There is little disagreement among researchers, mental health professionals, and policy makers that we have a teen mental health crisis on our hands; however, there is significant debate about the cause. In recent years, a number of prominent voices, including former U.S. surgeon general Vivek Murthy, social psychologist and author Jonathan Haidt, and psychologist and researcher Jean Twenge, have attributed the reason for this emergency to the rise in use of digital technology, especially social media, among children and adolescents, and in Haidt’s case to a simultaneous decline in real-world opportunities for free play in childhood. They have a compelling theory, one that resonates for many of us, as examples of each abound in our lives; our kids’ curated schedules combined with too much screen-based activity, and their many attendant ills, bear little resemblance to the childhoods that some of us remember so fondly. And yet, as appealing as it is to embrace one cause, or a pair of dovetailing causes, the story of how this increase in teen mental illness developed and took hold of a great swath of adolescents is, I believe, far more complex.
In this chapter, I’ll review some of the evidence that links social media and digital technology use to an increase in teen distress and offer you an additional view based in my own research and others’, one that will ring true for many of you: namely, that in many communities across the country and around the globe, it is school and extracurricular demands and achievement pressure that are driving this crisis. I’m not saying that social media and technology aren’t a problem, far from it; I believe that they are, especially when combined with academic pressure. But if we focus only on a single cause, we miss being able to address something that has been hiding in plain sight for years—that we demand way too much of our kids in school and extracurricular activities, and it’s taking a serious toll on them.
Jonathan Haidt’s bestseller The Anxious Generation: How the Great Rewiring of Childhood Is Causing an Epidemic of Mental Illness has drawn tremendous attention to how rampant and pervasive digital technology use is among teens, and even children, and how detrimental it can be to their developing minds. As he points out, it has unbalanced—to say the least—the foundations of childhood and family life. Wherever we look, it seems that we can find groups of kids and young adults, heads buried in their phones, their minds far away from the world around them. Educators struggle to compete with devices to maintain the attention of their students, and parents worry about kids who are lost to online content and exposed to porn, hate, and violence, yet have little understanding of how to pull them back or keep them safe. They sense that so much screen time and the corresponding loss of in-person connection is undermining their children in multiple ways but feel ill equipped to deal with the problem. I agree with much that Haidt has to say and welcome his and others’ expertise on the subject. I believe that some aspects and impacts of screen-based activities and social media are problematic and are very likely contributing to the rise in mental illness in teens. I believe, however, that we are remiss when we fail to acknowledge that for some young folks social media provides a lifeline as they find “their people” in online groups. Many of his policy recommendations make good sense to me, such as banning smartphone use in schools, as does his parenting advice, including creating device-free times, waiting as long as possible before giving your teen a smartphone, and reclaiming family time. I agree with his assertion that free (meaning unsupervised by an adult) play has virtually disappeared from childhood and that this lack of time and space to explore, to practice being in relationship with others, and to enjoy being a kid is having profound negative downstream consequences—social, physical, and intellectual—that carry into adulthood.
However, I do not believe that the use of digital technology by kids, and the world it has been instrumental in shaping for them, is the only driver of our teen mental health crisis, or even the primary driver in some communities. Other important forces are also at play, and we neglect them at our peril. I’ll begin by addressing what I see as the limitations of a position that only focuses on tech and obscures a deeper and more complex understanding of the threats to teens’ mental health—why they often feel so stressed, unworthy, and ill equipped to carry on in their current lives, let alone transition into adult life.
Haidt uses various graphs to illustrate his point, including one that tracks depression rates in girls and boys ages twelve to seventeen from 2004 to 2023. I took that same data, combined the boys and girls, and created the graph below.
The data is from the National Survey on Drug Use and Health (NSDUH), conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA), and reports the percentage of that age group who have suffered at least one major depressive episode in the past year, which is a proxy for depression rate. Before delving into this data, it’s important to state that this rise in depression is not a new trend, as the graph seems to suggest. Teen depression rates were not stable for a long stretch of time prior to a dramatic uptick in 2010. The graph starts in 2004, the year when the NSDUH survey began asking about depression, and Haidt used this dataset for good reason—it is rare to have such high-quality measurements of depression across a twenty-year span. That said, to have a full picture of teen depression and its cause(s), we need to have some idea of what was happening during the years before 2004, and for that we must turn to other data sources and research. While there are not the same high-quality measures stretching over the previous decades, there is strong evidence and general scientific consensus that the mental health of teens and young adults has been in steady decline for years—from long before the widespread adoption of smartphones—and this is supported by multiple studies. One such study, published in 2005, analyzed data from a national survey of outpatient (clinic) visits by kids aged seven to seventeen years. They found that between 1995 and 2002, the number of visits for depression more than doubled, from 1.44 million to 3.22 million.
Researcher Jean Twenge, who in recent years has become a strong proponent of the link between screens and poor mental health, was lead author on two studies that provide evidence that mental illness has been on the increase for decades. The first examined data from studies of teens from 1951 to 2002, utilizing the Minnesota Multiphasic Personality Inventory (MMPI), which includes questions about mental health. Twenge found significant increases in scores on mental illness scales, including depression, and she concluded that adolescent mental illness rose considerably over that time period. A second study by Twenge looked at data from the Monitoring the Future survey from 1982 to 2012, in which nationally representative groups of twelfth graders in the U.S. were asked about physical symptoms that could accompany depression, including sleep issues, trouble with memory, difficulty thinking, and shortness of breath when not exercising. A substantial increase in these symptoms was found across the entire thirty years of the study, and the rise was not limited to the last few years when smartphones made their appearance in teens’ lives. Twenge attributed the mental health decline in young people to several factors—reduced autonomy (lacking the capacity to have choices in life), a rise in extrinsic motivation (being motivated by outside factors like grades and money) and a fall in intrinsic motivation (being motivated by a personal sense of meaning or purpose), a decline in free play that preceded digital technology, and an increasing cultural emphasis on money and status as symbols of success. These are all elements that I’ll return to later in the book.
The evidence indicates that, despite a flat period between 2004 and 2010, depression and other mental illnesses in teens have seen a marked upward trend since the 1950s, not just since the introduction of smartphones and the rise of digital technology in daily life. In other words, the spike in the graph does not tell the whole story. Other factors have been harming teen mental health for decades—and it makes sense to continue to be open-minded to all possible causes.
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