Bill Klaproth (Host): This is Columbus Community Hospital Healthcasts. I'm Bill Klaproth. In this episode of Healthcasts, Behavioral Pediatric psychologist, Dr. Tara Sjuts-- we're going to call her Dr. Tara-- shares how to keep your family safe in the social media world. This is a big topic. Dr. Tara, welcome.

Tara Sjuts, PhD, LP: Hi. Thank you. Thanks for having me.

Host: You bet. Good to see you as always. So, let's start with this, Dr. Tara. What are the most common challenges parents face when raising children in the era of social media and how can these be managed more effectively?

Tara Sjuts, PhD, LP: Yeah. So, I think one of the first challenges is that this is essentially uncharted territory for most parents, and we're kind of making it up as we go. Most people who are parents now did not grow up with social media, so they weren't parented through that. So, we're trying to create the roadmap as we're kind of stumbling along the way.

And I think another piece of that is parents don't always know what they don't know. For example, there's lots of sneaky ways that people with bad intentions are trying to access kids through what seems like a clean app like Instagram. And parents don't necessarily know that that's even happening. And then, it's constantly changing. So as soon as we do feel like we know something, everything starts to shift, and privacy settings change and a new app shows up on the market. So, it's hard to keep up with.

And then, the apps and the phones themselves are really kind of designed against us as adults. So, some of these apps are intentionally deceptive, where maybe it looks like a library app, but it's actually an app that is meant to be used to share inappropriate photos. And then, like, the phone itself, these phones are not designed for kids. They're designed for adults, and so they are sold with every setting wide open. Every gate is open. And so, if parents want to go through and set up limits, they have to go into almost every setting and make changes. And so, how do you even know what you all need to change? So, you could easily accidentally leave a gate open that causes all sorts of problems. And so, that's just very tricky.

And then, you get a lot of pressure from kids, right? Take Snapchat for example, that's honestly probably how most teens are talking to each other. They're not using texting like adults are. They're using Snapchat for the most part. And so, you run into situations where the whole soccer team is using Snapchat. And if you're trying to stop your child from being on Snapchat, but then how are they going to communicate with their team and know what color of socks they're supposed to wear, and those kinds of things. So, it's really tricky. And then, I think, as parents, we don't always have great habits ourselves. And so, we're struggling with the same thing as we're trying to parent our kids through it.

So, I think, you know, how do we help with that? I think first we have to educate ourselves And we have to stay on top of it knowing that it's constantly going to be changing. I also think we have to empower parents to be in a position where they can parent, right? You are allowed to make rules about your screen time. Screen time is not a need. Humans, humanity survived for a very long time without screen time. So, drawing those boundaries, defining what is normal for your household, creating community. Like if you're talking to your child's friends' parents, and you guys are kind of on the same page about, "Yeah, I'm not going to let so and so get Instagram until they're 14." And then, the other parents are agreeing with that, then your child feels like they're not missing out on as much if their friends aren't even doing this.

And then, I think communicating with your child. Communication is just huge, leveling with them, and being on the same page in terms of values and the why behind the rules that we're making.

Host: Yeah. It's a kind of a minefield out there. There's a lot to deal with, Dr. Tara. So, really good advice. Stay on top of it, set rules, draw boundaries. As you said, try to create community And then, communicate with your child on the whys of why all of this is important. So, let me ask you this. What role does social media play in shaping a child's self-esteem and mental health? And how can parents encourage healthy online habits?

Tara Sjuts, PhD, LP: Yeah, there's a huge connection. So, there's a definite correlation between the rise of social media specifically on smartphones. And this is different from kind of widespread internet access. So, widespread internet access maybe started in around 2001. And then, we see Facebook becoming a little bit more popular around 2004-2005 time range. And it really starts to pick up a little later from that.

Around 2010, we start to see social media apps becoming available on smartphones. And by probably 2012 or so, you're seeing almost the majority of kids having access to that. So using that as a timestamp, you can see a definite connection between that increase in use of social media, and anxiety, depression, suicidal ideation, self-harm behaviors, body image, self-confidence kind of issues, all sorts of things.

So for example, I think, from 10 years ago, we see that depression is two and a half times more prevalent. Now, we have seen since 2024, in a 2024 study, they saw that ER visits for self-harm was up 118% for girls since 2010. And even worse than that, suicide rates for girls is up 167% since 2010, and for boys, it's up 91%. So yes, it's bad. And so, that's all really tied to that beginning of social media on the smartphone, where it's going with you everywhere.

Girls especially have a hard time. There's pressure to send pics, and the fallout that happens from that. If you don't do it, are you considered a prude? If you do do it, then you're worrying about what's going to happen with that, and who's going to get sent that, and if you're going to get blackmailed. And then, a lot of these girls are tying their self-worth to their likes, their comments, their followers, and then we see teens are really monitoring the whereabouts of other teens.

So, most teens seem to be sharing their location settings. Like in Snapchat, you have a Snap Map. And so, you're able to see where your peers are. And so, if you see a group of your friends somewhere that you're not, that isolation and that fear that you're missing out on something, that can be pretty strong. And that's really I think where anxiety starts to really come into this. So, anxiety, as it's function, is a survival emotion, right? So back in the days of the cave people, well before smartphones and social media, anxiety helped to keep us alive, right? So if you were out wandering around and you saw this big, furry thing off in the distance, you're much more likely to survive if seeing that animal strikes a little bit of fear in you, and you either run away or you are preparing to fight off that animal, right? And so, that's kind of the origin of some of that fight or flight response.

But it's not just about physical danger, it's also about social danger. So if you're part of your caveman tribe and the other cave people decide that they don't like you anymore, they're probably not going to let you sleep in the cave. And if you are forced to sleep outside, you know you're probably going to get eaten and die, right? So, social death is just as risky because we really need to stay part of the group. And so, that anxiety really gets spiked for kids, because now there's so many more windows as to, am I part of the group? And then, you take it to kind of that comparison, right? So, we're constantly analyzing ourselves, are we good enough? And is the group going to continue to like me? am I doing what everyone else is doing? Am I attractive enough? Is my lifestyle attractive enough? And so, there's all this anxiety that's wrapped up into the social media use.

Host: Wow. So, much more for parents to deal with in this day and age, even compared to 15 or 20 years ago before social media. You talked about depression, anxiety, suicidal tendencies for. Parents and kids alike. Again, a lot of minefields out there for them to try to manage and navigate. It really is tricky. So, are there recent studies linking excessive social media use with developmental or behavioral issues in children and teens?

Tara Sjuts, PhD, LP: Yes, there are a lot. I think, first and foremost, like when we talk about development just as a whole, the laws around social media, the Children's Online Privacy and Protection Act says that kids need to be at least 13 to be on social media. And that law is not so much about safety per se, it's more about whether or not a company is allowed to sell a child's data. But we still know that that younger age group is much more vulnerable. So even if that's not the intent of that, the intent of the law is not necessarily about safety. We still want to be kind of protecting those younger kids. However, even with that minimum age being 13, we see that about 40% of 8- to 12-year-olds are on social media anyway.

So, another thing to kind of think about is that age group is so vulnerable. So when, you know, they're on Instagram and some, you know, creep pops into their DMs and is like, "You're such a pretty girl. Can you send me some pictures?" They're a lot more vulnerable to those kind of statements, or there's a lot of nasty things that happen in terms of what these kids get sent online. And Roblox is another example where there's a lot of predatory behavior going on there. But even with all the privacy settings kind of set in place, predators can still get to kids. Like even if you have a private profile, if they go and like a picture or something like that, then basically that's a little stamp out there that someone else can click on their profile and they can send them a message even if they're not friends, even if their profile's on private.

So, that age group of girls under 14 probably are really heavily targeted by creepy people online. And even Kids YouTube is problematic. So, kind of going back to that Children's Online Privacy and Protection Act, the side benefit that they talk about is that  there's better moderated content and there's not as much weird adult stuff on Kids YouTube, which is true to an extent, but the whole purpose of Kids YouTube is to have YouTube without selling the child's data. And so, we can't just kind of blindly trust that everything that you're going to see on Kids' YouTube is going to be kind of up to par with what parents want their child exposed to.

Host: So when we talk about developmental or behavioral issues, how does this affect things like sleep?

Tara Sjuts, PhD, LP: Yeah. So, we see sleep hugely impacted. There was a meta-analysis, I think, at 36 studies that shows a significant correlation between sleep and high social media use. And so, part of that is because of just habits, right? We're up late and we're scrolling. And I think as an adult, you can tell where hard to shut it down sometimes and you just kind of keep going for a while. So if it's hard for adults, it's obviously hard for kids.

And then, you've got kind of that emotional activation. And so, that gets in the way of sleep. The blue light content might trigger some anxiety. But then, we see this impact on health where kids are having impaired task performance, more car accidents, weight gain, immune problems. They're irritable and anxious. It's a huge trigger for mental health concerns. Sleep and depression are totally tied up with each other.

And then, when you think about how much time kids are spending, I'm going to read you a few stats from a 2025 survey by Common Sense Media. So for 2- to 4-year-olds, we're seeing average daily screen time is two plus hours. For 5- to 8-year-olds, it's almost four hours every day. For 8- to 12-year-olds, it's four and a half to six hours. And for teens 13 to 18, it's seven and a half to nine hours. So of course, it's going to interfere with sleep. And it's replacing a lot of other things too-- physical activity, being connected with people around you, reading, communication, kind of going back to developmental and behavioral concerns. We're seeing lower reading scores, vocabulary scores, memory scores, lower developmental index kind of numbers.

Host: So many things. And I would imagine attention spans too, this really affects that. The continual scrolling just teaches them short attention spans too.

Tara Sjuts, PhD, LP: Yeah. Especially when videos are 15-second videos. And then, you're ready for the next one. But we do see that kids on average are getting about one interruption every minute. So, they are constantly being pulled to switch their attention between what they're doing, screen time, what they're doing, screen time. And so, that attention fragmentation is really harmful to their attention spans. And I think probably any teacher can back me up on that.

Host: Yeah, for sure. And then, as we talk about the ways that social media can hurt or damage children, talking about developmental or behavioral issues, how about addiction?

Tara Sjuts, PhD, LP: Yeah. So, we see it tied to addiction in a very strong way. It's lighting up the same areas of the brain. We have the same kind of dopamine response happening for addiction with phones that we do with other substances, really. So, dopamine is not a satisfaction neurotransmitter. It's we want more. And so, it drives the kind of the hamster wheel of doomscrolling essentially. And it's intentionally designed that way. So, an intermittent variable reinforcement schedule. And so, what that means is that you might not get rewarded every single time that you scroll to the next video. It might not hit the spot for you. It's a little bit unpredictable. But because it's unpredictable, it drives the behavior to keep going much more. And really, we see that nearly half of kids. There was a Pew Research study done. About half of kids said that they're online almost constantly. And about 25% of teens are actually meeting criteria for social media addiction. So, it's significant for sure.

Host: Oh, my goodness. There's just so much. The hamster wheel of doomscrolling. Oh my goodness. It's just kind of crazy. So, how can families establish healthy digital boundaries without isolating children from the benefits of online communication, meaning there are good sections of this. And there are good things about social media. So, how do they go about doing that?

Tara Sjuts, PhD, LP: Yeah. And I think that's important to kind of think about. Our purpose of maybe getting online is to have connection with other people. But the data is actually not very supportive of there being benefits to social media. There are a lot of research studies showing the downsides, the harms to kids, but there's actually very little showing the benefits. And so, although it's meant to be means of connection, it's just not as good as what it's replacing, which is that real-life connection.

So, I think, first, parents really need to model for their kids a good balance of with screen time. And then, I think we need to kind of think about how we're asking the question. So instead of asking how much screen time should my child have, I think when we ask it that way, we're prioritizing screen time first and foremost. We're saying we're going to block two hours of screen time or two hours of your day for screen time, and then we'll try to fit everything else in around that.

But we need to flip that script. So, we need to say, what are the important things that you want to be part of your child's childhood, and are we making sure to fit that into the day that we're saving and protecting time for that, which is hard enough with sports schedules and school schedules and trying to get enough sleep and all of that. So, fit all of that good important stuff that matches your values and your goals for your child, fit that in first. Then, if there's some time left over, we can fit in some screen time, but let's not bookmark and protect the screen time first and foremost.

Host: Yeah, really good advice. So, are there evidence-based strategies that exist to prevent cyberbullying and it's psychological effect on children.

Tara Sjuts, PhD, LP: Yeah. So, I would say with all of this, because it's uncharted territory, this is all baby science. So, there are almost no longitudinal studies on these kinds of things. We're just essentially trying to take what we've been doing and find ways to adapt it to this new world that we're in.

But yeah, cyberbullying has increased significantly and it's tied to severe psychological problems, depression, anxiety, suicidal ideation. And the cyber stuff is even harder because it's anonymous, it happens 24/7 instead of leaving the bully at school, you're bringing them home in your pocket. And then, there's this public unlimited audience of people that can kind of get a look at what's going on. They're joining in this bullying towards this person. So, I think limiting screen access in the bedroom at night is huge because at least then you're buying your child a break from the bully. So if kids charge their phone in their parents' room at night, they at least have some downtime.

And then, in terms of programs, there are school-based anti-cyberbullying programs that are showing some effectiveness in increasing willingness to seek help and willingness to defend others. And then, some social emotional programs that schools are already doing, just kind of adding in that feature of talking about social media.

Host: So, I'm wondering, while I am hearing you, Dr. Tara, for a parent listening to this, they might think to themselves, "Well, how do I know that this is affecting my child. My child seems kind of normal, but what are the warning signs I should look for that might be contributing to anxiety, depression, or even sleep disturbance?

Tara Sjuts, PhD, LP: Yeah. So I mean, I think you're going to look for kind of just the normal symptoms of anxiety and depression. Are they worrying excessively? Are they irritable? Are there changes in diet and appetite and sleep? Are there changes in mood, those kinds of things? Are they withdrawing from people?

But one of the things we know about from the research is that there's actually a kind of a dosage effect with social media exposure and increase in symptoms. And so, if they're spending a lot of time on their device and they are showing signs of depression or anxiety, there's a good chance that there's a connection there. So if you see them kind of fixated on their phone, having a hard time separating from it, they worry a lot about it, they're checking it constantly, those are all strong signs to look for. If they're on their phone at night, that's not going to be good for mental health either.

Host: That's really good information, but I would imagine a parent kind of would intuitively know if something is wrong. So, those are good warning signs to look out for, Dr. Tara. So, are there interventions or counseling approaches that have proven useful for children and families struggling with social media dependence?

Tara Sjuts, PhD, LP: Yeah. I think, first and foremost is kind of that parents are the first-line of defense. So parenting and permission to be a parent. So, that might be setting age limits for when your child has access to some of these things, when their first smartphone happens, when their first access to social media, not being afraid to set rules. And parents really need to recognize too that if your child has inappropriate content on their phone, the parent is the owner of the phone. And so, the parent is the one who's legally responsible for whatever is on that phone. So, having that communication with their kids about values, I always say if you don't talk to your kids about the tough topics, if you aren't the one that's teaching them about these difficult things, someone else will be their teacher. And for most parents, that's not what we want. We want to be the one that kind of helps to share our values as we're talking about some of these tough topics. So, just getting ahead of it and communicating with your kids.

And we also see that communication's huge in protecting kids too, because. If we're just kind of silently stalking our kids from the background and monitoring what they're doing without talking to them, kids will almost always outsmart us. They will find ways around whatever controls we try to put into place, so we really, we have to be on the same team.

So digital literacy, helping kids understand that whatever you put on the internet is a permanent footprint, and helping talk to them about the intent of others online. What does these-- you're such a pretty girl from a random stranger in your DMs, what is that really probably about? You want to start that kind of stuff early too so that we're talking about this with kids before they encounter it, because I guarantee you your child will encounter it before you think they're going to.

And then, just in terms of therapeutic approaches, again., It's a baby science. There's, you know, still a lot of work to be done in this area, but there's evidence that there's specific variations of cognitive behavioral therapy that could be helpful; acceptance and commitment therapy. And then, there's actually cool research showing that a digital detox, like a minimum of one week, best at three weeks, they're actually seeing results that show improvements in depression, anxiety, and insomnia following a digital detox. So, if that doesn't tell you everything you need to know, I don't know what will.

Host: Very true. I like what you said there. If you don't tell your kids about the dangers of social media or teach them about social media, someone else will. So, it better be you as the parent, right, to get in there and do that.

Tara Sjuts, PhD, LP: Yeah, yeah. I also feel that way.

Host: For sure. Yeah. This has really been great information. There's so much here. There's so much to deal with. Oh my goodness. Dr. Tara, thank you so much for your time today. This was really informative. Thank you.

Tara Sjuts, PhD, LP: Absolutely. Thank you.

Host: You bet. Once again, that is Dr. Tara Sjuts. And for more information and resources, visit columbuspsychiatry.org. And if you found this podcast helpful, please share it on your social channels and make sure you check out the full library for topics of interest to you. This is Columbus Community Healths. I'm Bill Klaproth. Thanks for listening.