Abstract

In my research essay I wrote about mental health on TikTok, but more specifically how people post videos describing symptoms of a mental disorder and how people might use these videos to self-diagnose themselves with the disorders seen in the videos. I also go over the dangers of doing so and what people should do to gain a more accurate look into their mental health, such as seeking out their doctor or another health care professional. To start my research and essay I also analyze the TikTok algorithm and how it plays into factors of self-diagnosing. The purpose of this essay is to gain a better understanding of how people self-diagnose online as well as how it is approached in the TikTok sphere. While I used a number of secondary sources, my primary sources involved me observing TikTok videos and spaces, as well as conducting a survey about mental health in correlation to TikTok. I had 16 participants and 7 of them fell into the range of having questioned their mental state due to TikTok videos. Some even answered that they have panicked about their mental health or sought medical treatment because of TikToks they viewed. The rest of my essay dives into secondary sources such as research done by medical professionals as well as popular news articles. By the end of my research and writing, I have concluded that self-diagnosing has a negative impact on the individual doing so and that, when in doubt about their mental health, one should seek out a medical professional.

Keywords: TikTok, self-diagnosing, mental health, symptoms, algorithm

Introduction

Social media can be very useful in a number of ways, but it can also be negative. Media applications such as Twitter, Instagram, TikTok, and Tumblr, can help people connect with others from different communities and areas of the world, especially those we can relate to or learn from. Since the creation of social media and its advancements, we, as a society, have been sharing and forming our identities online in order to advance these connections. As we constantly view and absorb videos and information, we might change our opinions about things or learn about something we relate to and perhaps did not realize. Whichever way one chooses to use social media, our identities and opinions tend to change with long term use. In today’s digital age it is important to take a look at the influence social media has on our identities and see how this exposure of vast information is changing the way we think about and view ourselves and the world around us.

When it comes to TikTok, there are many videos of people wanting to be relatable, and they generate higher numbers of views and interactions with these videos. While scrolling through your “for you page” you are likely to see videos with recipes, gardening tips, comedy sketches, and much more. But with these, you might also see videos about mental health disorders and their symptoms. Many TikTok users post videos making jokes about their mental disorders and creating comedic sketches that help people with these disorders connect to one another. While people cope with mental illness in many different ways, there are viewers who take these videos as medical advice and seek out more of these videos to help them understand themselves a bit better.

Videos with the captions “How to know if you have ADHD” or “Symptoms of Autism” gain a lot of popularity on TikTok, and people are using them to diagnose themselves with these mental disorders. While people might state their claims for why they think self-diagnosing is okay, the reality is that getting mental health diagnosis – as well as self-diagnosing – yourself based on TikTok videos is not safe, nor should it continue to be done.

The Algorithm

First and foremost, in order to understand TikTok and its vast amount and range or videos, one has to understand its algorithm and how it plays a part in people’s self-diagnosing. When scrolling through TikTok you will watch videos on subjects and topics you enjoy and follow, but you will also get recommendations based on what is trending at the moment, what you already watched, or videos similar to what your friends have shared with you. This is more so on the ‘For You’ page, and it can lead us to watching videos and users we don’t normally associate or identify ourselves with. This is where media might start to change our perceptions, opinions, and identities.

A Wired article by Eleanor Cummins (2022) titled The Creepy TikTok Algorithm Doesn’t Know You, explains how algorithms are created to profit off of user interest and gain their attention for longer periods of time. Cummins (2022) writes, “The TikTok algorithm’s near-universal renown has made it all too easy to treat TikTok’s probabilistic functions as diagnostic, or even deterministic. In another context, this might be understood as trust—if the algorithm was right that you’re a lesbian cottagecore Gleek obsessed with French bulldogs, it’s at least worth considering what it means for the same system to serve you ADHD content” (Wired). When users scroll through their for you page, they expect it to only be things they already like or would have interest in. As Cummins (2022) stated, when people see something new, they might assume that this will also interest them or that they can relate to it – why else would TikTok recommend it?

This sort of thinking can be dangerous, and it is not to say that the majority of users feel this way. If a video comes up talking about symptoms of a mental disorder or something similar, it is likely that this will catch people’s attention. Perhaps they want to see if they can relate to  that disorder, and if they do, could they possibly have it. In her research article, tiktok ≠ therapy: Mediating mental health and algorithmic mood disorders, Holly Avella (2023), discusses the TikTok algorithm and how people view the algorithm’s choices as “a therapist”. Similar to Cummins’ (2022) findings, Avella (2023) saw that users view that algorithm as “all-knowing”. Avella (2023) writes, “User comments like, “I feel like I was summoned to this video” mix with comments about the algorithm holding intimate knowledge about them” (Sage Journals). TikTok’s algorithm is set up to feel this way, that is how they garner their user’s attention and time. While TikTok wants to cater to each individual’s supposed interests and identities, it also shows them things they don’t necessarily agree with.

Journalist Sapna Maheshwari (2022) took an interesting look into the TikTok algorithm in her New York Times article, Young TikTok Users Quickly Encounter Problematic Posts, Researchers Say. In the article, Maheshwari (2022) states that “TikTok tailors a stream of short videos to people based on their interests, view times and the accounts they follow. It starts recommending content tied to eating disorders and self-harm to 13-year-olds within 30 minutes of their joining the platform, and sometimes in as little as three minutes” (NYT). While TikTok representatives have pushed back on this information, stating they don’t condone these videos, it is still interesting how people will receive videos related to mental health within their immediate joining of the app.

Relating to & Recognizing Symptoms

Self-diagnosing is not something new to the online world. In a New York Times article by Christina Caron (2022) titled Teens Turn to TikTok in Search of a Mental Health Diagnosis, Caron (2022) discusses how young TikTok users will turn to TikTok in order to feel seen about what they are experiencing. Caron (2022) writes, “A number of mental health providers say that they are seeing an uptick in teenagers and young adults who are diagnosing themselves with mental illnesses — including rare disorders — after learning more about the conditions online” (NYT). While someone can relate to symptoms that people with a diagnosed disorder can have, it is still harmful to immediately assume that one has that disorder. This can impact how they go about in their day to day life and how they might continue interacting with others online. While many people might self-diagnose because they cannot afford professional medical care or because they don’t have the support around them to go to the doctors, they have to keep in mind that the symptoms they see in these online videos can be common for many people, and many different disorders as well. Despite all of this, self-diagnosing is becoming normalized, and this can prove dangerous to people whose symptoms might be temporary or short-term.

People on the app promote these mental disorders as something “fun” and “cool”. Through my observations of TikTok and the users who post about their mental health issues, one stood out to me the most. Actress Chloé Hayden (2023), from the hit Netflix show, Heart Break High, is very open about her Autism and posts on TikTok talking about how she goes about her daily life with this diagnosis. From her many videos she upload one with the caption, “I will single handedly diagnose everyone around me”. In this video, Hayden (2023) is using a popular audio where someone is calling someone gay based on their observations. In her video captions, Hayden (2023) says she diagnoses people as Autistic based on their actions and behavior. Although this can be taken as a joke, it was alarming to me. Hayden (2023) has made several videos about how she is able to identify Autism in people based on how they stand or react to certain scenarios. Of course, someone who is on the spectrum is more likely to identify others that are Autistic, but people with the same mental disorder can feel different symptoms, or these symptoms that are listed in videos can call for any number of disorders.

In a research article done by doctors at the University of Toronto and University of British Columbia (2022), they found that out of the top 100 most popular TikTok videos online that discussed ADHD, “Approximately half of all videos analyzed were misleading, and the misinformation they contain has the potential to contribute to health anxiety” (Sage Journals). They also continued by writing, “Since self-report of ADHD symptoms may be over-endorsed, there may be an increased risk for overdiagnosis or misdiagnosis in these individuals as well” (Sage Journals). This study was able to prove how a lot of the information shown in these self-diagnosis and symptom TikToks, are false or misleading. The doctors mention the risk of overdiagnosis or misdiagnosis. Some people may view these videos consistently and believe this is truly the disorder they have, directly suggesting this to a health professional and perhaps only getting tested for one specific disorder. While this study showed that many individuals sought out professional health, they still went in with a set mind on what they would be diagnosed with.

The Canadian study went on to write, “even videos made without intent to disseminate medical information may describe non-specific symptoms, overgeneralizations, and characterizations about ADHD that could be misleading to viewers” (Sage Journals). This is the big problem that keeps coming up when discussions of self-diagnosing are on the table. There is a huge generalization of symptoms with some even as simple as “feeling restless” or, from what I have personally seen, “constant daydreaming”. In a survey I conducted, 16 people who watch TikTok videos were asked about their impression of mental health related videos and how they view their own mental health. In my survey 3 people said they “panic” when it comes to seeing several symptom related videos they relate to, that they even feel they need to dive deeper and research more because they worry about their mental health and that the videos they saw were accurate.

In another study titled The Phenomenology of Tics and Tic-Like Behavior in TikTok, a group of doctors (2022) from various states, but mainly Ohio and South Carolina, found that over the course of the COVID-19 pandemic, there has been an increase of reported Tourettes Syndrome and Frontal Lobar Degeneration on TikTok. Their studies show that this is likely due to “’social contagion’ or modeling” (Science Direct). Again, people will watch videos of people posting symptoms of a disorder, and then feel as though they have it to. In this case, people were acting these symptoms, tics, in real life.

DSM/Clinical Diagnoses

Without a professional medical diagnosis people can start to panic about their mental health or start to question their behavior and thinking. In my survey, I asked people if they believe they relate to videos showcasing symptoms of a mental health disorder, 4 of them said yes. Some explained that they see the videos and compare it to their current mental state or take time to think about how much they relate to the symptoms. In The Phenomenology research article, the researchers recommended that those who are experiencing characteristics they deem unusual or out of their ordinary should seek medical and professional health.

As I have stated before, people should seek a medical professional if they have concerns about having a mental disorder, and this would usually be a psychiatrist. A psychiatrist will use a handbook or a guide called a DSM (Diagnostic and Statistical Manual of Mental Disorders). This handbook contains the mental disorders that are known to medical professionals and that can be diagnosed. According to the American Psychiatric Association, the DSM contains sets of criteria for each diagnosis and how patients may display these criteria. The current DSM (The 5^th one) contains almost 300 mental disorders. This is why it is so important to not fall into the hole of self-diagnosis. While a viewer may watch a video and relate to the daily onslaughts of ADHD, they may very well have a different condition that would need separate treatment.

Many things are considered when diagnosing a patient and longevity is a key thing. If someone is experiencing a set of emotions or behaviors that they deem unusual or different, it seems that anywhere from 2-3 weeks of experiencing it is where doctors agree that a test for a diagnosis is important. While we might relate to videos we see online it is important to take our time to understand why we might relate to them and to also realize that many generalizations are at play. While watching an array of TikTok videos about mental health, I fortunately also saw videos from real health professionals that tell viewers they should take their mental health concerns to their doctor to see what steps they need to take in order to figure out if they can be diagnosed with a certain disorder.

Conclusion

A study done by the Harvard Kennedy School’s Women and Public Policy Program (2019), found that social media has the power to influence social norms and that information shared to the masses publicly is more influential than not. When we go on social media and share our identities and mental health disorders it can be a great way to connect with others and make friends that we can relate to. Through this, social media usage can take a turn and cause us to try to find answers for the way that we feel and why. This might become self-diagnosing or digging ourselves into a TikTok hole with videos of people discussing their disorders and trying to relate to them. When we keep posting and promoting self-diagnosis, this can cause a shift in identity for people where they rely on social media and others on it to relate to. While our identities can connect us online, they may also harm us and cause us to not fully understand who we are.

Lindsey Phillips (2022) from The American Counseling Association, states that “people are hungry for mental health answers” (Counseling Today). People will watch TikTok videos about mental health in order to understand why they feel a certain way, or to even understand why they related to a different video they say. Because of the vast information shared on social media today, it is easy for people to turn to it instead of seeking other forms of help. With one press on our phones we can have TikTok open, with large amounts of information pouring through and being thrown at us. We owe it to our mental states to take a step back from self-diagnosis videos and see if we are truly concerned about our health. When in doubt one should seek medical attention and understand that just because an individual with experiences certain symptoms in their disorder, we might not experience the same things, and that there are dangers to generalizations of a disorder and self-diagnosing.

References

About DSM-5. TR. (n.d.). https://www.psychiatry.org/psychiatrists/practice/dsm/about-dsm

Avella, H. (2023). “tiktok ≠ therapy”: Mediating Mental Health and Algorithmic Mood Disorders. New Media & Society, 146144482211472. https://doi.org/10.1177/14614448221147284

Caron, C. (2022, October 29). Teens turn to TikTok in search of a mental health diagnosis. The New York Times. https://www.nytimes.com/2022/10/29/well/mind/tiktok-mental-illness-diagnosis.html

Cummins, E. (2022). The creepy TikTok algorithm doesn’t know you. Wired. https://www.wired.com/story/tiktok-algorithm-mental-health-psychology/

Frequently asked questions. Psychiatry.org – Frequently Asked Questions. (n.d.). https://www.psychiatry.org/psychiatrists/practice/dsm/feedback-and-questions/frequently-asked-questions

Hayden, C. (2023). TikTok. Retrieved from https://www.tiktok.com/t/ZTRE8EWCf/?t=2

How does media influence social norms? A field experiment on the role of common knowledge. How Does Media Influence Social Norms? A Field Experiment on the Role of Common Knowledge. | Gender Action Portal. (n.d.). https://gap.hks.harvard.edu/how-does-media-influence-social-norms-field-experiment-role-common-knowledge

Maheshwari, S. (2022, December 15). Young tiktok users quickly encounter problematic posts, researchers say. The New York Times. https://www.nytimes.com/2022/12/14/business/tiktok-safety-teens-eating-disorders-self-harm.html

Phillips, L. (2022, May 2). Self-diagnosis in a Digital World. Counseling Today. https://ct.counseling.org/2022/03/self-diagnosis-in-a-digital-world/

Yeung, A., Ng, E., & Abi-Jaoude, E. (2022). TikTok and attention-deficit/hyperactivity disorder: A cross-sectional study of social media content quality. The Canadian Journal of Psychiatry, 67(12), 899–906. https://doi.org/10.1177/07067437221082854

Zea Vera, A., Bruce, A., Garris, J., Tochen, L., Bhatia, P., Lehman, R. K., Lopez, W., Wu, S. W., & Gilbert, D. L. (2022). The phenomenology of tics and tic-like behavior in Tiktok. Pediatric Neurology, 130, 14–20. https://doi.org/10.1016/j.pediatrneurol.2022.02.003