It May Be Life or Death: A Public Advisory on Social Media

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PSYCHIATRIC VIEWS ON THE DAILY NEWS

“I think social media is going to be our generation’s cigarettes.” - anonymous party guest

As one of our editors expeditiously covered on Tuesday in the article “US Surgeon General Issues Advisory on Impact of Social Media on Youth Mental Health,” the United States Surgeon General, Vivek Murthy, is at it again. After his striking call-out on our loneliness epidemic, which I covered in the column “Mayday! Mayday! We’re Lonely” on May 2, he just issued a public advisory on the mental health risks of social media for our youth. Despite some benefits of social media, he urges urgent action for its risks:

“. . . there are ample indicators that social media can also have a profound risk of harm to the mental health and well-being of children and adolescents.”

Of course, loneliness is also one of the contributing causes, as many teens are felling lonelier after a socially isolating pandemic, along with the increasing social media replacement of in-person interactions. Earlier puberty in both girls and boys is another factor, as it causes them to be more sensitive due to brain changes in the amygdala and the prefrontal cortex. Cyberbullying is particularly dangerous.

Black teens are being particularly affected. Over 2 decades, their suicide attempts have increased by 73% versus 18% of their white peers, per the New York Times article: “It’s Life or Death: The Mental Health Crisis Among U.S. Teens.”¹

So far, parents have had the main responsibility to address what has often become an addiction. Addictions are hard to treat in general, especially when the temptations are all around and, in this case, almost a requirement for social interaction among all ages. It can include us in the helping professions. That means that we in psychiatry, and especially our addiction experts like the current APA President, Petros Levounis, need to contribute to both prevention and intervention strategies. That is part of the ethical responsibilities of psychiatrists, as stated in Section 7 of our “Principles of Medical Ethics with Annotations Especially Applicable to Psychiatry, 2013 Edition”:

“A physician should recognize a responsibility to participate in activities contributing to the improvement of the community and the betterment of public health.”

Such call-outs by our Surgeon Generals have often proven to be beyond rhetoric. They have been associated with a variety of crucial public health and mental health improvements in such problems as: the deadly consequences of cigarettes and tobacco; the health dangers of AIDS; and, along with MADD (Mothers Against Drunk Driving), the risks of mixing alcohol intake and driving.

The challenge, as always, has been to keep whatever health and mental health benefits there are, while limiting the risks. There are no benefits with AIDS, and it would be hard-pressed to embrace one with tobacco, but there are obvious ones with driving. For social media, benefits include connections, especially those which could not be made in other ways and, if accurate, access to more information. The amount of passive time online seems to be correlated with the harms.

With these new mental health concerns by our current Surgeon General, who is not a psychiatrist, I am thinking that my prior calls for a psychiatrist Surgeon General are not needed right now.

Dr Moffic is an award-winning psychiatrist who has specialized in the cultural and ethical aspects of psychiatry. A prolific writer and speaker, he received the one-time designation of Hero of Public Psychiatry from the Assembly of the American Psychiatric Association in 2002. He is an advocate for mental health issues related to climate instability, burnout, Islamophobia, and anti-Semitism for a better world. He serves on the Editorial Board of Psychiatric Times.

Reference

1. Richtel M. ‘It’s life or death’: the mental health crisis among U.S. teens. The New York Times. April 24, 2022. Accessed May 25, 2023. https://www.nytimes.com/2022/04/23/health/mental-health-crisis-teens.html