CHARLOTTE — Is it an interesting coincidence or an alarming trend? As the number of teens with cellphones has increased, so has the incidence of mental health issues in that age group -- including depression and suicides.
Parents say a smartphone is a "must-have" for teens these days.
"It's like an umbilical cord. If you cut it, I don't want to see what's going to happen," said mother Shelly Sullivan.
But cellphones may be contributing to a mental health crisis among adolescents.
"What we know is that if a kid has a cellphone there seems to be a greater association with the likelihood for depression," explained Dr. Steven Schlozman with Massachusetts General Hospital.
The latest study on the subject appeared in a recent issue of Clinical Psychological Science. It found teens who spent time on non-screen activities -- such as sports, exercise, or print media -- were less likely to report mental health issues than those spending more time on devices such as smartphones.
Dr. Schlozman is a child psychiatrist at Massachusetts General Hospital's Clay Center for Young Healthy Minds. He says rates of depression among teens started going up as cellphone ownership rose. But, a million-dollar question remains.
"Would a depressed kid be more likely to own a cell phone. Or does the ownership of the cell phone lead to a greater likelihood of depression?" he asked.
So, how might cellphone use lead to depression? It may have to do with communication - or rather the illusion of communication - many teens have.
"We are wired to understand what each other are saying through these very nuanced communications: eyebrows going up or down, blinking, changes in facial expression," Schlozman explained.
What we are not wired for, Schlozman says, is texting. But that is primarily how teens "talk" with parents.
"If I don't text they won't talk to me. So, if I call they won't answer," said Sullivan.
And it's how teens talk with their peers.
"You can't communicate with people outside of school. It's like the only way to communicate," said teenager Juliana Troland.
Text conversations may be fast and easy, but some studies show lack of face-to-face communication contributes to isolation and loneliness. And then there is the permanence of nasty things said online.
"Kids are more impulsive than adults. So, they're more likely to send those texts or e-mails or Instagrams or Snapchats and they can't take it back," said Schlozman.
And that can lead to anxiety. For many parents, taking the phone away is neither an option, nor a desire, since cellphones do serve a useful purpose. But placing limits - even small ones - can have benefits.
Take Juliana Troland. She's a high school freshman who used to sleep with her phone nearby, and that meant lack of sleep. But now, she puts her phone down in the kitchen before turning in.
"It improves my focusing. I can pay attention for a longer period of time and I can get more work done at school," she said.
Mental health experts say it is often difficult to differentiate between normal teen behavior and signs of depression. Loss of interest in activities, increased time spent alone, sleeping during the day, and sudden changes in appetite can all be symptoms that could be associated with teen depression. If in doubt, consult your pediatrician.