I became aware that there was a problem with teenage mental health around 2016.  My clinics in the Rotunda and to a lesser extent in Temple Street hospital became busier and busier as I began to see stress related gynaecological problems in increasing numbers.

These girls were anxious, depressed, unable in some instances to attend school or sporting/social activities due to social anxiety and depression They had caring parents, and schools in the main were supportive. So, what, I wondered, was the problem.

The penny dropped when my own daughter decided at age 24 to come off social media. She had figured out that social media was bad for her! Of course! Spending time on a mobile phone or other device at any time of the day or night comparing your life/face/body with perfectly edited portraits/stories in carefully curated lifestyles, with little in person contact, is not designed to make you feel good about yourself….  Thankfully my daughter had spent some of her life in a world without social media and was able to see what was going on. What about our iGen people (born1995-2012) who have never experienced a social media free life?


Statistics on adolescent mental health

The figures below come from research in the USA into teen mental health from reputable sources such as the CDC, (centre for disease control, a government agency) and from various reputable and published American psychologists such as Jean Twenge, San Diego university; Jonathan Haidt, Yale university; Donna Jackson Nagazawa Duke University.

  • From 2012 there was a sudden increase in sadness, reduced self-worth, and self-harm in 10–14-year-old girls tripled.
  • Number of teens and young adults with clinical depression more than doubled in the 10 years 2011-2021
  • 25% of teen girls in the USA made a suicide plan in 2021
  • Between 2007 and 2019 there was 17,677 teen deaths by suicide – That’s 9 airline flights a year of 10–24-year-olds!!
  • Suicide rate for teens nearly doubled from 2007 to 2019 and tripled for 10–14-year-olds.
  • By 2016, 80% of teens were on social media so as not to be unusual. Social media use went from optional to mandatory in teens.
  • Depression is occurring earlier in teen girls as young as 12-13 years.
  • Between 2016 and 2020 teen girls were 43% more likely to suffer anxiety than teen boys.
  • In 2021 the CDC in the USA reported a 51% increase in suicide attempts by girls and an increase of 4% in boys.

Irish statistics are not as comprehensive but show a similar trend. The Royal College of Surgeons reported by the age of 13, 1 in 3 young people in Ireland have experienced some type of mental health problem and by the age of 24 that number had increased to 1 in 2. A particular concern is the fact that suicide for young people aged 15-19 years in Ireland represents the 4th highest in the EU.


History of social media

Most people owned smart phones by 2012 allowing unlimited access to the internet. Latest information from the communications regulator in the UK, Ofcom, show that 20% of children have a smart phone at age 3 and this rises to 55% between the ages of 8 and 11.

In 2009 Facebook (now meta) added the ‘like’ button.

Social media use increased dramatically in teens in 2012, and by 2016, 80% of teenagers were using social media.

Instagram became the main platform for young people as young as 8 even though the age limit for use is 13. Instagram was taken over by Facebook and the like button appeared on Instagram in 2012.

A new Pew research centre survey of American teens aged 13-17 years finds TikTok had increased in popularity with 67% of teens using it regularly while snapchat is used regularly by 40% of teens. The most common online platform used by teens in 2022 was You Tube used by a staggering 95% of teens.


Effects of social media on adolescents

The effects of social media have been recognised by health care professionals, teachers, parents and anyone who deals with children and teenagers. However, the people who know the most are the executives who work in social media as they have many years of research in this area. After all the user is the commodity and the vehicle to making money.

The following is an excerpt taken from the excellent book Girls on the Brink by Donna Jackson Nagazawa published in 2022:

“In September 2021, The Wall Street Journal ran a now-famous series called the Facebook Files, which exposed internal documents showing that Facebook (recently renamed Meta, which owns Instagram) has known for years that Instagram can be toxic to girls’ mental health. In one internal report, Facebook’s own researchers warned executives that among girls who felt bad about their bodies, 32 percent said “Instagram made them feel worse.” “We make body issues worse for 1 in 3 teen girls”, researchers concluded. Forty percent of teens said feelings of being “unattractive” began when they started using Instagram. About a quarter of teens who reported feeling “not good enough” said that feeling, too, began on Instagram. Many felt the app had undermined their confidence in their friendships. Other data shows that most children start using social media apps between ages eight and thirteen—even though users are supposed to be at least thirteen to have an account. Teens regularly reported wanting to spend less time on Instagram, but they also reported lacking the self-control to do so. Other controlled studies—which compare girls who frequent social media to those who don’t—paint a clearer picture: the more time a teenage girl spends on social media platforms, the more likely she is to develop depressive symptoms, poor body image, and lower self-esteem, and this association between social media use and depression is far more significant for girls than for boys.”

Increased use of phones, social media and busy after school activities have led to less time spent with friends after school just hanging out. Evidence shows that unstructured time spent with friends is important in developing relationships and confidence especially in young girls. In the past 15-20 years the way we raise our children has changed. Gone are the carefree hours where girls got to play in a carefree manner with their friends, learning safe social bonding and emotionally maturing while enjoying the protection of their family and community.  Now many of our girls after school activities consist mainly of performance based, competitive activities where a person’s value is judged according to achievement.  This has led to an increase in perfectionism, with increased rates of anxiety and loss of self-worth in our young girls.

We all know how important sleep is for everyone, but in adolescence it’s even more crucial for cognitive, psychological, and physical development. New neuronal circuitry is laid down especially in early puberty, facilitating the ability to think in a less concrete, more conceptual manner, problem solve and (eventually!) plan…

Unsupervised use of phones at home in the bedroom allows notifications to be received throughout the night, reducing duration and quality of sleep.  Having constant access to devices leaves our children open to the outside world even while in their beds at night. Remember when you came home from school, closed the door in your house and felt safe? School, friends, and the outside world were outside! Today there is no ‘Safe Space’ for our children unless we control access to devices.

Adequate sleep both in terms of quality and quantity are essential in promoting growth hormone, essential for promoting cartilage, bone and soft tissue development in puberty and one of the primary regulators of blood glucose levels in adults and children.


What can we adults and parents do?

Limit access to mobile phones/devices/social media until the adolescent brain can cope and discriminate.

Delay the age at which a smart phone is purchased for a child. A simple phone which allows texts and calls can go a long way. The entire parent population of Greystones in Wicklow agreed not to buy smart phones for their children until they got into secondary school. This wonderful project was reported in the Guardian in the UK and plans are being made to extend the project. Amazing what a group of like-minded individuals can achieve in the community!

France, Italy, Holland, and Finland have banned phones in the classroom.

Government legislation needs to be introduced to prevent the sale of smartphones to children under a specified age. This will support the efforts of parents and teachers.

Psychologists such as Jean Twenge who has extensive research in the area recommends that we increase the age of access to social media to 16 years! Access to social media in Utah in the US requires parental consent, age verification and young people under 18 have limited access between 10.30 -18.30!!

Increased accountability for tech companies is long overdue, not only in setting a verifiable age limit, but also in terms of privacy and content. We need a concerted effort from international agencies to bring pressure to bear in this area.

The increase in Mental health problems in our young people is concerning. Knowing what is happening, staying up to date with the platforms and content your daughter is consuming is key. However, there are glimmers of hope, such as the Greystones project. Being an agent for change can be as local as starting in your own house with for example removing electronic devices from the bedrooms, all the bedrooms!!! Alarm clocks are still available for purchase…

Pervasive negativity and pessimism are contagious, but so is positivity! There is scientific evidence now to show that the presence of mirror neurons in our frontal cortices allow us to perceive and mirror the emotions we take in. We are all connected, influencing each other in good and not so good ways. The stories we tell ourselves and others have a significant effect on all aspects of our lives; we need to ensure our teens are not receiving  toxic messages on the internet.

We can control the information we take in through our senses from our environment, our peers and our devices which all have an impact on our mental health. By choosing our inputs wisely we will improve our own wellbeing, and which can be an influence for good in our families and local communities.

Finally, I love how Lisa Damour, clinical psychologist, sums up good mental health.  She says that good mental health does not mean being happy all the time! It refers instead to having appropriate emotional responses to everyday stresses and the wherewithal to deal with them.

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  • The adolescent brain is wired to be hypervigilant: Melanie A. Gold and Ronald E. Dahl, “Using Motivational Interviewing to Facilitate Healthier Sleep-Related Behaviours in Adolescents,” in Behavioural Treatments for Sleep Disorders, eds. Michael Perlis, Mark Aolia, and Brett Kuhn(Amsterdam: Academic Press, 2011), chap. 38, pp. 367–80.
  • Rates of perfectionism have increased in children: T. Curran and A. P.Hill, “Perfectionism Is Increasing Over Time: A Meta-analysis of Birth Cohort Differences from 1989 to 2016,” Psychological Bulletin 145, no. 4 (April 2019): 410–29.
  • Girls on the Brink a book by Donna Jackson Nagazawa, publisher Harmony Books NY 2022.
  • iGen a book by Jean M Twenge publisher Atria Books 2017.