There is a lack of causal evidence for the role of social media in causing mental health symptoms or worsening conditions – although there is some data that for some people social media use may be associated with worse outcomes. But some people may find benefit in new social connections and support from social media. You can consider social media use in SMI along the lines of the “Goldilocks hypothesis” in that too much is likely bad, too little could potentially be bad as well, and there is an amount in between that is “just right.” What is “just right” is not currently known and likely depends on the quality, not just quantity, of social media use. A discussion about the hours they spent and what they do on social media may be a good starting point to talk about with your patients.
A 2019 study showed that for people with schizophrenia, changes in language used on Facebook may be a predictor of relapse. This evidence does not claim Facebook use causes relapse, rather that it may be help provide an early warning of changes. But this evidence is too early to apply directly into care.
Abi-Jaoude E, Naylor KT, Pignatiello A. Smartphones, social media use and youth mental health. CMAJ. 2020 Feb 10;192(6):E136-41.
Birnbaum ML, Ernala SK, Rizvi AF, Arenare E, Van Meter AR, De Choudhury M, Kane JM. Detecting relapse in youth with psychotic disorders utilizing patient-generated and patient-contributed digital data from Facebook. NPJ schizophrenia. 2019 Oct 7;5(1):1-9.