Increases in Depressive Symptoms, Suicide-Related Outcomes, and Suicide Rates Among U.S. Adolescents After 2010 and Links to Increased New Media Screen Time

What This Research Found

Jean Twenge and colleagues' 2017 study in Clinical Psychological Science represents a watershed moment in understanding the relationship between digital technology and adolescent mental health. Drawing on two of the largest and most rigorous datasets available, the Monitoring the Future survey (N = 506,820) and the Youth Risk Behavior Surveillance System (N = 109,306), the researchers documented an alarming pattern: adolescent depression and suicide had increased dramatically and suddenly, with the inflection point occurring precisely when smartphones became ubiquitous and social media use exploded among teenagers.

The magnitude of change was unprecedented in the history of adolescent mental health tracking. Between 2010 and 2015, depressive symptoms among adolescents increased by more than 50 percent. Suicide rates, which had been declining for decades, reversed course and began climbing. The rate of adolescents reporting severe depressive episodes rose from 8.7 percent in 2005 to 11.3 percent in 2014. Girls were hit particularly hard: major depressive episodes among girls increased 58 percent between 2010 and 2015. Suicide rates for girls aged 15-19 doubled between 2007 and 2015, reaching their highest point in 40 years. This was not gradual drift but a sharp discontinuity in long-term trends.

The temporal pattern pointed unmistakably to technology. The researchers identified 2012 as the inflection point, the precise year when smartphone ownership crossed the 50 percent threshold among Americans and approached 70 percent among teenagers. The iPhone 4, released in 2010, had introduced the front-facing camera that enabled selfie culture. Instagram launched in 2010, Snapchat in 2011. By 2012, the infrastructure for constant digital self-presentation and social comparison was in place and had achieved critical mass. Before this threshold, not having social media was common and unremarkable; after it, absence became social exile. The mental health data tracked this transition with remarkable precision.

Dose-dependent relationships emerged from the data. The relationship between screen time and depression was not binary but graduated: the more time teenagers spent on screens and social media, the more likely they were to report depressive symptoms, suicidal ideation, and suicide attempts. Adolescents who spent five or more hours daily on electronic devices were 66 percent more likely to have at least one suicide risk factor than those who spent one hour. This dose-response pattern, where more exposure produces more effect, is a hallmark of causal relationships in epidemiology.

Non-screen activities showed protective effects. Time spent on in-person social interaction, sports and exercise, homework, print media, and attending religious services was associated with lower depression risk. The research suggested a displacement mechanism: every hour spent on screens was an hour not spent on activities that support mental health. The platforms were not merely adding something harmful but displacing something essential. The adolescent brain requires face-to-face interaction, physical activity, and unstructured time for healthy development; screens were crowding out these necessities.

The underlying mechanisms align with what we know about narcissistic dynamics. Social media platforms operate through intermittent reinforcement, the unpredictable pattern of rewards that creates addiction-like dependency. Likes arrive unpredictably, sometimes many, sometimes none, keeping users checking compulsively. This is the identical mechanism that creates trauma bonding in abusive relationships, where occasional positive reinforcement amid mostly negative treatment keeps victims hoping and attached. The platforms also weaponise social comparison, constantly exposing users to curated highlight reels that make their own lives seem inadequate. The false self that narcissistic abuse survivors often develop finds its cultural equivalent in the curated online persona that users must maintain.

How This Research Is Used in the Book

This study appears prominently in Narcissus and the Child, particularly in Chapter 13: The Great Accelerant, which examines how digital technology has amplified narcissistic dynamics at societal scale. The research provides crucial empirical evidence for the chapter's central argument: that smartphones and social media are not neutral tools but environments that exploit the same psychological vulnerabilities as narcissistic abuse.

The book situates this research within a broader framework connecting individual pathology to cultural phenomena:

"Longitudinal analysis of data from 11 million young people documented increasing rates of depression and suicide among teenagers, rising by more than 50 percent between 2010 and 2015, precisely the period when smartphones became ubiquitous and social media use exploded. This is not merely correlation; dose-dependent relationships emerged: the more time teenagers spend on social media, the more likely they are to report symptoms of depression and anxiety."

The chapter draws an explicit parallel between narcissistic parenting and digital platforms:

"The smartphone does not merely resemble an abusive relationship; it exploits identical neural pathways through identical psychological techniques. The platforms employ neuroscientists specifically to optimise these effects. The correlation between smartphone adoption and rising mental health concerns reflects causation operating through documented, replicable mechanisms, the same mechanisms that make narcissistic relationships neurologically devastating."

The research also informs the book's discussion of scaling from individual to population effects:

"The stronger evidence lies not in trait scores but in behavioural and neural signatures. The 50 percent increase in adolescent depression since 2010, the documented cortical thinning in heavy users, the progressive amygdala sensitisation in habitual checkers, these are not self-report measures subject to shifting baselines. They are objective markers of a population undergoing neurological transformation."

The book uses Twenge's findings to argue that understanding narcissistic abuse requires understanding the cultural environment that normalises and amplifies narcissistic dynamics. Survivors are healing not only from individual abusers but within a digital ecosystem designed to exploit the same vulnerabilities their abusers exploited.

Why This Matters for Survivors

If you have experienced narcissistic abuse, this research speaks directly to your recovery and to understanding the cultural context that shaped both your abuser and your own vulnerability.

The platforms that damaged your abuser may be damaging you too. The intermittent reinforcement that kept you bonded to your narcissist operates identically through social media likes and notifications. The false self you may have developed to survive your abuser finds cultural reinforcement in platforms that reward curated self-presentation. The hypervigilance you developed watching for your abuser's mood shifts may now manifest as compulsive phone checking, waiting for the next notification that might bring validation or threat. Recovery requires recognising that the digital environment is not neutral ground but territory designed to exploit the exact vulnerabilities your abuse created.

Understanding this helps explain why recovery feels so difficult in the modern world. Unlike survivors in previous generations, you cannot simply leave your abuser and enter a healthier environment. The cultural environment itself has become suffused with narcissistic dynamics. Social media rewards the same self-promotion and image management that characterised your abuser. Dating apps facilitate the same love bombing and rapid devaluation patterns you experienced. Workplace cultures increasingly demand the self-branding that feels disturbingly familiar. This is not paranoia; this research documents that the environment has genuinely shifted toward normalising patterns that survivors recognise as pathological.

The research validates limiting your digital exposure during healing. When clinicians or well-meaning friends suggest taking breaks from social media, this is not technophobia but evidence-based recommendation. The dose-dependent relationships Twenge documented mean that every hour you spend on platforms designed to exploit your vulnerabilities is an hour of exposure to psychological mechanisms identical to those that harmed you. The protective effects of non-screen activities, including in-person connection, physical activity, and time in nature, provide alternative paths that support rather than undermine recovery. Your nervous system, still calibrated for threat detection from your abuse, needs respite that screens cannot provide.

This research helps you understand your children's vulnerability. If you have children, particularly adolescents, this research provides empirical grounding for protective decisions that may feel countercultural. The 50 percent increase in adolescent depression is not abstract statistics; it represents real teenagers whose mental health has been compromised by platforms designed to maximise engagement regardless of psychological cost. If you experienced narcissistic abuse, your children may carry both genetic predisposition and learned patterns that make them particularly vulnerable to these platforms. Protecting them from early and intensive social media exposure is not overprotection but evidence-based prevention.

The generational dimension illuminates intergenerational patterns. If your narcissistic abuser was a parent or older family member, they likely developed their pathology in a pre-digital context. The platforms may have amplified their traits, providing endless narcissistic supply and validation for their grandiosity, but they did not create the underlying pathology. However, younger people, including your own children and the next generation of potential partners, are developing in an environment where narcissistic traits are actively cultivated by design. Understanding this helps calibrate expectations: the pool of genuinely healthy potential relationships may be smaller than in previous generations, and discernment becomes even more critical.

Clinical Implications

For psychiatrists, psychologists, and trauma-informed healthcare providers, Twenge's research has significant implications for treating survivors of narcissistic abuse in the digital age.

Assessment should include detailed technology use evaluation. Patients presenting with narcissistic abuse histories often have complex relationships with digital platforms. Some use social media to monitor abusers, maintaining unhealthy connection under the guise of safety planning. Others have developed compulsive checking behaviours that mirror the hypervigilance they developed in the abusive relationship. Still others avoid digital spaces entirely, which may protect their mental health but also increase isolation. Comprehensive assessment should explore not just how much time patients spend on screens but how that time affects their mood, trauma symptoms, and recovery. Questions about what platforms they use, how they feel after using them, and what triggers compulsive checking can reveal patterns that inform treatment.

Treatment planning should address digital exposure as a recovery variable. Just as clinicians consider substance use, sleep hygiene, and social support in treatment planning, digital exposure deserves explicit attention. For some patients, structured reduction in social media use may be as important as any therapeutic technique. The neuroplasticity that enables recovery requires conditions that support neural change; constant digital stimulation that activates threat detection and reward-seeking pathways may impede this plasticity. Clinicians should consider recommending phone-free periods, social media fasts, or complete platform deletion based on individual patient response.

Psychoeducation about platform design is itself therapeutic. Many patients feel shame about their relationship with technology, viewing their compulsive phone checking as personal weakness rather than response to sophisticated manipulation. Education about how platforms are designed by teams of neuroscientists to maximise engagement regardless of user wellbeing can relieve this shame and redirect energy toward protective action. Understanding that intermittent reinforcement creates the same neurochemical patterns as gambling addiction, and that this is intentional rather than incidental, helps patients recognise that their struggle is not personal failure but predictable response to designed exploitation.

The therapeutic relationship offers corrective experience. In a world where relationships have become increasingly mediated through platforms optimised for engagement rather than wellbeing, the therapeutic relationship becomes even more important as a model of consistent, boundaried, authentic connection. The therapist who maintains consistent presence, neither idealising nor devaluing the patient, responding authentically rather than performing, demonstrates what healthy relating feels like in contrast to both narcissistic abuse and digital pseudo-connection. For patients whose primary experiences of relationship have been characterised by manipulation and performance, this corrective experience may be the most important element of treatment.

Consider family therapy implications for digital-age parenting. Parents seeking help for their own recovery from narcissistic abuse often struggle with technology decisions for their children. The research provides empirical foundation for recommendations that may feel countercultural: delaying smartphone access, limiting social media, prioritising in-person activities. Clinicians can help parents distinguish between appropriate protection and anxious overcontrol, recognising that some protective instincts, informed by their own abuse experiences, are validated by population-level research rather than representing projection of their trauma onto their children.

The Smartphone as Narcissistic Environment

The conceptual innovation in how Narcissus and the Child uses this research lies in reframing digital platforms not as neutral tools that humans use wisely or foolishly but as environments that actively cultivate narcissistic adaptations. This reframing has implications beyond individual mental health to understanding cultural transformation.

The mechanisms are identical, not merely analogous. Chapter 13 of the book identifies five mechanisms by which proximity to a narcissist reshapes the brain: chronic stress dysregulation, attachment system conditioning, mirror system atrophy, prefrontal cortex hijacking, and default mode network disruption. The chapter demonstrates that smartphones activate every single one. The notification ping triggers cortisol release. Social comparison activates threat-detection circuits. The unpredictable reward schedule of likes creates the same attachment conditioning as narcissistic abuse. Hours spent seeking connection through devices that cannot reciprocate produce mirror system deficits. The constant pull of notifications redirects executive function from self-directed goals to phone-checking. The endless scroll prevents the DMN rest necessary for self-reflection.

The platforms are designed to exploit vulnerability, not incidentally harmful. Frances Haugen's 2021 disclosure of internal Facebook documents revealed what researchers had suspected: social media companies deliberately design their platforms to maximise engagement by exploiting psychological vulnerabilities. They employ neuroscientists and behavioural psychologists whose explicit goal is creating what the industry euphemistically calls "engagement" but which operates through documented addiction mechanisms. The harms documented by Twenge are not unintended side effects but predictable consequences of intentional design choices prioritising advertising revenue over user wellbeing.

The scale difference transforms individual pathology into cultural phenomenon. A narcissistic parent damages one child. A narcissistic partner damages one family. A smartphone in every pocket, running algorithms optimised for engagement above all else, damages an entire generation. Twenge's research documents this transformation at the population level. The 50 percent increase in adolescent depression represents millions of individuals whose mental health has been compromised by platforms that found their vulnerabilities and exploited them. This is narcissistic abuse at industrial scale.

The intergenerational transmission has been accelerated. Previous generations developed narcissistic traits through specific family environments and cultural messages; the transmission was relatively contained. Digital platforms have democratised and accelerated this transmission. Every adolescent with a smartphone is exposed to an environment optimised for cultivating narcissistic adaptations: self-promotion, image curation, validation-seeking, social comparison. The intergenerational patterns that previously required specific family dynamics now operate through technological infrastructure reaching billions.

The Displacement Hypothesis

One of the most important findings in Twenge's research concerns not what screens add but what they displace. The protective effects of non-screen activities suggest that technology's harm operates partly through replacement of developmental necessities.

Adolescent brains require specific inputs for healthy development. Face-to-face interaction builds emotional empathy through mirror neuron activation that screens cannot provide. Physical activity supports affect regulation through neurochemical pathways that sedentary scrolling cannot access. Unstructured time enables the default mode network processing necessary for identity formation. Sleep, systematically disrupted by evening screen use, is when the brain consolidates learning and emotional processing. These are not optional extras but developmental necessities.

Every hour on screens is an hour not spent on these necessities. The displacement is not merely additive but substitutive. An adolescent scrolling through Instagram is not also engaging in face-to-face conversation, physical activity, or reflective solitude. The platforms compete for a finite resource, namely waking hours, and they win through design superiority. They are optimised to capture attention; unstructured time and face-to-face conversation are not. The resulting displacement starves developing brains of inputs required for healthy maturation.

For survivors, displacement operates doubly. Recovery from narcissistic abuse requires the very inputs that screens displace: authentic human connection that rebuilds capacity for trust, physical activity that regulates the nervous system, unstructured reflection that processes trauma. Survivors who fill these needs with digital connection, even well-intentioned support groups, may be displacing the non-screen activities that support neural healing. The neuroplasticity that enables recovery requires conditions that screens may actively prevent.

Methodological Considerations and Ongoing Debate

Responsible engagement with this research requires acknowledging both its strengths and limitations.

The datasets are exceptionally large and nationally representative. Monitoring the Future has tracked American adolescents since 1975, providing unparalleled longitudinal data. The Youth Risk Behavior Surveillance System provides complementary data with different methods. The convergent findings across these independent datasets strengthen confidence in the patterns observed.

Correlation does not definitively prove causation. The strongest form of causation, experimental manipulation, is ethically impossible here: researchers cannot randomly assign adolescents to years of heavy social media use. However, several features of the data support causal interpretation. The temporal pattern, with mental health decline following technological adoption rather than preceding it, rules out simple reverse causation. The dose-response relationship, where more screen time predicts worse outcomes, is characteristic of causal relationships. Subsequent longitudinal studies tracking individuals over time have generally supported the screen-to-depression direction.

Effect sizes are debated. Some critics note that screen time explains only a small percentage of variance in depression, comparable to other factors with modest effects. However, population-attributable risk, the public health impact when a modest effect is applied to billions of users, remains substantial. A "small" effect size multiplied across a generation represents millions of affected individuals.

Measurement of "screen time" is crude. Not all screen activities are equivalent: passive scrolling through comparison-triggering content likely differs from active communication with close friends. Future research distinguishing types of use may clarify which specific activities drive the observed effects.

Cultural variation requires investigation. Most research has focused on American adolescents; generalisability to other cultures with different technology use patterns and mental health baselines remains to be established.

Historical Context and Subsequent Developments

This 2017 study catalysed a still-ongoing transformation in how society understands technology's psychological effects.

The research arrived at a tipping point in public awareness. By 2017, parents, educators, and clinicians had observed changes in adolescent behaviour and wellbeing but lacked scientific framework for understanding them. Twenge's research provided empirical validation for intuitions that something fundamental had shifted. The study became one of the most widely discussed psychological papers of the decade.

Subsequent research has largely confirmed and extended the findings. The ABCD Study, tracking 10,000 American children with brain imaging, has documented that screen time correlates with cortical thinning across diverse brain regions. A 2023 study in JAMA Pediatrics demonstrated causal directionality through longitudinal fMRI, showing that habitual social media checking predicted progressive amygdala sensitisation. Research on specific platforms has identified Instagram as particularly harmful for adolescent girls' body image and self-worth.

Policy responses have begun but remain limited. Some jurisdictions have restricted smartphone use in schools. Social media platforms have introduced screen time tracking features, though critics note these are largely performative given platforms' profit incentive to maximise engagement. The Children's Online Privacy Protection Act awaits meaningful updates. Litigation against social media companies has begun.

The mental health crisis has continued to intensify. Adolescent depression and suicide rates have continued climbing since 2017, with additional acceleration during the COVID-19 pandemic when screen time increased and in-person activities decreased. The patterns Twenge identified have proven durable and deepening.

Further Reading

• Twenge, J.M. (2017). iGen: Why Today's Super-Connected Kids Are Growing Up Less Rebellious, More Tolerant, Less Happy—and Completely Unprepared for Adulthood. Atria Books.
• Twenge, J.M. & Campbell, W.K. (2009). The Narcissism Epidemic: Living in the Age of Entitlement. Free Press.
• Haidt, J. (2024). The Anxious Generation: How the Great Rewiring of Childhood is Causing an Epidemic of Mental Illness. Penguin Press.
• Turkle, S. (2015). Reclaiming Conversation: The Power of Talk in a Digital Age. Penguin Press.
• Zuboff, S. (2019). The Age of Surveillance Capitalism. PublicAffairs.
• Alter, A. (2017). Irresistible: The Rise of Addictive Technology and the Business of Keeping Us Hooked. Penguin Press.
• Maza, M.T. et al. (2023). Association of habitual checking behaviors on social media with longitudinal functional brain development. JAMA Pediatrics, 177(2), 160-167.
• Primack, B.A. et al. (2017). Social media use and perceived social isolation among young adults in the U.S. American Journal of Preventive Medicine, 53(1), 1-8.