Teens, Phones and Mental Health

For most teens, a phone is where friendships, school chats, music, news and jokes all live. That is not all bad. Online spaces can help teens stay close to friends, find people who share their interests, and get support when they feel alone. But phones and social media can also crowd out sleep, feed comparison, and expose teens to content and people that hurt. The goal for parents is not to ban phones, but to help teens use them in ways that support their mental health.

How social media can affect teens

Each teen responds differently, and the same app can lift one teen up and drag another down. Some of the main concerns:

• Comparison and body image. Feeds full of edited, filtered photos can make teens feel their bodies, faces or lives fall short. Some teens are pushed toward extreme dieting or exercise content, which can raise the risk of eating disorders.
• Endless scrolling. Apps are designed to keep people on them. Teens may lose hours without meaning to, and may feel restless or low when they put the phone down.
• Harmful content. Algorithms can serve up videos about self-harm, risky challenges or hate, even when teens did not search for them.
• Cyberbullying and drama. Hurtful comments, group chats that leave someone out, and shared screenshots follow teens home and into the night.
• Pressure and exploitation. Some teens are pressured to send private photos, and some are then threatened or blackmailed. Teens need to know they can tell you without being punished.

Sleep is a big piece

Teens need more sleep than many get. Phones in the bedroom make it worse: late-night texts, notifications, and the pull of one more video. Screen light and stimulating content can also make it harder to fall asleep. Too little sleep is linked to low mood, irritability, trouble focusing and more risk-taking. One of the simplest changes a family can make is to charge all phones, including parents' phones, outside the bedrooms overnight.

Make a family media plan

The American Academy of Pediatrics suggests a family media plan, a set of household rules you create together. The AAP's free Family Media Plan tool walks you through it. Ideas to include:

• Phone-free times, such as meals, car rides and the hour before bed
• Phone-free places, such as bedrooms overnight
• Which apps are okay, and at what age
• Privacy settings, location sharing and who can message your teen
• Turning off notifications that are not needed, especially at night
• What to do if they see something upsetting or someone asks for photos
• Time for homework, sleep, exercise, chores and face-to-face friends first

Involve your teen. Rules they help write are rules they are more likely to follow. And parents should follow the plan too, since teens notice when we are glued to our own phones.

How to talk about it

Teens shut down fast when talks feel like lectures. Try being curious instead:

• "Show me what is fun on your feed right now."
• "How do you usually feel after scrolling for a while?"
• "Have you seen anything online that bothered you?"
• "Is there anyone online who makes you uncomfortable?"

Talk about how photos are edited and how apps decide what to show. Help your teen curate their feed by unfollowing accounts that make them feel bad and following ones that make them laugh, learn or feel supported. Let them know that if something goes wrong online, you will help them fix it first and deal with rule-breaking later. The AAP's Center of Excellence on Social Media and Youth Mental Health has more resources for families.

Warning signs to watch

Moodiness is part of the teen years. But talk with your teen, and with your pediatrician, if you notice:

• Sadness, irritability or anger that lasts most days for two weeks or more
• Pulling away from family and friends, or quitting activities they used to love
• Big changes in sleep or eating, or new worries about weight and body shape
• Falling grades or skipping school
• Panic or distress when they cannot get to their phone
• Secrecy about who they are talking to, or new gifts or money from unknown sources
• Talk of hopelessness, self-harm, or not wanting to be alive

You can read more about teen mental health on MedlinePlus.

If your teen is in crisis

If your teen talks about suicide or self-harm, stay with them and get help right away. Call or text 988, the Suicide and Crisis Lifeline, which is free and open around the clock. Teens can text 988 themselves too, so make sure they know the number. If there is immediate danger, call 911. Lock up medicines and firearms.

When to call us

Call your A thru Z Pediatrics office if you see warning signs like lasting sadness, withdrawal, sleep or eating changes, or falling grades, or if phone use is causing constant conflict at home. Your pediatrician can screen for depression and anxiety and help you find support.

Call 911 or go to the ER if your teen is in immediate danger or has harmed themselves. Call or text 988 for a mental health crisis.

To talk with your pediatrician, request a visit.