By Mary Fetzer

In an advisory published in May, U.S. Surgeon General Dr. Vivek Murthy warned that social media can be harmful to children. But there’s an additional question: Are the potential risks of social media greater for kids who have ADHD?

ADHD Online posed this query to Dr. Ryan Sultán, a psychiatrist, researcher and therapist specializing in ADHD. An assistant professor of clinical psychiatry in the Department of Psychiatry at Columbia University Irving Medical Center and New York State Psychiatric Institute, Dr. Sultán’s expertise lies in understanding how ADHD influences individuals — particularly children and adolescents — and how external factors interact with ADHD to shape their lives.

“The Surgeon General indicated that while social media can offer some benefits, it can also pose significant risks to the mental health and well-being of young people,” Dr. Sultán says. “The concern here is the potential harm that social media can cause, considering that different children are affected in different ways by their exposure to social media.”

Potential Risks and Benefits of Social Media

The benefits for teens and children offered by social media, according to the Surgeon General’s report, include the potential to build communities with others who share similar identities, abilities and interests. Social media also provides a way for young people to access valuable information and allows for self-expression. The report — titled the Surgeon General’s Advisory on Social Media and Youth Mental Health — points out that these benefits are particularly important for racial, ethnic, sexual and gender minorities.

The key findings of the report, however, involve the potential harm social media poses to young people.

“We cannot conclude social media is sufficiently safe for children and adolescents,” the report states, adding that social media presents a “profound risk of harm” to children.

The report highlighted two main areas of concern:

• The risk of excessive social media use for some teens and children
• The exposure of teens and children to harmful content

How Risks May Affect Children With ADHD

“When it comes to children with ADHD, it appears that while social media use may not necessarily be harmful to typically developing children, it can be associated with a worsening of mental health in children who already have some mental health problems,” Dr. Sultán says. “This is an area where more research is needed, but the preliminary findings are enough to warrant caution and concern.”

The types of use and content children and adolescents are exposed to pose mental health concerns, according to the Surgeon General’s report. Children and adolescents who spend more than three hours a day on social media face double the risk of mental health problems, including experiencing symptoms of depression and anxiety.

The findings revealed that up to 95% of young people ages 13-17 report using a social media platform. Nearly two-thirds of teenagers report using social media every day, and one-third report using social media “almost constantly.”

“In light of this advisory, I believe it’s crucial to consider the particular risks and implications for children with ADHD,” Dr. Sultán says. “The relationship between screen time and ADHD is complex and multifaceted.”

According to Dr. Sultán, researchers have suggested that excessive screen time can be harmful, especially when it interferes with other developmentally important activities such as studies, hobbies, physical activity and sleep.

Dr. Sultán provides the example of a child with ADHD who is already struggling with impulse control.

“This child might find it more challenging to navigate social media, which is designed to be engaging and sometimes addictive,” he says. “They might be more likely to engage in excessive use, which could interfere with healthy activities.”

Dr. Sultán says that ADHD symptoms may be further complicated by other mental health concerns.

“Preliminary findings have associated excessive screen time and social media use with an increase in depression and irritability in teens,” Dr. Sultán says. “While further research is needed to determine the magnitude of this association, initial studies indicate that the amount of social media use may be associated with an increase in depressive symptoms and unhappiness in teens.”

Some social media is more harmful than other social media

According to the Surgeon General’s report, some social media content is potentially more harmful than other content.

“The type of content consumed can play a role,” Dr. Sultán says, “with some evidence suggesting that exposure to violent media can increase aggression in susceptible individuals, including those with ADHD.”

Dr. Sultán adds that children with ADHD might also be more susceptible to the negative emotional impact of certain social media content, including cyberbullying or content that triggers feelings of inadequacy and depression.

But gaps exist in the full understanding of the mental health impacts posed by social media. More research is needed to understand which types of content are most harmful and what factors can protect young people from the negative effects of social media, experts say.

Mitigating the Risks of Harm to Children

The Surgeon General’s report calls for “engaging in a multifaceted effort to maximize the benefits and reduce the risk of harm posed by social media.” It outlines immediate actions that children and adolescents, parents, policymakers, researchers and technology companies can take.

And a webpage on the Surgeon General’s website offers guidance on how anyone can help “based on your role.”

The American Psychological Association also released its first guidelines on social media use for teens — with or without ADHD — in May. It provided these recommendations to reduce the risks of psychological harm:

• Social media use should be preceded by training in social media literacy to ensure that users have the psychological competencies and skills for maximizing their chances for balanced, safe and meaningful social media use.

• Adolescents using social media should be encouraged to seek out social support opportunities that promote healthy socialization, such as online companionship.
• Social media use and permissions should
  be tailored to an adolescent’s developmental capabilities.
• Adults should monitor social media use by early adolescents (ages 10-14), with autonomy gradually increasing as kids age and gain digital literacy
  skills.
• Adults should monitor — and end access, if possible — to social media content that depicts illegal or health-risk behaviors — such as self-harm, harm to others and eating-disordered behavior.
• Exposure
  to cyberhate — online discrimination,
  prejudice, hate or cyberbullying, especially directed
  toward a marginalized group or toward an
  individual because of their identity or allyship with a
  marginalized group — should be minimized.
• Adolescents should be routinely screened for signs of problematic
  social media use that can impair their ability to engage in
  daily routines or that may present a risk for more serious
  psychological harm over time.
• The use of social media should be limited so as to not interfere with an adolescent’s sleep and physical activity.
• Adolescents should limit social media use for social
  comparison, particularly around beauty- or appearance-related content.

Dr. Sultán says that open communication and an understanding of the potential harms and benefits of screen time and social media are always crucial.

“I would recommend a balanced approach to social media use for adolescents with ADHD,” he says. “This could involve setting reasonable limits on the use of electronic media, monitoring the effects of social media on the child’s mood and keeping an eye on the exposure to potentially harmful content.”