Mental Health is Trending, It's Not A Bad Thing
TikTok self-diagnosis is a symptom of something that teens have always experienced and needed
I read an article recently that begged young people to stop sharing the details of their mental health on the internet. Similarly, over the last year especially. there has been endless media written about the concern over young people self-diagnosing psychiatric conditions as a result of social media.
In my therapy work, I have seen a bit of this. Usually, it is a tentative question, like “I know this sounds silly, but I saw this TikTok about Autism and it reminded me a lot of myself. Do you think I could be Autistic?” I welcome these conversations. I learn more about what my client is experiencing. I have yet to see anyone pursue further assessment based on their TikTok revelations, but I am sure it happens.
Every generation has it’s new boogey-man that threatens our youth and causes parents to panic. The concern over the impacts of social media and mental health are valid and critical. The U.S. Surgeon General released a 25 page document detailing both the positive and negative impacts of social media on youth mental health and I encourage you to check it out1.
However, I would argue that teenagers have been disclosing details about their lives on the internet for as long as the internet has existed. This phenomenon is not new, but certainly amplified and more visible. It is much easier to villainize social media or the DSM than it is to ask ourselves: what need is this fulfilling for our children? Why are they drawn to watching people post videos of panic attacks? Why do they seem to crave a diagnostic label? What are they needing? And how do we help them get that need met in a healthier way?
The alarm at TikTok diagnosis makes sense, and at the same time, we should not forget that the push for talking about mental health, trauma, and grief grew out of a historical tendency to stigmatize mental illness, causing it to be hidden, misunderstood, and delegitimized. Despite what is trending on TikTok, this stigmatization of mental health is still alive and well.
Access to mental health diagnosis and treatment is notoriously difficult. Many families are priced out of treatment; many communities simply lack qualified providers. The barriers to adequate care are especially dire for youth. There is a critical shortage of child and adolescent psychiatrists, according to the American Academy of Child and Adolescent Psychiatry. For example, according to the AACAP, there are only 36 child and adolescent psychiatrists in the entire state of West Virginia, which is home to over 350, 000 kids under 18. Additionally, therapists and psychologists are increasingly deciding to forgo participating in health insurance, because reimbursement rates from insurance companies make it challenging for therapists to make an income commensurate with their years of education and the challenges of the job.
If you think that kids should be getting mental health support at school, forget it. It should come as a surprise to no one that schools are woefully under-resourced and incapable of meeting this demand. Nationally, there is about 1 school psychologist for every 1,100 students. Most schools have guidance counselors on site, but they are overburdened with high caseloads and administrative demands.
At the same time, the rates of childhood anxiety and depression have sky rocketed since the beginning of the Covid 19 pandemic. Suicide is a leading cause of death for children and adolescents, and rates of suicide have continued to rise over the last several years.
So if it seems like our young people are being encouraged to talk incessantly about their mental health on the internet, don’t forget that our society still discourages and makes it challenging for them to talk about it anywhere else. In lieu of better options, teens are finding like-minded community in social media apps. Given the level of distress that our young people are experiencing, and the scarcity of qualified adults to help them, is it any wonder that they are crying out for people to hear them?
Adults and teens alike are eager to share their experiences on social media in reaction to a world that has historically given the message “It’s not ok to be unhappy or to struggle. If you are, it’s a personal problem. Don’t talk about it, don’t let it impact your productivity, and figure it out on your own.” If it seems like there is a push for everyone to go to therapy or medicate their every painful feeling NOW, I would urge you to remember that just a few decades ago, candid conversations about mental health were taboo. When I talk with parents in their 30s, 40’s and 50’s, most can recognize (and often lament) that no one was trying to understand their mental health experiences when they were children and teens in the 70’s and 80’s. To now discourage discussion and awareness of mental health threatens to undermine the important progress that has been made towards normalizing diverse mental health experiences, and encouraging people to seek help. There is no doubt that it has saved lives.
Teenagers disclosing and self diagnosing on the internet is not a symptom of a new problem, it is just the most recent manifestation of something that has always been true. Much of the work of adolescence is self-discovery. It’s a period of rapid physical, emotional, social, and moral growth that has always been challenging to navigate. And when left to their own devices, teenagers with their hormones and under developed frontal lobes will make un-wise choices about how to get their needs met. Social media is just the latest landscape for adolescent angst to run amok. And as has always been the case, teens need the caring adults in their lives to pay attention and help them navigate this tumultuous time safely (and maybe even with some joy and fun thrown in).
This is not a condemnation of parents. Of course parents are not skilled at acknowledging and supporting their teenagers mental health; our parents did not do it for us, and their parents did not do it for them. Its very hard to do what was never modeled for you, to give what you never got. Despite our best intentions, when faced with our children’s uncomfortable and challenging emotions and urges, we are much more likely to fall back into patterns that feel familiar. For many of us, that means relying on denial, punishment, power struggles or other unhelpful ways of responding to a teen’s experiences.
It is normal and healthy for teenagers to seek to understand their internal experiences, especially the painful or uncomfortable ones. Teens are also biologically inclined to seek connection and belonging among their peers. They crave being seen, heard, and understood. We can discourage them from doing this on the internet, yes. And we need to be prepared to help them meet those needs in other ways.
What Parents Can Do
Listen to your kids and validate their desire to better understand their own experience. One of the allures of a diagnosis is craving validation and legitimization of one’s challenges or painful experiences. You can be that for your child. Instead of launching into explanations of why labels are limiting and flawed, listen to what your child is experiencing and why they relate to a particular diagnosis. Focus more on listening and less on challenging or explaining.
Example: “I don’t know if you have ADHD or not. But you are right, you have always been energetic and classrooms are not designed well for kids with lots of energy. I know school has been tough for you.
Be the person that your child wants to talk to about their feelings and behaviors. Don’t want your teen exploring their gender identity on TikTok? Then make sure you speak thoughtfully and respectfully about gender diversity when talking with your kid, your family, and your peers. Otherwise, your child will understandably not bring their questions to you! This means being ready and willing to notice your own biases and open to listening and learning.
Help your child learn to research and look for reliable sources of information. Seek out more detailed and historical accounts of a mental health condition. The National Institute of Mental Health shares a list of teen-appropriate and factual graphics on their website, which I share below2.
Stay involved with your child’s social media use. Monitor it, ask to see it, and show interest in it. Have genuine conversations (not lectures) on how your teen is experiencing these apps. Be open to hearing the good along with the bad. Social media is a valued source of social validation, if you are only interested in demonizing it, your children will simply stop talking to you about it.
Seek out a mental health professional to help you and your child. Seeing a mental health professional does not necessarily mean being labeled with a diagnosis, but it is the most accurate and comprehensive way to explore whether a diagnosis is applicable. If you are concerned about the impacts of a mental health label, ask the clinician about their philosophy and standard practice in regards to diagnosis.
Trends tend to swing towards the extremes of a spectrum and it seems that humans on a collective level are less comfortable with existing in the middle. The middle is messy and gray instead of black or white, right or wrong. The ends of a spectrum tempt us with the promise of certainty. Clarity. But that is just a mirage. When we hang out on the extreme ends, we lose important details, nuance, and context. I don’t want our young people relying on social media for validation of their internal experiences. But I also do not want these conversations to go back into hiding. Our young people are telling us what they need, loud and clear. Will we listen?
In case you missed it, here are some recent articles that you may enjoy, including a link to the Crash Your Therapist’s Book Club discussion for March-April. I’d love to have you!
Disclosure: Dr. Amber_Writes is a newsletter designed to be informational, entertaining, and engaging. It is not therapy. Following this newsletter does not establish a therapeutic relationship with me. Dr. Amber_Writes, and other written communication by Amber Groomes on Substack, is not a substitute for treatment, diagnosis, or consultation with a licensed mental health professional. I assume no liability for any action taken in reliance on my writing here at Dr. Amber_Writes.
https://www.hhs.gov/sites/default/files/sg-youth-mental-health-social-media-advisory.pdf
https://www.nimh.nih.gov/get-involved/digital-shareables/shareable-resources-on-child-and-adolescent-mental-health
So many great resources in a non-judgment time to deal with the times in which we find ourselves. Thank you!
I agree Amber. TikTok can be the launching point for some really interesting conversations with teens and young adults in my experience.