Summary: A University of Cambridge study finds that adolescents with diagnosed mental health conditions report different, and often more negative, experiences on social media than their peers. Young people with internalising conditions such as anxiety and depression are more likely to compare themselves with others, struggle to control their time online, and experience mood changes linked to likes and comments.
On average, adolescents with any mental health condition reported spending roughly 50 minutes more per day on social media than those without a diagnosis. While this research does not establish cause and effect, the patterns suggest social media can amplify emotional vulnerability for some young people and point to the need for targeted guidance and support.
Key facts
- More time online: Adolescents with a mental health condition reported about 50 minutes more social media use per day on average.
- Internalising conditions most affected: Young people with anxiety, depression or related internalising disorders reported higher rates of social comparison, mood reactivity to feedback, and lower self-control online.
- Social risks: Those with mental health conditions were less satisfied with the number of online friends and more emotionally affected by social feedback than peers without diagnoses.
Source: University of Cambridge
Overview
This study examined nationally representative survey data from 3,340 UK adolescents aged 11–19 collected in 2017 as part of NHS Digital’s Mental Health of Children and Young People Survey (MHCYP). Unlike many previous studies that rely solely on self-report screening questionnaires, the Cambridge team used multi-informant clinical assessments carried out by trained clinical raters, sometimes supplemented with parent and teacher interviews. That clinical rigour makes these findings especially valuable for understanding how social media use varies by mental health profile.
The study found consistent differences in how adolescents with mental health conditions experience social media. Across all diagnostic groups, young people with any condition reported greater dissatisfaction with friend counts and higher overall time spent online. Differences were strongest for adolescents with internalising conditions—such as anxiety, depression and PTSD—who reported more frequent social comparison, stronger mood responses to likes and comments, and reduced honest emotional self-disclosure online.
For example, nearly half (about 48%) of adolescents with internalising conditions agreed that they compare themselves to others on social media, compared with roughly 24% of adolescents without a mental health condition. Around 28% of young people with internalising conditions reported mood changes tied to social media feedback, versus about 13% of those without a condition. They also reported more difficulty limiting time online and were less likely to be open about how they felt when using platforms.
By contrast, adolescents with externalising conditions (for example ADHD or conduct disorders) differed from peers mainly in reported time spent on social media, with fewer additional differences captured in the survey measures used.
Study lead author Luisa Fassi and senior author Dr Amy Orben note the research does not prove that social media causes mental health conditions. Rather, the results show that adolescents with clinical-level difficulties engage with social media differently. These differences could stem from how symptoms shape online behaviour, from online environments worsening symptoms, or a complex mix of both. The study highlights the need for more research using objective digital data and experimental designs to identify mechanisms and develop effective interventions.
The researchers set rigorous comparison thresholds, treating only effects comparable in size to established differences in sleep and physical activity as notable. Social media measures in this analysis came from participant questionnaires and did not identify specific platforms. The authors caution that perceived time online may differ from objectively measured use, so follow-up studies with direct platform data are needed.
Implications
These findings underline the importance of recognising diverse mental health profiles in clinical practice and policy related to young people’s online lives. Clinicians, educators and caregivers should be aware that adolescents with anxiety, depression or related conditions may be especially susceptible to harmful social comparison and mood reactivity on social media, and that support tailored to different diagnostic groups may be beneficial.
Notes
*Participants rated their social media use on a nine-point scale for a typical school day and a typical weekend or holiday day, from under 30 minutes to over seven hours. Adolescents with any mental health condition averaged a response roughly equivalent to “three to four hours,” while those without a condition averaged between “one to two” and “two to three hours.”
**The sample is nationally representative of 11–19-year-olds in the UK. Only participants who provided social media use responses were included (approximately equal numbers of males and females).
***Mental health assessments were clinician-rated and, in some cases, supplemented by parent or teacher reports—an advance over many studies that rely solely on self-report screening tools.
****Social media use measures were self-reported. The authors recommend future work combining experimental methods with objective platform data to clarify whether and how social media contributes to mental health outcomes.
About this mental health research news
Author: Fred Lewsey
Source: University of Cambridge
Contact: Fred Lewsey, University of Cambridge
Image credit: Neuroscience News
Original research: Open access. Title: “Social media use in adolescents with and without mental health conditions” by Luisa Fassi et al., published in Nature Mental Health.
Abstract
Social media use in adolescents with and without mental health conditions
Concerns about links between social media and adolescent mental health are increasing, yet few studies examine young people with clinical-level mental health symptoms. Using a nationally representative UK sample (N = 3,340, ages 11–19) that combines diagnostic clinical assessments with quantitative and qualitative measures of social media use, the study found that adolescents with mental health conditions report spending more time on social media and are less satisfied with the number of online friends than peers without conditions.
Differences were most pronounced for internalising conditions: these adolescents reported more social comparison, greater mood impact from social feedback, lower satisfaction with friend counts, and less honest emotional disclosure online. Adolescents with externalising conditions primarily reported higher time spent on social media. The results highlight the need for policy and clinical approaches that account for diverse mental health profiles when addressing young people’s online experiences.