Scrolling for Answers: When Distress Meets the Social Media Maze

As part of PRMS' ongoing commitment to behavioral health, we invited Dr. Hector A. Colon-Rivera MD, MBA, FAPA to be featured as a guest blogger this month. Dr. Colon-Rivera highlights teen social media usage and shares useful tips to help teens navigate the online environment safely.

Dr. Colon-Rivera is President of the American Society for Adolescent Psychiatry (ASAP), Consultation Liaison Psychiatrist, Medical Director at the Asociacion Puertorriquenos en Marcha, Healthcare Consultant at OK Health AI, Senior Advisor for Puerto Rico for the State Targeted Response Technical Assistant (STR-TA) at the Substance Abuse and Mental Health Services Administration (SAMHSA), and Medical Director at the University of Pennsylvania Medical Center Jameson Partial Hospitalization Program.

In a world where screen time fills the quiet moments, many teens and young adults turn to social media when they are feeling overwhelmed or lonely. But scrolling is not always an action of relief. More often than not, they are left feeling more confused and isolated where or how to ask for help. For some, it is a lifeline, but for others, it creates more anxiety, fuels self-doubt, and leaves them feeling more alone than ever (Uhls, Y. T., et al., 2024).

Adolescents who lack support systems or have strained peer relationships are particularly vulnerable. They are more likely to struggle with distress, engage in self-harm, or experience suicidal thoughts (Twenge et al., 2023; Livingstone & Stoilova, 2023). Teens who spent over seven hours a day on social media and had few friendships were significantly more likely to report poor mental health (Blackwell, C.K., 2025).

Platforms that emphasize appearance and constant comparison increase the risks for mood and eating disorders. Early and prolonged exposure to these negative interactions has also been linked to the later development of mood and anxiety disorders (Uhls, Y., 2024).

The American Society for Adolescent Psychiatry warns that current mental health systems for teens are disjointed and inconsistent. It's hard for young people and their families to know where to turn or who to trust (ASAP Executive Office, 2023).

Even the most caring adults can miss the signs. I once spoke with a teen who stayed up each night scrolling through her accounts, hoping to feel understood. Instead, she felt lonelier. Her phone became her only outlet because she did not know where to look or who would listen. Many teens are scared to open up. They fear being judged, minimized, or misunderstood. Others lack the vocabulary or awareness to recognize what they are going through, and for them, silence often feels safer than asking for help (Wyman, P. A., et al., 2021).

Take Mia, for example. She is 15. Over time, social media began to shrink her world. Her feed was filled with highlight reels of people living what seemed like perfect lives. It slowly chipped away at her self-worth. School, once her safe space, started to feel overwhelming. The school counselor felt cold and clinical. Talking to her family felt too risky. Online mental health resources looked vague and untrustworthy.

Mia's experience is far from rare. As social media use increases, so does the risk of depression, especially among teens navigating cyberbullying, poor sleep and appetite, body image issues, and low self-esteem (Orben, A., 2024). These factors do not exist in isolation. They often overlap, complicating both the experience and the path to recovery.

Why Don't Teens Know Where to Turn?

Mental Health Literacy Gaps

Most adolescents struggle to find the words to describe their feelings. Over 90% say that their misunderstandings about mental health prevent them from reaching out (Radez, J., 2021).

Digital Noise and Scattered Support

The internet offers a flood of advice, some of it sincere, some of it harmful. However, for teens like Mia, the lack of trusted, digestible guidance can make the search for help even more overwhelming (American Psychological Association, 2023).

The Complications of Chatbots and AI

Adding to the maze, many young people are now turning to chatbots or AI-powered tools for support. On the surface, these can feel safe: available 24/7, free of judgment, and responsive, and it may feel like the only option. While AI tools can be useful, they come with risks. They should not be seen as replacements for professional assistance, as they may offer generic, inaccurate, or harmful advice. Unlike human support, AI systems cannot fully understand nuance, urgency, or the cultural context of distress. This could lead teens to mistakenly view these tools as trustworthy sources of therapy, potentially delaying their access to lifesaving help.

While AI may one day complement mental health care and even substitute for some, it could now provide psychoeducation, reducing stigma, or guiding youth to vetted resources, if it is used correctly and under supervision. Without clear guardrails, chatbots risk becoming another digital trap that keeps young people cycling through the screen instead of stepping toward real-world help.

Managing the Risks of the Social Media Maze

We should recognize that social media is here to stay. In that case, part of our responsibility is to help young people, and the adults who support them, develop strategies that reduce harm and increase safety. Risk management in this context doesn't mean taking phones away; it means giving teens tools to navigate the digital world with more awareness, boundaries, and support.

Spot the Warning Signs Early

Parents, educators, and clinicians can learn to recognize digital red flags: sudden withdrawal from offline friends, significant drops in sleep, obsessive checking of feeds, or exposure to harmful communities. The earlier these are spotted, the quicker meaningful help can be offered.

Balance Screen Time with Real-Time

Replacing social media with healthy alternatives, like structured sports, creative outlets, or safe social groups, reduces reliance on the "scroll" for emotional regulation. This isn't about punishment but about building buffers against risk.

Encourage Digital Literacy Skills

Helping teens identify misinformation, unhealthy comparisons, and algorithms empowers them to question what they see instead of internalizing it. Teaching them how to "pause before they scroll" can be a simple but effective protective tool.

Build Multi-Layered Support Systems

No single safeguard works on its own. Schools, families, clinicians, and communities all play a role. Confidential support lines, peer mentors, and school-based check-ins should be easily accessible. A teen who feels dismissed in one setting should know there are multiple doors open elsewhere.

Create Safety Plans for High-Risk Teens

For adolescents already experiencing self-harm urges or suicidal thoughts, a clear safety plan is essential. This includes identifying crisis resources (such as 988), trusted adults they can contact, and strategies to limit access to harmful online spaces.

Partner with Platforms

Schools and health professionals can collaborate with platforms to demand safer design, such as stronger age checks, reduced exposure to harmful content, and transparent reporting mechanisms. Risk management should not fall solely on the shoulders of teens and parents.

What We Can Do, As Clinicians, Educators, and Peers

Bring Mental Health into the Classroom

Introduce lessons that normalize emotional check-ins, teach the language of help-seeking, and make it clear where students can go when things feel too heavy.

Make Support Feel Human

Move beyond sterile screening tools. Create casual, consistent ways to check in, like simply asking "how are you, really?" and ensure there is a simple, low-barrier path to help.

Teach Digital Awareness Without Shame

Help teens understand that social media can be both helpful and harmful. Show them how it distorts reality, fuels comparison, and affects mental well-being, without making them feel guilty for using it.

Even a basic, mobile-friendly resource can make a difference, a visual guide pointing to a trusted adult, a peer support group, a teen-safe mental health app, or a chat line.

For Mia and many other patients, the screen is both a lifeline and a trap. If we want to help them find their way through the maze, we need to create clear pathways, supportive environments, and fundamental tools they can rely on and feel connected to.  

References: 

American Psychological Association. (2023, May). Health advisory on social media use in adolescence. https://www.apa.org/topics/social-media-internet/health-advisory-adolescent-social-media-use

APA. (2023, May 9). Recommendations for adolescent social media use. https://www.apa.org/news/press/releases/2023/05/adolescent-social-media-use-recommendations

ASAP Executive Office. (2023, June 22). Youth mental health crisis.

https://www.adolescentpsychiatry.org/post/asap-s-president-discusses-the-crisis-in-youth-mental-health;  Blackwell, C. K., et al. (2025).

Adolescent social media use and mental health. Journal of Adolescent Health, 76(4), 647–656. https://doi.org/10.1016/j.jadohealth.2024.12.003 Ducharme, J. (2023). 

Teen video viewing and social media guidance. TIME. https://time.com/7177874/teen-video-viewing-guidance-apa 

Livingstone, S., & Stoilova, M. (2023). Digital media interventions for adolescent mental health. In Subrahmanyam & Šmahel (Eds.), Handbook of adolescent digital media use and mental health. https://doi.org/10.1017/9781009218790

Twenge, J. M., et al. (2023). Social media, depression, and suicidal ideation in adolescents: A meta-analysis. Journal of Affective Disorders, 338, 120–134. https://pubmed.ncbi.nlm.nih.gov/37671234  

Radez, J., et al. (2021). Barriers to help-seeking: A systematic review. European Child & Adolescent Psychiatry, 30(2), 183–211. https://doi.org/10.1007/s00787-019-01469-4

Uhls, Y. T., et al. (2024). Social media and adolescent depression: Pathways through sleep, self-esteem, harassment, and body image. Current Opinion in Psychology, 52, 101–109. https://pubmed.ncbi.nlm.nih.gov/31193561

Wyman, P. A., et al. (2021). Young people's perspectives on help-seeking. BMC Psychiatry, 21, 113. https://pmc.ncbi.nlm.nih.gov/articles/PMC7932953/ 

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