Abstract

Some studies suggest that social media use is associated with risk for depression, particularly among children and young adults. To characterize the association between self-reported use of individual social media platforms and worsening of depressive symptoms among adults. This survey study included data from 13 waves of a nonprobability internet survey conducted approximately monthly between May 2020 and May 2021 among individuals aged 18 years and older in the US. Data were analyzed in July and August 2021. Logistic regression was applied without reweighting, with a 5 point or greater increase in 9-item Patient Health Questionnaire (PHQ-9) score as outcome and participant sociodemographic features, baseline PHQ-9, and use of each social media platform as independent variables. In total, 5395 of 8045 individuals (67.1%) with a PHQ-9 score below 5 on initial survey completed a second PHQ-9. These respondents had a mean (SD) age of 55.8 (15.2) years; 3546 respondents (65.7%) identified as female; 329 respondents (6.1%) were Asian, 570 (10.6%) Black, 256 (4.7%) Hispanic, 4118 (76.3%) White, and 122 (2.3%) American Indian or Alaska Native, Pacific Islander or Native Hawaiian, or other. Among eligible respondents, 482 (8.9%) reported 5 points or greater worsening of PHQ-9 score at second survey. In fully adjusted models for increase in symptoms, the largest adjusted odds ratio (aOR) associated with social media use was observed for Snapchat (aOR, 1.53; 95% CI, 1.19-1.96), Facebook (aOR, 1.42; 95% CI, 1.10-1.81), and TikTok (aOR, 1.39; 95% CI, 1.03-1.87). Among survey respondents who did not report depressive symptoms initially, social media use was associated with greater likelihood of subsequent increase in depressive symptoms after adjustment for sociodemographic features and news sources. These data cannot elucidate the nature of this association, but suggest the need for further study to understand how social media use may factor into depression among adults.

Highlights

  • Social media use has been associated with diminished well-being and greater levels of anxiety and depression, predominantly in cross-sectional studies among adolescents[1] or young adults,[2] concern has been raised that reporting bias may result from individuals with greater depressive symptoms overreporting social media use.[3]

  • In fully adjusted models for increase in symptoms, the largest adjusted odds ratio associated with social media use was observed for Snapchat, Facebook, and TikTok

  • Among survey respondents who did not report depressive symptoms initially, social media use was associated with greater likelihood of subsequent increase in depressive symptoms after adjustment for sociodemographic features and news sources

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Summary

Introduction

Social media use has been associated with diminished well-being and greater levels of anxiety and depression, predominantly in cross-sectional studies among adolescents[1] or young adults,[2] concern has been raised that reporting bias may result from individuals with greater depressive symptoms overreporting social media use.[3] A small number of short-term longitudinal studies. Social Media Use and Self-reported Symptoms of Depression in US Adults provide further support for this association—for example, among 82 young adults sampled 2 weeks apart.[4,5]. These results have 2 notable gaps that raise questions. Is the observed cross-sectional relationship apparent in longitudinal studies, as suggested by a randomized trial of Facebook discontinuation?6 Second, does this risk apply to older consumers of social media? To investigate these questions, we used data from multiple waves of an ongoing 50-state US survey

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