How Is TikTok Affecting Mental Health?

A question for JD Haltiganan assistant professor of child and adolescent mental health in the Department of Psychiatry at the University of Toronto, where he conducts interdisciplinary research informed by a life history, evolutionary perspective.

Is TikTok making kids sick?

SPart of what’s happening on TikTok, especially with young teenage girls, is contributing to clinical presentations consistent with a kind of social contagion effect around mental illness-like behaviors. This most recently includes tic-like behaviors, which are more physical manifestations similar to what you might see in clinical cases of Tourette syndrome or autism in young individuals. You will see stereotyped behavior such as clapping. A number of reports have come out about this, which I note in mine new paper IN Comprehensive psychiatry.

Additionally, you have many individuals posting content diagnosing themselves with conditions consistent with classic symptoms or classic diagnoses, which you would link to the Diagnostic and Statistical Manual of Mental Disorders, or DSM. But it’s clearly more of a performance thing. It is not an actual diagnosis of the true classic cases of self-diagnosed anything – ADHD, depression or borderline personality disorder. These are not diagnoses made by clinical professionals. This is happening more and more on TikTok, but it’s also on Instagram, and its origins can almost be traced back to Tumblr. In a way, what we’re seeing is more of a personality-like concern associated with some of these algorithmic platforms, where there are individuals who come to them to take on a new identity, and that identity is associated with a mental illness. .

What inspired me to write the article, which reviews the literature and draws attention to these issues, is that there are few papers that bring empirical work and information from the wider public discourse. Bringing these two aspects together was part of the impetus for the paper. The other part was describing the immersive audio-visual nature of TikTok and Instagram, which can absorb the personality concerns that make individuals post there. The algorithm reinforces, reinforces and exacerbates the identity around mental illness, or around the symptoms they are experiencing. It is reinforcing the psychopathology of the personality that is creating other aspects with which they identify, such as common clinical mental illness.

A lot of what’s happening on TikTok is disproportionately among teenage females. We see a lot of increases in depression and anxiety in general during puberty in females, as well as other personality traits like neuroticism, and this is hormonally mediated during this very significant puberty transition. And if you have those heightened feelings and you’re attracted to the immersive audio-visual nature and the community nature of these platforms, that can amplify a lot of the propensity for individuals to experience those feelings. This leads to a more toxic stew of effective content that then reinforces the problematic reasons or symptoms of why they came there in the first place.

You can think of TikTok as the incubator of what is already latent in people. When you have inaccurate or problematic diagnoses or personality characteristics that are positively reinforced in the absence of intervention or real clinical diagnoses, you will have an individual who will concretize their identity around that. It gets shared with others and creates this amplifying mix of symptoms that reinforce each other. They may not have dissociative identity disorder, or major depression. They may not exhibit the actual organic behaviors traditionally associated with those diagnoses. They may have a personality disorder, or high levels of personality psychopathology, which is also a mental illness. Narcissism, borderline personality disorder or schizoid personality disorder are some examples.

If their self-diagnosed illness is presented as their identity, what is more troubling to me is how this is shaping the current professional understanding of these disorders. Incubation in a collective group can lead to the formation of a group of a coherent activist identity. For example, the dissociated identity plural community has become a full-fledged community that has fostered ideas of non-consensus realities. If these communities come out more in public discourse and demand that the disorder be seen as they are presenting it, they can influence clinical views of how these disorders manifest. Once you reach a certain threshold of people identifying with a mental illness, it can change the way we professionally understand and create diagnoses or manuals of what these disorders are and how we view them. It can be pseudo-normalized.

If you have three different personalities in which you exist or depart, your consensus-based reality is defined differently than normal functioning, in which an individual is intact and interacts with the world in that way. A non-consensus reality might include someone thinking they’re living on Mars, or that dinosaurs are on the way. When this is seen as okay—everyone can have their own reality based on non-consensus—it wreaks havoc on what we consider disordered thinking or disordered thinking. There is this notion of critical psychiatry, where if you stigmatize a disorder, you are harmful; therefore we normalize and destigmatize. But the line between destigmatizing something and normalizing it is blurring at the edges. The more this goes in, the more we will need a serious discussion about what mental illness actually is.