How Social Media Actually Impacts Our Mental Health

The mass media serve as a system for communicating messages and symbols to the general populace. It is their function to amuse, entertain, and inform, and to inculcate individuals with the values, beliefs, and codes of behavior that will integrate them into the institutional structures of the larger society."

— Edward S. Herman and Noam Chomsky, Manufacturing Consent

The wrong measure

People love to make sweeping claims about social media ruining our mental health. But the research is murkier than you'd think. A Curtin University study published in late 2024 measured people's actual social media use, not what they reported.

It found a very weak link to anxiety, no link to depression or stress, and even a slight improvement in attention. The lead researcher was careful to say this doesn't mean social media is harmless. The relationship, she said, has many layers.

I agree, and I'd go further. The study measured how people felt at a single moment. But a snapshot of someone's mood is the wrong measure. It's what social media, corporations, and society teach us to want, believe, and expect that is impacting our mental health.

Herman and Chomsky made that point about mass media decades ago. It applies even more today as we become exposed to a globalized Western monoculture.

Most of us sense that social media, and legacy media too, is affecting us in negative ways. We just can't always say how. So let me give you several examples from my own field.

Follow the money

TikTok and podcasts have turned complex therapeutic ideas into easy-to-market caricatures. That's good for the platforms and good for the influencers who appear to be advocating for mental health.

I find it ironic when an influencer pauses a video to tell viewers how important mental health treatment is, then reads an ad for a teletherapy platform. When a therapist talks about mental health, they carry a responsibility for the well-being and safety of the people listening. That responsibility is written into our licenses and our ethics codes. An influencer carries no such obligation; their responsibility ends when the video does.

I can't overstate how much these companies, platforms, and influencers are shaping the way we talk and think about mental health. And what they're selling looks nothing like real clinical work, which is slow, careful, and deliberate.

BetterHelp, the teletherapy arm of Teladoc Health, spent about $518 million on advertising and marketing in 2025. Its revenue that year was about $950 million. For every dollar BetterHelp took in, about 55 cents went to ads.

Now look at what the therapists see. BetterHelp's own job postings list $43 to $70 an hour for live sessions. Therapists have also reported being paid by the word for messages they send clients between sessions.

This is where we start to see how social media is attempting to fundamentally change mental health treatment.

When pay is tied to messaging, the incentive is to message more. When I write to a client, anything beyond a scheduling note takes me twenty to thirty minutes. That's not because I write long emails. It's because what I write must hold the same therapeutic frame I bring to our sessions. A system that pays for volume over quality incentivizes the wrong behaviors and changes the essential features of the clinical relationship.

Across large parts of the field, this wears away the safeguards and standards of our profession. When neither the clinician nor the patient has ever experienced real psychotherapy, therapy becomes a hollow imitation of itself. And no one notices, because no one has anything to compare it to.

Social media didn't start this. It amplified a shift that insurers and parts of academia set in motion decades ago.

"Cognitive Behavioral Therapy is statistically significant"

This is one of the greatest misdirections ever sold to people who are genuinely struggling. Since the 1970s, health insurance companies and some academicians in the field of psychology have pressured clinicians to offer short-term, manualized CBT, backing it as "evidence based." So, let's look at what evidence-based means.

In 1989, the National Institute of Mental Health published its landmark study on the efficacy of psychological and pharmacological treatments for depression. Two hundred fifty patients were randomly assigned to one of four 16-week treatments: short, manualized CBT; interpersonal therapy; the antidepressant imipramine; or a placebo pill. Both pill groups also met with a psychiatrist for brief, supportive check-ins.

CBT, the treatment we are told is the gold standard, did not do significantly better than a placebo pill paired with supportive check-ins. On the Hamilton Rating Scale for Depression, a 54-point measure, the difference came to a 1.2-point reduction; this was deemed statistically significant.

In normal conversation, "significance" means that something is large and important. In statistics, significance refers to a result that is directly attributable to the intervention and not some other variable.

By 18 months, 78% to 88% of the patients who entered treatment via these short, manualized methods had relapsed or sought further treatment. At follow-up, there were no significant differences between CBT, interpersonal therapy, medication, and the placebo group.

What does evidence-based research really show?

In 2004, Westen et al. reviewed the research on brief, manualized treatments for depression and found:

• The average patient was still clinically symptomatic at the end of treatment.

• Within two years, about half had sought further treatment.

• Marginal improvements were seen in about 25 percent of people.

The golden rule

The reframe from slow, careful, and deliberate care to short-term, "evidence-based" manualized therapy has clearly benefited the bottom line of insurance companies seeking to maximize shareholder value. After all, it's the people with the gold who so often make the rules. Yet, when it is people like you and me who fund our privatized insurance system, we aren't getting to make the rules.

Companies and academicians push these short-term, manualized therapies to create a new normal, and call them evidence-based when the actual evidence shows a very different reality. Some academics went further. In 2008, Baker, McFall, and Shoham published a major report in Psychological Science in the Public Interest arguing that clinicians were failing to use the treatments with the strongest research behind them (Baker et al., 2008). In an accompanying editorial, Walter Mischel called the gap between science and practice "an unconscionable embarrassment" and "a case of professional cognitive dissonance with heavy costs" (Mischel, 2008). The message is clear: therapy as most clinicians practice it doesn't count as science. Psychologist Jonathan Shedler cites Mischel's remark as an example of how academic researchers denigrate psychotherapy as it is actually practiced (Shedler, 2013).

What to look for

Social media changes our norms, our values, and how we think about the world. It also offers companies and those with something to gain an unprecedented avenue for social engineering. Studies that focus on discrete experiences of happiness, depression, or stress miss the forest for the trees.

Good therapy is life changing. It exposes us to the worst parts of ourselves in a manner that allows us to engage productively with those dynamics. Therapy is often expensive and a serious investment for several years. There are no short or fast solutions.

Look for smaller private practices that seem to have a developed point of view and understanding of how they offer treatment, particularly ones that offer both virtual and in-person sessions. The in-person environment is a critical component of my work with teenagers. I also find that it gives my patients the chance to develop a flesh-and-blood connection sorely lacking in the modern age. In-person care costs more to offer: an office, furnishings, rent, a fixed schedule. Even if you prefer to see your therapist virtually, a practice willing to carry that cost is telling you something about its priorities.

Sometimes, patients wish to find a clinician who mirrors them or shares the same characteristics. In the long run, this matters less than you might think. Find someone you feel comfortable talking to and sharing with in the beginning. It is more important to find a therapist who can point out what you are doing (reenacting, idealizing, devaluing, people-pleasing) in the context of your clinical relationship.

Avoid people who offer quick solutions. Professionals stand to make money in a competitive environment from their chosen modality and theoretical position. Does their position seem to suggest they have a quick fix?

A fish doesn't know it's swimming in water. Most outcome research is done the day the intervention is over, at most 18 months; life is long. We are all swimming in it. Part of the work of good therapy is learning to notice the water