The new school year is a busy time for students as they settle into their routines. And social media makes it even busier.

Erlanger pediatrician doctor John Heise has been working with teens for decades. He says social media has flipped the script for adolescent life.

"A couple of years ago the question was should they have social media, should the kids have any cell phones at school,” Heise said. “That boat has sort of passed now."

Heise says he already sees teens spending 3 to 8 hours a day online. With the start of school, he says the onslaught can be overwhelming.

"They're kind of coming back to it and instead of getting a little bit, they're getting piled on,” he said.”

Heise tells me it's a game of comparison that can be dangerous.

"We're seeing some evidence that social media particularly is causing more problems with mental health issues particularly with depression, anxiety,” he said.

Heise says takes 2 to 4 weeks to settle into a normal school routine. So in the first weeks of the year, it's important for parents and teachers to look out for changes in teen behavior.

"Are they social? Are they being isolated from the other kids in the class? Somebody that used to be very popular, now they really don't talk to anybody,” Heise said.

Those changes might be signs that something is wrong.

"More anxiety, depression, suicidal thinking. Eating disorders become a big problem oftentimes at the beginning of the year,” he said.

But Heise says social media isn't all bad. Many schools are using it to engage their students. He says the key is finding the right balance, and putting real life first.

"Social media should probably be about third or fourth. Very often it's kind of flipped completely the opposite,” Heise said.

There are a few things you can do to make sure your teens are putting real life first. Heise recommends keeping them engaged with after school activities, aiming for 8 hours of sleep a night and making sure they're eating healthy meals.