Verified by 
This blog post was co-authored by Charlotte Blease, Ph.D., Keane Scholar at OpenNotes, Beth Israel Deaconess Medical Center/Harvard Medical School.
A patient, let’s call her Ms. S*, asks an interesting question during a doctor’s office visit: “Do you think I should quit social media to make my depression better?”
Ms. S and I explore the quantity and quality of her online interactions and agree to a plan for her to track her symptoms in relation to her social media use. The next time we met, she shows me her data and says she has already deleted her Snapchat and Instagram accounts, seeing something in her own data that worried her. She has been spending more time online than she wants to and feels that her mood is worse after spending more time on social media.
Is such an experience generalizable to others? And what does it mean in light of news about mental health responses from Instagram last year and now Snapchat this month?
Snapchat's new feature, called “Here For You,” will direct users “who may be experiencing a mental health or emotional crisis” to curated resources and content. So perhaps if Ms. S searched for “depression” she would now see a small video about mental health help or link to local resources. We don’t yet know as the feature has not been fully deployed at the time of this writing. On the surface, this appears to be positive, as mental health help is being offered to people at potentially the right time.
But exploring the value of “Here For You” requires us to look much more closely at the relationship between mental health and social media. It is no secret that parents, clinicians, and many users themselves have begun to raise concerns about social media negatively impacting their mental health and well-being. The 2018 New York Times headline “A Dark Consensus About Screens and Kids Begins to Emerge in Silicon Valley” portended growing fears that have only expanded since.
Yet the clinical and medical research is inconclusive, in part reflecting the challenges of establishing a causal link between social media use and harm. Perhaps the most cautious guidance is to take a ‘goldilocks’ approach—there may be a ‘just right’ amount of social media that is not too little or too much. But defining ‘just right’ is not easy: quality of social media use may sometimes matter more than quantity. So, determining the right time to offer mental health messages is complex, and whatever algorithm Snapchat may be running to tailor messages for people like Ms. S is not necessarily optimized to the task yet.
Taking a step back from the question of the right time to intervene online, we can try to ask what is happening with social media use that may impact mental health instead of simply when we should intervene. Led by Joseph Firth, our team published a paper in World Psychiatry in June 2019 that noted how screen time can impact attention, memory, and social cognition in youth.
We cannot yet determine how screen time exposure changes the brain or whether these changes lead to more negative mental health outcomes—but if they do, then the solution is not popping up mental health messages on social media but rather limiting exposure. Further, the mental health benefit (if any) of such online messages itself remains unclear today. Others have proposed the deficit hypothesis related to social media and mental health, suggesting that more time on social media may be a reflection of less sleep, fewer real-world social interactions, and less time engaging in other pro-mental health activities.
Of course, these ideas need to be balanced against the possibility that social media is helping some people and allowing them to form healthy and meaningful connections and support systems.
Social media companies like Snapchat, Instagram, and Pinterest may be rushing to offer mental health support to respond to public fears. Offering solutions like Snapchat’s “Here For You” suggests the company is rejecting the deficit hypothesis—that time on social may impact mental health. They could be right. They could also be wrong, and the lack of supporting evidence for their decisions to roll out these features should raise a red flag. We should expect them to soon share more with the public and researchers and professionals working in the medical community.
What would Snapchat’s “Here For You” feature do for someone who believes that social media is harming her mental health? Spending more time with friends offline may be the solution for some. Would messages about mental health and links to local resources give someone a false sense of security about spending time online? We don’t know. But we do know the scope of the challenge and can agree on a need for more knowledge created by greater transparency from social media companies about why they are offering these new services.
*Ms. S is a fictional person drawn from broad experiences seen by both authors in the last several years.
*The views expressed by Drs. Torous and Blease are personal and do not reflect those of Beth Israel Deaconess Medical Center or Harvard Medical School.
