Teens Turn to TikTok in Search of a Mental Health Diagnosis

Oct 29, 2022 · 178 comments
PB (Canada)
Teens, young adults, adults, middle aged... We are all talking about neurodivergence and mental health disorders more openly now. We have seen a malignant narcissist in action. We can then pinpoint those relationships around us that had similarities. we can recognize what behavior is outside our expectations. and finding community with those who have experienced similar disconnects. As for self-diagnosis, especially with ADHD and autism, it is valid. it has to be, especially for those of us who are older. I have two children, who are neurodiverse. these diversities are often genetic. parents are often diagnosed AFTER the child is. So here is a generation of amazingly self-aware kids who have access to so much information. Yep, they will get it wrong. Dr. Google also tells me i have a possibility of cancer every time i google my migraines. SO, have the professionals walk them through the DSM diagnoses. And know that the DSM is biased towards white, male presentations. That was who was studied before, so it will NOT present itself the same way with everyone. That is why there are so many Gen-X and Millennial women who are finally figuring out that ADHD explains so much of their own struggles in life. TicTok and Facebook Reels -- they can be curated to have valid content. Doctors shouldn't diagnose, but people should use the information they get and seek professional help. OR find other tools to use. It is a reality in the world with less access to healthcare.
PB (Canada)
*Doctors shouldn't diagnose from tiktok alone, but it doesn't mean it is invalid.
MH (NYC)
“You don’t really need to have a mental health disorder to be suffering -- Everyone needs emotional support.” This really does say it all. Disorder labels are an easy explanation and action oriented goal for those seeking help, or parents looking to help their children. Support, ongoing and truly empathetic, is hard to give and hard to find. It takes time and attention, and an open mind, and loving ability to accept whatever it is your child is feeling as valid.
Peter Wolf (New York City)
A major underlying issue here is the business of diagnosis itself. It has gained importance for two reasons: 1) with every new diagnosis drug companies can sell new drugs, and 2) insurance companies need an easy way to keep track of things, actually reducing all categories to numbers. It is not just whether one is an "expert" in finding the right label; it is the labeling process itself. As a psychologist, now retired, I rarely thought of my patients in such categories, except when I had to fill out a form. I tried to understand what was going on internally with the patient- conflicts, hidden fears, unconscious desires, vulnerabilities and strengths. What they were afraid of facing in themselves and in relationships with others. And what are the patients' real life circumstances. Yes, if the patient was psychotic, or narcissistic or very defensive or with self-esteem issues, they were important. But they don't have a number attached, where everyone labeled bipolar one can be understood or treated the same way. This should be obvious from the fact that diagnoses are fashionable, like clothes, in and out of fashion. Twenty years ago everyone was ADD. Now everyone is bipolar. My Asperger's relative if no longer that- the diagnosis has been discontinued. You don't understand someone by finding a label. You understand them by engaging them and trying to understand them. More or less the way you should try to understand yourself.
CEK (Portland, ME)
It's such a fragile line between shrinking the stigma teens can feel around talking about serious depression and glorifying it. Social media is so dangerous because it flattens and oversimplifies what it means to be a human. Teenagers are naturally black-and-white thinkers, and TikTok (and all social media) both feeds the thinking and feeds on it. Do kids know that you can be sad without being clinically depressed? They assume the pretty girl pictured amongst all her friends at a party is HAPPY. Like HAPPY is a personality type. I wish we could ditch social media for anyone under 21. Why is the mainstream media so slow to recognize the damage it's doing? This article could have been written at least a year ago about TikTok, and five years ago with Instagram, et al.
Sarah Fay (Chicago)
This is so important. Thank you, Christina Caron. But it's a far more serious situation than the article makes it out to be. The article is very balanced, but the balance comes as a result of leaving out three crucial points: 1) I know from experience what can happen when a young person over-identifies with a diagnosis and grows up believing that thoughts, emotions, and behaviors are "symptoms." After receiving a diagnosis at age twelve, I spent twenty-five years in the mental health system. Yes, I was suffering and needed help, but seeing myself as one diagnosis after another and not learning to manage and understand my painful emotions, disturbing thoughts, and undesirable behaviors almost caused me to end my life. 2) We aren't just talking about young people hearing about diagnoses on social media, self-diagnosing, asking for a diagnosis, and giving it to themselves even if the clinician doesn't agree. With a diagnosis comes serious psychotropic medications that haven't been sufficiently tested on this population. Medications can be very helpful, but how many of them are being warned about the withdrawal effects of remaining on said medications long-term? 3) DSM diagnoses are useful because we use them, but they're shaky at best. These young people aren't informed. They don't know that a diagnosis is, as former head of the NIMH Thomas said, little more than a construct. I hate to think that a young person would make the same mistake I did purely out of ignorance.
Dcc211 (Los Angeles)
I am so glad this is finally being written about. I see so many teens coming in having diagnosed themselves, especially with personality disorders that aren’t usually diagnosed in adolescents. The article is completely right, they believe the internet over professionals, and attach to it as a personality trait/something that defines them. Thank you for bringing this out in the open NYT.
Barbara (Myrtle Beach)
"'It’s almost as though me, as a professional — with a master’s degree, a clinical license and years of experience — is competing with these TikTokers,'Ms. Barsch said." In my experience, it's not "almost." I too am a clinician with a master's degree and years of experience, but people repeatedly assume they know more than the professionals, including me. It's insulting, but worse, it leads to inappropriate and misleading judgmentalism that some people share far and wide. Nothing dissuades them. One woman whose family ties with my family go back to our parents (and we are both seniors now) apparently blocked me on a social media app after I tried gently to explain that she was mistaken about a lay term being a clinical term. I wonder what she would have thought if I insisted I knew more about her profession than she does.
Justine (Tennessee)
1) I have definitely noticed among my peers (people in their 20s or early 30s) a tendency to proclaim (usually on social media) that they got a mental health diagnosis and that's how they explain/excuse poor behavior. I think getting diagnosis is great if it helps you find treatment, but just treating it like a personality trait and continuing to behave poorly is not helpful. 2) I have seen the sentiment (usually on social media) that getting mental health help from a true expert is a privilege and some people can't afford that, so their only option is getting help via Tik Tok, so you're being insensitive by judging people who get help on Tik Tok. I think this notion also motivates people who seek questionable alternative health practices too. People are responding to the broken and expensive health care system in the US and rather than direct energy at lawmakers and other leaders to advocate for change, they seek potentially dangerous alternatives. 3) I absolutely abhor that OCD is an adjective and a personality quirk. I have felt this way since I was in high school. I always liken it to, what if people who were coughing a lot due to allergies or a cold said "OMG, I'm like so lung cancer today!" It's weird sounding, and we don't do it with other illnesses.
Boyo Amsterdam (The Great North)
Tik Tok and other non social media has poisoned everyone’s mind. Tik Tok is a tool of communist China. An FCC director recently called for banning it. The latest generation has no clue what socializing actually means.
Robert Scott (California)
I suppose teens might be doing more self diagnosis than they used to. That just means they're catching up to their parents, neighbors, relatives, uber drivers, ED staff, social workers, school psychologists, dentists, judges, prosecutors, defense attorneys et al who know more than I do a psychiatrist who has seen over 30,000 very ill patients in the last 30 years. Every American knows that becuse they can think that means they're a budding expert on mental illness. Just like believing you are a junior cardiologist because your heart pumps blood.
Jason (Illinois)
Great article, but Elburn, IL is not a suburb of Chicago. It's a small town in the middle of corn and soy fields about 60 miles west of Chicago.
Mary (Missouri)
I think this is wonderful. Getting information and having open dialogue about mental health conditions is one thing this generation has gotten right over previous ones. They can take this information to a qualified doctor for diagnosis and treatment. I was misdiagnosed by doctors for 20 years. If I had had the resources of a tik tok and the societal acceptance to talk about my mental health - my life would have been filled with far fewer struggles.
Claire Dockery (Albuquerque, NM)
The rise of TikTok and other content creation-focused social media has tied social clout to the content you put out. You want to be the most unique, the most creative, because those are the qualities that will help you make the kind of content people will engage with. And so I wonder whether the "tortured artist" stereotype is also at play here -- the toxic conflation of mental illness and general unhappiness with creative potential. Mental illness labels are a convenient marker of demonstrable difference from the general population, and in line with Ronan Cosgrove's quoted comments, it's a difference that audiences have come to associate with their creative idols. This is in addition to people's need to feel validated in their individual struggles, where the mental illness label is meant to serve as evidence that said struggles are genuine.
ResWY (Laramie, WY)
Mental health care is a misnomer. The brain is extraordinarily complex; as a geneticist, I would note that numerically more genes are expressed in the brain compared with any other organ, and we know virtually nothing about what alters gene expression in the brain (i.e., when genes are on/off, developmental variation in expression, expression by environment, novel gut microbiome effects on mood identified recently etc). Quite fundamentally, psychologists can not and do not know what they're doing. While I agree that there is a depression / anxiety crisis among teens, I am not sure what to do about it.
Barbara (Myrtle Beach)
@ResWY We don't have to know how every gene is expressed to know how to treat mental illness. Anxiety and depression respond well to tried and true therapies. Psychologists, social workers and counselors know what they are doing. They trained for years to do their work.
Emily (USA)
I can't help but think about how, in many areas of the US, there is a significant shortage of mental health professionals, in part exacerbated by the pandemic and how mental health has worsened nationwide. While, in many cases, TikTok is pushing these teenagers to self diagnoses that are not accurate, the fact remains that something is pushing them toward these diagnoses. It could be normal puberty mood swings, stress from school or work, or something far more serious. Whatever the cause, teenagers experiencing these troubles should DEFINITELY have access to some form of mental healthcare (be it a compassionate school counselor or a psychiatric specialist) in order to figure out what's going on. Until this shortage resolves and young people are able to access services, they'll be left only with an app that pushes them algorithmically toward self diagnosis, misinformation, and (arguably) worse mental health. While lack of access is by no means the reason for everything here, I don't think it is helping.
Steven Pettinga (Indianapolis)
@Emily That point was on last night's news. There has been a shortage of psychiatrists since the 60's. No one seemed too concerned. Then 1/3 of all the soldiers fighting in the Mid East came home with them needing qualified Doctors. I think they kind of did it to themselves. In my live I have gone to such a Doctors 3 times. It was unhelpful and they made me do all the talking. I thought they would be there to answer what is wrong with us. No such luck. Antidepressants, if you're lucky, they make you feel basically nothing. Many other patients find a lot of help with them. A story on PBS Newshour suggested that many homeless & people with mental illness could be helped by two or three more Doctors each. Where are these experts supposed to come from? If all these experts giving this advice, had a better answer than creating another question, I might have reason to not be so skeptical, but I don't believe they are much help. That kids seek out answers on Tic Tok, isn't much different than I looking for ways to fix my yard hydrant on You Tube. There were over 10 videos instructing me 10 different ways how to repair the IOWA yard/farm hydrant. Sometimes, the internet is not such a daft idea. Steven Pettinga, Indianapolis.
Barbara (Myrtle Beach)
@Steven Pettinga Young doctors tend not to choose the field of psychiatry because it is one of the lowest paying medical fields. With large student loans, they fear they will be in debt "forever."
RLG (Simsbury, CT)
It was only a few years ago that young people from stable backgrounds were heeding the siren song of distant voices from social media and joining ISIS. QAnon, the most dystopian social movement in this country's history, seeped into millions of ordinary brains through the power of social media. So why should we be surprised about what kids are buying into on TIk Tok? I don't understand the psychology behind any of this, but the tycoons of social media are raking in vast fortunes while we as a society are losing our sanity. And now, here comes Elon Musk.
R (Ohio)
I'm a pediatric mental health therapist. Please do a search and read the pubmed articles on TikTok tics. It's fascinating. I knew something was up when two separate patients came in with a history of "tics" in one week. Kids coming in with sociogenic "tics" largely caused by Tiktok videos are straining already scarce resources devoted to treating rare issues like tics. Researchers have found this pattern in both US and Germany. One pub med article reported it as one of the first documented sociogenic illnesses. Similar to when Sybil was published DID suddenly became more common. Ironically, DID, tics, ADHD and other more "visible" diagnoses seem more commonly shared on TikTok and brought up by my clients compared to diagnoses that you can't make viral videos of, like generalized anxiety disorder or illness anxiety, for example.
Lisa (Toronto)
I only have to spend 5 minutes thinking back to my own 1980’s adolescence to confirm that there have always been troubled teens, often in more danger in previous generations. Unplanned pregnancy (close friend), serious car accident due to drunk driving (my sister), daily nicotine use, binge drinking on weekends, female classmate having “secret” sexual relationship with a married male teacher, closeted gay classmate who was was horribly bullied (no surprise to anyone when he came out after high school). One of my friends cried daily for 6 months (often at school) when her boyfriend dumped her - no help available, either meds or counselling, in that era. Boys with ADHD being physically disciplined in middle school, then dropping out in high school. It’s way better now. The only exception is that the available street substances are much more dangerous now, but overall less kids use them.
Bruce Williams (Chicago)
Social media is entertainment. Anything purporting to be fact is so limited and selective that it amounts to self-misinformation. It's an education problem.
Lisa (Laguna Niguel)
As a former school counselor, I thought I saw it all. But I had students avoiding any amount of class work or participation during my last year. I had one student start claiming she suffered from ticks another one wanting to wear diapers and endless mental health issues. We’re they clinically depressed? A few. Parents refused to take their cell phones so they would get enough sleep to function at school or do some homework. It was the school must accomodiate. Where did they get these ideas? Tik Tok. Parents start to parent, please! ADD or OCD could be valid. But how many hours are you on Tik Tok vs completing your homework?! Ask your teens!
Justanne (San Francisco, CA)
@Lisa I will add to this, though, teachers, stop assigning all work on the computer! It's impossible to monitor them the entire length of homework time. And frankly, they're accessing these apps at school during laptop/Chromebook time. Go back to books! Watching "educational" videos on YouTube isn't teaching kids programming, so all the "tech time" isn't helping them anyway.
Thunda (Downunda)
One of the fascinating shifts over the past couple decades has been the widespread recognition of depression and other mental "illnesses" as being very prevalent and worthy of public discussion and acceptance - rightly so. What has been an unfortunate side effect is the predictable faux "mental health" badges that the younger generation wants to slap on themselves to avoid taking responsibility for....anything really. It's the get-out-of-jail-free card for being incapable of dealing with inanely common travails of life. Beyond that, and I can't even believe I'm saying this (but it is certainly true in many cases) it's cool to have a mental health diagnosis of some kind. Bizarre times.
TheBackman (Berlin, Germany)
Far too much of all this is driven by "professionals" who need to be published. Or worse drug companies who want to create a new disease so they can pedal a drug. In a more "physical vein", acid reflux is a perfect example. It is caused by too little acid in your stomach which means the nerve that closes the esophagus is not fully triggered. Even low acid burns like hell in the tender flesh of the esophagus. The fix is simple, HCL Betaine is a form of your stomach acid. I was eating Tums by the truckload when a biologist told me to try HCL Beatine. The first one did not work and he recommended trying a few more, worked like a charm and somehow my stomach learned to increase the acid level. There is no money in simple cures. I suffered as a Manic Depressive for years. The drugs were horrible. took all pleasure out of my life. I met another man who said, "Remember that the depression is only going to last so long and then the super highly creative Manic will come back. Enjoy those times and just sleep as much as you can and take long walks when you are depressed." I would hate to be a teenager today. You have to Identify as something. Am I gay, straight, bi, trans, or furry, et al. How do I get the right brand to make me match what the media is hammering away on me to be? No one gives the advice to turn off your phone pushing TikTok Facebook brainwashing so they can make money off you, go for a walk with a friend and talk. Professionals try to stuff you into a box.
Carol (Encinitas)
Young people wouldn't have to turn to social media for mental health issues if they had better access to mental health care.
CC (Chicago)
@Carol Unlikely, as social media is where younger people go for just about everything. Of course they go there first (without having to involve parents).
Andrew (New York)
Of course they are. That's where they live. Online. In fantasy worlds of unchecked "fact", selfies, shameless self promotion, insatiable thirst for more "likes" and views- all while wasting their vapid lives away before they've even begun. No different than the idiots on Nextdoor posting for advice on doctors, tax prep, and everything else. why bother doing any legitimate research from credible sources? Son't we all choose our hear surgeons based on referrals from complete strangers on social media?
Michael (Blue Virginia)
Seeking medical diagnoses from TikTok? Tick tock, folks.
JJ (West Coast)
Imagine writing all those words and thinking this was caused by something other than poor access to mental health care and no universal health care.
CC (Chicago)
@JJ You are likely incorrect. The younger generation goes to social media first for everything and they can do so without involving parents etc. Yes, there are issues with access to mental health care but I don’t think they are the primary driver of this phenomenon.
MrWiggins' Human (Houston)
You are certainly correct that too many people in this country don't have access to or ability to pay for mental healthcare, which is sad and disgusting for such a rich nation. But I also see people in my kid's peer groups--teens who go to therapy and have support at home--mining Google and social media for labels they can put on themselves. It's tough for parents, teachers, and therapists to deal with the malady of the month, and it often interferes with treating the verifiable issues the teen may have because they spend so much time convincing themselves & others that they have {fill in the blank}.
Cate (California Bay Area)
Maybe it’s a good idea we don’t dope them and cut on them until they figure out the source of their anguish?
David J. Krupp (Queens, NY)
Type in your mental health problem and read the results from, The Mayo Clinic, Johns Hopkins, Medline Plus.com (NIH), Web MD, Drugs.com, CDC,Cleveland Clinic: Health Library. NEVER SEEK ADVICE FROM SOCIAL MEDIA!
Mrs B (CA)
This should have been reported on years ago. Why is the adult world and NYT just catching on? Parents have lived with this for awhile even if they didn’t know it . The 2900 lb elephant in the room and clearly the writer is steering clearly around is the impact of TiK Tok on the dramatic increase of children identifying as trans and self diagnosing with gender dysphoria. Except there very are few therapists who are going to be as cautious if a child who comes in with these claims because according to political dogma “you.must.affirm or else you are a transphobe bigot and the child will commit suicide.” If adults took a tour of what kids are being told about their gender and sexuality, we would want to burn down TikTok.
Justanne (San Francisco, CA)
@Mrs B 1,000%! It's complete insanity.
Kyle Reese (LA, calif)
@Mrs B Yes, but other countries have done reviews and found the approach to child gender dysphoria practiced in the US is harmful and not the best way to address child gender dysphoria. UK, Sweden, Finland found gender meds and social transformation don't help dysphoria or anything else and actually make kids psych issues worse. Part of the reason the US is so behind other counties on this issue is the media's complete failure to weigh both sides of the gender dysphoria issue. Complete lies are published daily containing false claims regarding these kids and the "care" subjected on them. A quick glance at the sources and methodology of these stats and claims would result in discovering all these claims are based on unscientific online polls and shoddy low quality studies that shouldn't be used as a basis for anything. Most kids with gender dysphoria grow out of it, unless given gender meds. Yet, half the public mistakenly believes in the mythical "trans child". In reality, most kids with gender dysphoria suffer from previous trauma, abuse, are orphans, or simply have normal dysphoria due to being gay. The last thing they need are adults telling them they're "trans" or affirming harmful ideas pushed on them by anonymous adults on questionable websites. Yet, this is what's happening in the US and millions of kids are being harmed by this fraud.
Deb (Denver)
Ridiculous. But that is where we are now, at total stupidity.
keith (flanagan)
Anyone else notice how easily "mental health issues" in this article could be replaced with "youth gender dysphoria"? Hopefully therapists and doctors keep this in mind before prescribing chemical or surgical treatment to kids showing up with the latter.
Lisa (Toronto)
@keith It’s mostly girls with gender dysphoria now. I think the girls look at the boys around them and realize that it is way harder to be female ( body image problems, expectation to have perfect skin, cosmetics, menstrual cycles, birth control etc). In many ways, it is a logical decision to become male - TicTok has just shown them that it is possible to do that.
Justanne (San Francisco, CA)
@keith Also, the girls see what it "means to be a girl" on TikTok, and if you're a girl who's repelled by heavily made-up and sexualized female stereotypes (hello, Khardashians), the girls make the leap that they must be boys. There's very little room for girls to have diverse interests now. I never in a million years thought girls would feel even more constricted previous generations, but here we are.
CEK (Portland, ME)
@Lisa But it isn't really possible. There is no way to change the entire body from one biological sex to the other. It's a mishmash of plastic surgery and damaging endocrinological interference with serious, longterm health implications. There is no research on the efficacy! It's a cruel lie and the most emotionally vulnerable kids (boys and girls) are the ones who fall for it.
Robin (West Virginia)
My daughter has struggled with mental illness since middle school and I believe it all started when she dove into the world of social media. Tik Tok, Facebook, Instagram. We have tried different therapists and doctors and a few trips to a mental hospital. She stopped caring about school and her appearance. She started trying to diagnose herself. She would talk to all these health professionals and they didn't take her seriously. Now she is 17 and has been living in a state run mental facility with a school structured campus for months. She might not even get to come home until some time next year.
Tom B (Earth)
@Robin: "We have tried different therapists and doctors and a few trips to a mental hospital. She stopped caring about school and her appearance" That's because you have shown that you have no respect for her. Coercing her into treatments and locking her up in an institution are proof you don't care about her.
Tawaki (Detroit, MI)
Tik Tok is a plague. The local neurologist would not even evaluate a teen family member to ruled out Tourettes, until they were seen by a psychologist first because of all the Tik Tok self referrals for Tourettes and other movement disorders. The teen's GP was livid. Yes, Tourettes usually presents in 4 to 9 year old boys with multiple other issues. My family member is not this. Or a female with severe OCD, which my family member does not have. At the end of the day, yes this person has Tourettes. It took the neurologist (big deal area specialist in this) a glorious 8 minutes, probably even less. She apologized, but said both the adult and pediatric clinic have been swamp with teen self referrals. There were almost no appointment slots for patients with Parkinson, Huntington disease etc. They had to shut down all self referrals. Crazy what a mobile phone and a few "look at me" short vids will start.
mb (-)
2 + 2 = 4 Addiction to social networks and media are real addictions, like other drugs, pathological gambling, compulsive obsessions, alcohol, smoking, and so on. "Addiction is defined as not having control over doing, taking or using something to the point where it could be harmful to you."
Mary G. (Austin, Tx)
Mental health advice is not all that people are getting from TikTok. My parents former caretaker, a young lady who lasted in the job for only 4 weeks, told us that she couldn’t eat regular meals due to her recent gastric sleeve surgery. To further the conversation, we asked her about the procedure, her doctor, eating requirements, etc. She told us she found her doctor on TikTok. “Lots of people mentioned his name, and he was cheaper because he was in Tijuana.” She had difficulty caring for our parents because she was constantly suffering from stomach pain and bowel issues. There should be a huge disclaimer permanently posted on this, and all, social media sites: “For Entertainment Purposes Only!”
Lpb (Ny)
There is no real “private” company in Xi’s China. Everything is controlled by, and for the benefit of, the Chinese Communist Party. And the CCP is trying to undermine, if not destroy, America — and Americans. TikTok may not be a safe space for us. Why do parents allow their children on TikTok? Why didn’t our government ban TikTok in the early days? In the fullness of time we may desperately regret our lax attitude. In China our version of TikTok is banned. Chinese leaders who know what’s really going on do not allow their own children on the site.
MB (Washington)
Like most things in life, there are positive & negative sides to TikTok w/lots of grey area in between. One positive side is that it seems to be helping to destigmatize & humanize mental/behavioral health issues. TikTok has created a place that has open dialog about something that has never been properly & openly discussed amongst the general public. TikTok seems to be creating community amongst groups of people who would otherwise feel alone & isolated. It seems to not only be encouraging people to seek professional medical care & diagnosis, but it is also raising awareness so that when they do speak to docs & counselors they are better able & equipped to assist their provider in caring for them. As a middle aged woman who survived two traumatic experiences at a young age, who grew up knowing something was “wrong” with me, who spent much of her life being harshly criticized & ridiculed for not being “normal” I can say without a doubt that a resource like TikTok would have been life-changing. For those concerned about misdiagnosises, about kids/young adults identifying themselves as having specific mental health conditions erroneously, or about developing mental health conditions bc of what they hear, saw, read…well that was going on long before Tik Tok. Quality, consistent, & equally accessible mental health care is very difficult both to find & to afford; that should be the real concern & where our energy/focus is directed. Articles like this are fluff & distraction.
Michelle L (pnw)
As a parent of a teen who has been diagnosed w/ GAD, Social Anxiety Disorder, Depression, & ADHD Inattentive Type by a certified psychiatrist, what I can tell you is that it has become increasingly difficult to obtain consistent quality mental/behavioral health care by appropriate mental health professionals for my teen even though we have insurance through a leading insurance company & live close to a major US city. Why? Well, per our insurance, there are not enough providers to meet the demand for care “due to the pandemic” which has now become the standard excuse for any & all less than acceptable services in all industries as well as an excuse to price gouge everyone for everything. Aside from the tragic loss of life, one of the most damaging consequences of the pandemic is that businesses of kinds & of all sizes have realized that they can not only get away w/ providing less customer care, less quality products & services, but they can also charge more & make more profits all in the name of “due to the pandemic” & healthcare is not immune to this new way of doing business. Unfortunately our government is doing nothing to stop this or even regulate it because this is America & we are a capitalistic society in which corporations have the same rights as a person which translates into lobbyists pushing & politicians passing laws which benefit those w/ the most money rather than the majority of the American people. Apathy is the American people’s greatest enemy.
A (New Mexico)
@Michelle L you’d find it even more impossible to access care under any major universal system, I assure you. Your child’s diagnoses scarcely exist in these nations and given the lack of severity are deprioritized. Our “disorder” culture is not indulged in these environments and the systems are not built to provide intensive mental health care to 1 in 5 young people as entitled American consumers are demanding.
Lisa (Spain)
@A This is simply not true. In Spain my son has received mental health care from the pediatric psychologist in the public health care system.
Cemal Ekin (Warwick, RI)
This almost sounds like drinking ethyl alcohol to fight against alcohol addiction.
LT (Toronto, Ontario)
I thought this piece was a mockumentary spoof, sadly, it wasn't.
Andy Morris-Friedman (Amherst MA)
Like turning to a drug pusher for help with heroin addiction.
SteveRR (CA)
Dr Google's slightly less intelligent cousin: Halfwit TikTok - Thanksgiving dinners are always a great deal of fun.
Jk (Seattle)
All I need to see is the title of these type of articles and I think "man I feel sorry for the people who grew up not knowing a world without social media."
E (Edmonton)
This is an article is about how kids are feeling isolated and finding community and helpful perspective about mental health online. There are no examples of the drawbacks of learning about the mental health struggles of others.
Mrs B (CA)
@E Here is why from a commenter below. This is the missing perspective: "Teens who are forming their identities find a community. The price: a diagnosis. Depressed children get locked into a cycle of rumination with peers whose common connection is depression. "This is who I am" becomes a shared helplessness reinforced by the community. You don't need to find ways to get better. People who reach out just don't understand. You are one of us, and they are the problem. Come sit on the virtual couch called TikTok and never leave - the algorithm is waiting. You don't need to move forward in life when you can hold hands with us and spiral downward together."
CD (MA)
I don’t think this is necessarily a “TikTok is entirely bad” situation. This is more so the result of a society that has historically ignored/stigmatized mental health issues, and the yearning for a feeling of community and connection. Accurate professional mental health care should be more accessible…but TikTok isn’t the platform for those nuanced and difficult conversations.
finally (MA)
Are we almost ready to acknowledge that many kids/teens are on the internet diagnosing themselves with gender dysphoria & being coached to tell their parents that if they don't transition they will kill themselves, then lining up to see therapists who are at risk of losing their licenses and careers if they don't immediately affirm a new gender identity? Or is this one thing exempt from the dynamics explored in this article?
Mysha (Brooklyn, NY)
@finally Maybe we aren't acknowledging it because it's not true.
Mrs B (CA)
@Mysha Alas, but it is.
Mrs B (CA)
@finally Seems to be because all the comments regarding this connection except for yours have been pulled. Not sure if they will post mine. Several attempts have failed.
Alex Colvin (London Ontario)
I have a friend in their 30s who came to the conclusion during the pandemic that they were non-binary and autistic. They’d never previously mentioned any issues with their identity or ability to function, but they became highly isolated during COVID and emerged explaining everything they did as effects of autism and their new gender identity. I’ve tried to be supportive and polite about it, but there’s been no diagnosis or input from a professional, and their behaviour is becoming increasingly erratic and blamed on these new self-diagnoses. It’s difficult to know how to proceed, but this article was a huge relief to know this is a widespread issue and some skepticism about someone’s internet-based self-diagnosis doesn’t make you a cold, inconsiderate jerk.
Mariana (Portugal)
@Alex Colvin Though I understand the skepticism, a lot of autistic people seem “more autistic” after they find out about a diagnosis (these are incredibly hard to get for AFAB people by the way!). Self diagnosing is completely valid in the autistic community because we know how hard it is to be validated when you don't meet a 7-year old boy criteria. I do understand why it can be “weird” or different for you now, but autistics learn how to unmask after they realize they're autistic and there's nothing wrong with them. That's why the symptoms may present more often or in different ways. Your friend might just be finding their way in the world through unmasking, and discovering themselves as the person they hid for so long without knowing. Of course, this is the situation that happens to most late diagnosed autistics, but I don't know your friend, and therefore can't make assumptions on what they are/aren't. I just like to believe that if your friend did the proper research and didn't just base themselves on TikTok or other social media platforms, then they're most likely right in saying they're autistic. No one knows us better than ourselves :)
Joe (New York)
@Mariana I am not convinced that there is such a thing as “unmasking.” I know the Western idea of an internal “true self” is popular nowadays… to say the least… but nevertheless I believe it is mostly false. Authenticity is misleading; we are what we do first and foremost. I also don’t think that validation or self-discovery are what we should be looking for in life. We should be focusing on improving our moral behavior rather than in dissecting our own self/identity. I think this article hints at the fact that TikTok propagates a disturbed sense of human nature… and probably does more harm than good.
Emily (Seattle)
@Joe You're entirely misunderstanding what autistic masking, and thus the mentioned "unmasking" is, judging by your reply. Masking is about disguising your autism. My masking involves me concentrating on holding my hand and arm at a certain angle at all times so that it looks "normal" instead of curling up into a T-Rex position like it naturally does when I'm relaxed. It's not about self-actualization or the id and ego, etc.
Martine (Texas)
It is all a cry for attention. Getting medical advice from Tik Tok whether you are 13 or 80 is a bad idea.
Revolution (Los Angeles)
Scare fiction for Boomers and out-of-touch parents. Stop deriding TikTok which is wholly unlike any other social media platform and has overwhelmingly positive impacts.
Kate (Chicago)
Is this satire?
Maryrose (New York)
Tic Tok, Instagram, Twitter, etc. are ruining our lives. It sounds dramatic, but it's true. We will look back in horror at the level of control and influence we allowed them to have. And we have only ourselves to blame. Put your devices down.
Garrulous (Eritrea)
Needless to say, this is the fault of adults. We have failed utterly to protect the young from, or prepare the young for, the perils of our technologically inflected life. Don't be surprised when suicides go up.
Jk (Seattle)
All I need to see is the title of these type of articles and I think "man I feel sorry for the people who grew up not knowing a world without social media."
Drew (California)
I have a nine and six year old and am doing my best to keep them off YouTube and any other social media, but I fear I only have a few years before it will become too difficult. Some 4th graders at our school already have phones. It’s insane. I just hope we as a society can put up some guardrails to protect these kids. These products, including social video games, are crack for kids. They are designed to be addictive. I am pretty laissez-faire, but if we regulate other addictive vices (e-cigs, gambling, alcohol, etc.), why not regulate social media in the same way? If an adult wants to spend all day on TikTok, go ahead and waste your life. But social media is clearly horrible for developing brains…I don’t care if kids are “connecting” with friends online. Do it in real life!
Physician (West Coast)
Introductory psychiatric rotations are legendary for this. Every medical student suddenly thinks they have every disorder. (Actually, each of us probably zeroes in on several favorites). Reading the DSM (in any edition) can do that to a person. The definition of a disorder is that it is present to such a degree that it interferes with *function* — and the point of treatment is often just to get the person functioning again (by whatever definition they choose) and not to make all the features of the illness “go away.” Medical students in psychiatry rotations read the DSM and feel certain that they fit one (or more) of those descriptions. We all do. Then they encounter patients who are really not functioning, and they see that they themselves are attending school, sleeping, eating, making friends, keeping track of a complex course load — and they recognize that being functional is an important bar that they ARE getting over. Teens have a very tenuous relationship with “function” at baseline. They don’t have to earn a living. It’s developmentally appropriate for them to have intense conflict with parents as they individuate. What they have to do is go to school and build a peer group. The advent of remote school coupled with the shift of social relationships to the internet has made teen “function” very hard to assess — for the adults in their lives but more importantly for teens themselves. Of course they think they have some kind of mental illness.
Brianna (Canada)
Well said. Another challenge is that some adolescents and young adults conceptualize mental health differently than do health care workers, psychologists, and others. This was brought home recently when students working on a project in my class operationalized mental health as “level of self reported stress in the past one day.” After some discussion, we realized that we were not talking about the same thing when we used the term mental health: they were talking about temporarily feeling stressed or down, and I was talking about meeting DSM diagnostic guidelines such as distress coupled with impairments for two weeks or longer.
Bronco Pete (Great Midwest)
The internet and social media provide too much access and too much information. Information without context or guidance is confusing and misleading. Put these powerful information tools in the hands of adolescents and you create all sorts of problems. The internet, as we have seen, has a certain self fulfilling prophecy about it. There is a niche audience for every conceivable idea no matter how off base. Also during COVID, there were many Zoom and virtual appointments and I think people came to see the ether as a magic eight ball of advice. More mental health and councilors are needed in this country. The past few years have been rough on everyone but especially young people.
escondido2005 (Bucerias, Mexico)
Where is a 'live' online site for specifically diagnosed disorders where different age groups can have group therapy sessions led by a trained psychologist -- FREE! Along with a way for 'audits' -- those not able to physically take part in a live session to listen in and anonymously comment on the proceedings. Get that site up and running with corporate sponsorship and watch your profits skyrocket!
Mysha (Brooklyn, NY)
@escondido2005 Who will pay for this? Who will give consent? This is a really murky area.
escondido2005 (Bucerias, Mexico)
@Mysha Thank you for your comment. First, who will pay for this? I mentioned dedicated corporate sponsors who have a stake in mental health and the internet. Apple, Zuck, Microsoft, and yes, even Meta. Who will give consent? There would have to be a screening process to make sure the group falls into the age range designated and that all 'live' participants have 'handles' and even masks to cover their on-screen identities. Written Consent would be like any similar legal document -- you can't hold the site, or the therapist or psychologist libel for any brief, cursory misinterpretation of symptoms, diagnoses or participants' actions or /statements. In fact there would be a 6-second delay in transmission to weed out objectionable content. All this has been unmurkyized. So will you join FREE GT? Best, Escondido.
Reality Cookie (NYC)
It seems like this year’s hottest accessory is ADHD. I created an Instagram years ago so friends could easily share funny dog videos. Then whatever algorithm they use started including ‘emotional support’ alot. Not a cat person, but the ducks and goats were funny. The pigs inside the house, not so much. Bad hair color and tattoos could be overlooked. Recently the algorithm has been including ADHD videos with no pets. Everyone sharing and celebrating their neurodiversity. The urges, the voices they hear, how they have to do things. Fabulous! Self-diagnosed, untreated hearing voices. Sound like a win for everyone!
Jp (Ml)
@Reality Cookie :"It seems like this year’s hottest accessory is ADHD. " ADHD Focus seems to pop up regularly every several years. From what I can tell, this has been occurring since the 1990s.
MN (Michigan)
I see this exactly. And the kids earnestly explain that it is not a disorder but rather who they are - not to be treated and cured, but to be accepted and even bragged about. I just wonder how long they will stick with these views of themselves.
Theresa Guirato (Delray Beach, FL)
This is wonderful! People, especially our youth, using the benefits of technology will now be exposed to and able to understand a multitude of conditions. They can then take control of their lives and, with non-challenging and affirmative care, embark on the journey of self awareness called life.
Mrs B (CA)
@Theresa Guirato Non-challenging and affirmative care is not what people with mental health disorders need. One of the commenters (a psychologist) said: "Teens who are forming their identities find a community. The price: a diagnosis. Depressed children get locked into a cycle of rumination with peers whose common connection is depression. "This is who I am" becomes a shared helplessness reinforced by the community. You don't need to find ways to get better. People who reach out just don't understand. You are one of us, and they are the problem. Come sit on the virtual couch called TikTok and never leave - the algorithm is waiting. You don't need to move forward in life when you can hold hands with us and spiral downward together."
Theresa Guirato (Delray Beach, FL)
@Mrs B Forgive me if I can't keep up. I thought non-critical and affirming was all the rage nowadays. It's not?
Princeton (NJ)
The underlying issue is an utter loss of trust in social institutions: school, family, medicine, police-except, oddly, social media. Social media leads young people to think that they are utterly exceptional and so no old, trained psychotherapist could ever understand them. In fact, their training IS the problem because it is biased in a host of ways. A colleague said it well: today's youth expect adults to solve all their problems, but won't actually engage or listen much. I think the latter is based upon this broken trust.
Danny Malooly (Texas)
I am a high school educator. I saw a massive amount of self-diagnosed everything about two years ago. Students would claim to dissociate, they would demonstrate tics, and would claim disorders for which there was no documentation for. It has slowed down a bit, but I remember one student in particular that developed a tic disorder that was so unlike any other I had seen from diagnosed students, and resembled many of the faked symptoms seen on TikTok. These tics were often minor twitches and high pitched mews. Her parents emailed all of her teachers to inform them that their daughter had seen a specialist and was not diagnosed with a tic disorder. The student then emailed each teacher informing us that she had been diagnosed and not to listen to her parents. It was a very sad case because she had found this identity in the disorder and developed friendships because of her behavior. All of her tics were light and deemed by some students as "cute." A friend of mine has an actual tic disorder. He once broke a bone while bowling because of a tic mid-stride. The anger around faked, easy-going tics amongst people who actually struggle with the disorder is high. These disorders are a means in which to find community and identity. I am now seeing journal entries from students who have reflected on their self-diagnosed disorders. Many of them have stated that their desire to fit in led them to be someone they aren't. I think the situation is getting better.
Richard Hahn (Erie, PA)
From this psychologist: Behavioral signs don't necessarily mean symptoms of disorder. There are all kinds of frustrating elements in this situation, including that the DSM (diagnostic manual) has become very behaviorally focussed and is available all over the Internet. Yes, there can be seen "a bullet list of symptoms." The diagnostic criteria are indeed in lists of explicit behaviors, (e.g., "headaches, poor sleep and [in effect] the odd feeling of living outside of...body")--with very important qualifiers that apply to them--and can at least be a start to guiding understanding. Of course, even for behavioral health professionals, the DSM notes that the manual is for use as basically a guide in diagnosing, as well as for gathering statistics for further evidence base. This caveat is meant to have professionals use their expertise in carefully identifying psychopathology. This NYT article is a good discussion that reflects proper ways to do so through warning about improper ones and advising that professional guidance may best be obtained (if affordable!).
Diane (Portland, Oregon)
TikTok at its worst gives youth what they absolutely don't need - a false understanding of themselves, and a community of misinformed peers reifying those beliefs. A youth explained how they had Multiple Personality Disorder. "Self-diagnosis" based on conversations with friends, who have emotional problems, and reading online "misinformation" or taking on "diagnoses" without having the disorder(s), perhaps as a way to try to understand what is wrong with how they're feeling. Perhaps also to feel like they "belong" somewhere and with someone - a community. I've found non-judgmental listening, accepting yet also providing alternate reasons for emotional distress, providing support and therapy for youth and parent (as needed), medication if indicated - as well as - most importantly - a focus on the youth's strengths and nurturing those capacities - is vital to helping youth on their path to mental health wellness. And this, too, - yes, psychiatric illness is very real - but life can also be very hard with trauma, suffering, inequalities, and dangers. One can have emotional and behavioral problems and be in need of help, but this is not necessarily because one has a psychiatric disorder. Nor should a "diagnosis"of mental illness be required (where there is actually no mental illness) for the right help to be given. Society can also be "sick" and requires intervention. There are nuances to mental health understanding, assessment, and treatment that TikTok can never provide.
Megan (Oregon)
The popularity of Tic Tok amongst younger folks is emblematic of our broken health care system. Kids and young adults are looking for answers and support for behavioral concerns that are often times ignored, criticized, or dismissed by adults in their lives. If they are lucky enough to have adult support, it can take months to find the professional support they need and that’s dependent upon whether or not they have adequate mental health coverage. As we move away from the model of mental health being dismissed as something that is “all in our heads” to a more inclusive model of overall health, insurance companies need to follow suit. As a mental health professional I see coverage that greatly limits behavioral care in some of the most robust plans. For many people out there they no behavioral coverage, this is unacceptable. Mental health care is health care, and as long as it’s marginalized by health insurance plans, kids and adults will continue to flock to platforms like Tic Tok to try and get the answers and support they need.
Lisa (Toronto)
Just a reality check about teenagers of today - in many ways they are doing well. Substance use, suicide rates, teen pregnancies are all statistically lower than they were in the idealized 1980’s and 90’s. Teens of today (and their parents) are very open to talking about their problems and in many ways that’s a good thing. You rarely see the “good news” stats in the media. There was an era (early 2000’s) when suicide rates were lower. The kids that are using substances today are in more trouble though, like their parents (opioids, meth, etc). Also rural and Republican state kids overall doing worse.
Suzanne (Boston)
How is it possible that this article did not address the 500% increase in teen girls self-identifying as the opposite sex? Indeed, teen boys are affected too, but as we know, teen girls are particularly prone to social contagions (anorexia, bulimia, cutting, recently seen facial tics).
MN (Michigan)
@Suzanne YES. so much of it....will these identifications last????
G. (M.)
Why is it that there is an article about this but not about teens diagnosing themselves with gender dsyphoria after immersion in social media like TikTok? Let's please connect the dots in a commonsense way. Gender dysphoria appears to be socially influenced, which is why exploratory therapy and proper assessment before any medicalization is so key. Thank goodness jurisdictions like Florida, Sweden, Finland, and the UK now understand this and are prioritizing the mental health of such gender distressed young people.
Theresa Guirato (Delray Beach, FL)
@G. We are proud of Florida. Good post.. glad it passed muster.
AD (Austin)
@G. amen!! I have a distressed teen who caught gender dysphoria from a friend and then found the mega support for this that they needed online, 4 years ago. I had no idea until it was too late. I have been a "good progressive liberal" all of my adult life, and have found myself fighting my own "tribe" to find common sense around this issue and to save my child from a lifetime of medical catastrophe's. And fighting the fight undercover, lest I lose my progressive community and my child! The world has gone completely bonkers, and I blame social media and the decline of professional journalism. EVERYTHING is political now due to hysteria and exaggeration and bias in media. I keep waiting for the sane and moderate voices to be heard, to protect our kids from the harms of the internet - to value their health over profit, but all you can hear is the extreme shouting of the extreme left and right. If I would have known 18 years ago that the world would be like this now, not sure I would have chosen to be a mother. P.S. my other teenager caught an eating disorder from social media. Adults can barely handle, and many times don't, the addiction and effects of SM. How in the world do we expect kids, without developed prefrontal cortexes, to manage the onslaught of influences from online??
MeinBmore (Baltimore)
@AD Liberal media is pushing trans issues with no questioning. Many other countries are not allowing kids to transition until they are adults. No, not because they are 'transphobic'. Because they are concerned about child welfare. And I identify as a liberal.
Emmett (Rhode Island)
Is it advisable that young (or older) people should be submitting themselves psychologically to a platform that is owned, managed, and aggregated by an awesome and fearsome adversary of the United States? Say what you will about Zuckerberg and co., however, I'll entrust California with my brain state over Shanghai any ol' day.
Lisa (Spain)
Many of these comments are really condescending and patronizing from people of an older generation who have never even bothered to check out TikTok. Like everything online, there are great content creators with reliable information and others who are not any good at all. We all should be getting our information from multiple sources, and there is no reason why TikTok cant be one of them. Finding a community of people navigating similar things as you can be wonderful.
Mrs B (CA)
@Lisa Sure. The problem is that there are plenty of damaging dark corners that are easy to find. Especially for vulnerable people like adolescents. The industry wants us to believe only the good as if the bad doesn't outweigh the good for human society and wellbeing.
Someone (Somewhere)
@Lisa As an 'older' person, I agree.
Lisa (Spain)
@Someone Disclaimer, I am not a young person, but started watching TikTok thanks to my teenage son.
A doctor (California)
This is the biggest challenge I face now as a psychiatrist. I don't see kids, but this phenomenon is rampant among the younger adults I see. Probably 30 percent or more of my new patient evaluations are people fretting about having ADHD and/or autism spectrum disorder. Some of these patients are really ill and have astutely diagnosed themselves, but most are the "worried well". Some are malingerers who are looking for stimulants to help them get a leg up on the competition at school or at work, or just to party with. It can be very hard to separate the patients from the pretenders and this not0infrequently leads to some angry arguments, patient complaints, etc. There are several pill mills online now where a "provider" will prescribe Adderall for you after you give a little information (including your credit card number)-hopefully a lot of these "patients" will follow the path of least resistance and start going online...and get out of my office and give me more time to take care of sick people.
Ex-Procrastinator (Rome, Italy)
@A doctor: I share this experience as a practitioner. The ”worried well” are testing my patience. It is very hard to say no to people who have self-diagnosed themselves. Even if a full detailed assessment does not support a self diagnosis of ADHD or autism, I feel really pressured.
Richard Hahn (Erie, PA)
@A doctor I completely corroborate and sympathize, as having been a psychologist in practice prior to retirement. In particular, I relate to the difficulties and even dangers involved in people asking about ADHD diagnoses and those "pill mills." I received referrals from PCP's to assist with evaluating young adult cases presenting with possible ADHD. I included a computer-based test of attention and impulsivity that controlled against faking (i.e., would produce no results if not taken according to its simple rules), along with questionnaires and interview. That test clearly showed difficulty with attention with or without impulsivity in some cases. But oftentimes, all indicators from the test were negative, along with questionable responses obtained through subjective inquiry. Thereby, I duly gave feedback to the patients who sometimes were at the very least disappointed--yep, with some arguments and complaints. Memorably, when in my feedback to one such case, I mentioned study skills, he flatly said, "Study skills don't work for me." (Of course, there are published manuals that address managing difficulties with study even for people accurately diagnosed ADHD.) Regarding such cases, in my reports to my medical referral sources, I pointedly advised that any prescribed medication nevertheless be very carefully monitored.
Steven Reidbord MD (San Francisco CA)
You may like this blog post I wrote many years ago, about psychiatrists as gatekeepers. I too would prefer to step out of the way when patients already know what they want: http://blog.stevenreidbordmd.com/?p=30
Paul S (Miami)
I don't see why if you can go from man to woman you can't go from human to dolphin. It's just biological changes after all.
Pastries (NJ)
@Paul S what on earth does this comment have to do with the article (or reality, for that matter), and why have 4 people recommended it?!?!?!
Karma dilly (Oregon)
Where do you think kids are getting the idea they are trans or non-binary? The only difference is how it is treated in the US. Rather than question, everyone is told to go along with it, leading to unnecessary medication and surgery.
Pastries (NJ)
@Karma dilly if you actually believe that’s how it works, that shows how you’re as influenced by the messaging you’ve received via a certain segment of the media as the kids apparently are.
Steven Reidbord MD (San Francisco CA)
Ever hear of “medical student syndrome?” That’s when med students, learning about a new disease, begin to worry they have signs of it. This happens to smart, scientifically sophisticated folks who are well out of their teens. So it’s really no surprise it happens to youth on TikTok. Since there’s no putting the social media genie back in the bottle, we’re stuck with periodic waves, fads really, of popularized diagnoses. I expect that continued exposure to social media hype will eventually lead to desensitization — “the boy who cried wolf” effect. In the meantime, parents and mental health professionals like me can be a moderating voice. The real message here is that the range of normality is a good deal wider than many fear.
Richard (Nevada)
I recall that it was very tough to be a teen. Teenagers in particular are unsettled- it seems intrinsic to their development. Tic Tock and other social media platforms that are detached from real interpersonal connections, in depth discussions, and lack specificity, are far from a healthy place to deal with teenage angst. The strange rise in gender dysphoria is one example of the dangers these social media sites engender. Pandemic restrictions have also played a significant role in greater alienation of our teens. The closing of schools left many teens searching in all the wrong places.
East Side Toad (Madison, WI)
Thank you for listing some of the obstacles brought on by the pandemic. Many teens were isolated in their rooms, disconnected from their peers for a LONG time. However, let's not just blame the parents. We knew our kid needed help. The only consistent therapist we could find we have had to pay out of pocket for. When the condition escalated after starting college, we tried to find a psychiatrist. After months of being told doctors weren't taking patients, a family friend told us of a clinic an hour away that had openings. With a dearth of real resources, it is unfortunate that kids turn to the one that is available 24/7.
Jp (Ml)
"Teens Turn to TikTok in Search of a Mental Health Diagnosis" That's like having an AA meeting at a table in the bar - at 10 pm on a Saturday night. Will any good come of it? There could be some benefit so someone but the whole idea is, well you get the message.
Dan (New England)
Credentialed experts defensively emphasize when TikTok diagnoses are wrong, but there is also a danger when they are right. Teens who are forming their identities find a community. The price: a diagnosis. Depressed children get locked into a cycle of rumination with peers whose common connection is depression. "This is who I am" becomes a shared helplessness reinforced by the community. You don't need to find ways to get better. People who reach out just don't understand. You are one of us, and they are the problem. Come sit on the virtual couch called TikTok and never leave - the algorithm is waiting. You don't need to move forward in life when you can hold hands with us and spiral downward together.
Martine (Texas)
@Dan Excellent comment.
Mrs B (CA)
@Dan Yes. And this is what I see especially with kids who suddenly identify as trans or queer in teenage years.
EB (San Diego, CA)
@Dan Good point. It takes work, but families can be "wholesome", still, even in this day and age. I recently saw such - the daughter of an old friend, her husband and two teenage girls. Always active as a family - mainly in sports, dinners together, high expectations, and wwith parents serving as strong and loving role models, the girls were a breath of fresh air as teenagers go these days.
Michael (Massachusetts)
Neurologists have referred to the platform as Tic Talk. People should consider the diagnoses they come across as hypotheses. For some diagnoses such as ADHD, they will often be correct, but people should know that ADHD is more common among MIT students than in the general population, so considering it to be a disability is a narrow view. For tics, self diagnosis is less likely to be correct.
Candace Kalish (Port Angeles)
@Michael No, ADHD is not more common among MIT students than it is in the general population.
Genia (Lake Erie)
Psychologists and drug companies also want to diagnose every kid and teen with anxiety, depression or ADHD. Although there also are nuances to these vague disorders, and circumstances (ie. isolating our poor youth for years when biologically and developmentally they need to socialize in person) that make one sad or on edge. Based on a few nuanced questions taken on one day, of one week, of one year of these children's lives, these psychologists with master's degrees prescribe 'medicine' for the child to be taken indefinitely.
Mysha (Brooklyn, NY)
@Genia yeh, no, that's not how it works. Plus psychologists don't prescribe.
thebigmancat (New York, NY)
The trend towards online "therapy" services is incredibly dangerous. With all due respect, social workers and PAs are not diagnosticians and usually not qualified to work with people whose issues require in-depth therapy and nuanced decisions on medication. But it's all most people can afford - IF they can afford it. Finding a competent therapist in the United States who either accepts insurance or charges less than $150 a session is a full-time job.
Mysha (Brooklyn, NY)
@thebigmancat masters level clinical social workers can diagnose patients. Insurance companies are problematic though, as their reimbursement rates are insulting and make care that is affordable for patients unsustainable for the clinicians.
Jasmine12 (MD)
The online therapist I found through an aggregator was better credentialed, more knowledgeable about psychological theory, and far more practical than the few providers (all social workers) offered by my costly insurance. In my experience, social workers simply do not have the rigorous training or oversight of psychologists, but instead rely on weekend CEU training in areas such as trauma and CBT. If you need a place to vent, they offer what may be a safe space and support, but little insight,
Someone (Somewhere)
Maybe the medical profession could modernize to meet people where they are at in the 21st century. People need answers, and they need relief for their distress. The medical profession is great with life saving emergencies, organ transplants, etc. But TERRIBLE at addressing chronic health issues that often cause of worsen mental distress. And the general platform used had been outdated for decades now. Also terrible with diagnosisimg people, particularly women and people of color. Trying to get help for a chronic issue leads to gaslighting, judgmental, condescending behavior from patronizing, distrustful doctors who think they understand psychology. Social media is merely fulfilling people's unmet needs. Sad.
BiffNYC (Fort Lauderdale)
Oh right, it’s the medical profession that’s caused all these ills. No, it’s people’s ignorance and need for quick fixes that is the problem. Americans don’t want to believe that it may take a long time in talk therapy to understand what is happening with their mental health.
Kate (Chicago)
There are so many incompetent therapists out there! True or not, its a well known old cliche that many got into the field to figure out their own issues.
Sam (Tenn.)
Talk therapy is often very poorly covered by insurance. For example, on my (good) insurance, therapy is $50 a session and there are only a few therapists in my area who take my insurance. In comparison, my antidepressants are under $10 a month. I use both therapy and medication, but medication being a money-maker as compared to talk therapy isn’t the reason.
Robert Hunt (Vermont)
How many kids experiment with gender identity as an answer for their mental struggles? The steady rise in "binary" or other novel gender designations is in direct correlation to the rise of social media.
EB (San Diego, CA)
@Robert Hunt Big Pharma and its handmaidens have succeeded in pathologizing everyday life I recently visited a wonderful family - with two teenage girls - in Massachusetts. They have supper together every night, do sports activities together, and the rules are old fashioned and strict. The girls are stunningly "normal" and my hat is off to these parents. They are not wealthy, not poor, but set high standards and expectations and serve as clear role models for their girls.
LH (Tacoma)
@Robert Hunt Did you mean "non-binary?" Binary implies just two choices. I would say that is the traditional view of gender.
KatCaakes (Susanville, CA)
@Robert Hunt It is normal and healthy for kids to question their gender identity and should not be equated as a "mental struggle". The steady rise in non-binary numbers is due to a number of factors, some of which include society being more accepting, younger generations generally being more accepting than previous generations, and people feeling safer being who they are out in the open. This of course depends on where you live.
BC (Boston)
Let's stop infantilizing all teens and require they take some personal responsibility. Snap them out of the mindset that the world should be a safe bubble where every answer is available at the click of a button in 280 characters, or where credibility is commensurate with how shiny and flattering an influencer is. Kids can join the army at 17 and we therefore need to prepare them for a world where they make real decisions. If you head to the army (or college or trade school or work) and can't tell the difference between TikTok and the DSMR, it's because we've truly failed to provide you with any reason to care enough to challenge the safe bubble you want to live in. Fortunately, the kids who join the army are asked to leave that bubble quickly. But without the ability to truly interrogate ideas and deal with nuance, they'll just end up joining the Reawaken America Tour and confuse spreading election lies with actual democratic participation.
SMS45 (Coral Springs)
You don't buy shrimp from the back of a pickup on the side of a highway, buy diet pills from Dr. Oz, or tug on Superman's cape. Additionally, you don't get medical diagnosis from social media.
Ken Dodge (Ames Iowa)
When I taught psychopathology to graduate and undergrad students I always began with a disclaimer regarding self-diagnosis. I explained that they will have likely experienced most of the individual symptoms we would discuss and that having a symptom is not a diagnosis. We discussed the Barnum effect and the human tendency to self discover to try things on to see if they fit. I repeated the disclaimer regularly during the semester. Today, technology exposes everyone to information without any consideration of the consequence of that exposure. The toothpaste isn’t going back in the tube so, as a society, we must work much harder at protecting ourselves from the damage caused by exposure.
furious (usa)
Every media company should be required to attach a clear message to any website, video, podcast, etc. that conveys health related information, but not from a legitimate or official source. I don't get why we have a surgeon generals warning on cigarettes, but we're allowing millions of kids to hear terrible advice on life-altering health issues by people and organizations trying desperately to trick them into thinking they know what they're talking about.
David H (Northern Va.)
I want to say that my heart goes out to parents these days. It seems for all the world that the old rules -- which I discuss in an earlier comment here -- do not readily apply. And just so you know: even when your kids get to be young and fully functioning adults, like mine are, they STILL need guidance. My son (late 20s) phoned me a few weeks ago to tell me about the miracle of "passive income" -- he had read somewhere on the internet that its possible for ANYONE to make money while they sleep. All you need to do, he said, was send some money to a guy in Las Vegas and he'd send you the instruction manual. He reassured me that this fellow was an "entrepreneur" and an "influencer." I stayed silent. (For those parents who do not know, silence is often the best way to call into question the things your kids tell you because the last thing that they hear echoing in their heads is the cockamamie notion that they just shared with you.) After about 10 seconds, my son asked me what I thought. Then, without giving me a chance to respond, he said, "yeah, you're right."
Artemisia (Gentileschi)
It sounds like your son is eager to build wealth. Forgive me for offering unsolicited advice, but seriously, I’d urge him in another direction before he accidentally stumbles onto the Dave Ramsey bandwagon (great for getting out of debt, but otherwise a cult-like organization dispensing foolish advice) or starts buying crypto or NFTs. I’d give him the book The Simple Path to Wealth by JL Collins. The author wrote the book for his daughter who was graduating from college. It is easy to read and actually makes boring investing sound exciting. It explains what index funds are and the power of compounding over time. Then your son can move on to podcasts by folks in the FI (Financial Independence) community like Choose FI, Mr Money Mustache, or The FIoneers. The FI community is empowering and exciting, but in a positive way.
Mr. Big (US)
Parents can help by taking kids/teens for a walk (including to get sweets, especially at first), pulling out a deck of cards, cooking together, making lists together (including silly ones). And parents need to get off their phones to do those things! The kid in the article says it all: kids need support and attention. Let's start with ourselves. In fact, I'll be taking my own advice now and begin chopping some vegetables that my son and I can use in omelettes when he wakes up shortly...
Mrs B (CA)
@Mr. Big I do that. As a professional I teach others how to do that. The media environment is still winning.
Laura (MI)
@Mr. Big that works when the kid is actually able to get out of bed. And believe me, we try and insist and push. Some days depression wins the fight.
KV (Boston)
My daughter tried to convince us that she had autism, she doesn’t. She even developed tics and stims. Now she’s on an adhd kick. Still no. I have over 20 years experience in the classroom and am fully versed in both conditions. There is no there there. What there is however is very real clinical depression that at times like the article said can turn into a part of her identity not just a struggle she has. Luckily with a good therapist and the right dose of medication, she more or less is like a typical teen. But the media influence is insane. And before anyone either too young or too old to have teens chimes in about how parents should keep their kids off social media and screens etc… She isn’t on social media but YouTube and a browser is all they need for this to happen. The genie is out of the bottle and unless you are raising your kid isolated from others, they are exposed. It’s truly frightening what we’ve unleashed in the name of profit.
Mrs B (CA)
@KV indeed
Amone (CA)
@KV My 25 year old step-daughter is always saying she has ADHD. As was mentioned by the child in the article, it is trendy to have some type of disorder and ADHD and anxiety are the ones they all seem to have. There is a lot of bad information out there and influencers are this generations snake oil salesman.
L. (Pa)
I have a similar problem with my (autistic) son. He has been listening to a certain 'influencer' who 'doesn't believe in depression'. My son has been diagnosed with depression and anxiety, but now refuses to take medication which has helped him function in the past.
@no.bs.therapist (Boston)
I’m a therapist and psychology professor and I’ve watched with horror as the commodification of mental health has grown. I’ve repeatedly spoken out against this problematic influencer on my own social media platforms (I’m going to assume it’s the same one; she has millions of followers). I use my platforms to empower people to be more informed consumers of self-help content, as not all of the messaging we see online is actually in our own best interest.
Someone (Somewhere)
@@no.bs.therapist Or you mean the rise in the informed consumer who wants to be involved in healthcare decision making? Let's be real-there is a lot of improvement needed in the mental health world. Gone are the days where a person tolerates patriarchal professionals who are condescending and think they know what's best for us. The profession is maladaptive, and it fails people, then blames every else, such as social media. Time to take your own medicine and change, get with the times.
Tom B (Earth)
@L: your son is taking agency in the control of his own life, you should be celebrating. Just because you can't force him to comply with your desire that he drug him doesn't give you the right to go and complain that he's using his right to bodily autonomy for himself.
Bleex (7th House On The Right)
It’s not just teens. It’s not just diagnoses. TikTok is also being used for medication information. The unpleasant side effects, strategies for safely eliminating, and holistic alternatives are also discussed. Information is presented by creators and commenters alike. Typing in a web browser #(topic of your interest) TikTok will let you explore some content so you can draw your own conclusions. I find it has been a positive experience and I’m well educated in the field.
Ken (Chicago Burbs IL)
@Bleex The issue is that most aren't educated in the field so when they draw their conclusions its based more on emotion than fact.
Aaron (Orange County, CA)
These kids began their precipitous road to mental decline the day they sent their first snapchat message. The CEO's of Silicon Valley who created these weapons of mass destruction should be tried in the Hague for War Crimes. Ironically, the device that wreaked havoc on these kids is probably the only device capable of saving them.
David H (Northern Va.)
@Aaron The CEOs of Silicon Valley have nothing to do with what can save in fact "save" kids: parental involvement in the life of a child. It seems to me that its critical to differentiate between a tool (technology) and what one is taught about using that tool.
Tom B (Earth)
TikTok randos are more attentive to the mental health needs of fellow randos than most mental health professionals. The pros only want to force compliance with a pre-formatted treatment plan, not actually address the distress that sent their victims to them in the first place.
Someone (Somewhere)
@Tom B Exactly. And many mental health 'professionals ' are abusive, such as inpatient 'care" where suffering people who need help have less rights than prisoners.
Tom B (Earth)
@Someone: There are no mental health conditions that justify involuntary inpatient care. Self-harm does not justify it, and harm to others can better be handled by courts. I've lost 41 days of my life to those ghouls, and it's incredibly frustrating to see people advocating for increased involuntary treatment.
Paul (Millbrook)
Also - let's look at words like "stoner" and "pothead." Do we call people the following: 1. valiumers 2. xanaxers 3. Zolofters 4. Prozacers 5. Adderallers 6. Welbutriners 7. Heavy drinkers 8. Grifters I write this as a homeless man screams obscenities outside my condo. We seem to be okay with these folks and others in our midst, yet we will make others with arguably "less damage" be referred to "negatively." Things need to change.
Ken (Chicago Burbs IL)
@Paul Potheads call themselves potheads/stoners though.
JimmySerious (NDG)
“Everyone needs emotional support.” I think that's got a lot to do with the rise of social media platforms over conventional media. But Freedom of Speech doesn't mean freedom to hurt, hate or humiliate others. And it comes with a responsibility to tell the truth. Especially for those who use it as a source of income. It seems that part of it has been lost in the transfer.
Big Cow (NYC)
Social media is toxic and TikTok is no exception. It’s important to understand that acontextual information or partial information is no different from misinformation, in the same vein as the old trope “a half truth is the most pernicious lie.” The mental health industry is doing itself no favors by overdiagnosing and overmedicating certain conditions like ADHD and adolescent depression, making it seem like these disorders are much more common than they are and contributing to the type of social contagion noted in this article where half informed teens see mental health problems as personality traits. I have to say I am so happy I am not a teen today. I’m sure I would be unable to resist social media, as I have a hard enough time staying off of it as a 40 year old professional, even though I recognize that all it does for me is waste my time and make me feel angry about my life and the world. It was hard for me to delete Facebook and dating apps and I can imagine it would be harder for a teen whose while social life is online.
Big Moo (GNVS)
@Big Cow That is so true for teens in the world today. So teens have life on Social media and other Platforms on the internet.
Jp (Ml)
@Big Cow :"I have to say I am so happy I am not a teen today." That give rise to another malady that is making the rounds on social media - post traumatic stress disorder.
M (NYC)
A huge missing piece of this article is the very real difficulty of getting actual, professional, consistent mental health care. It's no wonder kids resort to TikTok. My child is 14 and has been struggling for about 3 years with what was ultimately diagnosed (at least for now) as bipolar disorder and PTSD. Treatment for these conditions has been really helpful. (She had inaccurately self-diagnosed with dissociative identity disorder, based on online articles.) But it took YEARS of searching, seeking out insurance-covered services, waiting lists, and so on to get us to a point where she is on a (tentatively) better trajectory. And my daughter has two well-educated, well-insured, middle-class parents actively advocating for her. It's no surprise that struggling young people look for information and relief online.
K (Chicago)
@M Absolutely true. When I was in middle school years ago, it took several years for doctors to diagnose me with anorexia, despite the VERY obvious symptoms and being white, thin, and economically privileged. I'm a social worker and MSW student now. Your daughter was on the right track with her self-diagnosis: there's a lot of overlap between DID and bipolar and PTSD. It sounds like the online articles were helpful in seeking a diagnosis and getting treatment. I'm glad she has parents like you on her side.
Ian (Philadelphia)
@M PTSD is a disorder developed in response to seriously traumatic events such as warfare, sexual violence, or attempted murder. On social media and in the news I'm seeing lots of children, from supportive families in peaceful communities, claiming to be diagnosed with PTSD. What are so many young people experiencing that's resulting in PTSD?
M (NYC)
@Ian I can't speak for anyone else, but my child has experienced trauma.
Someone (Somewhere)
Maybe we are asking the wrong questions. Another way to look at this is that DSM pathologies normal behavior. Also, if someone has an orthopedic injury, they don't get labeled as "orthopedically ill" . Why should someone with a mental health problem be labeled "mentally ill"? This is likely a sign the current mental health model does not meet people's needs. The problem is the antiquated mental health model, not kids on Tik Tok.
Big Cow (NYC)
@Someone I think it is absolutely true that the DSM pathologizes normal behaviors, and I think it’s really the case of good intentions gone awry. The DSM’s primary import in America is deciding who gets funding for treatment - insurance will often pay only for DSM identified conditions, a fact well known by its committees and they don’t want anyone who could benefit from treatment falling through the cracks just because they couldn’t get an insurance company to fund treatment because of a narrowly worded definition. I’m not exactly sure what the solution is here.
SH (USA)
@Someone What I learned while in grad school and then working in a mental health field was that the majority of symptoms described in the DSM can be seen in the majority of the fully functioning population. BUT once you see someone officially diagnosed with that disorder, you know. For example: read through the diagnostic criteria for autism. I think that the majority of our population can identify with enough of the criteria to say they "could be" diagnosed with it. But work with someone officially diagnosed (not educational autism) and you can see exactly how it manifests itself and why the majority of the population should not have that diagnosis.
CR (NJ)
@SH As an LCSW, I'd agree with you and add that the DSM does also require these collection of symptoms to (and I'm paraphrasing) cause distress daily and inhibit social, professional/school, family functioning. So, I can feel depressed and anxious about, say, climate change to the extent where I might actually tick off 3-4 of the required 5 or 6 for the part A of the Dx of Dep/Anx, but I'm still going about my business, raising my kids, going for runs, etc. Anyway, you know all this, sorry, didn't mean to therapist-splain it! Point is, is it interfering with daily functioning? If not, in theory, we professionals can't really say it's a full Dx, although it may make the client feel bad when they think about the issue.
David H (Northern Va.)
Teens turning to the source of their angst for relief from the source of their angst. From the fire into the frying pan. How terribly sad. Where are the parents in this horror story?
M (NYC)
@David H There is only so much parents can do to limit kids' electronic use. Even if your kid doesn't own a device, they encounter their friends' devices, devices at school, and so on. Certainly parents should try to stay on top of this and communicate with their kids about it, but it's simplistic to imagine that parents of teenagers can effectively control their online lives.
David H (Northern Va.)
@M Thanks. Maybe I should have been clearer. When my kids were young and showed signs of mental health distress, I made it my number one priority to get them help. I should hasten to add that this was before phones became a veritable extension of the human anatomy. As a parent, I was not distracted by one myself to the point that I did not notice my children's distress.
M (NYC)
@David H Yes, I agree parents need to be on the alert and ready to help. Unfortunately, help can be really, really hard to find, pay for, etc.
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