Why are you nervous?

You don’t like having conversations with your father?

Fancy conversations [giggles].

This is a fancy conversation?

The voice you just heard belongs to a very special member of my family, my 16-year-old daughter, Sky. Now, don’t get me wrong, I love all of my daughters equally, of course. Sky though, is unique in her own way. She is the kid that every other parent in the neighborhood goes to for advice. She’s the one who knows CPR. She is the absolute top choice for babysitter for everybody. She is really something else.

You are the child who, I have to say, has always been the kid that would just give the shirt off your back. You’d help anybody in any situation,.

Wouldn’t you?

Where did that come from?

Maybe. Maybe your parents.

I was about to say, probably not.

Wait, what?

She even makes jokes. If you’ve been on this journey with me since episode one, you know that I brought all three of my daughters along for the ride this season. That’s something I’ve really never done before in more than 20 years of being a medical journalist. I’ve really insulated my kids from the television and media part of my world. But I really wanted to have honest conversations with them about how technology has shaped their childhoods. Obviously, they’ve grown up in a digital world for better and for worse.

What inspired you to do this podcast?

You know, it’s really interesting, Sky. I feel like a lot of times we’re supposed to know the answers to things as parents, you know? But when it comes to things that are brand new like this, like keep in mind that smart phones really only came into, became popular in 2007, the year you were born. Nobody knew how to live a world with these devices and social media, and nobody knew for sure how to parent with this. Like what was right, what was wrong, like when the right age is, should we, and does it worry us as parents about social media? Yes. Because think about it, I didn’t know what it was doing to your mental health, to be honest. I guess it was your mental health that I was most worried about. That was part of why I wanted to do the podcast on this topic, this season. Is that a legitimate concern, by the way, the idea of depression, anxiety?

Definitely. I’ve heard a lot of like, I’ve heard about it happening a lot and it’s like, I’ve never seen it. But like I definitely think..

Do you have friends who deal with this?

Yeah, I do have friends. More of them deal with anxiety than depression, and I don’t think all of them are phone, like caused by the like, phone. But like I definitely see that concern.

Obviously, it’s tough to know what exactly is causing it, but how much do you worry about the phone and social media being part of the cause?

I think that like is definitely a big concern that like social media has like an effect on our mental health. And I think it does definitely.

So you asked me like what was the the inspiration for the season? And I guess that was probably it more than anything else. Exactly what you’re talking about. And we still don’t really have a good handle on, right?

My guess is it’s different for different kids. There’s not an exact amount that’s right for everybody.

Yeah, I think it’s different for everyone. You can never really know exactly what’s going on in someone’s head. Like, even like my best friends, I like, we talk all the time. We like, can I feel like I can tell them anything. I still don’t really know what’s going on in their head exactly.

Sky’s right. No surprise. I mean, no matter how close we are to our friends, even our family, we don’t, maybe we can’t always really know exactly how they’re feeling. What I can say with more certainty is that my daughter’s mental health is one of the most important things in the world to me. And throughout the season it’s been at the top of my mind.

How people see you, I guess with social media, you want to put out like a good picture of yourself, make it seem like your life is so perfect, even though not everyone’s life is perfect.

Has that ever happened to you that you have developed some anxiety over pictures?

Yeah. I like, I definitely want to like, put like a good image of myself out on social media. And so, like, I have had like, something’s wrong just like, like, like, oh, no, like kind of just like, thinking about it.

The funny thing about you is that and I don’t say this again lightly, but you look good in every article of clothing that you’ve ever worn. You look good in every color. I mean, it’s kind of crazy.

It’s kind of crazy. So it’s hard for you to take a bad picture. You know that. Do you know that?

Yeah. But there’s still an anxiety sometimes.

You know, sometimes I really wish that my daughters could see themselves through my eyes because I meant what I said to Sky. To me, she doesn’t ever take a bad photo, but at the same time, I am not naive. I’m not just a guy who’s full of platitudes without acknowledging reality. Truth is, I have no idea what it’s like to grow up in a world full of selfies, full of picture perfect filters, Photoshop. So I can truly honestly understand why that for some kids that pressure to be perfect in this digital world might go too far. Even further than what Sky is describing, making them feel really anxious, even depressed. It feels like there are new reports and data coming out every day which shed light on the current state of our kids mental health. And as you probably know, it’s not a particularly hopeful picture. So today I’m turning to a child psychologist to get her take as someone who treats young kids with mental health issues.

We are seeing a lot of depression. We are seeing a lot of anxiety. We’re seeing a lot of trauma. These are some of the main reasons that young people end up in front of me.

I want to know what I can do as a dad to support Sky and the rest of my girls as they navigate this new world. I’m Dr. Sanjay Gupta, CNN’s Chief Medical Correspondent. And this is Chasing Life.

You know, just a few weeks after I recorded that conversation with Sky, there was some new data that came out from the CDC confirming some of our worst fears as parents. I’m going to warn you now, before I read you this, that a few of the statistics are pretty disturbing. A few mentioned suicide.

America’s teen girls are engulfed in a growing wave of sadness, violence and trauma.

This data was recorded in the fall of 2021, but the tragic trends have been heading this way for a while now.

Over the past decade, teens, especially girls, have experienced dramatic increases in experiences of violence and poor mental health and suicide risk.

Let me be more specific here. What they found was that 57% of teen girls reported feeling sad or hopeless. And that was nearly double the rate for teen boys. And this next one will probably shock you as it did me. But nearly 25% of teen girls reported making a suicide plan. One out of four girls. That was not easy for me to hear as a parent. Hearing about young people in such distress, feeling alone in the worst case, feeling hopeless, like they had nothing more to live for. That is a gut punch. And we cannot turn away our eyes to this. What exactly is driving it?

Basically, the numbers have worsened every year my girls have been alive. And that does coincide with the birth and the growth of the digital world. After looking over the report, thinking back to my conversation with Sky and my other daughters, I couldn’t help but wonder what role is social media playing in all this? What can we say for sure?

It’s very obvious that so much of what’s happening, right, for the average teen is like they’re living so much of their lives in the digital world on social media. And so much of this is connected and impacting their mental health and their presentation and how things work for them and how they feel about stuff.

That’s Professor Keneisha Sinclair-McBride. Her entire job is treating adolescents’ mental health. She’s a licensed clinical psychologist at Boston Children’s Hospital and an assistant professor of psychology at Harvard Medical School. She actually works alongside Dr. Michael Rich, the “Mediatrition” who we heard from earlier this season. And I learned a lot from Dr. Rich. I’ve been reflecting on that conversation quite a bit. But after I read the CDC report, I still had a lot of questions, and that’s why I called up Professor Sinclair-McBride. I started by asking her to simply respond to the one statistic from the report that I think really stuck out the most. And that is that more than 40% of high school students report feeling sadness or hopelessness. That’s keeping some of them from living their lives. 40%. And I wondered, was she seeing and hearing this from the young people she treats?

When you hear something like that, that’s, we’re talking about symptoms of depression. And I think a lot of kids are facing an epidemic of kind of loneliness and overwhelm. And when we think about everything that’s happening in the world, there’s a lot to feel hopeless about, if that’s the lens you’re looking at it in, or if you’re still learning and growing. Everyone’s upset about something. Bad things are happening all the time. So when you think about a young person trying to figure this out as their brain is developing in the shadow of a world altering event with COVID 19, this is not a surprising statement from the CDC’s report. Maybe the numbers are surprising people, but the actual diagnostic elements of it in terms of like these are the symptoms that kids are reporting, don’t feel surprising.

Part of what you specialize in as well is is body image issues and eating disorders. Do you think that this is all related when we, when we’re talking about what we’re seeing with mental health overall, body image issues, eating disorders and the impact of social media devices, content being fed to people on a regular basis, is it too flimsy to draw a connection between all these things, or do you think it exists?

I don’t think it’s too flimsy at all. I think that may start out pretty innocently of like, oh, I’m going to follow this influencer’s workout routine or that person’s eating looks really healthy. Maybe I’m going to copy some of her recipes and that can be super innocuous and fun and simple. But you know, you can easily fall down a rabbit hole of more and more and more and more depending on your particular makeup. And then there’s the fact that there’s so much of people’s appearance in the digital world that is not real. Right. The filters, Photoshop, cosmetic enhancements that people have, and a lot of teenagers who are still getting used to their growing bodies are comparing themselves. Well, I don’t look like her. It’s like she doesn’t look like her either. But you don’t know that, right? Because you’re looking at her social media feed. But now you’re feeling inadequate because of what you’re seeing on your screen.

Professor Sinclair McBride calls this the “Selfie Effect.” What the studies have shown is that scrolling through an unlimited supply of picture perfect images and then comparing them real time to your selfies – bam! That can have a real effect on people’s moods and psychological health. And while the trend does mostly impact young girls, they are not the only ones affected. People of all ages and genders have experienced this.

I think sometimes young people are like, It’s not that we don’t understand this. They know that Photoshop exists. They use Snapchat filters, they understand it. But like if that’s all you’re seeing, it kind of distorts your lens of what’s real. If everyone’s face is smooth with no pores. If, like everyone, you know, has a particular shape and that’s all you’re seeing, now you feel inadequate.

They know that these filters exist. They know that there’s Photoshopping and all that. And yet still they think that that becomes an ideal, even though they know it’s fake or it’s not real exactly. It’s filtered in some way. It’s still it changes what they want to aspire to be or look like.

Right. Like if you think about the trend lately now I think it was a couple of years ago now, like the idea of someone being goals, your goals, that person is goals. But like you don’t know what’s happening behind the scenes to make them look that way, right? Or like, you don’t know how realistic this is. Or maybe that’s just, that’s not your body type or that, you know, like there’s just so much more variety in life than just a few set ways of being. But those are the things that get the most views and the most attention. And you can just see how that would kind of change people’s perceptions.

Has that sort of thing been there much longer than social media. I mean, you know, when I was growing up again, it was magazines and pictures of just inexplicable models. You know, they couldn’t possibly have that skin or that body type. It’s the same thing, isn’t it?

But it’s just so much bigger. Like, you know, there’s only there were only so many fashion magazines. And once you read that issue, you could keep it. But that’s the end of that, right? You read the whole thing, you looked at the images. That’s what it is. But now you’ve got the stuff in your phone and it’s always there. It’s always available to you. You can look at hundreds of pictures of the people that you’re interested in looking at. It just it never, never really ends. And I think that that accessibility is what feels different. We’ve always been comparing ourselves. None of these things are new, but there’s the accessibility of it all feels very different.

And I guess the persistence, like you’re saying, it’s just always there are something you’re carrying around in your hands. Do you think that a younger person, a person whose brain is not yet fully developed, who’s continuously exposed to these types of images, what does it mean for them long term? Does it do their brains change in some way in terms of expectations?

If that’s what you’re seeing, it’s got to do something to your expectations of what people look like, which I think is why that like kind of tuning your feed, deciding where you’re going to put your attention, kind of creating that balance becomes super important because you don’t just have to look at one type of body on your social media. But I think that that involves having a conversation with young people to really like kind of see where their heads are around this stuff, right? Because there’s a lot that can be really affirming. But we have to like we have to look for it. We have to give our attention to it. Everybody on the internet is trying to buy your time. I talk to young people about that a lot because they don’t like to be played. So it’s important to like to like so this is this is a business, right? And that influencer, yeah, she’s doing a workout, but she also is trying to get more sponsorships. So when you see it for what it is, right, a business, I think kids can kind of take that step back and be like, okay, if you want to buy my time, I’m going to give my time to people who are standing for what I believe in.

You know, you’re absolutely right about that. It’s funny when I’m, again talking to my girls, that was the thing that seemed to get to them the most. The idea of being played, like you say, you know, someone’s trying to take something from them – that did seem to get their attention a bit. I wonder you run a practice where you’re caring for these children, these young people, adolescents. How big a problem is this? Is there a way to contextualize this?

So when it comes to social media, I feel like there’s a reassurance I can offer here – that honestly, most of my patients, the things that we’re talking about, in terms of what are, what their hopes and fears are, what are the things that are increasing their anxiety and the depression. Like teenagers from 30 years ago, would resonate, it would resonate with them too. Am I going to get into college? I had an argument with my parents. I’m really anxious when I have to talk in front of class. Their lives are these like complex, rich things that have hopes and dreams and problems just as they’ve always had. So that’s good. It’s not like every kid is going to get mental health treatment because social media is, you know, ruining their life. That is definitely not the case at all.

Hearing Professor Sinclair-McBride put this into a little context was helpful because these issues are not black and white. For some kids, even most kids, being on social media isn’t really a problem. It’s certainly not a bigger problem than teens had before social media. But the issue is that for some kids, it could be a huge problem. And you can’t always predict who. But the one thing I learned, the kids probably know themselves. And as a parent, you have to ask the questions then. Do you think this is a problem in your life? Is it interfering with things you would like to be doing instead? And yes, do you believe that social media might harm you? Might it make you feel bad about yourself, affect your mental health? These are not easy conversations to have, but they are necessary ones. As the parents of children who now straddle two worlds – a real life world and a digital world. And after the break, we’re going to do a house call with Professor Sinclair-McBride to get her advice for me, my family and all of yours as well.

And do I have responsibilities as a dad at this point to, I mean, I’m present, I’m very present. But to, should I be doing anything.

You should still say it even if they roll their eyes. Like as much as teenagers are like of course you have to say that you’re my dad or like of course, my parents think that. They always say I look great. They say it with like an eye roll, but also this little smile.

That’s coming up in just a moment. But before we go to break, you know, I’ve been the one asking a lot of questions this season, but I also do want to hear from you. I know this is deeply personal for a lot of people. What do you want to know when it comes to mental health and social media? Have you made any changes to your own digital diet since listening to this season of the podcast? Just give me a call at 470-396-0832. Leave a message. It would mean a lot to hear from you, and we might even include your voice on an upcoming episode of the podcast.

You know, from a brain perspective, a neurological perspective, teenagers brains are still growing and developing, probably even up until their mid-twenties. So it makes sense that they may be more at risk for stress or anxiety from using social media. And that helped me put the CDC report we talked about earlier into a bit more context. And if there’s one thing that I’ve also learned on this journey, it’s that many experts agree abstinence is not the answer. It is not realistic to give up our phones or our devices completely.

I saw something really interesting in one of the earlier episodes where one of your daughters mentioned that she thought that.

Yes.

Millennials probably had the best childhoods because we had balance. There was time to be connected to the digital world, and there was time that you were not connected. And I was like, okay, that’s a kid who knows what she’s talking about because that’s my main mission is to talk to people about balance. I think there’s so much fear when we’re talking about social media. People just want to take away, take away, restrict, restrict, ban and like that’s not really realistic. First of all, adolescents don’t respond very well to that.

You’re right about that.

So what does that balance actually look like? Professor Sinclair-McBride says it’s different for every teen she treats, and it typically starts with a few questions.

What are their goals? Are they participating in the school play? Are they doing community service? Like whatever it is, they have something. If you don’t have that, then I’m more worried about you lying in your bed staring at the phone all day.

If somebody is listening right now and says, okay, yeah, I am checking these boxes that they’re talking about in terms of I realize that this is interfering with my real life. This is I’m not doing some of the things I’d like to do. But what do you tell somebody then who says, yes, that’s me. I’m experiencing these issues.

First, I give a lot of praise and affirmation because it takes a lot to be able to say, hey, I’m having a problem with something. There’s a vulnerability to that and a humility to that that definitely needs to be honored. Because there’s a lot of shame in realizing that you’re not kind of living your life the way you want to be living it, right? So that’s the first step for me. And then I like to find out kind of what, before this was a problem, what did you like to do? What were you like? What did you do? What were you interested in? What did you and your friends do? And then so that’s like going in the past and then going in the future, what do you want for the future? Not necessarily what you want to be when you grow up, what kind of stuff you want to spend your time doing, right? Like, you know, what do you want to do after high school? What are what are your goals like? What’s fun for you? What is your dream vacation? Like just any like sort of like, where are you trying to go with things? Because that gives me hints into what we can spend time on now, that’s not just the device.

You know, Professor Sinclair-McBride is right. It does take a lot of bravery and vulnerability to admit you have a problem. But at the end of the day, I also wonder if there’s more that us parents should be doing, that we can be doing, on a larger scale to protect kids in the first place. Multiple experts have told me just how easy it is to get sucked into a social media rabbit hole. Apps like TikTok or Instagram, they are made to activate a stream of dopamine that rewards us for staying online. They know what they’re doing. They also do things like fire up your amygdala, which then stirs up your emotions. So now you got this really big mix of neurochemicals circulating in your brain. And for what? One of my guests, Catherine Price, even compared social media to slot machines, saying they are both engineered purposely to encourage us to keep on playing or in this case, scrolling. And with that in mind, I asked Professor Sinclair-McBride what actions she might want to see from tech companies.

Transparency. Like, you know how you said the thing that resonated with your daughters the most was when they realized it was a business. People trying to buy your time, all that kind of stuff. I wish that that information was constantly available to them. Like, if you were just like watching a TikTok and it says underneath this person is sponsored by blah, blah, blah, like it should just be, like just in big blaring letters. Not in a way that you can avoid it or like, you know, this person is selling you this supplement, but really they work out five hours a day. Like I don’t know, whatever it is just to make it really clear what’s really happening.

I don’t want to again, sound naive or Pollyannish, but like I was really interested in the comments she made about the “Selfie Effect” and the filters and all that. And I mean, should should these filters, I guess they’re going to exist. It is, is as one of my daughters said, we talk about these things as being good things or bad things. Sometimes they’re just a thing. They are there. And, you know, people like to look at beautiful pictures of sunrises and sunsets and mountains and nature. But when it comes to filtering the human, you know, our own bodies and stuff. If you were to wave a magic wand or the tech companies came to you and said, with all your expertise, how should we handle the idea of people modifying, altering their appearance in ways that make it less authentic?

I think I have a kind of an intersectional response to that in the sense that, like a lot of the filters kind of have a very Eurocentric lens. So it would be great if they did not make people’s skin colors lighter or change the shape of their noses or change how big their eyes are, or do things that make them more towards a certain.

Interesting.

Standard of beauty that may not be from the cultural background that they’re from, right? Like, I think that would be really clutch. Like it would be nice if like when you put a filter on, it said you’re beautiful as you are, but you can play with this if you want, right? Like, it’s just just a tool is just something that is here. But also this picture of you without the filter is also really cool. And I notice that some kids are really into sending them each other unfiltered, silly pictures or like making like really ridiculous faces and like, that’s a sense of a kind of like vulnerability or connection that like, I really care about you, we’re really close because I sent you this really unflattering picture of myself.

Right. I’m curious if we can start to predict trajectories of where this goes based on the people who are using these technologies the most. I know this is a totally hypothetical question that requires a crystal ball, but if you had to sort of look a decade or even two decades into the future, do you think that girls or kids, adolescents that are my adolescents’ age, my kids age, they’re teenagers, do you think that they will continue to be using social media as much as they do now? Or is this something you believe is more a period of adolescence?

I think probably the amount of time is the period of adolescence. I also am very inspired by how much this generation of kids is very take-no-prisoners about things that cause them harm or needs to be fixed in the world. Maybe they’re going to be the ones to figure out how to make that so. I can’t imagine everyone who’s like 14 now is going to be sitting at 30 looking at the same Snapchat filters that they are right now. I’m sure there will be doing something completely different, but I also think that they may be a part of the change of how to make this feel more balanced and empowering.

It has been amazing to watch this movement among Gen Z and even younger generations to start to forgo filters, forgo Photoshop and use social media in a more authentic way. It makes me feel pretty hopeful, and it’s something that I see my own daughters doing as well. They are just unapologetically themselves, and most of the time they’re not afraid to put up an unedited or unfiltered photo of themselves out there. But I do know there is that pressure to be perfect and it can still get to them. It’s something that Sky told me at the very beginning of our conversation.

How people see you, I guess, with social media, you want to put out like a good picture of yourself, make it seem like like your life is so perfect. Even though not everyone’s life is perfect.

Sky’s right. There is pressure to be perfect online. That’s no secret. And like phones and social media itself. Filters and Photoshop probably are not going away. But as we’ve learned today, they can go too far. Falling down this rabbit hole can have a real impact on your mental health. Those CDC numbers, they’re still on my mind. So what can I do as a dad? What can any of us do as parents to support our children, to help them navigate this virtual world? Telling Sky, for example, she is beautiful, is absolutely sincere. It’s honest, she knows that. But it just doesn’t feel like it’s enough sometimes either. So I decided to get a little vulnerable myself with Professor Sinclair-McBride and asked her for advice.

A lot of young women feel like they’ve got to put out this perfect picture because you’re supposed to put out perfect aspects of your life and they know it’s not reality, but they’re giving that to other people. So we’re all just in this like feedback loop of looking at perfect pictures and perfect photos, even though we know that’s not reality. So we’re just comparing our worst days, our worst moments, our worst angles to other people’s best. And of course, you’re going to not feel great when you do that.

I keep saying I don’t want to be naive here, and I really don’t. But like I think I was surprised when Sky said that she, I guess I look at the pictures of my family. I think you’re all perfect no matter what. I mean, you look great no matter what, you know. But it is, I don’t know, it kind of gets to me a little bit. I’m feeling myself get a little emotional thinking about her saying that because I, like it’s not that big a deal, right? The picture. It’s not. I think that she would agree with that. And yet the motivation for her to have said that must come from a deeper place where something has, it’s not that it’s harmed her, but it’s made her feel that way. And I you know, I want to I want to protect my kids from feeling that way. And yet if I just say, hey, you always look great, then that’s not going to work. That’s not that’s not that doesn’t get through, I’m just dad saying, of course I’m going to say that, Dad, you know.

I think that this kind of stems from this, a fear of like fear of imperfection. Like if I if I make a mistake, if I’m not always presenting my best, the bottom is going to fall out and I’m, people are going to reject me or I’m not going to get the things that I dream of getting. And like it’s not necessarily that any, you know, set of bad circumstances or good circumstances makes someone feel like that. It’s just like if you get a lot of positive feedback, you want to keep getting positive feedback, right? And so being being able to feel comfortable in your mistakes and in your imperfection is like a continuous lifelong process. And as she gets older, I think that that sense of just feeling more ownership over that, this is me all the good, all the bad, and you know, I have value that starts to really kind of solidify for people as they get older.

And do I have responsibilities as a dad at this point to, I mean, I’m present, I’m very present, but to, should I be doing anything?

You should still say it even if they roll their eyes. Like, as much as teenagers are like, of course you have to say that, you’re my dad. Or like, of course my parents think that, they always say I look great. They say it with like an eye roll, but also this little smile. Like people need to know that they’re valued, right? People need to, need to hear that, to know that no matter what, there’s a safe space to come home to. And they’re going to give you that eye roll because they’re supposed to. But I think it really does matter the amount of kids who will tell me things their parents say and not like, oh, my God, you won’t believe this Dr. Sinclair. But like, they’re like, happy or proud or pleased. They might not want their parents necessarily always to know that. But the stuff that you guys say really does matter.

Truth is, I will take the eye rolls any day if it means my daughters know that I care. Sometimes it does feel like the words you say to your kids don’t really make a difference. But they do. They’re listening and they are playing a role that has been handed to them. That role is to roll their eyes, to be nonplused. I can’t be bothered, Dad. But they are hearing you. They are processing what you’re saying. They are storing that information, hopefully feeling affirmed by all of it as well. After speaking to Professor Sinclair-McBride, I’m more inspired, frankly, to just keep telling my daughters just how much they mean to me over and over again. It’s important. I hope you’re going to do the same with your kids, but also your friends, your loved ones. Because being in a world surrounded by screens, those real life conversations, they make even more of a difference than ever.

There was another part of the conversation with Professor Sinclair-McBride that really stuck out to me, and that’s when she called for social media companies to be more transparent. It’s an interesting proposition. Throughout the season, I’ve asked different experts their opinions and takes on what we can do to make social media a better place. But now there is a push to pose that very same question to the social media companies themselves. And the professor isn’t the only one calling for change.

Unregulated social media is a weapon of mass destruction that continues to jeopardize the safety, privacy and well-being of all American youth. It’s time to act, and I urge you Senators, to make meaningful steps to regulate these companies.

On our next episode. We’re going to give you an inside look at the fight to hold social media companies accountable. Thanks for listening.

Chasing Life is a production of CNN Audio. Our podcast is produced by Grace Walker, Xavier Lopez, Eryn Mathewson, and David Rind. Our senior producer is Haley Thomas. Andrea Kane is our medical writer and Tommy Bazarian is our engineer. Dan Dzula is our technical director. The executive producer of CNN Audio is Steve Lickteig. And a special thanks to Ben Tinker, Amanda Sealy and Nadia Kounang of CNN Health and Katie Hinman.