Societal discourse about mental health has changed. What used to be a highly stigmatized topic is now openly discussed on public forums—something that we, as mental health professionals, can appreciate.
But there has been an unintended consequence of these open conversations as well. In recent days, there has been a well-documented phenomenon of people—especially young people— self-diagnosing themselves with mental health conditions based on information they’ve gathered on social media. This has led to misdiagnosis and overpathologization of normal human experiences.
As a qualified mental health provider, you have the power to move the mental health conversation forward to a place in which people are free of stigma and are equipped with correct information.
There has been a recent increase in young people who are self-diagnosing mental illness based on something they saw on social media, in particular the video-based platform TikTok. You may have already observed it yourself in your practice, particularly if you work with adolescents or young adults.
Researchers have noted recent evidence of mass psychogenic illness and social media-facilitated factitious disorder within young people who use TikTok and other social media platforms.
Videos discussing relatively rare mental health conditions, such as Tourette’s or dissociative identity disorder, have racked up millions of views. Many of these videos are created with the intention of “helping” their peers figure out, for themselves, whether or not they may have the same disorder. They have titles like “Hidden signs of ADHD” or “If you do this, then you might have autism.”
Vox, an established digital publication, describes a TikTok post claiming that being an avid reader during childhood is a sign of dissociative identity. The comments on the post included many young people who seemed to take this new information as fact—leading to many newfound self-realizations and even self-diagnoses of dissociative disorders.
Obviously no qualified mental health provider would take “a love of reading as a child” to make a diagnosis of any dissociative disorder. We know that diagnosis is a complex task that requires examination of history, symptom presentation, assessment scores, and more. We would need to rule out other explanations of symptoms. We may even need to get a full developmental history to make diagnoses for neurodevelopmental conditions like autism spectrum disorder.
Could someone with a dissociative disorder have been an avid reader as a child? Of course. But making a diagnosis is quite a bit more complex than that. So complex, in fact, that even seasoned mental health professionals get it wrong sometimes. To say that a TikTok video can get it wrong is an understatement.
The dangers of this type of post is highly evident to us as mental health professionals, and it can be incredibly frustrating when someone comes into your practice either pathologizing normal human behaviors or insisting on a self-diagnosis that simply doesn’t fit.
On the other hand, this type of content has improved the mental health conversation as well. While talking about mental health issues used to be highly stigmatized, now we can talk about them openly more and more. But it’s important to talk about them in a way that doesn’t spread misinformation.
As a mental health professional, it can be frustrating and confusing to have young clients come into your office after having self-diagnosed themselves with a mental illness due to something they saw on TiKTok or other social media.
But there are ways to reframe this so the conversation can be effective and helpful for both you and your client.
First of all, think of self-diagnosis as a collaboration, rather than a contest—and frame it this way for your client as well. In other words, your client brings to you what they know about a certain diagnosis. Self-reported symptoms are a useful tool to make an assessment, and you can take them into consideration.
Rather than feeling like it’s their (or TikTok’s) assessment versus your own, you can consider what your client has learned from TikTok as valuable input to make the correct diagnosis.
As a mental health therapist, you’re well-trained in the use and demonstration of empathy with your clients. This is nothing new. Although it’s undeniably frustrating when clients come in insisting on diagnoses that just don’t fit, try to show the same empathy in these moments as you would in any other situation in which your client is experiencing suffering.
As you well know, an important component of empathy is perspective-taking, or being able to see the world through the eyes of another person. Try to see the situation from your client’s point of view. Ask them open questions to explore their perspective, such as “What would that mean for you if you did have this condition? What would it mean if you didn’t?”
Especially if your client has received misinformation on a platform like TikTok, it’s important to provide appropriate psychoeducation. Do this empathetically and collaboratively, like you would in any other situation.
It can be helpful to first get a sense of what your client already knows about a subject before providing them with supplemental information. You might start the conversation by asking something like “Apart from the TikTok videos you’ve seen, what else do you know about dissociative identity disorder?”
Part of providing psychoeducation may be to direct your client to more authoritative sources of information—for example, the National Institute of Mental Health website.
The real danger of TikTok self-diagnosis is that young people may replace real mental health treatment with “TikTok therapy.” Clients who are coming to see you are already on the right path—they may (perhaps mistakenly) believe that they have a certain mental health condition, but they have come to you to confirm or deny their suspicions.
Be a sounding board for your client. Turn it into an opportunity for discussion. What are the symptoms that they relate to? What do they need reassurance about? What is upsetting about the symptoms they are experiencing?
The world has changed when it comes to discussions about mental health, mostly for the better. As mental health therapists, we have a responsibility to ensure that the stigma against mental health continues to decline while also being a source of accurate information for our clients.