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TikTok: The Funhouse Mirror App For Mental Health

If you've ever listened to The Symmetry Sessions Podcast, you've probably heard me comment about my disdain for TikTok on more than one occasion. While there can be nuggets of truth in any social media and news outlet, the odds of finding misinformation, particularly on mental health are higher than you think.

It's happened more times than I can count since TikTok gained popularity, a client comes in after following content related to mental health and described feeling validated by someone describing the symptoms they struggle with. And I get it, no one wants to feel alone. We like to know as biological, surviving creatures that we belong to a group and are understood. The problem is mental health is not an identifier. You are not your symptoms and, even more than that, the symptoms that someone else is describing to you, that you feel so connected to, may not be a part of the diagnosis these folx are saying that it is.

I have heard so many self-diagnoses based on TikToks: I have PTSD. I am on the spectrum. I'm ADHD. I have narcolepsy... You name it. And I've usually known the client for long enough to say, that is not my clinical opinion. But while I'd never begrudge a client their own experience, TikToks often give misinformation based on a random person's experience and barely any clinical knowledge.

In a recent study conducted by Woods, Gantt-Howrey, and Pope, on 50 TikToks using hashtags related to Obsessive-compulsive disorder (OCD), they found that only 40% of them accurately depict the symptoms that comprise OCD. The rest of them share misinformation, minimize what it really is or perpetuate stereotypes about it. And that's just OCD! Imagine how many other symptoms/diagnoses and mental health-related hashtags are doing the same thing.

Further, our results demonstrate the importance of public education to decrease stigma related to mental health disorders (Webb et al., 2016), particularly targeted to individuals who do not have an OCD diagnosis, as they may be more likely to share or create trivializing content.

TikTok can be like a funhouse mirror. It can distort the truth, and if you look at it long enough, it can make you believe it could be real. It's seductive and it's dopamine-driven (the science of their system is made to play on your dopamine rewards system) and it can feel like you've finally found your people. But, I am reminded of Lewis Black's rant on America's obsession with health:

On the plane was a Time magazine and there was a 30 page article on diabetes, and I read every page. By the time that plane landed, I had diabetes.

We worry that something is wrong with us and we want immediate answers to what that is. It feels like it helps to know others are going through the same thing. But the minute you put a label on it, you may have missed the point.

The Diagnostic and Statistical Manual of Mental Disorders (DSM) (now in its 5th text revision edition) is a complex organization of mental health diagnoses. Its codes are often used to convey to insurance companies what one is being treated for and its descriptions are used to inform prescribers and healthcare professionals of treatment plans and best practices.

Most people don't perfectly fit into the categories inside the DSM and pinning down a diagnosis can take years because of the necessary testing and evaluations. Often, even mental healthcare professionals can misdiagnose their clients because so many of the diagnoses in the DSM share criteria. It can take a lot of testing by specialized doctors to narrow it down. It is a process that should not be left up to the laypeople and armchair experts of TikTok.

Furthermore, these words we've come to use to describe mental health issues and challenges are just that. They are words. They do not define who you are. And as Richard C. Schwartz, Ph.D. and founder of Internal Family Systems (IFS) therapy states, these words are not who you are, but they may describe parts of you. But those parts can be healed.

So maybe the better question for TikTok users that want these words to define them is, do you want to differentiate yourself from your symptoms? Who would you be if you weren't governed by these parts? Only through this work can the mirror actually give us clarity.

I do recognize that there are therapists and medical professionals out there on TikTok and I'd like to think that they are fighting the good fight by challenging the misinformation that is so staggeringly running rampant. However, as the study found:

Counselors are not immune to holding stigmatizing views about OCD (Steinberg & Wetterneck, 2017). Exposure to trivializing content may influence how counselors view OCD symptoms and the severity of OCD with their clients, potentially contributing to misdiagnosing OCD.

While OCD is just the focus of this one study, I have to imagine the point is that we are all just influencing each other in detrimental ways when we do not have formalized, specialized training to know the difference. But in the end, naming the thing is not as important as doing something about it. I believe the point is that we focus more on the negative beliefs we carry and the behaviors that arise because of those beliefs and less on finding identity within those things; to bring curiosity to internal parts, mechanisms, and ways of coping without pathologizing ourselves.

So if you're a fan of TikTok, try not to look too long at it and if you get sucked into the funhouse don't take Joe Schmo's word for it. If you have questions about yourself or your behaviors don't make assumptions, just be curious and reach out to a therapist who can help you navigate the confusion. And if you really need a label for it, seek out a professional who can do the appropriate evaluations and then sit with why that label is so important.


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