media has a negative impact on mental health,” Makarin says. “We are not saying that social media can explain 100 percent of the rise of mental health issues…. But it could potentially explain a sizeable portion.”

Mitch Prinstein, chief science officer at the American Psychological Association (APA), which recently released recommendations for adolescent social media use, points out that there’s nothing inherently harmful or beneficial about social media. “If I’m 12, and I’m reading Scientific American and going on social media to talk with my friends about how interesting the articles are,” he says, then that’s a far cry from “going on a site that’s showing me how to cut myself and hide it from my parents.” He suggests that social media companies should take down the potentially harmful content, letting youth use social media more safely.

In addition to toxic content, Prinstein worries about the effects of social media on young people’s sleep—and therefore brain development. “No kid should be on their phone after 9 P.M.,” he says, “unless they’re going to sleep well into the morning.” But actually closing down the social apps and putting that phone down is difficult, Prinstein says. This is in part because of the design of these platforms, which aim to hold users’ attention for as long as possible. Kris Perry, executive director of the nonprofit Children and Screens: Institute of Digital Media and Child Development and a former senior adviser to California governor Gavin Newsom, agrees. Besides being sucked in by app design, she says, adolescents fear disappointing their peers. “Kids feel genuinely scared that they’ll lose friendships, that they won’t be popular, if they don’t like their friends’ posts instantly,” Perry says.

The flood of new studies on social media’s harms is spurring lawmakers to action. Except for the Children’s Online Privacy Protection Act, which passed in 1998—years prior to the advent of smartphones or social media—the U.S. Congress has never really involved itself with what kids do online. “It’s kind of the Wild West out there,” Prinstein says of the lack of oversight. Since around 2021, however, when a Facebook whistleblower testified that the company knew its platforms harmed youth mental health—allegations that Facebook denied—both Republican and Democratic lawmakers have moved to follow Europe’s lead on stronger Internet regulations. On the federal level, members of Congress have introduced a slew of overlapping bills: at least two would bar social media use outright for kids under a certain age, while others would restrict targeted advertising and data collection, give young users more control over their personal information, prioritize parental supervision, facilitate additional research and hold social media companies liable for toxic content viewed by minors. Though nothing has yet passed, President Joe Biden seems largely onboard with these measures. In his February State of the Union speech, Biden said, “We must finally hold social media companies accountable for the experiment they are running on our children for profit.” And on the same day as the surgeon general’s warning this week, the White House commissioned a task force to analyze how to improve the health, safety and privacy of kids who go online.

Meanwhile state legislatures have jumped into the fray. California recently passed a law designed to protect children’s online data. Montana banned TikTok. And Arkansas and Utah mandated, among other things, that social media companies verify the ages of their users and that minors get parental consent to open an account. Similar bills are pending in many other states.

Of the federal bills currently pending, arguably the Kids Online Safety Act (KOSA) has gained the most attention thus far. Sponsored by Republican Senator Marsha Blackburn of Tennessee and Democratic Senator Richard Blumenthal of Connecticut, the bill would require social media companies to shield minors from content deemed dangerous. It also aims to safeguard personal information and rein in addictive product features such as endless scrolling and autoplaying. Supporters of KOSA include Children and Screens, the APA and the American Academy of Pediatrics, along with several parents whose kids died by suicide after being relentlessly cyberbullied.

On the opposing side, organizations that include the Electronic Frontier Foundation, a digital rights nonprofit, and the American Civil Liberties Union have come out against KOSA, stating that it might increase online surveillance and censorship. For instance, these parties have raised concerns that state attorneys general could weaponize the act to suppress content about, say, transgender health care or abortion. This is particularly problematic because it could negate some of the positive effects social media has on teen mental health.

Researchers acknowledge that social media can aid kids by, among other things, connecting them with like-minded people and facilitating emotional support. This appears to be especially important for “folks from underrepresented backgrounds,” Prinstein says, “whether you’re the only person around who looks like you or the only person with your identity in your family.” If KOSA leads to the restriction of speech about LGBTQ issues, for instance, it could be detrimental to members of that community. “That support, and even accessing information, is a great benefit,” Prinstein says. “There really was no other way to get that resource in the olden times.”

Jason Kelley, associate director of digital strategy at the Electronic Frontier Foundation, says that rather than a bill like KOSA, he would prefer to see stronger antitrust laws that might, for example, increase competition among platforms, which could encourage each one to improve its user experience in order to win out. More options, he says, would force social media companies “to deal with the ways they ignore user interest and desire and safety and privacy.”

As the debate continues over the best legislative fixes, essentially all the researchers Scientific American spoke to agree on one idea: more information about these platforms can help us figure out exactly how they’re causing harms. To that end, KOSA would mandate that the social media companies open up their closely held datasets to academics and nonprofits. “There’s a lot we don’t know,” Hancock says, “because we’re prevented.”

IF YOU NEED HELP

If you or someone you know is struggling or having thoughts of suicide, help is available. Call or text the 988 Suicide & Crisis Lifeline at 988 or use the online Lifeline Chat.