Reprinted from the Winter 2020 Issue of The Ohio Family Physician
By: Tamer Said, MD, Program Director Family Medicine Residency, and Heba Elghalban, MD, Resident, University Hospitals Cleveland Medical Center
Now more than ever, teens are constantly glued to their screens; endlessly receiving beeping, buzzing, and blinking alerts and/or social media notifications. In 2018, a Pew Research center survey1 of 750 teens (13 – 17 years) revealed that approximately 45% are almost constantly online and 75% are using social media such as Facebook, Instagram, Snapchat, and YouTube. For many adolescents, social media can be relatively addictive.2 Data suggests that over 75% of teenagers have a profile on at least one social media application. More than one-half of teenagers are visiting their social network at least once daily. One of four adolescents are described as heavy users, which is defined by CivicScience as people who spend four or more hours a day on social media sites and apps.
Given that there is an increasing number of social media users, it seems worthwhile to evaluate its impact on its users, especially adolescents. As family physicians who care for teenagers, understanding the impact social media use has on these young individuals becomes essential for proper screening and counseling. Teen development and behavior may be affected by information they receive through the different platforms. Social media allows teenagers to create their own online identity, which enables them to build a social network.
In virtual life, it may be easier for them to express their real feelings and talk freely about their thoughts. The networks they create can provide them with valuable support, especially when it comes to those having difficulties with in-person social interactions. In the virtual world, geographic boundaries do not exist, what happens in one corner of the world travels fast to the rest of the globe.
Although we can’t ignore the good face of social media, it is very important to understand that teens’ brains are extremely vulnerable. Sometimes it can be challenging for them to filter inputs appropriately. Additionally, it could be difficult for them to self-regulate the quantity and the quality of their screen time. This creates an opportunity for their caregivers, as well as their family physicians, to work together to counsel and educate these young individuals regarding their emotional and mental health.
It was suggested that excessive social media use should be approached as other addictive behaviors with screening, brief intervention, and referral to treatment.3 A list of mental and emotional problems can be also directly related to excessive social media usage. On top of the list is depression, anxiety, low self-esteem, sleep deprivation, envy/jealousy, sadness, loneliness, dependence, and communication issues or a lack of socialization skills.4
It’s worth updating the framework and incorporating the discussion about social media usage as part of the regular health maintenance visit. Bringing up this topic will not only help physicians stratify the risk of social media on patient health, but it will also raise the patients’ and their caregivers’ awareness of its possible addictive nature.5
In order to address these issues, family physicians should take into consideration that the adolescent period is a critical time with rapid physical and emotional changes. However, it is a relatively physically healthy period in life and most teenagers infrequently visit their family physician compared to young children who need more frequent visits for well-child care and immunizations. Having a teen in for an office visit should promote wise use of the opportunity to reveal any problem that they may be facing, although it can be challenging to gain a teenager’s trust and get them to openly discuss their concerns.
It becomes very important to discuss social media use with teenagers in a non-judgmental way and to acknowledge its valuable existence in their life. We should consider the impacts of social media when changes in teens’ behaviors are observed. The use of social media platforms may be helpful in increasing awareness of the teenage population with some health issues that are relevant to them. As a model of using social media platforms, researchers successfully used Facebook to target teenagers and young adults to increase their awareness about chlamydia infection.6 According to this study, the website analysis showed a 277% increase in the direct entrance on the chlamydia testing kit page and a 41% increase in chlamydia test kit orders, in comparison with the baseline period prior to the intervention.
As family physicians, we are well positioned to observe and address the impacts of social media on teenagers by providing long term care and early counseling. In many instances we have known our young patients since very early in life and have followed their growth through their teen years. As we continue to provide comprehensive care in our practices, we can provide advice regarding the impact of social media on the physical and mental health of our patients.
References available on the OAFP website.