As social media’s influence has surged, so too has the debate over its effects on psychological well-being. Once envisioned as a means to connect communities and amplify self-expression, these platforms are now under scrutiny for their potential long-term impact on mental health—especially among adolescents.

During this critical stage of development, social interactions play a pivotal role in helping adolescents shape identity, influencing their sense of self and belonging. This can make them especially vulnerable to peer feedback, which, in the age of social media, can be pervasive. Adolescents on social media are exposed to a digital landscape where “likes,” “comments,” and “shares” serve as instant yet superficial measures of validation. The pressure to curate an idealized online persona can heighten sensitivity to social comparison, increasing vulnerability to anxiety, low self-esteem, and a reliance on social media for self-worth.

Young adults who spend more than three hours daily on these platforms are two times more likely to have mental health problems, most notably depression and anxiety. This is alarming considering that the average teen spends 4.8 hours on social media every day as of 2023. It is also a concerning trend that I have observed firsthand in my 25 years as an adolescent psychiatrist.

Various entities are taking action to combat social media’s impact on the youth mental health epidemic. In May 2023, U.S. Surgeon General Dr. Vivek Murthy released a general warning spotlighting the need for a warning label on social media platforms to improve youth mental health. One year later, New York City became the first major U.S. city to declare social media as a public health crisis for its ramifications on youth mental health.

Numerous studies evaluating social media’s impact on youth mental health report varying findings, but there is little evidence to suggest any benefits of unfettered social media use. Appropriate safety measures should be built to ensure these platforms will not cause long-term harm to young minds. Below are some best practices for providers working with youth to consider as they navigate the evolving social media landscape.

Put on the “seatbelt.”

When a child learns to drive, they must follow a structured process to ensure safety before being given independent access to the keys. Yet, when young people are given unrestricted access to social media, they are essentially handed the “keys” to social media without guardrails, exposing them to potentially harmful content that can damage their self-esteem, mental health, and overall development. Just as seatbelts are a nonnegotiable safety measure in driving, digital literacy—equipping young users with the skills to critically assess online information and protect themselves—should be a prerequisite before navigating the digital world independently.

Social media usage should be monitored from an early age, including not only setting screen time limits and utilizing parental controls but also providing guidance to instruct children on how to evaluate sites for false or destructive content. The goal is for the teen to be able to discern reliable sources, engage in healthy and supportive online interactions, and make informed decisions about their well-being.

It is also worth noting that children learn by example, so adults should be mindful of their own online usage. Parents or caregivers can model balanced screen habits, limiting social media use themselves to encourage children to develop healthier digital practices.

Encourage in-person socialization.

For many kids, the most enticing aspect of going to school is the opportunity for social interaction. However, children with anxiety or depression are less eager to attend in person and often find social media an easy substitute—although not necessarily a healthy or effective one.

While socializing online can be a useful alternative to in-person interactions, particularly for kids with increased anxiety, it still does not adequately replace face-to-face human connection. A recent study during the COVID-19 pandemic emphasized that face-to-face communication is more beneficial for mental health than digital connection.

In-person socialization is pivotal for all adolescents, especially those with social anxiety. This can help them overcome anxiety and develop healthy coping skills.

I once worked with a shy teenage boy who struggled with school refusal due to severe social anxiety. His best friend had recently moved away, leaving him feeling alone. Around the same time, online schooling had become more prevalent and, after deliberation, his parents let him switch to online school.

Without in-person interaction with his classmates, he turned to online gaming for a sense of community and grew to consider the other players as his primary social group. But this increased reliance on this online group for social connection caused him to become increasingly isolated; he later described the experience as having a cult-like influence on his behavior. When he finally broke down and told his parents about his dependence on this group, they were able to help him address this with therapy and behavioral interventions.

If a child is categorically uninterested in spending time talking to others without their devices, offering a reasonable compromise can also help facilitate healthy social behaviors. For example, for every chunk of time an adolescent spends online, an equivalent time (or more) should be spent interacting “off-screen.”

Understand social media’s risks.

Social media content and technology in general are more engaging and ubiquitous than ever before. This will only continue to evolve. In turn, we have an obligation to protect young people from consuming damaging information that negatively impacts their self-esteem—especially as threats to their psychological well-being are steadily growing.

Looking ahead, mental health clinicians need to work closely with parents to take a more hands-on approach in regulating their children’s behavior. Fortunately, the newest generation of parents is much more familiar with social media, giving them a better understanding of its benefits and risks.

With the right education and support, they will be better equipped to set boundaries, encourage healthy online habits, and intervene when necessary to ensure social media use remains balanced and beneficial rather than harmful.

Ellen K. Feldman is a child psychiatrist.