Teens, Frequent Social Media Use, Bullying, Sadness and Suicide Risk: 2023 U.S. Survey

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Image from CDC's report.

The first national measure

Social media is part of daily life for young people: other surveys find that about 95% of high school–age youths use a platform, and about a fifth use one "almost constantly." Research increasingly links frequent use to depression and suicide risk, and to being bullied online, which can itself harm mental health. Some groups — girls and lesbian, gay, bisexual, transgender and queer or questioning youths — are more often bullied online. Yet young people can also find support and connection online.

In 2023, for the first time, CDC's Youth Risk Behavior Survey (YRBS) — a nationally representative, school-based survey of students in grades 9–12, run every two years since 1991 — asked how often students use social media. This report used those answers (20,103 students surveyed) to estimate how many use it frequently, and how frequent use relates to bullying, persistent sadness or hopelessness, and suicide risk.

How it was measured

• Frequent use: using social media at least several times a day. Everyone else — including students who don't use it at all — counted as less frequent users.
• Outcomes, all in the past 12 months: being bullied at school; being bullied electronically; feeling so sad or hopeless almost every day for 2 weeks or more that usual activities stopped; seriously considering suicide; making a plan; attempting suicide.
• Comparisons were adjusted for age, race and ethnicity, sex and sexual identity, and also run separately for girls and boys and for heterosexual and LGBQ+ students (lesbian or gay, bisexual, questioning, or describing their identity another way).

Who uses it most

77.0% of high school students used social media at least several times a day — 29.5% more than once an hour.

Use was otherwise much the same across groups. The lower figure for American Indian and Alaska Native students may reflect weaker broadband access in rural and tribal communities. The lower figure for lesbian and gay students runs against earlier research suggesting they may spend more time in affirming online communities.

What frequent use went with

After adjustment, frequent users were more likely than less frequent users to report:

By sex. Among girls, frequent users were more likely to be bullied at school and online, to feel persistently sad (55.1% of them did), and to have considered suicide. Among boys, frequent users were more likely to be bullied online, to feel persistently sad, and to have considered suicide.

By sexual identity. Among LGBQ+ students, frequent users were more likely to be bullied online and to feel persistently sad — 68.6% of them did — but did not differ significantly in bullying at school or suicide risk. Among heterosexual students, frequent users were more likely to report every outcome except attempted suicide.

What might explain it

• Bullying crosses settings. Bullying at school and online overlap: those bullied in person are more often bullied online, and vice versa — which may be why frequent users were also bullied more at school. For girls, the relational and psychological kinds of bullying common among adolescent girls may suit a digital world where anonymity and distance lower the barriers to conflict.
• LGBQ+ students who use social media often may meet discrimination or stigma-based bullying online, beyond school networks — so frequent and less frequent users may share similar experiences at school but different ones online.
• Suicide risk is less direct. Researchers suggest the link between social media and suicide risk is more complex than "more use, more risk." How young people meet suicide-related content matters: interactive, close exposure — online forums or suicide clusters — may carry more risk than passive viewing. Indirect paths, such as online victimization or poorer sleep, and buffers, such as connection to others, were not measured. Attempts were too rare in the sample to show a difference.
• The link with suicide risk held up only among heterosexual students, suggesting social media may not be the strongest influence on the high suicide risk among LGBQ+ students — for whom emerging research finds social media can be protective, linking them with affirming communities, support and resources.

Limits

• The survey is a snapshot: it cannot show cause or direction.
• Its examples of social media were not exhaustive.
• Non-users were grouped with infrequent users, which may hide differences between them.
• Only one mental-health measure was used, to keep the same recall period.
• Sexual identities were combined into two groups for lack of numbers, which may mask differences — especially given lesbian and gay students' lower use.
• Bullying at school and online may overlap, since one can happen through the other.

What can help

Better understanding can support safer digital spaces — consumer safety policies, media literacy education, and platform protections for young people — and help families decide about social media use. Proven options already exist:

• School-based programs against bullying and for suicide prevention work, as do efforts that build young people's skills, create protective environments and connect them with positive adults and peers, such as CDC's What Works in Schools.
• CDC's resources for action on community violence and suicide prevention set out evidence-based strategies.
• StopBullying.gov gives steps for schools, youths and families: clear expectations for behavior, and building empathy, self-awareness and self-regulation.
• The U.S. Surgeon General's advisory on social media and youth mental health and the American Academy of Pediatrics' Center of Excellence on Social Media and Youth Mental Health offer guidance for young people and families.

Survey data by group are on CDC's Youth Online tool; the questionnaire and data are at cdc.gov/yrbs.

Sources

Based on Emily Young, Jessica L. McCain, Melissa C. Mercado and others, "Frequent Social Media Use and Experiences with Bullying Victimization, Persistent Feelings of Sadness or Hopelessness, and Suicide Risk Among High School Students — Youth Risk Behavior Survey, United States, 2023," MMWR Supplements 73(4), Centers for Disease Control and Prevention (as corrected); a work of the United States government in the public domain. The report's discussion says about "one third" of LGBQ+ frequent users felt persistently sad or hopeless; its own table gives 68.6%, which is used here.