More often than not the whole digital world of smartphone usage and social media interaction, particularly amongst young people, can be viewed within the broad health field largely from a negative bias. Smartphone usage and social media engagement is almost considered as bad for mental health as sugar can be on the impacts for physical health. Simon Stevens, the chief executive of NHS England, has recently called on social media companies to do much more to limit the amount of time young people spend using their platforms and has even called for a special tax for the tech companies to pay for treatment services.
A new phenomenon called ‘Snapchat dysmorphia’ has also appeared more recently shining even more light on the negative consequences of social media. The term was coined by Dr Tijion Esho, a cosmetic doctor based in London (yes, him from Channel 4/E4’s cosmetic doctor in residence on hit show Body Fixers). The term is intended to help explain where patients are seeking out surgery to help them appear like the filtered versions of themselves.
Can we say there is actual evidence to support such a contention that social media causes mental health problems?
Professional researchers such as Professor Andrew Przybylski, Director of Research, Oxford Internet Institute, would say,no, that there is not any actual evidence to say that social media apps actually cause mental health illnesses. Some studies would point to correlational factors, for sure, but that there is insufficient data to demonstrate hard evidence of strong casual data. It was very informative hearing his evidence to the House of Commons Technology Committee into the impact of screen time on young people.
When researchers refer to a correlation between social media use and something like mental health well-being, it does not necessarily mean that A causes B or that B causes A. In many cases, A and B are actually both caused by X. There might be factors such as being male or female, socioeconomic status, educational attainment of parents and geographic location, such as whether or not kids can get out to play. When those factors systematically vary or are fixed over time, we see that as predictive of both lots of screen time and, maybe, more mental health deficits.
Recent research by University College London (UCL) claimed to show a correlation between use of social and depression and that teenage girls are twice as likely to show depressive symptoms linked to social media than their male counterparts, The UCL research, based on data from almost 11,000 young people, appears to add to a growing amount of information about links between social media and mental health. It found that 12 per cent of light social media users and 38 per cent of heavy social media users, defined as those who use it for five or more hours a day, showed signs of having more severe depression. But we need to be careful about causation with studies such as these. Who is to say that the participants were not already depressed? There are no longitudinal studies that have investigated the use of social media addiction and problematic social media use, particularly among teenagers and emerging adults.
To answer my own questions at the start of this post I would say the problem of emotional regulation resides ultimately with the individual rather than with the technology per se. It is the interaction with the technology rather than the apps themselves that might be causing the problems. That said, there are many groups, especially young female girls, who are particularly susceptible to the boosts to self-esteem that are on offer from the social approval strokes (such as the dopamine drip of ‘likes’ and new followers). Young females are more vulnerable given that they are often socialised to outsource their self-esteem to others and are, therefore, generally more tempted by the attraction of social media apps and filtered images. Boys are more likely to be attracted by gaming, gambling and porn.
Some social media apps can be especially harmful for teens and especially those with BDD, and social media tech companies could be more pro-active with warnings to users on their platforms as well as displaying support advice to those who might appear to be in trouble. There has to be a balance drawn, however, surrounding privacy as users do not wish to be spied upon when using social media. Who wants to feel monitored when searching and receiving targetted banner messages? It is also important that the providers of cosmetic surgery understand the implications of social media on body image to better treat and counsel their patients. An ethical practice would robustly assess the reasons someone is wanting corrective surgery before agreeing to go ahead with any procedures. Additionally, BDD awareness needs to be added to GP training to better identify the condition on initial presentation.
So, whats the technical diagnostic stuff about BDD? The disorder has been classified as part of the obsessive-compulsive spectrum in the Diagnostic Statistical Manual (DSM), the psychiatric bible used by psychiatrists in order to make a diagnosis, currently in its fifth iteration (this is why it is often referred to as DSM5, or DSM-V if using Roman numerals). BDD is characterised by the obsessive idea that some aspect of one’s own body part or appearance is severely flawed and warrants exceptional measures to hide or fix their dysmorphic part on their person. In spite of greater awareness about BDD it is commonly misdiagnosed as social anxiety disorder, obsessive-compulsive disorder, major depressive disorder, or social phobia.
For more information on accessing support services for symptoms of BDD see my article on accessing help
Noel Bell is a UKCP Psychotherapist based in London. He can be contacted on 07852407140 or noel@noelbell.net
