Social Media and Self-diagnosis

Jennifer Katzenstein, Ph.D.

Jennifer Katzenstein, Ph.D.

Published in Johns Hopkins All Children's Hospital - Summer 2023

Is your child convinced they have obsessive compulsive disorder (OCD), autism, anxiety or depression, perhaps? Increasingly, mental health professionals observe children and teens “self-diagnosing” mental disorders after watching influencers discuss them on TikTok and other social media platforms. While awareness and understanding of mental health issues are important, certain exposure on these platforms can be harmful.
We put some questions to Jennifer Katzenstein, Ph.D., director of psychology, neuropsychology and social work, and co-director of the Center for Behavioral Health at Johns Hopkins All Children’s Hospital in St. Petersburg, Florida.

Can you describe what is happening on social media platforms regarding children watching influencers and then diagnosing themselves?

On platforms such as TikTok, children and teens are exposed to content where influencers openly discuss their mental health experiences. This may include anecdotes about symptoms, coping strategies and even potential diagnoses. These platforms provide a space for people to discuss their struggles and experiences, often in an attempt to share their story, raise awareness and reduce stigma surrounding mental health. Their experiences may resonate with some teenagers, and they may begin to self-identify with various disorders such as anxiety, depression or even conditions like autism. For instance, if an influencer describes their challenges with social interactions, a viewer might hastily conclude that they also have autism based on this limited information, when this symptom may actually be normal or related to another mental health condition.

Why do you believe this is happening? Are kids simply looking to feel better? Are they in search of community?

This trend likely stems from a combination of factors. Adolescents are in a phase of identity formation, autonomy development, and self-discovery, seeking validation and understanding. The open discussions on social media provide them with relatable content, fostering a sense of belonging and reducing the feeling of isolation. The anonymity of the internet can make it easier for people to be open about their struggles.

Are you seeing this reflected in your own practice?

Some of my teen patients have mentioned content from social media platforms during therapy sessions, often discussing how they feel they have certain symptoms, or can relate to certain experiences that they've seen online. At times this leads to a misunderstanding of a diagnosis or over-pathologizing of a symptom that is within the range of typical. We talk about the importance of a professional assessment, with evidence-based measures.

How do you respond to this when you see it? 

I approach the situation with empathy and understanding. I acknowledge their feelings while also highlighting the complexities of mental health. I emphasize the importance of a comprehensive evaluation by a qualified mental health professional to determine an accurate diagnosis. I also encourage young people to focus on their personal experiences rather than relying solely on what they've seen on TikTok, or what an influencer might have said. This is something I commonly discuss when patients or their families bring up terms such as “bipolar” or “OCD.” We oversimplify and overgeneralize these terms, which leads to a lack of understanding of the complexities of these diagnoses.

Is there a difference between a mental health experience and a disorder or illness?

Absolutely. A mental health experience refers to the range of emotions and psychological states that individuals encounter as part of their everyday lives, which is a spectrum of normal or appropriate emotions and states. A mental health disorder or illness involves a pattern of symptoms that significantly disrupts a person’s daily functioning in their home, school, work or other environment. It causes distress and requires a professional assessment, meeting specific criteria and warranting intervention.

How can self-diagnosis be harmful?

Using social media platforms for self-diagnosis may lead to incorrect perceptions of one's mental health and as a result can cause unnecessary stress and anxiety. This can also delay access to appropriate interventions, potentially worsening the individual's condition or making them feel something is wrong when it is actually on the typical end of functioning. It may also lead to the adoption of labels that don't accurately represent their experience or symptoms.

Can scrolling for mental health information actually increase mental health problems?

It can indeed exacerbate anxiety, depression or other mental health issues, especially if scrolling impacts sleep. Constant exposure to triggering content can heighten emotional distress — and comparisons to others' experiences can lead to feelings of inadequacy or depression. This is why it’s always important to monitor your emotional functioning when you look at content. Recognize when content doesn’t make you feel better and, whenever possible, only follow people you know in your everyday life.

Can you help us understand the effect of algorithms on these sites?

Algorithms on social media platforms are designed to show users content that aligns with their interests and behaviors. This can create an “echo chamber” where the viewer is repeatedly exposed to content related to their perceived mental health concerns.

As a result, this may reinforce a concept or mental health condition, rather than provide a challenging thought or another perspective.

Advice for parents who see this in their children?

Open communication is crucial. Talk to your child daily and engage in conversations about what they’re viewing on social media. Encourage them to share their thoughts and feelings. Know every platform they are on and ensure you and other trusted adults follow them. Educate them about the complexity of mental health and emphasize the importance of professional evaluation for an accurate diagnosis, as well as how to be a good citizen on social media and a well-educated consumer. The idea is to help them develop critical thinking skills to differentiate between relatable experiences and medical conditions.

Is there anything else you’d like people to know about the mental health information on these platforms?

Social media provides an opportunity for community, a sense of understanding and global interaction. However, being a good consumer of social media information is crucial. Mental health is complex, and if you have concerns, please reach out for professional guidance and assessment.