¹Alexandra Enciu, MD,²Shivaughn Hem-Lee-Forsyth, PhD, MPH

¹Department of Public Health and Preventive Medicine

²St. George’s University School of Medicine

Instagram, the largest growing social network site today, has grown exponentially since its launch in 2010. Mental health challenges, particularly anxiety and major depressive disorder in those aged 16 to 30 have been associated with Instagram’s popularity. Depression is of particular interest to health care providers within the public health sector: it affects 264 million people globally; suicide is the second most common cause of death in 18 to 29-year-olds. This age group also constitutes the main demographic group of Instagram users. A narrative review was conducted on peer-reviewed articles between January 2019-July 2020 to analyze Instagram use and its association with depression, and using it as a tool to diagnose depression. PubMed, EBSCO, NCBI, NIH, and Google Scholar were used to source articles published between 2015-2020. The narrative review focused on four primary papers. The first study looked at the social comparison theory, while the second and third studies used screening questionnaires in conjunction with analyzing an individual’s Instagram content into text-based scores. The fourth study analyzed the content of photos which were posted to give insight into an individual’s status regarding depressive states. Accounting for 18 to 30 year olds’ Instagram usage into how they engaged with content can accurately screen for, and diagnose depression.

Social network site (SNS), Instagram, mental health, social comparison theory, depression, teenagers and young adults

1) Alberga, A. S., Withnell, S. J., & Ranson, K. M. V. (2018). Fitspiration and thinspiration: a comparison across three social networking sites. Journal of Eating Disorders, 6(1). https://doi.org/10.1186/s40337-018-0227-x

2) Andalibi, N., Ozturk, P., & Forte, A. (2015). Depression-related Imagery on Instagram. Proceedings of the 18th ACM Conference Companion on Computer Supported Cooperative Work & Social Computing - CSCW'15 Companion. https://doi.org/10.1145/2685553.2699014

3) Andalibi, N., Ozturk, P., & Forte, A. (2017). Sensitive Self-disclosures, Responses, and Social Support on Instagram. Proceedings of the 2017 ACM Conference on Computer Supported Cooperative Work and Social Computing. https://doi.org/10.1145/2998181.2998243

4) Brailovskaia, J., & Margraf, J. (2018). What does media use reveal about personality and mental health? An exploratory investigation among German students. Plos One, 13(1). https://doi.org/10.1371/journal.pone.0191810

5) Chiu, C. Y., Lane, H. Y., Koh, J. L., & Chen, A. L. P. (2020). Multimodal depression detection on instagram considering time interval of posts. Journal of Intelligent Information Systems. https://doi.org/10.1007/s10844-020-00599-5

6) Deighton-Smith, N., & Bell, B. T. (2018). Objectifying fitness: A content and thematic analysis of #fitspiration images on social media. Psychology of Popular Media Culture, 7(4), 467–483. https://doi.org/10.1037/ppm0000143

7) Depression. (2020, January 30). https://www.who.int/news-room/fact-sheets/detail/depression.

8) Donnelly, E., Kuss D.J. (2017). Depression among Users of Social Networking Sites (SNSs): The Role of SNS Addiction and Increased Usage. Journal of Addiction and Preventive Medicine, 02(01). https://doi.org/10.19104/japm.2016.107

9) Fadus, M. (2018). Duck Syndrome, Social Media, and Struggling Together. Psychiatric News, 53(18). https://doi.org/10.1176/appi.pn.2018.9b22

10) Glynn, B. P. (2021, April 7). Khloe Kardashian tries to get unfiltered photo removed from social media. BBC News. https://www.bbc.com/news/entertainment-arts-56660476

11) Gupta, A., & Dhingra, A. (2018). The Role of Primary Care Physicians in Curtailing Harmful Social Media Trends. Cureus. https://doi.org/10.7759/cureus.3271

12) Hwang, H. S. (2019). Why Social Comparison on Instagram Matters: Its impact on Depression. KSII Transactions on Internet and Information Systems, 13(3). https://doi.org/10.3837/tiis.2019.03.029

13) Lin, L. Y., Sidani, J. E., Shensa, A., Radovic, A., Miller, E., Colditz, J. B., … Primack, B. A. (2016). Association Between Social Media Use And Depression Among U.S. Young Adults. Depression and Anxiety, 33(4), 323–331.] https://doi.org/10.1002/da.22466

14) Mackson, S. B., Brochu, P. M., & Schneider, B. A. (2019). Instagram: Friend or foe? The application’s association with psychological well-being. New Media & Society, 21(10), 2160–2182. https://doi.org/10.1177/1461444819840021

15) Mun, I. B., & Kim, H. (2021). Influence of False Self-Presentation on Mental Health and Deleting Behavior on Instagram: The Mediating Role of Perceived Popularity. Frontiers in Psychology, 12. https://doi.org/10.3389/fpsyg.2021.660484

16) Muralidhara, S., & Paul, M. J. (2018). #Healthy Selfies: Exploration of Health Topics on Instagram. JMIR Public Health and Surveillance, 4(2). https://doi.org/10.2196/10150

17) National Institute of Mental Health. (2019, February). Major Depression. Mental Health Information. https://www.nimh.nih.gov/health/statistics/major-depression.shtml.

18) Nesi, J., & Prinstein, M. J. (2015). Using Social Media for Social Comparison and Feedback Seeking: Gender and Popularity Moderate Associations with Depressive Symptoms. Journal of abnormal child psychology, 43(8), 1427–1438. https://doi.org/10.1007/s10802-015-0020-0

19) Reece, A. G., & Danforth, C. M. (2017). Instagram photos reveal predictive markers of depression. EPJ Data Science, 6(1). https://doi.org/10.1140/epjds/s13688-017-0110-z

20) Ricard, B. J., Marsch, L. A., Crosier, B., & Hassanpour, S. (2018). Exploring the Utility of Community-Generated Social Media Content for Detecting Depression: An Analytical Study on Instagram. Journal of Medical Internet Research, 20(12). https://doi.org/10.2196/11817 Rsph. #StatusofMind.

21) RSPH. https://www.rsph.org.uk/our-work/campaigns/status-of-mind.html.

22) Sherlock, M., & Wagstaff, D. L. (2019). Exploring the relationship between frequency of Instagram use, exposure to idealized images, and psychological well-being in women. Psychology of Popular Media Culture, 8(4), 482–490. https://doi.org/10.1037/ppm0000182

23) World Health Organization. Adolescents: health risks and solutions. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/adolescents-health-risks-and-solutions.

VOLUME 04 ISSUE 08 AUGUST 2021