Warning Labels on Social Media Apps for Teens? What It Could Mean for Nurses

• The U.S. Surgeon General advocates for teens by identifying associations between mental health and social media. He recently suggested warning labels be added to social media apps. 
• Adolescent mental illness is on the rise and social media use among this group has grown significantly over the past 10 years. 
• Nurses can help by screening for adolescent mental illness and educating on the risks of unsupervised social media use. 

We’ve all seen warning labels on various items such as cigarettes or household supplies, warning against the risk of cancer or fetal harm. But should warning labels be placed on social media apps? The U.S. surgeon general believes just that as a way to help protect teens as mental illness diagnoses continue to increase.

“It is time to require a surgeon general’s warning label on social media platforms, stating that social media is associated with significant mental health harms for adolescents,” wrote U.S. Surgeon General Vivek Murthy in a recent opinion piece in the New York Times.

The warning label would appear regularly on screens when someone is using a social media platform. Dr. Murthy explained that the warning label would serve as a reminder to parents and teens that social media has not been proven safe. 

Social Media Use Among Teens: Warning Labels and Mental Illness

Social media use among U.S. teens has nearly doubled over the past 10 years, and mental illness has followed suit.

“Adolescents who spend more than three hours a day on social media face double the risk of anxiety and depression symptoms,” wrote Dr. Murthy. 

Teens grade 9 to 12 who experienced depression symptoms rose from 28% in 2011 to 42% a decade later. Globally, one in seven children aged 10 to 19 experience depression, anxiety, and behavioral problems among the leading causes of illness and disability.

Social media may even lead to eating disorders.

In a 2022 survey on social media use among teens, 46% of adolescents said social media contributed to their poor body image. This may place them at risk for eating disorders like body dysmorphic disorder, anorexia nervosa, and bulimia nervosa.

Mental illness among youth is considered a health crisis and nurses play a vital role in keeping teens safe. 

The Nurse’s Role in Teen Health

While nurses cannot limit a teen’s social media use, they play an influential role in screening and education. 

Pediatric nurses are trained to handle various teen health problems, including mental illness. In a 2020 position statement, the American Nurses Association (ANA) identified pediatric nurses as not only care providers, but advocates for adolescent health. This also applies to any nurse who cares for adolescent patients in clinics, urgent cares, hospitals, and other emergency care settings.

The ANA supports proper education for nurses on the complexities of teen health, including the impact of scientific, ethical, and practical issues. Nurses should be able to identify teen health issues related to societal expectations and should take an interdisciplinary approach in caring for this vulnerable population.

Over the years, many organizations and leaders, including Dr. Murthy, have made associations between social media and teen mental health, advocating for change in policy. As care advocators for teen health, nurses’ primary role is to screen for mental illness and educate teens and parents/guardians about the risks of unsupervised social media use.

Identifying teens already impacted is critical. Early identification leads to early treatment. Then, nurses can provide education to reach those not yet affected.  

Screening for Mental Illness

Nurses should screen for depression, anxiety, and eating disorders in teens by recognizing the signs and symptoms. Nurses should keep in mind that anxiety can encompass several conditions, including generalized anxiety, panic attacks, social anxiety, and phobias. Additional assessments include asking teens about their social media habits and screening for other risk factors.

The National Institute of Mental Health outlined the following signs and symptoms of mental disorders in adolescents. Look for these signs and use them as a guide to formulate the right questions to ask a teen during a care visit, particularly in private, away from their parent(s)/guardian(s).

Symptoms of depression:

• Feeling sad most of the time for a few weeks or longer 
• Unable to concentrate 
• Unable to do things once enjoyed 

Signs and symptoms of generalized anxiety disorder: 

• Feeling restless, wound-up, or on-edge 
• Being easily fatigued 
• Having difficulty concentrating 
• Being irritable 
• Having headaches, muscle aches, stomachaches, or unexplained pains 
• Difficulty controlling feelings of worry 
• Having sleep problems, such as difficulty falling or staying asleep 

Signs and symptoms of panic disorder:

• Pounding or racing heart 
• Sweating 
• Trembling or tingling 
• Chest pain 
• Feelings of impending doom 
• Feelings of being out of control

Signs and symptoms of social anxiety disorder: 

• Blushing, sweating, or trembling 
• Pounding or racing heart 
• Stomachaches 
• Rigid body posture or speaking with an overly soft voice 
• Difficulty making eye contact or being around people they don’t know 
• Feelings of self-consciousness or fear that people will judge them negatively

Signs and symptoms of phobia-related disorders: 

• May have an irrational or excessive worry about encountering the feared object or situation 
• Take active steps to avoid the feared object or situation 
• Experience immediate intense anxiety upon encountering the feared object or situation 
• Endure unavoidable objects and situations with intense anxiety 

Signs and symptoms of an eating disorder: 

• Obsession with being thin or extreme fear of gaining weight 
• Distorted body image 
• Denial of seriousness of body weight 
• Dramatic restriction in food type or amount 
• Lack of appetite or interest in food 
• Picky eating that gets progressively worse 
• Binge-eating 
• Excess dieting 

Educating About Social Media Use

Education is the final piece to the puzzle. Nurses should educate parents/guardians and teens on responsible social media use. This may include placing limits on social media browsing — for example, turning off cell phones or access to social media apps at bedtime or during homework time. This may also include setting parental monitoring and controls on these apps to manage the content viewed.

Nurses can also recommend parents/guardians discourage their teen from gossiping, making up rumors, or bullying on social media platforms. Encouraging in-person activities instead of online activity may be beneficial as well.

A primary goal is to encourage parents/guardians to start conversations with their teens about social media habits. Finally, nurses should educate on common mental illness among teens, risk factors, signs and symptoms, and when and who to contact for support.

The Bottom Line

While social media use and mental illness is increasing among teens, nurses can help teens and their families identify associations between social media use and mental health. Mental illness is best addressed through prevention. Will we see warning labels on social media apps? Only time will tell. In the meantime, nurses can serve as the “warning label,” prompting teens and parents/guardians to consider the impact social media may have on mental health outcomes.

If you or anyone you know is suicidal, call or text 988.

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