CHICAGO â Add "Facebook depression" to potential harms linked with social media, an influential doctors' group warns, referring to a condition it says may affect troubled teens who obsess over the online site.
Researchers disagree on whether it's simply an extension of depression some kids feel in other circumstances, or a distinct condition linked with using the online site.
But there are unique aspects of Facebook that can make it a particularly tough social landscape to navigate for kids already dealing with poor self-esteem, said Dr. Gwenn O'Keeffe, a Boston-area pediatrician and lead author of new American Academy of Pediatrics social media guidelines.
With in-your-face friends' tallies, status updates and photos of happy-looking people having great times, Facebook pages can make some kids feel even worse if they think they don't measure up.
It can be more painful than sitting alone in a crowded school cafeteria or other real-life encounters that can make kids feel down, O'Keeffe said, because Facebook provides a skewed view of what's really going on. Online, there's no way to see facial expressions or read body language that provide context.
The guidelines urge pediatricians to encourage parents to talk with their kids about online use and to be aware of Facebook depression, cyberbullying, sexting and other online risks. They were published online Monday in Pediatrics.
Abby Abolt, 16, a Chicago high school sophomore and frequent Facebook user, says the site has never made her feel depressed, but that she can understand how it might affect some kids.
"If you really didn't have that many friends and weren't really doing much with your life, and saw other peoples' status updates and pictures and what they were doing with friends, I could see how that would make them upset," she said.
"It's like a big popularity contest â who can get the most friend requests or get the most pictures tagged," she said.
Also, it's common among some teens to post snotty or judgmental messages on the Facebook walls of people they don't like, said Gaby Navarro, 18, a senior from Grayslake, Ill. It's happened to her friends, and she said she could imagine how that could make some teens feel depressed.
"Parents should definitely know" about these practices," Navarro said. "It's good to raise awareness about it."
The academy guidelines note that online harassment "can cause profound psychosocial outcomes," including suicide. The widely publicized suicide of a 15-year-old Massachusetts girl last year occurred after she'd been bullied and harassed, in person and on Facebook.
"Facebook is where all the teens are hanging out now. It's their corner store," O'Keeffe said.
She said the benefits of kids using social media sites like Facebook shouldn't be overlooked, however, such as connecting with friends and family, sharing pictures and exchanging ideas.
"A lot of what's happening is actually very healthy, but it can go too far," she said.
Dr. Megan Moreno, a University of Wisconsin adolescent medicine specialist who has studied online social networking among college students, said using Facebook can enhance feelings of social connectedness among well-adjusted kids, and have the opposite effect on those prone to depression.
Parents shouldn't get the idea that using Facebook "is going to somehow infect their kids with depression," she said.
American Academy of Pediatric: http://www.aap.org/
Media and Children
Today's children are spending an average of seven hours a day on entertainment media, including televisions, computers, phones and other electronic devices. To help kids make wise media choices, parents should monitor their media diet. Parents can make use of established ratings systems for shows, movies and games to avoid inappropriate content, such as violence, explicit sexual content or glorified tobacco and alcohol use.
Studies have shown that excessive media use can lead to attention problems, school difficulties, sleep and eating disorders, and obesity. In addition, the Internet and cell phones can provide platforms for illicit and risky behaviors.
By limiting screen time and offering educational media and non-electronic formats such as books, newspapers and board games, and watching television with their children, parents can help guide their children's media experience. Putting questionable content into context and teaching kids about advertising contributes to their media literacy.
The AAP recommends that parents establish "screen-free" zones at home by making sure there are no televisions, computers or video games in children's bedrooms, and by turning off the TV during dinner. Children and teens should engage with entertainment media for no more than one or two hours per day, and that should be high-quality content. It is important for kids to spend time on outdoor play, reading, hobbies, and using their imaginations in free play.
Television and other entertainment media should be avoided for infants and children under age 2. A child's brain develops rapidly during these first years, and young children learn best by interacting with people, not screens.
"The hottest places in hell are reserved for those who, in times of great moral crisis, maintain their neutrality." - Dante