Impactul rețelelor de socializare asupra sănătății mintale

Introduction

Social media has become an omnipresent component of daily life. While it offers opportunities for connection, information and expression, excessive and compulsive use can lead to significant disturbances in mental health. Although the term “social media addiction” is not currently included in DSM‑5 or ICD‑11⁽¹⁾, numerous studies indicate patterns and symptoms similar to those of classical addiction, from loss of interest in other activities to withdrawal-like syndromes^(2,3).

This review emphasizes the need for multidisciplinary approaches and deeper exploration of this everyday problem. In the future, social media addiction may become a subtype of internet addiction, along with online shopping addiction, pornography and cybersex addiction, or video game addiction (the only one currently recognized in DSM-5)^(1,2).

Social media addiction – concept and mechanisms

Like any other addiction, social media addiction begins as a maladaptive mechanism to cope with daily stress which, with increased use, manifests in loss of interest in other pursuits, impaired functionality, and social withdrawal. The proposed risk factors include:

• Psychological factors – social media fulfills natural individual needs for belonging, expression, self‑esteem validation, and avoidance of psychotraumatizing factors⁽⁵⁾.
• Neurobiological mechanisms – various images and videos activate reward areas in the brain via dopaminergic circuits. Social media and the internet offer small rewards at short intervals, conditioning the cortex to pleasure with minimal effort^(6,22).
• Technological elements – today’s personalized algorithms learn entertainment preferences to encourage the prolonged use^(4,6,7). Additionally, the vast availability of content promotes endless scrolling.

Social media addiction, or social networking addiction (SNA), is considered a behavioral type of addiction. Other items in this category include exercise, shopping or work addiction. Griffith et al. propose a six-criteria system for identifying those patterns. They are applied to the subject of social media:

1. Salience – when social media use would dominate one’s life (thoughts, feelings and behaviors). Even though the person is not actively engaged in SNAs, this is the main train of thoughts.

2. Mood modification – when usage of social media would alter and enhance one’s mood, such as from bad to good.

3. Tolerance – when increased amount (usage of social media) would be required to get previous effects, particularly on the mood or satisfaction.

4. Withdrawal symptoms – unpleasant feelings when one is unable to use social media. The withdrawal is a psychological one, usually generating irritability, short temper, depressed mood, lack of volition, lack of impulse control, and proneness to anger.

5. Conflict – when SNAs would cause conflict in real-life relations or other activities such as academics, work or relationships.

6. Relapse – revert to social media use after attempts of controlling SNA^(1,23).

Adolescents – a vulnerable group

The most vulnerable demographic is adolescents, whose developing cortexes lack fully defined coping and adaptation mechanisms. Adolescents and young adults appear to be the primary victims of social media. Recent data show that 98% of young Americans have access to social networks, with an average daily use of 42 minutes⁽⁶⁾. Furthermore, sociopolitical contexts from 2017-2020 exacerbated the situation: the percentage of adolescents who are permanently online rose from 24% to 45%, correlating digital exposure with an increased risk of depression and suicidal behaviors⁽²¹⁾.

A broad meta-analysis of 26 studies (N=55,340) indicates that excessive social media use increases the risk of depression, especially among girls. The risk increases by 13% for each additional hour spent online, showing a clear dose-response relationship, highlighting the need for active, direct, long-term monitoring⁽²¹⁾.

Disorders associated with digital use

Certain DSM‑5 psychiatric symptoms and disorders can be described in relation to inadequate social media use, including:

Sleep disorders. Perturbations of sleep hygiene is a well-known behavior under the name of “bed time procrastination”, when passive scrolling is used to compensate for the accumulated stress during the day. Using devices before bed (40% of young adults) significantly disrupts sleep quality, contributing to anxiety and fatigue. The responsible mechanisms include blue light, small dopamine hits in the brain, and extended mental focus and prefrontal activity at a time when it should lessen. A more concerning problem is the use of the phone during the night (36% of the people who use the phone before bed), or waking up to check the phone, a behavior that disrupts the normal sleep patterns necessary for optimal functioning^(15,16).

Eating disorders. Online beauty standards can trend toward the pathological – e.g., pro‑ana (“thinspiration”, “bonespiration”). Constant exposure contributes to the onset of eating disorders, with young females at a threefold higher risk of anorexia or bulimia due to online aesthetic pressure⁽¹⁶⁾.

ADHD-like symptoms. Online exposure among individuals with neurodevelopmental disorders revealed specific coping mechanisms and increased clinical visits. Some studies report the emergence of ADHD-like symptoms after just 24 months of heavy screen use in previously unaffected individuals. This raises questions about causal mechanisms^(17,18,21).

Neurobiological research also highlights that social media activates the Default Mode Network (DMN) – the brain’s default mode system –, comprising regions such as the medial prefrontal cortex, temporal lobes, and posterior cingulate cortex. DMN is involved in self-referential reflection, mind‑wandering and introspection^(2,3). Hyperactivity in this network is associated with depressive rumination and hallucinations, while hypoactivity is linked to neurocognitive disorders^(2,4).

Social media activates brain reward structures (striatum) and suppresses self-control regions (anterior cingulate). Personalized algorithmic content (e.g., TikTok) encourages excessive self-referential processing and loss of self-control through disrupted connectivity between the DMN and sensory regions, as shown in MRI neuroimaging studies^(3,22).

Online misinformation

Another major obstacle is misinformation, which fundamentally disrupts the doctor-patient relationship in mental health. Personal experiences are often portrayed as scientific truths, leading to misguided self-management of disorders⁽²²⁾. This negative influence stems from content creators whose credibility is often tied to financial incentives.

Positive impact of restricting access

Observational studies on screen abstinence provide insight – a comparative study of youths spending five days at a nature camp without screens showed significantly improved recognition of nonverbal emotional cues compared to the control group. Thus, face-to-face interaction supports social and emotional intelligence development⁽¹⁹⁾.

Potential benefits of social media

Social media should not be viewed solely negatively. Recent geopolitical contexts illustrate benefits: social media promotes user creativity, constructive expression, and support networks for vulnerable individuals. Additional potential benefits include:

• Guidance toward health-promoting activities
• Access to education and information
• Cognitive and creative flexibility
• Civic engagement and professional networking^(13,22).

Thus, when used responsibly, social media can become a tool for personal and professional development.

Tools for measuring addiction

Validated psychological scales have been developed to detect problematic social media use: the Bergen Social Media Addiction Scale (BSMAS) and the Social Media Addiction Scale. These instruments assess parameters common to other addictions, such as tolerance, mood modification, relapse, withdrawal, and conflicts stemming from harmful use^(5,6).

For example, the Bergen Scale is a self-reported questionnaire that includes six parameters, measured on a scale that ranges from “very rarely” to “very often”. The total score ranges from 6 to 30, with higher scores indicating a greater risk of problematic use. An additional metric often used is the count of items scored ≥3, reflecting behaviors experienced at least “sometimes.” A cutoff score of 24 or more is commonly accepted for identifying potential cases of social media addiction, particularly in adolescents. The BSMAS has been widely validated across various populations and is a brief yet effective tool for screening excessive social media engagement and its impact on daily functioning^(13,17).

The Social Media Addiction Scale, or Social Media Disorder (SMD) Scale, is another scale meant to diagnose this disorder, formatted in two versions: a longer one, consisting of 27 items, and a shorter one with nine items. Compared to the Bergen Scale, the SMD Scale uses six criteria from behavioral addiction (salience, tolerance, withdrawal, relapse, mood modification, functionality altering) and three criteria from internet gaming disorder (conflict, deception, displacement). Despite the broader range of questions, the SMD Scale is limited by the fact that it is a self-reported questionnaire using yes/no answers. Thus, this scale is to be used carefully, mainly because it yields less reliable answers than a multiple-choice test. However, as the criteria for social media addiction become well established, the SMD Scale will prove to be an efficient monitoring tool⁽²⁴⁾.

Interventions and prevention strategies

Although no standardized protocols exist, treating problematic social media use often involves psychological therapies. Pharmacological treatment is reserved for severe cases affecting functionality, addressing symptoms rather than causes. Effective interventions include: cognitive-behavioral therapy (CBT) – identifies patterns, restructures behaviors, and develops coping mechanisms⁽¹⁰⁾; mindfulness – raises awareness of triggers and helps manage impulses⁽¹¹⁾; self-regulation techniques – establish clear boundaries, discipline, and offline time; education and awareness campaigns – promote critical and balanced technology use.

Current limitations

When assessing potentially dangerous behaviors, the main problem is the objectiveness of those studies. Social media addiction is considered dependent on the user, and in order to study the full effects of its use, the most common method is through self-reports. However, those are prone to inaccuracy, probably because they are based on the users’ own perception of their behavior, and those perceptions tend to be inaccurate⁽²³⁾.

Another limitation is attributed to the researchers. Studying these kinds of behaviors requires methodological consensus, which needs to be further developed. Thus far, most studies utilize different concepts regarding social media use, different scales and different cutoff points, resulting in heterogenic results. Those variable methods hinder further the growth of this subject and, also, questions whether social media addiction truly possesses construct validity as an actual addiction^(23,24).

Conclusions

Social media can be a powerful tool with multiple benefits, but uncontrolled use, especially among adolescents, is associated with significant mental health risks: depression, anxiety, sleep disorders, distorted body image, and concentration difficulties^(6,15,16,21). It is essential to distinguish between problematic and functional use and to develop effective prevention programs, early interventions, and media literacy education. In the digital age, the major ongoing challenge remains balance.    

Corresponding author: Eva-Maria Ciobanu E-mail: evamariaciobanu21@gmail.com

Conflict of interest: none declared.

Financial support: none declared.

This work is permanently accessible online free of charge and published under the CC-BY licence.