When I worked in a medical office, I found myself having the same conversation at least once a week. Someone would call the office in a panic. They would tell me their symptoms, inform me that they looked them up on the internet, got some catastrophic diagnosis, and were now were convinced that they were dying.
I would advise them to back away from the computer and come in for an appointment.
We’ve all heard the joke about plugging some minor symptom into the WebMD search and learning that a potential diagnosis was cancer, but when working in any portion of the health field, we know that this scenario plays out more often than we would like.
As frustrating as it was to talk people off of the self-diagnosis ledge, it made sense at the time. Women’s health – the field of practice of the doctor I worked for – was woefully lacking in information when it pertained to anything other than pre-natal and peri-natal care. WebMD was one of the few legitimate sites women could go to if they were experiencing unusual symptoms.
I’m seriously aging myself with this, but…
Today it is estimated that 49% of health information seekers use social media as a means to educate themselves. Many utilize groups and pages that focus on specific health issues that are affecting them or someone they love.
Much like women’s health, psychology is gaining traction and evolving from a taboo subject to a part of important conversations. You can’t scroll through Facebook, Instagram, or TikTok without seeing posts about everything from Anxiety and Depression to ADHD, Bipolar disorder, and ALL of the personality disorders.
As with everything, this can be both a blessing and a curse.
Breaking down the walls of mental health is important. Being able to have honest and open conversations about mental illness and treatment ensures that more people seek out help when they need it, and like so many things in our society, Gen Z seems poised to run through this wall, Kool-Aid man style so that talking about mental health becomes as normal as talking about the weather.
The downside of this is that much like the good ole days when we only had WebMD to plug our symptoms into, seeking out a mental health diagnosis via the internet can be rife with problems.
Tik Tok is the site that addresses mental health with the most compassion, empathy, and the most volume of posts. There are creators in the space who have been diagnosed with a mental illness, there are BIPOC men and women who talk openly about going to therapy, there are veterans who post about their struggles with depression and PTSD and there are mental health professionals who inform viewers about different areas of their practice.
The issues arise when viewers who are not actually experiencing the same issues as their favorite creators start to believe that they have the same diagnosis. And with approximately 2.4 billion views the potential for that sort of social influence is HUGE!
Dr.Adeola Adelay, a practicing psychiatrist, stated in a recent article that the rise in young people self-diagnosing themselves with ADHD, OCD, Dissociative Identity Disorder (DID), autism, and Tourette Syndrome in the last year has been a cause for concern. (Regan Olsson, Nov. 2021). Adolescents from ages 11 to 17 are the most susceptible to social influence, and that is the age group that is flocking to TikTok in droves.
Some mental health professionals are finding that the exposure to so much information about mental health challenges leads to clients coming into the office expecting a particular diagnosis and trying to convince the therapist that they do in fact suffer from something like ADHD, depression, autism, or Tourette’s. The client can then present with symptoms similar to what they have seen on social media and will be misdiagnosed or receive a “false positive” which can lead to further problems down the road. This phenomenon is referred to as “Munchausen by Internet” (Sam Dekin)
One of the biggest factors in this rise of self-diagnosis is the pandemic. Young people have had more time to use social media and as COVID forces them indoors and away from their regular social groups, they are reaching out for interaction and a sense of community. Meanwhile, mental health options have become scarce as providers are overwhelmed with clients due to the lingering COVID crisis. It is a perfect storm.
Accurately diagnosing something like ADHD, Generalized Anxiety Disorder (GAD), depression, or bipolar disorder is a process that requires more than a 3 minute TikTok could ever provide.
Consultations with licensed, certified professional mental health professionals involve a thorough review of symptoms, as well as a complete family and medical history. Even if a diagnosis is confirmed after the consultation and testing, the treatment plan varies from one individual to another and can change over time.
Diagnosis and treatment are specialized for each client, that’s the only way for it to be successful.
Another issue lurking behind the posts is the possibility of misdiagnosis. ADHD in an adult woman looks very different than the way it would present in a young man. Anxiety and depression are closely tied, and sometimes treating one will expose another. As someone who has been in therapy for years, it wasn’t until my anxiety was treated prior to my ADHD instead of dealing with the ADHD head-on that I felt real progress in my own mental health journey.
A proper clinical diagnosis is nuanced and treatment for that diagnosis can be trial and error. If you are not correctly diagnosed, or if you give inaccurate information to your specialist, you can be doing more harm than good.
Additionally, the path to wellness is never a straight line. There is progress and there are setbacks. Treatment and therapy need to be recalibrated. Sessions may need to be ramped up. Only a specialist who has worked closely with you and your specific issues is able to help you to understand the ups and downs of mental health. Social media can be a wonderful place for support and information, but for real lasting treatment, you need to seek out help IRL.
A more nefarious issue with utilizing social media as a way to diagnose mental illness is that the person who is doling out advice or offering diagnosis may not even be a licensed, certified mental health professional. The concept of going viral and in turn being able to monetize an account is a huge draw for people to create content on social media. You only need to be on TikTok for a little while to see the insane number of views and comments on any post that discusses mental health.
This can be tempting for anyone who wants the views and/or to make a quick buck to pose as a psychologist or psychiatrist and hand out misinformation. Most legitimate mental health experts who post on the site will provide disclaimers while they inform and educate, but even this doesn’t do much to offset the rise in self-diagnosis.
An issue that is talked about less but is as important when it comes to the “Social Mediatization of Mental Health” turning mental health terms into part of the vernacular and delegitimizing the struggles of those who have been diagnosed with a mental illness.
OCD, ADHD, Bipolar disorder, autism, and personality disorders like Borderline Personality Disorder (BPD) can be debilitating to those who suffer from them. People who are in treatment for these disorders overcome battles that have affected literally every aspect of their lives. Using the terms to describe yourself because you are someone who likes things a certain way, tend to be easily distracted, or as an insult to someone you may have a conflict with is detrimental to people who actually live with these very real issues. These are serious mental health diagnoses, not the equivalent of your astrological sign.
Overuse of words like trigger, neurodivergent, and even trauma can cause them to be misunderstood which could result in someone who truly needs help not getting it because the resentment and degradation associated with those words can prevent someone from recognizing their own issues. Ironically, our willingness to use terms associated with mental health can lead to overuse, where we run the risk of adding another layer of stigma onto an already sensitive issue.
We’ve seen this in real-time with the word trigger. The American Psychological Association defines a trigger as a stimulus that elicits a reaction. It’s a very real outcome of someone who has experienced trauma and is reconnected to that trauma through an event. Lately, the word has been weaponized as a sign of mental weakness or over-sensitivity when it is actually a biological response to a stimulus that causes your amygdala to go into protective mode.
We’ve come a long way in the discussion of mental health. Opening up communication and destigmatizing the process of asking for help will undoubtedly save countless lives. The next step is to make sure that those who are looking for help are set on the correct path to get the best care they can without fear of being misdiagnosed or taken advantage of by someone trying to stack their views and gain social media fame.
Although we can never completely stop people from plugging their symptoms into a search bar on a website (I have also been guilty of this from time to time.) We can and will educate as many people as we can about how to find the help they need.
We may not do it to a viral dance routine, but it will be just as effective.