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== Harmful effects == Research has demonstrated a number of serious consequences of cyberbullying victimization.<ref name="patchin1" /><ref name="patchin2" /><ref name="patchin3" /><ref name="patchin" /> Victims may have lower self-esteem, increased suicidal ideation, and a variety of emotional responses, including being scared, frustrated, angry, and depressed.<ref name="patchin3" /> Cyberbullying may be more harmful than traditional bullying, because there is no escaping it.<ref name=":8">{{cite web|url=http://demetrioskritikos.com/cyber-bullying/ |title=Archived copy |access-date=November 25, 2015 |url-status=dead |archive-url=https://web.archive.org/web/20150813032718/http://demetrioskritikos.com/cyber-bullying/ |archive-date=August 13, 2015 }}</ref> One of the most damaging effects is that a victim begins to avoid friends and activities, which is often the very intention of the bully. Cyberbullying campaigns are sometimes so damaging that victims have committed suicide. There are at least four examples in the United States in which cyberbullying has been linked to the suicide of a teenager.<ref name="patchin3" /> The [[suicide of Megan Meier]] is an example that led to the conviction of the adult perpetrator of the attacks. Holly Grogan committed suicide by jumping off a 30-foot bridge near Gloucester in the UK. It was reported that a number of her schoolmates had posted a number of hateful messages on her Facebook page.<ref>{{Cite journal|title=High school teachers' perceptions of cyberbullying prevention and intervention strategies|journal=Psychology in the Schools|volume=49|issue=4|page=352|doi=10.1002/pits.21603|year=2012|last1=Stauffer|first1=Sterling|last2=Heath|first2=Melissa Allen|last3=Coyne|first3=Sarah Marie|last4=Ferrin|first4=Scott|url=https://scholarsarchive.byu.edu/cgi/viewcontent.cgi?article=3777&context=etd}}</ref> According to Lucie Russell, director of campaigns, policy and participation at youth mental health charity Young Minds, young people who suffer from [[mental disorder]]s are vulnerable to cyberbullying as they are sometimes unable to shrug it off: <blockquote>When someone says nasty things healthy people can filter that out, they're able to put a block between that and their self-esteem. But mentally unwell people don't have the strength and the self-esteem to do that, to separate it, and so it gets compiled with everything else. To them, it becomes the absolute truth – there's no filter, there's no block. That person will take that on, take it as fact.<ref name="Guardian8813">{{cite news|title = Cyberbullying websites should be boycotted, says Cameron: Prime minister calls for website operators to 'step up to the plate', following death of 14-year-old Hannah Smith|newspaper = The Guardian|date = 8 August 2013|author = Alexandra Topping|author2 = Ellen Coyne and agencies}}</ref></blockquote> Social media has allowed bullies to disconnect from the impact they may be having on others.<ref>{{cite web|url=http://www.carlyleobserver.com/article/20120427/CARLYLE0101/304279977/-1/carlyle/cyber-bullying-and-popular-culture|title=Cyber-bullying and popular culture|author=Kelly Running|work=Carlyle Observer|access-date=January 5, 2015}}</ref> === Intimidation, emotional damage, and suicide === According to the Cyberbullying Research Center, "there have been several high‐profile cases involving teenagers taking their own lives in part because of being harassed and mistreated over the Internet, a phenomenon we have termed cyberbullicide – suicide indirectly or directly influenced by experiences with online aggression." Cyberbullying is an intense form of psychological abuse, whose victims are more than twice as likely to suffer from mental disorders compared to traditional bullying.<ref name="cyberthreat">{{cite journal | journal=[[Ideas and Discoveries (magazine)|Ideas and Discoveries]] |title=Cyberthreat: How to protect yourself from online bullying | year=2011 | page=76}}</ref> The reluctance youth have in telling an authority figure about instances of cyberbullying has led to fatal outcomes. At least three children between the ages of 12 and 13 have committed suicide due to depression brought on by cyberbullying, according to reports by ''USA Today'' and the ''Baltimore Examiner''. These include the [[suicide of Ryan Halligan]] and the [[suicide of Megan Meier]], the latter of which resulted in ''[[United States v. Lori Drew]]''. Teen suicides tied to cyberbullying have recently become more prevalent. Rebecca Ann Sedwick committed suicide after being terrorized through mobile applications such as [[Ask.fm]], [[Kik Messenger]] and [[Voxer]].<ref>{{cite news|last=Alvarez|first=Lizette|title=Girl's Suicide Points to Rise in Apps Used by Cyberbullies|work=[[The New York Times]]|url=https://www.nytimes.com/2013/09/14/us/suicide-of-girl-after-bullying-raises-worries-on-web-sites.html?_r=0|access-date=November 20, 2013}}</ref> === On youth and teenagers === The effects of cyberbullying vary, but research illustrates that cyberbullying adversely affects youth to a higher degree than adolescents and adults. Youth are more likely to suffer since they are still growing mentally and physically.<ref name="Effects of Bullying">{{cite web|title=Effects of Bullying|url=http://www.stopbullying.gov/at-risk/effects/|website=StopBullying.gov|publisher=U.S. Department of Health & Human Services|access-date=November 18, 2015|date=February 29, 2012 }}</ref> Jennifer N. Caudle, a certified family physician, says, "Kids that are bullied are likely to experience anxiety, depression, loneliness, unhappiness and poor sleep".<ref>{{cite web|title=Cyber-Bullying and its Effect on our Youth|url=http://www.osteopathic.org/osteopathic-health/about-your-health/health-conditions-library/general-health/Pages/cyber-bullying.aspx|website=American Osteopathic Association|publisher=American Osteopathic Association|access-date=November 21, 2015}}</ref> [[File:Against Cyberbullying.png|thumb|This image shows different aspects of cyberbullying that can take place on the internet which puts more emotional strain on the younger children and teenage who experience cyberbullying.]] Most of the time cyberbullying goes unnoticed; the younger generation hides their bullying from anyone that can help to prevent the bullying from occurring and from getting worse. Between 20% and 40% of adolescents are victims of cyberbullying worldwide.<ref name="Effects of Bullying" /><ref name="ReferenceA">{{cite journal|last1=Deniz|first1=Metin|title=A Study on Primary School Students' Being Cyber Bullies and Victims According to Gender, Grade, and Socioeconomic Status|journal=Croatian Journal of Education|date=July 7, 2015|volume=17|issue=3|pages=659–680|doi=10.15516/cje.v17i3.835}}</ref> The youth slowly change their behaviors and actions so they become more withdrawn and quiet, but this may go unnoticed since the change is subtle.<ref name="Effects of Bullying" /><ref name="ReferenceA" /> Metin Deniz believes cyberbullying will "become a serious problem in the future with an increase in the Internet and mobile phone usage among young people".<ref name="ReferenceA" /> If preventive actions are not taken against cyberbullying, younger children in addition to teenagers will feel more lonely and depressed along with having significant changes in their eating and sleeping patterns as well as loss of interest in their normal activities.<ref>{{cite journal |last1=Nixon |first1=Charisse |title=Current perspectives: the impact of cyberbullying on adolescent health |journal=Adolescent Health, Medicine and Therapeutics |date=August 2014 |volume=5 |pages=143–58 |doi=10.2147/AHMT.S36456 |pmid=25177157 |pmc=4126576 }}</ref> These changes will affect their growth and development into adulthood.<ref name="Effects of Bullying" /><ref name="ReferenceA" /> Younger children and teenagers are 76.2% less likely to display suicidal behaviors and thoughts, but are still at risk depending on other factors such as mental health status, home care, and relationships with others.<ref name="ReferenceA" /> The risk of suicide increases by 35% to 45% when victims do not have any support from anyone in their life, and cyberbullying amplifies the situation.<ref name="Effects of Bullying" /> Young people seem particularly vulnerable to the effects of cyberbullying through [[anonymous social media]], perhaps because adolescents are attracted to these platforms as a means of seeking validation from their peers.<ref>{{Cite book|title=Odd Girl Out|last=Simmons|first=Rachel|publisher=Mariner Books|year=2011}}</ref> Abuse on these platforms, such as [[ASKfm]], [[Yik Yak]] and [[Sarahah]], can be particularly keenly felt by young people, leading to issues of loss of confidence.<ref>{{Cite journal|last=Binns|first=Amy|date=2013|title=Facebook's Ugly Sisters: Anonymity and abuse on Formspring and Ask.fm|url=http://clok.uclan.ac.uk/8378/|journal=Media Education Research Journal|volume=4 | issue = 1 |page=27}}</ref> There have been a number of suicides related to bullying on these platforms in the US<ref>{{cite web|url=http://www.newsday.com/long-island/suffolk/family-friends-shocked-at-cyberposts-after-teen-s-death-1.1827393|title=Family and Friends shocked at cyberposts after teen's death|last=Polsky|first=Carol|date=March 23, 2010|website=Newsday}}</ref> and Britain.<ref>{{Cite news|url=https://www.telegraph.co.uk/technology/social-media/8653867/Teenager-in-rail-suicide-was-sent-abusive-message-on-social-networking-site.html|title=Teenager in rail suicide was sent abusive message on social networking site|date=July 22, 2011|work=The Telegraph}}</ref> ===Suppression of speech=== By at least 2018, some doctors have been targets of online harassment from [[anti-vaccine]] activists responding to their social media posts, including hundreds of negative false reviews on doctor ratings sites. This made some of the doctors more reluctant to share information about vaccines, but others formed groups to spread factual information about vaccine safety on social media in response.<ref>{{Cite web|url=https://www.bostonglobe.com/metro/2019/05/11/vaccine-opponents-target-doctors-social-media-and-ratings-websites/Y8RQie1xJdr1RtKvbdR9mI/story.html|title=This doctor posted online in favor of immunization. Then vaccine opponents targeted her - The Boston Globe|website=BostonGlobe.com}}</ref>
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