Intricate screen-time trackers have made it possible to know exactly how many hours, minutes, and seconds you use social media each day. If all the time you spend liking, scrolling, and sharing happens to reach certain thresholds, new research from a team of psychiatrists suggests that it can affect mental health even when you’re logged off.

A paper published Wednesday in JAMA Psychiatry shows evidence that for teenagers, using social media for more than 30 minutes a day was linked to increased mental health risks. But the most powerful effects were seen in teens who used social media for more than 3 hours per day. Teenagers in this study who immersed themselves in social media for 3 hours or more each day had a 60 percent higher risk of mental health problems compared to teens who didn’t use social media. Those who spent 6 or more hours more increased their risk by 78 percent.

Three hours of social media use per day may seem like a lot, but it’s not so farfetched. In one sample of 1,125 teens in this study, 30.7 percent reported using between 30 minutes and 3 hours of social media each day, and 12.3 percent reported using between 3 and 6 hours each day.

The study’s authors warn that this 3 hour cutoff may not be an iron-clad rule, but the bigger picture is that that much social media use appears to take a toll in a very specific way: It affects the way teenagers process their stresses, anxieties, and problems.

Three or more hours of use in particular was associated with a specific type of behavior called internalizing. Internalization is like a negative internal dialogue that causes someone to withdraw emotionally, and it’s often linked to depression, anxiety, or loneliness.

Teens who spent more than 3 hours on social media are at higher risk for mental health issues. Flickr / sc.lover

The opposite of internalization is externalization is when someone acts out, sometimes aggressively, in response to a problem. In the study, social media use was associated somewhat with externalization, but it was more powerfully linked to internalizing behavior in the long term and after adjusting for other factors.

Kira Riehm, the study’s lead author and a Ph.D. candidate at Johns Hopkins Bloomberg School of Public Health, tells Inverse there are three leading ideas that explain why social media may be connected with internalizing behavior:

“This pattern of findings may be explained by a number of potential mechanisms, including exposure to cyberbullying, poor quality sleep, or exposure to idealized self-presentations, which have been found in other studies to be associated with depressive and anxiety symptoms,” she explains.

These three ideas come from very different places, scientifically speaking. There are connections between lack of sleep and mental health issues like depression or anxiety (also linked to internalization behavior). Studies on social media’s effect on sleep has produced mixed results: some showing that use can cut into sleep time, in part, because lights from screens (including TVs) do affect sleep time.

Other studies that specifically looked at social media have shown non-significant effects, but there may be impacts that have yet to be discovered.

Social media use at night has been linked to poor sleep before. Riehm adds that lack of sleep may be one way that social media impacts mental health. Pxhere

But Riehm also mentions one of the most basic critiques of social media: that it exposes use to idealized versions of ourselves and others that make reality feel drab by comparison.

In the paper, the team goes so far as to suggest that it might be worth re-evaluating the way social media sites are designed — specifically, they applaud instagram’s efforts to hide “like counts” from some posts.

At least going by these early results, a system that’s run on the currency of a like, share, or retweet does seem to have some damaging effects on mental health, especially when teenagers spend hours immersed in that world. In the paper, they propose that it might be time to rethink these models, for the sake of mental health.

“We believe that technology companies and regulators responsible for social media platforms should consider how these platforms can be designed to minimize risk of mental health problems,” they write.

Snapchat's filters, for example, can create an idealized version of a person's face that they have a hard time living up to. Kate Symons/ Sydney Morning Herald

Is Social Media Really to Blame?

At first glance, it feels logical that spending endless hours gazing at VSCO girls or celebrity dream vacations would make someone feel bad about their own life by comparison. Social media use has been consistently linked to mental health issues, but there’s still some debate about which way this goes. Does social media actually change the way we feel about our own problems, or are people prone to internalization turn to social media more frequently?

Riehm says that her study tried to address this directly, to find out whether social media has unique effects.

“In our study, we measured mental health problems before social media use and controlled for this in our analyses, so we can be more certain (but not completely certain) that reverse causality does not account for our findings,” she says.

In other words, she and her team propose that social media may actually influence the way people deal with their problems. At the end of the day, they believe that if teenagers limited their use of social media to less than 30 minutes per day, there would have been 9.4 percent fewer internalization problem cases and 7.3 fewer high externalizing problem cases.

Riehm’s team’s paper is just one of many that are delving into how digital social lives can affect our mental health — sometimes in positive ways too. But it’s contributing to a growing field that’s showing just how powerfully an app can affect our lives, and even our health.

Partial Abstract

Design, Setting, and Participants: This longitudinal cohort study of 6595 participants from waves 1 (September 12, 2013, to December 14, 2014), 2 (October 23, 2014, to October 30, 2015), and 3 (October 18, 2015, to October 23, 2016) of the Population Assessment of Tobacco and Health study, a nationally representative cohort study of US adolescents, assessed US adolescents via household interviews using audio computer-assisted self-interviewing. Data analysis was performed from January 14, 2019, to May 22, 2019.

Exposures: Self-reported time spent on social media during a typical day (none, ≤30 minutes, >30 minutes to ≤3 hours, >3 hours to ≤6 hours, and >6 hours) during wave 2.

Main Outcomes and Measures: Self-reported past-year internalizing problems alone, externalizing problems alone, and comorbid internalizing and externalizing problems during wave 3 using the Global Appraisal of Individual Needs–Short Screener.

Results: A total of 6595 adolescents (aged 12-15 years during wave 1; 3400 [51.3%] male) were studied. In unadjusted analyses, spending more than 30 minutes of time on social media, compared with no use, was associated with increased risk of internalizing problems alone (≤30 minutes: relative risk ratio [RRR], 1.30; 95% CI, 0.94-1.78; >30 minutes to ≤3 hours: RRR, 1.89; 95% CI, 1.36-2.64; >3 to ≤6 hours: RRR, 2.47; 95% CI, 1.74-3.49; >6 hours: RRR, 2.83; 95% CI, 1.88-4.26) and comorbid internalizing and externalizing problems (≤30 minutes: RRR, 1.39; 95% CI, 1.06-1.82; >30 minutes to ≤3 hours: RRR, 2.34; 95% CI, 1.83-3.00; >3 to ≤6 hours: RRR, 3.15; 95% CI, 2.43-4.09; >6 hours: RRR, 4.29; 95% CI, 3.22-5.73); associations with externalizing problems were inconsistent. In adjusted analyses, use of social media for more than 3 hours per day compared with no use remained significantly associated with internalizing problems alone (>3 to ≤6 hours: RRR, 1.60; 95% CI, 1.11-2.31; >6 hours: RRR, 1.78; 95% CI, 1.15-2.77) and comorbid internalizing and externalizing problems (>3 to ≤6 hours: RRR, 2.01; 95% CI, 1.51-2.66; >6 hours: RRR, 2.44; 95% CI, 1.73-3.43) but not externalizing problems alone.