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Social Media: The Good, The Bad, And What Do We Tell Our Teens

While recent studies suggest prolonged social media use can lead to anxiety and depression among teens, other studies show these platforms can have a positive effect on personal creative expression, peer connection and digital literacy. The pros and cons of social media usage are significant, so what do we tell our teens?

Dr. Mary Fournier joins the show to weigh the good and the bad when it comes to social media use among teens.
Social Media: The Good, The Bad, And What Do We Tell Our Teens
Featured Speaker:
Mary Fournier, MD
Mary Fournier, MD is a Washington University adolescent medicine physician at St. Louis Children's Hospital. 

Learn more about Mary Fournier, MD

Melanie Cole, MS (Host):   The pros and cons of social media usage in our teens are significant. So what do we tell them? This is Radio Rounds with St. Louis Children’s Hospital. I'm Melanie Cole and today we’re discussing social media. The good, the bad, and what do we tell our teens? Joining me is Dr. Mary Fournier. She’s a Washington University adolescent medicine physician at St. Louis Children’s Hospital. Dr. Fournier, thank you for joining us. What a great topic. Today’s children they grow up immersed in digital media, which can have both positive and negative effects on healthy development. What’s happening with our kids in this digital world? Do you feel that it’s making them smarter, more worldly? Is it positive? What do you think of it?

Mary Fournier, MD (Guest):   Well, I think just like almost everything else in life there are good things and bad things about social media. I think social media has become ubiquitous among not just teenagers but adults and pretty much everybody at this point. There are definitely reasons why we use it. I think particularly for teens it can help in a variety of ways. When you actually ask them in surveys what they like about social media or what they get from it, they talk a lot about the social aspect. They talk about being able to kind of maintain their friendships. Most of teenagers are on social media and they don’t have just real life friends anymore. They have online friends. A lot of times their social life has moved from being in real life. Not going out as much, not talking out as much but on social media. So they are reporting feeling more connected to their friends, developing some friendships, and also being able to maintain them even across distances. So that’s, I think, a good thing. Other positive things—Like I said, it’s everywhere. It’s not going away. The online community and just digital technology in general is something that teens have to learn to use efficiently and effectively. The more you use it, the better you are at it. So there are some skills that teens can develop by using social media and can hopefully transfer them as they move forward into different careers. There’s, I think, a variety of things that they get from social media but certainly there’s some positive.

Host:    So for other providers and pediatricians that are helping their teens at their well visits and talking with the parents, can teens become addicted to a smart phone? Tell us as an adolescent medicine physician, what do you see as the impact of too much social media on these teens. Are you seeing mental issues going on? Are you seeing more depression or addiction type behaviors?

Dr. Fournier:   Addiction, I think that information is still coming. Certainly there are some programs around the country who are starting to offer treatment for things like video game addiction and so forth, but really I think that is a very newer piece of care. There’s a lot of concern about how social media effects teen’s mental health. So we know very clearly about the increased prevalence of depression, of anxiety, of suicidal thoughts among our adolescents today as opposed to 20 or 30 years ago. There have been some suggestions that the excessive amount of screen time or the excessive amount of social media has contributed to this. I think the data right now is not clear if there is a direct association between increased social media use and decreased mental health concerns. We know that most cross functional studies that have looked at this are seeing an association between increased screen time and increased social media use and increased depression and anxiety, but there’s not a lot of data out there that is continuing to see that association when you look at a person’s own social media use across timelines. If you're using more social media, do you increase your risk of depression in individual. That data’s not there yet.

What we do know is that increased social media use does effect sleep in a variety of ways. Whether it’s strictly displacing sleeping time by them spending hours online or if they're getting woken up throughout the night because their phone is right there and they're getting alerts and their screen’s turning on and that’s disrupting their sleep. So we have very clear evidence that social media and increased sleep time is directly effecting sleep quality. We know that the poorer sleep quality is the more likely anxiety and depression are going to be in there. So it is, again, unclear right now if the increased depression and anxiety is associated with increased social media use, but we think it’s mediated at least by this sleep issue. So there are definitely some concerns to talk about with the mental health and social media use.  

Host:   Well, and I think along those lines time management becomes a problem when kids are so immersed in this social media. As a result, are they not practicing healthy behaviors? You're talking a little bit about sleep and depression and mental health issues, but then there’s the lack of exercise because they're sitting there staring at their phones or they can't time manage. Or they realize they have homework and it’s already 11:00 at night, they’ve been sitting on their phone. I'm not talking from personal experience here. So do you feel that some of the health behaviors are starting to suffer as well? Exercise, healthy eating, time management, all of these things. How can the pediatrician help with this?

Dr. Fournier:   I think you're definitely onto something. People talk about kids being so busy these days. They're not really. If you look at the amount of times kids spend on homework and extracurricular and sports and exercise, that really hasn’t changed. But they do have all this extra time that they're spending online and that pushes other sort of important things in their life away. So they're going to be sitting on their phone and not necessarily out taking a run. As far as time management goes, the one thing that’s really unique, I think, about teenagers today as opposed to people who did not kind of grow up in this digital age. Their attention span and the fact that they're not really just doing one thing. You mentioned homework. There's studies that looked at when kids are on their computer doing homework, like how much time are they actually spending doing their homework? What else are they doing? They're constantly multitasking with other digital environments, digital media. So they might have Instagram up. They might have their paper that they're researching up. They might have some websites that they're using to help write their paper. They might have Tik Tok or Netflix or something else. They're just constantly going back and forth between these screens. So I think time management, in that regard, is certainly very different than in previous generations. I don’t know if it’s good, if it’s bad, but we certainly know it just is at this point. So it’s something to just recognize that teens are certainly understanding, or their attention is very different than previous generations.

So I think how that translates to parents or providers or teachers is that we have to recognize we can't spend time and lecture teens. We really have to have this interactive experience. When we’re trying to educate—I do health education with my patients. I tend to use little snippets now and also use other things. I bring in websites and I kind of recommend they look at different apps to help with health information because that’s what they're used to. They're not just going to necessarily take my little spiel for granted. They kind of want to see what else is out there.

Host:   Well, I appreciate that you also brought up screen time in school because even the AAP has recognized that now screen time has changed. When it used to be television or movies, whatever, now they need some of that screen time for their homework. They're on there. As you said, they may not be doing what they're supposed to be doing, but they do need it for their homework. Do you have any resources for providers so they can direct their patients to help make some of these decisions because these can be tough decisions for parents?

Dr. Fournier:   It is. Also, I think, parents are sometimes struggling because if somebody is on their computer doing homework it’s a little bit challenging to figure out, again, because they're multitasking and flipping between sites or screens. They're on their homework. How much are they doing? How much are they social media or facetiming or whatever with their friends? That can be a little bit challenging for parents to put limits. I think open communication for families with their kids, having expectations, modelling good behavior with digital media and social media in general I think is very important. As far as going back to the screen time, it’s difficult to include time spent on work or classes in the screen time, but I think outside of that that recommendation of a two hour limit of extra screen time whether it is their phone or computer or tablet or TV or whatever, I think that’s just a good time limit. It allows for other activities like family meals and appropriate bedtimes and social activities with their friends outside of the digital world. So I still use that classic two hours of screen time outside of homework as a recommendation and a guideline for my families.

Host:   As we wrap up, what else would pediatricians and other healthcare providers want to know about this topic? When you're counselling your patients, what would you like other providers to know about working with their teens and the parents to develop that communication? Helping them through this whole crazy digital world.

Dr. Fournier:   Well, I think the communication and the discussion starts very young. We know that seven, eight, nine-year-olds now have smart phones. That number’s growing every year. So it has to start right at the very beginning, the first time they get a phone having parents set very clear guidelines and expectations about what the family’s beliefs and values are around phone use. Then enforcing them just like they would any other rule or guideline with consequences that are clearly set out ahead of time and follow through. So if they need to lose their phone or take away social media for a while, that is reasonable. I also recommend—and this is maybe unpopular—I usually do recommend that parent’s friend their kids on these social media sites and encourage their teens to accept other family members so they're not just hiding what they're doing. It’s a little bit more out in the open. That, I think, is at least one way to stay connected online.

I think the final thing is to encourage activities outside of social media. It’s very easy to get lost in it, to get to spend so much time. Everybody, including teenagers, enjoy actually putting down their phones and interacting in real life with their friends and family. So just prioritizing that and encouraging that to happen a little bit every day, a little bit every week so that they are able to maintain those social connections outside of the digital world.

Host:   Well, it is great advice, Dr. Fournier. Thank you so much for joining us again and sharing your expertise and helping us to understand what our teens are going through. Thank you, again. That concludes this episode of Radio Rounds with St. Louis Children’s Hospital. For resources available at St. Louis Children’s Hospital, please call the children’s direct physician access line at 1-800-678-HELP. To learn more about this and other healthcare topics at St. Louis Children’s Hospital, please visit for more information and to get connected with one of our providers. Please remember to subscribe, rate, and review this podcast and all the other St. Louis Children’s Hospital podcasts. I'm Melanie Cole.