Even before she joined Instagram, Sonali, a teenager in the Indian city of Kanpur, was dealing with body image issues and being bullied at school for her weight. India is Instagram’s largest market with around 180 million users, and many of Sonali’s classmates joined the platform when they were around 13 years old. Eventually, she felt peer pressured into opening her own account too.      

“I did not have an Instagram, so I was not the cool kid,” said Sonali, who asked to be identified using a pseudonym to protect her privacy. Joining the photo-sharing app instantly elevated her standing among her peers. But the platform exacerbated her body image issues.

Sonali, who is now 16 and comes from a wealthy family, said that she would spend up to four hours a day on Instagram consuming content from fashion models and diet and workout accounts. One IGTV clip suggested that she could lose eight pounds in one day by skipping solid food and only consuming four drinks. She took the advice. “The next day my weight did not decrease, and then that day was horrible,” Sonali said.

She coveted how popular her “thin”-looking best friend was on the platform, drawing hundreds of likes. But when Sonali posted a picture of herself imitating her friend’s pose, she got just 50 likes. Devastated, Sonali deleted Instagram the following day. “I think Instagram fuels how you feel mentally,” she told Rest of World. “If you’re happy, Instagram can fuel it in a better direction. But if you’re not [in] a good mindset, it can deteriorate your health.”

In September, the Wall Street Journal published a lengthy report on the impact of Instagram on the mental health of teenagers, based on a cache of leaked documents that would come to be known as the Facebook Papers. The report suggested that Facebook had downplayed its own research, which indicated that certain subsections of teenagers on Instagram said their body image issues or depression were sometimes exacerbated by using the app. The Wall Street Journal story sparked a broad conversation about the role of the platform in mediating teenage mental health.

But the report largely excluded the experiences of teenagers like Sonali, who live outside the U.S. and U.K and constitute the vast majority of teenagers who use Instagram today. That’s because the bulk of research cited by the Wall Street Journal exclusively focused on teenagers in the U.S. and U.K. Behavioral scientists and mental health advocates told Rest of World that the apparent dearth of Facebook research on Instagram’s impact on teenagers outside the West echoes deeper Western biases and knowledge gaps in the current scholarship. Facebook did not respond to multiple requests for comment about its research on the topic of mental health among teenagers in the Global South. 

A review by Rest of World of over a dozen outside scholarly papers on teenage mental health and Instagram use in the Global South suggests that cultural factors and socioeconomic conditions may shape the experiences of teenagers using the platform, but there remains a pressing need for further research.

“I did not have Instagram, so I was not the cool kid.”

Not all of the studies on the impact of social media on the mental well-being of teenagers contained in the Facebook Papers focused exclusively on Western users. One spring 2020 study entitled “Social comparison on Instagram,” which was conducted by researchers inside Instagram and has been reviewed by Rest of World, did take a more global look at the positive and negative ways in which users compared themselves to others on the app. But even this study was largely oriented toward Western countries. The findings of this study, which surveyed 100,000 users in the U.S., Australia, Brazil, Korea, France, Great Britain, Germany, Japan, and India, showed how negative social comparison can vary notably by country, and pointed to Facebook’s own blind spots in interpreting this data.

Facebook’s nine-country social comparison survey revealed a shared set of global experiences for Instagram users. Western pop stars and celebrities were found to incite the most negative social comparison across countries. Increasing exposure to posts about fashion and beauty led to increased negative comparison. Researchers spotlighting Instagram’s discovery feed singled out the Explore page as a major source for sparking social comparisons, with its frequent curations of ideal beauty, body, and lifestyle posts. And across the study, teenagers were more likely than adults to say they experienced negative social comparisons.

The 100,000-user survey, however, also revealed country-by-country differences in social comparison that don’t fit neatly into more established patterns in the U.S. and the U.K.

For instance, positive social comparison — known as “inspiration” in the study — was higher in India and Brazil than in Western countries. And teenage boys in India were more likely than teenage girls to say that they experienced negative social comparison, with about 10% responding “often” or “always,” as opposed to roughly 7% for teenage girls. Korea had the highest rates of negative social comparison among teenage boys, with roughly 14% indicating that they experienced it “often” or “always,” about 5% higher than teenage girls in the country. These findings stand at odds with gendered trends found among teenage users in the U.S and U.K, where more girls than boys reported experiencing negative social comparison, suggesting those studies cannot be used to easily extrapolate understandings of teenage mental health for users in India, Korea or other non-Western countries.

In the 100,000-user survey, researchers referenced a Facebook study of 18 countries about users on Facebook’s namesake platform published in January 2020. That study similarly saw heightened levels of social comparison among men in India, and in Asia generally, relative to other countries. Based on user interviews, it theorized that men have increased experiences of negative social comparison on topics like finances and one’s profession in countries where they occupy a larger percentage of the workforce. The study also hypothesized that men in India were less likely to talk openly about their negative responses to these posts.

The authors of the 100,000-user Instagram study admitted blind spots in their ability to fully understand the cultural factors at play in these findings, writing that “we shouldn’t focus exclusively on women in the West.” 

There is a global bias across studies on mental health and social media usage, tilted heavily towards people living in Western and high-income countries, said Sakshi Ghai, a Ph.D candidate at the University of Cambridge’s Digital Mental Health Group who has conducted field research on technology use, including social media, of women in rural India. In scholarly reviews she has conducted on social media use, depression, and well-being, the majority of the published studies on these topics looked exclusively at users in the Global North.

These Western-centric studies risk generalizing, and even misunderstanding, the impact of social media when it comes to a global platform like Instagram. A majority of the world’s adolescents reside in the Global South, and India alone is home to one-fifth of the world’s youth, according to the United Nations Population Fund.

As Ghai puts it, much of the mental health scholarship on topics she has reviewed fails to account for 88% of the world’s population. 

The dozen or so scholarly studies identified by Rest of World focused on Instagram usage and adolescent mental health in countries like Turkey, Kuwait, Indonesia, and Singapore. While this research is precedent-setting, some researchers told Rest of World that their work is the exception that proves the rule, and few of these studies had access to large-scale data.

Facebook only selects a few scholars every year to partner with through grants, according to Michael Prieler, a professor at Hallym University in Chuncheon, South Korea who studies self-esteem and social media use among Korean teenagers. “Many scholars are interested in working with Facebook, since only in that way they are able to really access the necessary data,” he told Rest of World over email. “They could give more scholars the chance to conduct research, but the question is whether it is in their own interest to let many scholars research their activities.”

“We shouldn’t focus exclusively on women in the West.”

“We need to describe, before we prescribe,” Ghai told Rest of World. Relatively well-resourced subfields of psychology looking at misinformation and polarization on social media have already leapfrogged into a problem-solving stage and are developing strategies to mitigate harm. “In mental health, the focus is still very much on the U.K. and U.S. I would say we need to first understand, to go beyond that.”

Urvashi Aneja, director of the Digital Futures Lab in India, a tech policy research organization,  highlights that the wider public still often sees platforms like Instagram in the Global South through the lens of micro-entrepreneurship and opportunities for youth, rather than as points of concern from a mental health standpoint. 

Mainstream media coverage of Instagram in India hasn’t evolved beyond the promise of social mobility and the jaw-dropping amount of money influencers can make, Aneja said. Even recognition of the challenges that come with social media success isn’t acknowledged. The conversation “hasn’t kind of tipped over to mental health,” said Aneja, whose team is authoring a paper on the rise of the Indian influencer industry. 

In the meantime, teenagers like Sonali in Kanpur are left to navigate the social pressures of platforms like Instagram on their own. Sonali told Rest of World that she was now in a much better headspace, and had re-downloaded Instagram four months ago.   

Following her break, she set out to conduct her own research about social media and mental health, striking up conversations she did not see in the public discourse with her peers. During a recent internship with the social enterprise Tribes for Good, Sonali and four other girls conducted their own survey investigating whether social media use led to increased body image problems.

Based on personal insight, the team designed their questionnaire and solicited 120 responses from students aged between 13 and 19. “When we asked if Instagram did negatively affect their mental health, or how they looked at themselves, a lot of people agreed, which made us feel more comfortable,” Sonali said. “We were like, we’re not the only ones being affected by it.”