Teens: TikTok is not your therapist

Ayoung woman sits in front of her computer. In just 28 seconds, she creates a TikTok clip called, ‘‘What social anxiety can look like at school’’. The symptoms she outlines include: ‘‘avoiding eye contact’’, ‘‘finding it difficult to ask for help’’, ‘‘forever fidgeting’’ and ‘‘not contributing to group activities’’.

Three million people watch this video. With a moody soundtrack and snappy captions, it reels in 532,000 likes and a flood of comments. Many are from teenagers. ‘‘OMG, that’s me, but the whole time I didn’t think it was anxiety,’’ says one. ‘‘I didn’t know I had that,’’ writes another. ‘‘I figured out I got school anxiety,’’ says a third.

For some of the 8300 people who commented, there’s an epiphany. ‘‘Oh, I have anxiety.’’ ‘‘Literally me.’’ ‘‘This is me.’’ ‘‘Yep.’’ ‘‘That’s me all the time.’’ ‘‘I have it.’’ ‘‘I do all those things.’’ ‘‘I have all this.’’ ‘‘Exactly me.’’ ‘‘Just described me.’’ ‘‘Thank you.’’

Perhaps the most revealing comment comes from someone called Anya. ‘‘Not to self-diagnose, but why is this so accurate?’’ she asks.

Self-diagnosis is as old as the internet. In the 1990s, sites like WebMD allowed people to look up their symptoms before deciding whether to visit the doctor. But in 2023, self-diagnosis is a much wider trend, and it has the potential to help – and to harm.

Across New Zealand, people struggle to access mental health support. Underfunded public services have months-long wait lists. Private therapists and psychologists can be expensive. There simply aren’t enough trained professionals to meet demand.

While adults can be resigned to this, teens are more resourceful. On social media, they can find millions of bite-sized pieces of content about mental health conditions, learning disabilities and trauma.

On TikTok alone, the #adhd hashtag has 20 billion views, while #anxiety has 22 billion. Even a less common condition, borderline personality disorder (#bpd), has 8 billion views. Most of those clips are not created by mental health experts. Rather, they’re homegrown – made by ordinary people. Some have become online celebrities by sharing their experiences and opinions.

This can be useful. For 15 years, social media has helped remove stigma and shame around mental distress. After hearing other people’s stories, many of us – including me – have accepted that it’s OK to seek help. Using online content, we’ve learnt how our brains work. We’ve gathered tools like mindfulness and gratitude from the clips we have watched, the Instagram influencers we have followed, and the Reddit discussion threads we have perused.

Today, a young person can access a wealth of information for free, without leaving their bedroom. They don’t need to risk shame or rejection by speaking to a parent or teacher. Their mates won’t find out. They may find comfort by connecting with complete strangers online.

At its best, social media makes people feel they aren’t alone in their darkest moments. That can save lives. But there’s a shadow side, and it’s becoming harder to ignore.

The causes of mental distress are complex. A teen who self-diagnoses may rely on limited or misleading information, and come to inaccurate conclusions about their wellbeing. They may label themselves as ‘‘mentally ill’’, when in fact they are experiencing normal, healthy emotions that relate to challenges in their home or school life.

Social media can magnify a teen’s emotions and make them seem bigger and scarier than they actually are. Algorithms learn what you’re interested in, and then feed you an endless stream of similar content. If you click on videos about depression, you’ll gradually find your timeline filled with more and more of them. If that content is focused on other people’s problems, rather than tools or strategies to improve wellbeing, a young person may be left feeling even more hopeless.

Academics share these concerns. Last year, a paper published in the British Medical Journal highlighted an ‘‘explosion’’ of verbal and physical tic disorders in children and adolescents. The authors noted a coinciding increase in popularity of Tourette’s-related content on TikTok, with 2.5 billion hits for the #tourettes hashtag.

The researchers suggested that, although TikTok allows teenagers to find peer support, the content they watch may also be ‘‘inadvertently reinforcing and maintaining [their] symptoms’’.

While social media can empower young people, it can also trap them in harmful feedback loops.

Is this common? I believe so. I travel around NZ speaking about mental health. I regularly meet teenagers who have self-diagnosed. They often speak about mood disorders in a very casual way: ‘‘Oh, yeah, I’ve had depression my whole life.’’ ‘‘I can’t do that because of my depression.’’ ‘‘All my friends have anxiety.’’ ‘‘Anxiety is just part of who I am.’’

Many do not view depression or anxiety as an ‘‘event’’ in their life, or even a ‘‘period’’ of distress. Rather, a diagnostic label has become part of their identity. And that scares me – especially if they are the author of their own diagnosis.

If you’re a parent, be aware that your child may have diagnosed themselves with a disorder – and you don’t know about it. What can you do? Have regular, open conversations about terms like depression and anxiety. Ask your children age-appropriate questions about how they understand those words. Do they identify with them?

Parents can share their own experiences of navigating mental distress and talk about how they make sense of difficult emotions. If you have a clinical diagnosis, explain to the child what it means, where it came from, and how it helps you to look after your wellbeing.

It’s important for young people to understand that it’s common to feel depressed or anxious for a period – without ‘‘having’’ clinical depression or anxiety.

Without prying, be curious about the content your child is consuming on platforms like TikTok, Twitch and Netflix. School up on popular media content that may influence their knowledge of mental distress. When you spend time together, expose them to different perspectives and forms of storytelling.

Most of all, it’s important to make it easy for your child to ask for help. Often, young people try to sort out their mental health issues in secret, because they’re ashamed. Remind your child that you’re

happy to support them if they ever want to speak to a professional. Explain that counsellors and psychologists are trained to provide support in a safe, structured way. For those living in remote areas, online counselling may be an option too.

Many local websites provide useful resources. The Lowdown contains stories and information for youth, covering topics like body dysmorphia, drugs, bullying and grief. For older teens, Small Steps and Just a Thought offer mini courses and tools to help you to calm your mind.

Young people can easily get hung up on whether they meet the criteria for a particular condition. It’s worth teaching them that the purpose of a diagnosis isn’t just to give a label to a problem – it’s used to provide a signpost to appropriate treatment options.

Rather than fixating on a diagnosis, it’s more helpful to focus on the tools, actions or strategies that contribute to their wellbeing on a day-to-day basis.

Finally, young people need to be relieved of their self-imposed pressure to have all the answers.

As you get older, you realise that it’s not always possible to stick a nice, neat label on your mental health challenges. Some things can’t be diagnosed – and nor should they be.

Adulthood is about learning to be comfortable with being uncomfortable, and recognising that no matter what challenges you’re facing, it’s your choices that matter.

For some, that choice could be as simple as logging off TikTok for a while.