Social media's widespread use has dramatically altered human interaction, coinciding with a surge in anxiety and depression among youth. This review investigates the potential link between social media and these mental health disorders in young people (aged 12-26), aiming to identify predictive patterns and suggest future research directions. The rise in youth suicide rates, particularly among girls aged 10-14, is linked to social factors and potentially influenced by extensive social media use. Adolescence and early adulthood are crucial periods for psychological development, but also carry a heightened risk for mental health issues. The significant global prevalence and economic burden of anxiety and depression underscore the urgency of understanding their potential connection with social media, given the high social media engagement among teenagers and young adults.

The literature review examined studies investigating the correlation between social media use and anxiety and depression in youth. Early studies focused primarily on the duration of social media use, showing a strong correlation with psychological distress. However, more recent research shifts focus towards the patterns of social media usage, beyond mere frequency or duration. The review considered various patterns, including passive versus active use, emotional investment, and problematic social media use (PSMU), as potential predictors of poor mental health outcomes. The review also considered the impact of specific activities like cyberbullying, sexting, and the effects of exposure to self-harm content.

This narrative review followed the Scale for the Assessment of Narrative Review Articles (SANRA) criteria. A comprehensive search of the Medline database (December 23, 2022) utilized keywords related to social media, depression, anxiety, self-harm, cyberbullying, sexting, and other relevant terms. The initial search yielded over 184,924 articles. After screening abstracts and selecting full-text articles, 77 studies examining social media use's relationship with anxiety and depression among youth (aged 12-26) were included in the review. The authors summarized the findings of these 77 articles. Table 1 details the number of articles retrieved for each specific search term combination.

The review revealed a strong association between specific social media usage patterns and poor mental health outcomes in youth. **Passive Social Media Use:** Passive use (observing others' activities without interaction) linked to low mood, loneliness, lack of confidence, self-deprecation, and jealousy. Exposure to online self-harm content, particularly visual content, increased the likelihood of self-harm behaviors. Media multitasking (using multiple platforms simultaneously) correlated with higher rates of depression and social anxiety, negatively impacting productivity and contributing to feelings of guilt and worthlessness. Appearance-based activities (using filters and editing) led to body dissatisfaction, eating disorders, depression, and anxiety. Night-time social media consumption was linked to sleep deprivation and potentially to depression and anxiety. Disaster awareness through social media exacerbated pre-existing anxiety. **Active Social Media Use:** While some studies showed active social media use negatively associated with depression, sexting and cyberbullying demonstrated links to poorer mental health. Sexting's impact varied by gender and the nature of the sexting (consensual vs. coerced). Cyberbullying and online ethnic discrimination were significantly associated with increased depression and anxiety symptoms. Emotional investment in social media was a crucial factor in depression, anxiety, and low self-esteem. Problematic social media use (PSMU) predicted depression and anxiety and often co-occurred with other addictive behaviors. The review noted a paucity of reliable research on the impact of social gaming, accessing nudity via social media, and excessive online shopping on mental health. **Experimental Studies:** Several experimental studies demonstrated that social media-based interventions could significantly reduce anxiety and depression in young adults. These interventions included peer support websites, online counseling, and single-session interventions.

The findings highlight a complex relationship between social media use and mental health in youth. While the review didn't establish causality, it strongly suggests a correlation between specific patterns of social media engagement and increased risk of anxiety and depression. The patterns identified—passive use, problematic use, cyberbullying, sexting, and others—offer potential targets for interventions aimed at improving youth mental well-being. The success of social media-based interventions suggests that these platforms can be leveraged for therapeutic purposes. The review also highlights the importance of considering individual differences and contextual factors when assessing the impact of social media on mental health.

Specific social media usage patterns are strongly associated with poor mental health outcomes in youth. Clinicians, parents, and policymakers need to address social media exposure and promote healthy usage patterns. Future research should focus on establishing causality, understanding mediating factors, exploring the effectiveness of various interventions, and investigating the impact of less-studied aspects of social media use.

The review's reliance on existing literature limits its ability to establish causal relationships between social media use and mental health outcomes. The heterogeneity of studies included, in terms of methodology and population, might also affect the generalizability of findings. Further, the review highlights a paucity of research on certain aspects of social media use, such as the impact of social gaming, pornography consumption, and excessive online shopping.