Twelve and a half years old. That’s the average age at which a child opens a social media account. Growing research has found the more time a person spends on social media, the more likely they will experience mental health symptoms such as anxiety, isolation, and hopelessness. And according to one recent study, high levels of social media use over the span of four years was associated with increased depression among middle and high school youths.

According to John Piacentini, a professor in the UCLA Department of Psychiatry and Biobehavioral Sciences, the weight of the pandemic was especially heavy for adolescents. Teens and young adults have an increased need for peer interaction and a higher sensitivity to social exclusion. Lockdowns, online learning, and social distancing mandates have disrupted their lives. Social media, he said, has helped to fill those gaps, and TikTok has become a new coping strategy.

TikTok, one of the fastest-growing social media video platforms today, dominates youth culture and attracts more than one billion users worldwide, of which nearly half are 10 to 29 years old. TikTok recently dethroned Instagram as the most-used social media app among kids 12 to 17, with 63 percent of them using the app on a weekly basis. Data from the World Health Organization shows that in 2021, one in seven adolescents ages 10 to 19 struggled with mental health challenges. That group is a key part of TikTok’s audience.

As TikTok gains more acceptance among youth, there is growing concern among parents, policymakers, and clinicians about the actual impact the platform is having on the mental health of youth. As with any issue, there are two sides to consider.

TikTok Can Encourage More Isolation and Loneliness of Young People

For adolescents, finding community and validation on TikTok is not only normal but necessary for their development.

“There are youth, especially those with social anxiety or depression, who may have a tendency to spend more time online and reduce their real, face-to-face contact with other folks,” said Anne Marie Albano, PhD, director of the Columbia University Clinic for Anxiety and Related Disorders. “When an individual is not engaging in the world in a healthy way—interacting with others, managing themselves in challenging situations…speaking up in class, dealing with conflict with peers—this can exacerbate their feelings of alienation, hopelessness, isolation, anxiety, and depression.”

The “culture of comparison” mindset that is encouraged by social media platforms like TikTok can be very challenging for a young person, added Albano.

“Any kid who is prone to concerns about their self-image and who they are, is anxious about fitting in or what other people think about them, will inevitably compare themselves to the number of likes, friends, or followers other people have when they go online,” she said. “They are looking at these sites through a negative lens of, ‘I’m never going to be as good as these people’ and that mindset puts them at risk of increasing depression and isolation.”

Despite the presence of strong evidence, some clinicians still believe the jury’s still out for a final verdict on TikTok. Jaclyn Halpern, PsyD., is director of the SOAR program at Behavioral Medicine Associates, a practice offering psychotherapy and testing for children and adolescents.

“There is reason for concern given the content available on TikTok, differences in ethics and values surrounding TikTok’s content, the pressures children and teens may feel based on TikTok’s content, and the possibility of encountering an online predator when using the app. Ultimately, research has begun to show both risks and positives for youth using TikTok and other social media platforms.”

Use of TikTok Might Aggravate Mental Health Conditions

In his research, Piacentini found some patients at the UCLA Child OCD, Anxiety and Tic Disorders Clinic and Tourette Assn. Center of Excellence exhibited worsened symptoms he believes may be a result of watching TikTok content online.

Research shows the cyberbullying, social exclusion and drama that can occur on these networks have been associated with higher rates of mental health issues in adolescents.

Halpern’s research also seems to confirm that children with complex mental health and environmental stressors or trauma may see at least temporary increases in emotional symptoms after TikTok use.

TikTok Can Help Improve Knowledge About Mental Health Conditions

One of the main benefits of talking about mental health on TikTok is that users are exposed to people with different conditions, says Peter Wallerich-Neils, known as Peter Hyphen to his more than 416,000 followers on TikTok, where he initially began posting to discuss his diagnosis with attention deficit hyperactivity disorder.

When they find other people with their own issues, they can start a dialogue about their symptoms.

“It’s kind of holding a mirror up to themselves and they can realize, ‘Oh, my gosh, I didn’t realize that this is something that I thought only I dealt with’… — and ‘I am part of this community that I didn’t even know existed.’” he said.

TikTok Offers Young People Validation and Community

Those who may be feeling alone in their struggles often can find the validation they need through TikTok. Like many others, Wallerich-Neils took to social media at the beginning of the pandemic to fill the void created by the lockdowns. On TikTok, he began to analyze and share the ways his ADHD diagnosis affected his everyday life and found that many people connected with his journey.

Kojo Sarfo, MD, a mental health nurse practitioner and psychotherapist with more than 1.9 million followers on TikTok, credits the app with creating spaces where those with mental health conditions can feel that they belong. This connection is especially important for communities where mental health is rarely talked about or is even considered a taboo subject.

Strategies for Showing Young People How to Engage with TikTok in a Healthy Way

Given that social media research is mixed and in its very early stages, clinicians offer several ways for adolescents and their parents to gain the most positive results from engagement with TikTok.

“In our program for social anxiety at Columbia University we teach teenagers and young adults how to create healthy boundaries,” said Albano. “We work with them on what’s within their comfort zone, what makes sense when it comes to posting and liking other people’s posts, and how to stay safe and avoid buying into risky gimmicks or stunts that may be trending. We also work on how to respond to comments while ignoring others that may be inappropriate and learning when to block people.”

Experts also recommend teaching young people how to set limits on social media use. Mealtimes are a great time to put the phones away. Another healthy habit is to set a time each night when they put all the screens away to give themselves enough time to wind down and prepare the body for sleep.

How Parents Can Help

Parents will have to monitor and learn how to limit social media and overall screen time with their kids, starting at an early age. They should consider parental controls until they know their child is mature enough to manage their own accounts. Experts believe parents show the strongest influence when they stay involved in their kids’ lives and model desired behavior. Parents can set the example when they put away their phones and screens and take time to talk with their children at the end of a school day. Modeling this good behavior is critical.