Diagnosing serious disorders with TikTok is a dangerous trend

I’m not suggesting you put down the paper or log off the website; I’m just asking. By the way, did you know that difficulties with organisation and prioritising tasks are symptoms of ADHD? If you’re irritated by the suggestion that I might be trying to diagnose you here, without any medical qualifications, it’s worth noting that being easily irritated is another symptom…

This is how it begins, you see. You needn’t be googling personality traits, or worrying if your behaviour is normal. You might just be minding your own business online when the question creeps in: do you perhaps have an undiagnosed mental disorder? Might this explain why life isn’t always easy for you, and why you aren’t living up to your true potential? What if a diagnosis, and finding a tribe of like-minded people, could make all the difference?

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To some, it’s a seductive proposition, a chance to feel validated and understood after years of feeling like they don’t quite fit in. What if a label could make all the difference, and be the key to unlocking social and professional success? Increasingly, content creators on platforms like Instagram and TikTok understand the power of these ideas, and are exploiting them to build followings, develop personal brands and acquire clout, or digital social capital. It might sound bizarre, but slapping a medical label on your quirky digital persona can represent a shrewd business move.

The internet has, of course, opened up huge possibilities for good when it comes to raising awareness of mental disorders and illnesses, providing support groups and forums and dispelling harmful stereotypes. Friendships can be formed regardless of geographical distance, advice and coping mechanisms can be shared, and emotional support can be provided – anonymously, if preferred. And at a time when it’s harder than ever to access mental health support, it’s little wonder some people are latching onto the idea of self-diagnosis.

But reports this week of a sharp rise in young women presenting with nervous tics after prolonged exposure to Tourette’s videos on TikTok raises serious questions about the extent of online influence.

It reads like an urban legend. During the pandemic doctors around the world started noticing a sharp rise in the number of teenage girls presenting with nervous tics. Unusually, in some cases these tics were not unique to the individual patient – groups of girls were all blurting out the same phrases. In Germany, doctors came to realise that these echoed those of a popular German TikTok content creator who has Tourette’s.

Doctors do not think most of these girls actually have Tourette’s, but that doesn’t mean their symptoms are not real. In spring, researchers at Great Ormond Street Hospital published a paper describing a “new surge of referrals consists of adolescent girls with sudden onset of motor and phonic tics of a complex and bizarre nature.”

Interestingly, exposure to TikTok videos with the #tourettes hashtag was just one factor highlighted by the researchers. The other was the tendency of these patients to film their tics and post the videos online. “They report that they gain peer support, recognition and a sense of belonging from this exposure,” says the paper. “This attention and support may be inadvertently reinforcing and maintaining symptoms. The role of social media needs further exploration, particularly the potential for ‘contagion’ and the maladaptive gains that might unintentionally arise from this peer identification.”

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This is not the same as saying you can “catch” Tourette’s from watching TikTok videos, but it does raise questions about the real-world health consequences of becoming fixated on defining your identity in relation to a medical condition you may or may not actually have.

The use of the phrase “a little bit OCD” to describe someone who is merely very tidy or fastidious about cleaning has long frustrated those who actually suffer from obsessive compulsive disorder, but increasingly TikTok content creators are serving to pathologise all sorts of other normal human behaviours. The platform’s algorithm rewards those whose videos get the most engagement, which creates a clear incentive for them to get as many people as possible thinking “hold on … that sounds like me”. A disorder might not sound like something to aspire to, but might it be preferable to accepting you are just, for example, lazy, ill-disciplined or shy?

The top result for #ADHD on TikTok is a video titled “ADHD superpowers” which shows a young man who has acquired various impressive creative talents (and three million TikTok followers) by “following the dopamine” instead of doing his homework. In this context, it’s easy to see why some young people could see having his condition as desirable and cool.

Demand for ADHD medication has risen by more than 200% in the past year – a year when demand for mental health support was sky high. This could be a positive thing, reflecting increasing awareness of the condition and its symptoms, but TikTok is no substitute for professional psychiatric help. As the spate of copycat Tourette’s tics shows, social media influencers are not just earning “likes” and selling products, but rewiring brains.