How to Talk About Mental Health and Social Media

Most therapists intuitively understand the negative link between mental health and social media use—perhaps personally, as well as professionally. 

Personally, we may observe our own feelings of powerlessness as we doomscroll for much longer than we intend to. We may also feel preoccupied by creeping sensations of stress, dread, or anger associated with the content we consume. 

Professionally, many of us hear clients compare themselves to others online, see them compulsively check their phones, and try to help them make sense of TikTok self-diagnoses.

From its associations with depression in young adults to its addictive nature, social media’s effect on mental health is well-documented. Within tech industries, the “attention economy business model” incentivizes companies to purposely design addictive media platforms. 

So, how can we help our clients mitigate the risks associated with social media use?

Look at social media use as a health behavior

In my own work, I used to hesitate to describe the health risks of using Facebook, Instagram, YouTube, TikTok, Twitter, or other platforms. I was afraid that doing so would impose my own values on the client. The most significant change that helped me was when I began to view social media use as a “health behavior.” 

Health behaviors are, as the term suggests, behaviors that affect our health. Alcohol consumption, drug use, sleep hygiene, and diet are all health behaviors that we may find ourselves discussing with clients. 

Social determinants, like access to care and collective stress, impact the ways in which different communities engage with health behaviors. Some of the non-medical factors that affect an individual’s health, as observed in empirical studies, include “social and physical contexts—families, schools, workplaces, neighborhoods, and the larger political-economic organization of society.”

Modernity requires us to spend a lot of screen time on performing basic daily tasks—whether that be at school, home, or work. Beyond that, social media use, video games, and television are common leisurely activities that are also spent in front of a screen. 

Much of our work as mental health providers is to align the client with their healthiest, most actualized self. If someone is feeling lonely and unfocused, locked into the blue glow of their screen, it may become more difficult for them to live a satisfying life aligned with their values.

Support your clients’ relationships with their screens

I have found a few key ways to start helpful conversations about social media use and to support clients in creating empowered, sustainable relationships with their screens.

Before a client starts work with me, they complete a standard battery of new client intake forms and assessments. 

One section of my intake form asks the client a handful of common questions about their health behaviors, such as how much alcohol they consume, what prescription medications they take, and whether they use any nonprescription or recreational drugs. 

Within this section of my intake form, I have inserted the following two questions:

• “How much time per day do you spend in front of screens (phone, computer, tablet, etc.)?”
• “How much of this time is spent on social media platforms (Facebook, Instagram, Twitter, TikTok, etc.)?”

By placing these questions in a section that asks about drinking, sleeping, smoking, and going to the doctor, I’m attempting to start an important conversation that approaches social media as a value-neutral, but potentially addictive force in the client’s life. 

My intent is not to shame or judge the numbers they type onto my form, but to develop my understanding of what it is like to be this person.

In the intake session, the client and I review their responses together. When I get to this section, I may say something like, “I see you spend about three hours per day on social media,” and then I’ll pause. The client may jump in and share how they feel about their self-reported number. 

I often follow up by asking, “Does this amount of time feel comfortable for you?” If the client feels good about their relationship with their screen time (in my experience, they rarely do), I’ll move on to the next question. 

If they express discomfort with their media use or a desire to curb it, I may say something like, “I’ll make a note to include this in our goals for working together. What do you think of that?” 

Motivational interviewing (MI) provides a useful framework for helping clients to achieve their ideal relationship with screen time and online media consumption. Most often associated with substance use treatment, this modality connects the client with their own desire to make behavioral changes and to move from ambivalence to empowered action.

During the treatment planning phase of therapy, it can be helpful to write down direct quotes from the client about the negative impacts of social media that they notice in their own life. 

As in any treatment plan, it’s important to include specific, measurable goals about what changes the client would like to make. 

Listing frameworks, like MI or your cognitive-behavioral modality of choice, ensures that you have an evidence-based plan for walking with the client on the journey toward their desired change.

Brainstorm creative ways to meet mental health and social media needs

Depending on the client’s goals, it may also help to brainstorm creative ways to meet the client’s needs that they were attempting to meet with social media use. 

If they enjoy curating images, would they be interested in developing photos and hanging them where they can regularly see them? My younger clients especially seem to enjoy stringing up pictures with aesthetically pleasing lights or clippings. 

If they crave a reliable way to slow down, would they benefit from regular outdoor time? 

If connection is what they seek, could they commit to sending regular texts or voice memos to a handful of people who matter to them? 

Even if a client has not set a technology-related goal at the onset of treatment, you may likely hear them mention their concerns well into the therapy process. I can’t count how many times I have heard a client express powerlessness or frustration from time lost to scrolling. 

These comments can provide a helpful opportunity to start or revisit the important conversation about their social media use. You may say something like, “How often do you feel like you spent more time on Instagram than you meant to?” 

Oftentimes, I’ve found that clients bring up social media as it relates to their feelings of self-consciousness or social comparison. Having helpful discussion points at the ready can make a passing comment into a powerful moment of psychoeducation.

Share resources about mental health and social media

Finally, I like to have a few popular resources on hand for my clients who want to learn more about technology’s effects on mental health. 

For example, two great starting points are Johann Hari’s 2022 book “Stolen Focus” or the 2020 documentary “The Social Dilemma.” Both speak to the systemic forces that shape our engagement with platforms like Facebook and TikTok.  

The dramatic changes I have seen in my clients as they replace screen time with in-person connection, tailored self-care, or other nurturing activities has inspired me to practice vigilance and intention in my own technology use. 

One of my favorite parts of my job is supporting people as they rediscover a sense of agency. 

In and outside of the therapy room, we can reclaim our agency over the ways in which social media affects our mental health. 

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