“Engineered Addiction”: Redefining Addictive Disorders and the Psychiatric Impact of Social Media

Clinical research indicates that problematic use of social media is harming youth mental health, further evidenced by the May 2026 surgeon general’s warning about the need to reduce screen time. Yet social media disorder remains noticeably absent from psychiatric diagnostic frameworks, and positive psychosocial outcomes are mostly ignored in larger conversations. Let’s take a closer look at addictive and behavioral disorders.

Social Media Under Legal Scrutiny

Casinos. Drugs. Social media…? According to lawyer Mark Lanier, Meta and Google, “2 of the richest corporations in history,” have “engineered addiction in children’s brains.”¹ Who holds the power to determine the psychiatric and clinical impact of social media on youth—the courts or the field of psychiatry?

In a trial in Los Angeles County Superior Court, social media giants Meta (parent company of Facebook and Instagram) and Google (parent company of YouTube) faced claims that their platforms deliberately addict and harm the children who use them, allegedly leading to a myriad of disorders, such as depression, anxiety, insomnia, eating disorders, and suicidality. TikTok and Snapchat, 2 social platforms also named in the lawsuit, settled outside of court for undisclosed sums. The 20-year-old plaintiff, identified only as “KGM,” claimed that her use of social media as a child addicted her to the platforms and worsened her depression and suicidal thoughts—and this was done through deliberate design choices by the companies in order to make their platforms more addictive and increase profits.² KGM is part of a large group of plaintiffs who are suing social media companies, collectively known as JCCP 5255.³

“Borrowing heavily from the behavioral and neurobiological techniques used by slot machines and exploited by the cigarette industry, [Meta and Google] deliberately embedded in their products an array of design features aimed at maximizing youth engagement to drive advertising revenue,” reads the lawsuit.³

On March 25, 2026, the jury found Meta and YouTube liable, awarding KGM $3 million in damages and further recommending an additional $3 million in punitive damages after deciding the companies acted with malice, oppression, or fraud in harming children.⁴

“This is going to be one of the most impactful litigations of our lifetime,” said Joseph VanZandt, colead counsel for the JCCP 5255 plaintiffs. “This is about large corporations targeting vulnerable populations—children—for profit. That’s what we saw with the tobacco companies; they were also targeting adolescents and trying to get them addicted while they were young.”⁵

This is not the only case of its kind. In a separate lawsuit brought by the New Mexico attorney general, a jury ordered Meta to pay $375 million in damages after finding ​the company misled users about the safety of Facebook and Instagram while simultaneously enabling child sexual exploitation on the platforms.⁶ There are more than 2000 pending lawsuits brought by parents, school districts, and child advocates with similar claims.⁷ With the legal battles continuing, now is the best time to explore just how dangerous and addictive social media really is for our youth.

Redefining Addiction

In a Psychiatric Times poll, readers overwhelmingly agreed: Social media is addictive (Figure). However, Petros Levounis, MD, former American Psychiatric Association (APA) president and behavioral addictions expert, is not so sure. In his opinion, it has the potential to develop into a behavioral addiction, but is likely not as prevalent as presumed.

“Social media addiction is not currently formally recognized, although we do have some significant early research and evidence that it may well end up being a bona fide medical disorder,” Levounis said. “There may be some people who do have a social media addiction in a classic sense—very similar to alcohol, tobacco, and opioids—but this may be a small group of people.”

This is backed by recent research, in which investigators found that social media users overestimate their addiction to apps, and that those who perceive themselves as more addicted experience less ability to control their use. This may be due to the perception of addiction, which is encouraged by the frequent labeling of social media as addictive, as compared with habit-forming.⁸ Other studies indicate that social media addiction among teenagers ranges from 5% to 20%.^9,10

Importantly, although gambling disorder and gaming disorder are formal clinical diagnoses in the DSM-5 and the ICD-11, social media disorder is not. Behavioral addictions in general are relatively new in formal diagnostic systems like the DSM and ICD, and according to Marc Potenza, MD, PhD, problematic social media usage could potentially be diagnosed under "other specified disorders due to addictive behaviors.” Potenza is a prolific addiction psychiatry specialist and director of the Division on Addictions Research, the Center of Excellence in Gambling Research, the Yale Research Program on Impulsivity and Impulse Control Disorders, and the Women and Addictive Disorders Core of Women's Health Research at Yale School of Medicine.

“There are many different ways in which one could debate what is addictive or not. Many youth are engaging in this behavior, and it is having negative consequences for a proportion of developing youth—that should be a concern that we address,” Potenza told Psychiatric Times.

According to the APA, there are a few ways to distinguish a “technology addiction,” encompassing social media, online gaming, online gambling, online shopping, and pornography (Table 1).^11,12 However, it is important to note that the amount of time using tech alone does not necessarily indicate problematic or compulsive use, and excessive use may be an indicator of an underlying psychiatric condition.

With the APA’s restructuring of the DSM, is it time to formally acknowledge the addictive potential of social media? 

What Research Tells Us

There is a dearth of evidence pointing to negative mental health outcomes for youth who overuse phones and social media. Here is just a small sampling of that research.

Prolonged use of social media platforms has been linked to heightened levels of anxiety and depression, especially among adolescents and young adults.^13,14 One survey of 1787 young adults aged 19 to 32 years found that participants in the highest quartile of social media site visits per week and those with a higher global frequency score had significantly increased odds of depression compared with their lowest quartile counterparts (AOR, 2.74; 95% CI, 1.86-4.04; AOR, 3.05; 95% CI, 2.03-4.59, respectively).¹⁵ Another survey of 563 young adults aged 18 to 22 years found that more time spent on social media was significantly associated with greater symptoms of dispositional anxiety (95% CI, 0.59-0.90; P < .001) but was unrelated to recent anxiety-related impairment (95% CI, 0.00-0.1; P = .051).¹⁶

The number of platforms visited also contributes to risk. A national survey of young adults showed that using a large number of social media platforms was associated with a negative impact on mental health. Youth using between 7 and 11 different social media platforms, when compared with respondents using only 2 or fewer platforms, had 3 times greater odds of having high levels of depressive symptoms and 3.2 times greater odds of having high levels of anxiety symptoms.¹⁷

According to a 2025 study, extended screen use, or “high or increasing addictive use trajectories,” was associated with suicidal behaviors, suicidal ideation, and worse mental health in youths. Specifically with social media and mobile phone use, both the high and increasing addictive use trajectories were associated with 2 to 3 times greater risks of suicidal behaviors and suicidal ideation.¹⁸

Overall, internet and phone use are linked to poor sleep outcomes, including shorter sleep duration, daily dysfunction, and longer sleep latency.^19-21 A study of students in grades 10 to 12 found that more than 60% reported keeping their cell phones on and in their rooms while they are sleeping. Nearly a third of the adolescents slept 6 hours or less, and this was correlated with the time they spent using devices, such as phones.

One study found a link between excessive use among adolescents and impaired attention, reduced working memory, and diminished executive functioning. However, platforms like Facebook and YouTube demonstrated potential benefits for enhancing language skills and memory through educational engagement.²²

Finally, yet another study found that video screen media activity altered resting-state brain functional connectivity and led to poorer developmental measures that persisted longitudinally, suggesting that we need strategies to decrease kids’ excessive time spent watching videos.²³

Levounis is especially concerned about 2 aspects of extended social media engagement, like video watching: the flow zone and psychological echo chambers. The flow zone, or flow channel, is when an individual is completely engrossed in an activity to the point that little else seems to matter, and they continue to engage. One survey found that both Instagram and TikTok users reported experiencing this flow state, though TikTok users reported higher levels of overall flow, as well as flow zone "enjoyment" and "time distortion."²⁴

“When the intrigue of social media meets your abilities and your needs, that is when you stay in that flow zone, and you keep on engaging over and over again,” Levounis said.

Psychological echo chambers are the result of amplified algorithms, he explained. “The algorithms of social media can detect your political leanings, and instead of poking holes in your understanding of the world, they do exactly the opposite. They give you more confirmation of your own inclinations. Therefore, instead of bringing people closer together, it actually polarizes them. We are starting to feel that there may be something very similar happening on the psychological side of things, where it amplifies messages of how you conceptualize yourself.” This reinforcement of negative perceptions can be dangerous in the hands of vulnerable, developing youth.

Compounding these issues is the pervasive presence of media and technology in youth’s lives. Pew Research Center data show a significant increase in the proportion of youth being online almost constantly. More than a decade ago, 24% of youth aged 13 to 17 years reported being online almost constantly; in 2022 and 2023, that percentage increased to 46%.²⁵

“There has been a substantial change in the proportion of developing youth being online almost constantly, according to their self-reports,” Potenza said.

The Importance of Empathetic Curiosity

Australia is addressing social media concerns through a unique method: banning social media for youth altogether. Anyone younger than 16 years is unable to keep or make accounts on social media apps like TikTok, Instagram, YouTube, Snapchat, X, Facebook, and others. Social media platforms that fail to comply risk heavy fines of up to $50 million.²⁶ However, experts say the evidence base behind the ban remains inconclusive, and prohibition alone is “unlikely to be effective.”²⁷ Notably, social media bans inhibit adolescent psychosocial needs and can result in negative consequences, such as creating a sense of isolation, instilling a sense of rebellion against authority, and hindering digital literacy.²⁸ 7NEWS Australia even warned that the ban could trigger symptoms of withdrawal in teens.²⁹

Rather than punishing youth for social media’s pervasiveness with outright bans, Stephen Mateka, DO, the child and adolescent psychiatry section editor of Psychiatric Times, says we must find ways to engage with them that come from a place of empathy and understanding. Then we can guide them toward healthier, safer use.

“It is incumbent on the guardians and caregivers to set boundaries, limits, and expectations. It would be completely inappropriate to expect a child or an adolescent to police themselves, because their brain is primed to actively do the opposite,” Mateka told Psychiatric Times. “It’s all about empathetic curiosity. With kids, you need to do a lot of work to create a space where they are going to be actually genuine and forthcoming with you.”

A major part of social media’s role in youth’s lives is as a social tool; its loss can equate to real harm among peers.

“Nothing is more important to an adolescent than peer approval. Their need for peer connectedness affects the same type of centers in the brain that light up from physical pain. When kids get their devices taken away or they lose access to their people online, these brain centers light up. You can say no social media, no screens, but then you have to be considerate of the consequences socially,” Mateka said.

He suggests finding ways to start a dialogue about social media with child/adolescent patients that express empathy, curiosity, and genuine interest (Table 2).

“If you can create open conversations without judgment, then they are going to be more likely to be real with you. Normalize talking about what they are interacting with, and if you are doing it consistently, you can start to pick up on when answers change or when there is a significant deviation,” concluded Mateka.

Concluding Thoughts

It is crucial to acknowledge the fundamental role social media plays in today’s youth’s lives; to disregard that would be devastating. The world today operates digitally, and these children and adolescents are products of that environment.

“I am hopeful that we can make the environment a safer place for individuals in general, but particularly for vulnerable groups, like developing individuals. I hope that we can do so in a manner in which we empower youth to be able to utilize digital technologies in a healthy fashion, and that we try to minimize the harms related to problematic usage,” Potenza said.

References

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