Teen Influencers as Social Media Psychiatrists
Young people are imagining empowerment in self-diagnosis.
Posted January 25, 2023 | Reviewed by Vanessa Lancaster
- Mental health videos on social media have received billions of views, and many young people are diagnosing themselves with disorders like ADHD.
- When asked about what is driving the self-diagnosis trend, college students said almost nothing about illness.
- Students spoke of the value of a diagnosis to explain and negotiate obstacles to achieving social ideals.
“I can’t; no matter how much I try, it’s like my brain won’t let me do it,” said a teen in a user-generated TikTok video, responding to a challenge to put her hand on a stove for $100.
When the teen said her brain was stopping her, the challenger (same teen) quickly drew a parallel to struggles with routine demands, such as to “start your homework" or “just get off the couch.”
Those afflicted with a “paralysis” that, according to the video, is a symptom of attention-deficit/hyperactivity disorder (ADHD) have brains that prevent them from doing everyday tasks.
Welcome to the brave new world of teen influencers offering lessons in pop psychiatry.
Scrolling through other videos marked with the TikTok hashtag #ADHD yields a boundless list of ambiguous “symptoms”–withdrawn, talkative, distractible, spacey, forgetful, disorganized, procrastinating, competitive, clumsy, given to outbursts of anger, binge eating, sleeping in, and on and on it goes.
There are videos showing many variations of what ADHD looks or feels like. Some suggest that while ADHD differs from “normal” experience, sufferers may have special abilities or be hyper-productive. Throughout all of them, neuro talk prevails, with references to brains and dopamine and faux-clinical descriptions of the “ADHD type.”
The hashtag #ADHD on TikTok has 19.8 billion views. Depression, anxiety, bipolar disorder, “trauma response,” and many other such problems have also drawn billions of views.
While no doubt intended to be helpful and empowering, these videos appear to be having unintended and even perverse consequences, including what may be called a social contagion effect. Perhaps the best evidence comes from reports of young people pursuing medical treatment for tics they developed only after watching videos of Tourette's syndrome sufferers displaying tics on social media.
The TikTok algorithm keeps bringing viewers back to the sort of content that they have previously lingered over or viewed. “Every second you hesitate or rewatch, the app is tracking you,” the Wall Street Journal found in a study using bots to simulate human users to learn how the TikTok recommendation engine works. By being repeatedly exposed to the behavior modeled in the recommended videos, vulnerable kids may be drawn into unconscious imitation.
Videos on TikTok and other platforms also directly encourage viewers to identify with disorders and self-diagnose—and many do. The comments sections that accompany popular videos are filled with statements like “you just described me exactly” or “today I learned … I may have ADHD.” Something more than imitation is at work here. But what, exactly?
Recent conversations with some two dozen college students provided a chance to informally explore what they see going on with all this self-diagnosing. Medical literature defending popular mental health content usually cites two alleged benefits: It provides undiagnosed sufferers with valuable information they can use to get needed help and reduces the stigma around mental disorders.
Yet, while the students I talked with did mention picking up “symptom language they can take to a doctor to get medication,” as one put it, they made almost no reference to illness. Rather, they spoke of the value of a diagnosis for easing feelings of personal inadequacy and gaining peer acceptance and access to online communities.
Nearly every student mentioned the strong pressure that young people live under to be high achieving and to stand out as unique and special. One student offered that young people are expected to be “the best of the best in every aspect of their lives,” and when they don’t live up to those standards, “it is hard not to feel as if you are inadequate or have failed.” A diagnosis, she continued, can “take some of the pressure off.” It’s “okay to be imperfect,” stated another, “if you have the explanation of a diagnosis for your limitations.”
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Similarly, students observed that a diagnosis can deflect “criticism from other people based on aspects of your personality” or explain why you might have “certain undesirable qualities like shyness.”
Having come to think of any shortcomings as symptoms of a “biological condition that you can’t control,” some conclude that it is an “easier pill to swallow.” It is far more difficult, many said, to acknowledge “painful experiences” or accept that there is “something wrong with you” or your character. In the TikTok video I mentioned, the teen presents her behavior as being controlled by something in her brain to counter the idea that she might be “lazy.”
A diagnosis, some remarked, can function almost like a “credential.” Many communities coalesce around diagnostic categories and mental health issues on social media. Finding one’s place and being accepted by peers often requires that one’s struggles be recognized as “real” and “validated” by a diagnostic label. The self-diagnosis serves as a “ticket” for entry. As community participants, young people can “fit in,” finding support and understanding from those they feel they can relate to.
Students also said that a diagnosis can help you “feel special” or stand out, especially if you are achieving a lot. Many TikTok videos I watched presented disorder in a positive light, portraying the ADHD sufferer, if somehow impaired, as able to accomplish all sorts of things. Adding a “layer of hardship,” as one student observed, “shows that you can overcome hurdles and reach your goals.”
At the same time, another student insisted, “It’s not enough or ‘cool’ to be ‘perfect’ anymore.” Influencers have been criticized for presenting themselves as perfect, students explained, and are now required to show some vulnerability. Similarly, those from a “privileged background,” such as “being white or upper-class,” need an “offset.” In both cases, students said “having a disorder” can show that they also struggle. It provides an “identity” that allows even the privileged to “voice their thoughts and feel included.”
These student reflections are, of course, neither representative nor exhaustive. But they suggest that diagnostic categories and brain talk are all too often being used in ways that have very little to do with mental illness.
On social media, this language helps its users explain and negotiate obstacles to the achievement of social ideals, but it finally ends up reinforcing the view that there is nothing flawed, amiss, or even unhealthy about the ideals themselves. Talk of symptoms and disorders never challenges whether trying to be “perfect,” “the best of the best,” or “special” might be a problem–even the main problem–because the ideals remain the standards against which the deficits are defined.
Far from freeing, social media pop-psych ends up drawing kids even further under the spell of social ideals that are contributing to the very sense of inadequacy they are seeking to escape.