For some teens, social media is the primary way they interact with friends, says Dr. Gwenn O'Keeffe, co-author of the report.
And elements of Facebook make online interaction challenging for those with low self-esteem. Prominent displays of status updates, flattering photos and shots of happy-looking people provide a skewed version of reality and make some teens feel like they don't measure up.
Judgmental messages and cyberbullying also contribute to risks of depression and could cause "profound psychosocial outcomes."
On the other hand, Facebook and other social media are a healthy interaction for many children, according to the study. O'Keeffe says social sites allow kids to stay in touch with friends and family, make new friends and exchange ideas.
However, the study urges pediatricians to talk to parents about discussing Facebook depression and cyberbullying with their kids.