For Some Troubled Kids and Teens, Social Media Can Be a 'Vicious Circle'

Coming of age in the Information Age means many children and adolescents step out into a virtual frontier to find themselves.

"As children grow, the need increases to separate from their family of origin and become better connected to their peer group," says Dr. Meena Vimalananda, medical director of child and adolescent services at Sheppard Pratt Health System, a private, nonprofit health system based Towson, Maryland, that offers mental health, substance abuse and special education services.

Kids and teens turn to social media sites from Facebook and Twitter to Instagram not only to carry on interactions with flesh-and-blood friends online, but to learn about the world at large. And for some, social media sites offer an unspoken promise of fitting in, experts say, where face-to-face relationships are limited or fall short.

"For those children who lack self-confidence or have been socially awkward and are in any way threatened by direct, face-to-face social connections, this gives them a way to feel connected to a much larger world with incredible anonymity," Vimalananda says. "Kids feel that they are connected, they feel that they are communicating, and yet they are not face-to-face, so they don't worry as much about being not liked or being rejected."

But for children struggling with psychological issues, experts say, going online to make connections may end up potentially exacerbating those problems. "It takes away from immediate connectedness to their families -- to the support system that is most familiar with them, to those people who are best equipped to actually be there for them, understand them [and] support them," Vimalananda says. "Those who already are struggling with mental health issues don't reach out and get the help they need where it's available, and become more isolated in a sense ... imagining themselves to be connected to people that nobody in their real world knows."

A study published in July in the journal Cyberpsychology, Behavior, and Social Networking found that more time spent on social networking sites was associated with unmet need for mental health support, poor self-rated mental health and reports of psychological distress -- based on symptoms of depression and anxiety -- and suicidal thoughts by children and adolescents. The latter was assessed by asking participants if they'd considered committing suicide in the previous 12 months.

The research studied 750 middle and high school students in Ottawa, Ontario. "The purpose was to investigate the association between the use of social media and mental health problems," says Dr. Hugues Sampasa-Kanyinga, study co-author and an epidemiologist with Ottawa Public Health. He notes that students who reported using social media sites for more than two hours every day had a higher rate of mental health issues, and they also reported an unmet need for mental health support.

The study did not determine cause and effect -- whether heavy social media use was to blame for mental health concerns or if the mental health concerns were the reason for heavy social media use. But he and others like Vimalananda say it's most likely a two-way street. Many of those struggling with psychological issues seek solace online; on the flip side, time spent online can increase isolation from flesh-and-blood support. "It's a vicious circle that goes both ways," Vimalananda says.

Health and mental health experts advocate limits on screen time. The American Academy of Pediatrics advises: "Children and teens should engage with entertainment media for no more than one or two hours per day." In addition, the AAP encourages parents to monitor media choices using established ratings systems for shows, movies and games to avoid inappropriate content, such as violence or glorified tobacco and alcohol use.

Similarly, Sampasa-Kanyinga says it's important not only to pay attention to the amount of time youth spend on social media, but to how they're wiling away the hours online. Chatting and connecting with friends differs, he says, from engaging in risky behavior, such as sharing passwords with strangers, which could open a child up to cyberbullying, or comparing one's weight or social status to others online. "We just need to teach kids about how they can use social media safely," and instruct them on the potential pitfalls of social media, he says.

For children and adolescents exploring the world online as they come into their own, the same virtual social outlets they may seek to cope with life's kinks can prove treacherous.

"Sometimes, for no apparent reason, these [online] social connections will tell them, 'you're a loser, you might as well go kill yourself,' and so on," Vimalananda says. "We've seen many instances, and read about children responding to those and, in fact, committing suicide, with their immediate family having no clue at all about what is driving that."

In addition, she says, sexual predators preying on children's vulnerability remain a serious threat. "A lot of girls become very vulnerable to total strangers who then find them, and the families have no idea who they are, where they are or what they're doing," she says.

Sampasa-Kanyinga is optimistic, though, that while social media can be problematic, it's also part of the solution. Ottawa Public Health recently launched a social media marketing campaign called ''have THAT talk,'' a video series educating and encouraging parents to incorporate mental health and suicide prevention into conversations with their children and teens.

Sampasa-Kanyinga views social media as a potential venue to reach children with mental health problems who may otherwise be difficult to access. "Maybe they're not at school because they're sick or they don't feel very good and they maybe drop out or stay home," Sampasa-Kanyinga says. "But we can still meet them [on] social media because they're seeking interaction, they're trying to cope with their problems. Whatever reason they are there, we can reach them."

Still, Vimalananda views more traditional, non-virtual venues as the best place to reach kids who are struggling. "I tend to look more for where their real lives are, where their face-to-face lives are. For example, schools are a great place to identify kids that are having trouble, and often families will identify children showing changes in their behaviors, which are signs of distress. But, in those areas, I think the social networking impedes that happening."

Even so, like Sampasa-Kanyinga, she's hopeful social media could be made part of the solution, since that's where so many children are turning already. However, she reiterates, major pitfalls remain.

"I'm sure there's potential there, to use that as a way to reach out to kids. But I think it has to be thought through very carefully and organized in a way that's safe," she says. "Because any number of people, anybody, anywhere, can pretend to be mental health professionals and then reach children for other predatory reasons."

Michael Schroeder is a health editor at U.S. News. You can follow him on Twitter or email him at mschroeder@usnews.com.