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Why the nature of TikTok could exacerbate a worrisome social media trend


In recent years, parents and policymakers alike have started to focus on the negative effects social media can have on young people, on everything from introducing them to hate groups to encouraging eating disorders. So we want to tell you about another debate that's emerging around what some think might be a new threat, the self-diagnosing of mental health issues. There doesn't seem to be any hard data on this, but if you spend any time on TikTok or Reddit or other platforms, you can easily see videos documenting mental health symptoms - sometimes from health professionals, often not. On TikTok, for example, if you type #DID, which stands for a dissociative identity disorder, you'll find videos that total 1.5 billion views on that topic alone. And while some people think the increased discussion of mental health is a good thing, others worry it's creating a misunderstanding about certain mental disorders.

To help us break down this trend and what's being done to address it, we've called Taylor Lorenz, a technology and culture reporter. And she's with us now. Welcome. Thanks so much for joining us once again.

TAYLOR LORENZ: Thank you for having me.

MARTIN: Now, before we dive in, I'm sorry if this sounds super-basic, but for folks who don't know, what exactly is TikTok? And how does something like self-diagnosis work on a platform like that?

LORENZ: So TikTok is a short-form video app where people can go and post videos around 15 seconds to three minutes long set to music, usually. A lot of these are just dance videos, cooking videos, things like that. And then a significant portion are people sort of sharing information about their lives. So they might be talking about struggles that they have, interpersonal relationships and mental health.

When it comes to mental health, a lot of people on TikTok are very open about their own mental health struggles. So, you know, for instance, hey, I struggle with ADHD. Here's how it makes my life hard. Here's how I'm trying to address it. And sometimes they can get pretty personal. So viewers then watch that, and, you know, some of it resonates with them to the point that they wonder if they themselves are struggling with that mental issue.

MARTIN: So, you know, I mean, it's not like it's new for people to use media to talk about any kinds of health issues - I mean, blogs and, you know, YouTube, for example. What do you think it is about TikTok that's making this such a big deal right now? - because, as we said, kind of, there's really a debate opening up about this, and some professionals in this field are really concerned. Is there something about TikTok that you think makes this particularly worrisome?

LORENZ: TikTok is so fundamentally different than every other social platform out there right now because the primary way that you consume content is through this algorithmically generated feed. You could actually be on TikTok all day and never follow a single person and you would just be getting fed this feed of content. Every other social platform - Twitter, Instagram, YouTube - you have to subscribe to someone else's content. So when things go viral on TikTok, suddenly they're sort of just shoved into the feeds of millions of people that might not have ever followed that stuff before. So I think it just - the mechanisms of it allow certain things to spread and allows certain videos to really take hold in a way that they couldn't.

MARTIN: As we said, there are a lot of professionals who say, you know what? We've talked so much about destigmatizing mental health issues. People are finally doing it, and now people are mad about that. But other people are concerned that people aren't doing the second step, which is to getting confirmation or to actually seeking out professionals who know more about it or that they may be misdiagnosing themselves, which, as we know, can always be...


MARTIN: ...You know, worrisome. So do we know something about this trend? Has this been studied in some way? Like, do - you know what I mean?


MARTIN: Is there anything we actually know as opposed to what we suspect?

LORENZ: Researchers are just beginning to study the effects of these things. And I don't have any kind of specific numbers. I will say that, like, I do think the conversation sometimes gets flipped a little bit backwards, where people say, like, if they're going on TikTok and they're getting the idea that they have certain conditions, but then they don't go and get the diagnosis.

A lot of times the reason that they're going on TikTok is because there are all of these hurdles in the health care system to getting these mental health diagnoses. It's incredibly hard, especially during the pandemic, to even get an appointment for a lot of people. And a lot of these people are minors, so it can be even harder for them to kind of get mental health care. So I think it's kind of like TikTok is a symptom of the broader problem instead of TikTok is necessarily causing the problem, if that makes sense.

MARTIN: And as we mentioned, that, you know, policymakers have gotten very interested in social media - people from across the political spectrum. So wondering whether social media companies have said anything about this kind of content?

LORENZ: Well, they definitely regulate it in certain ways. So, you know, there are hashtags that are banned on TikTok for certain - you know, self-harm. If you post on Instagram about - you know, joking about killing yourself, you'll get a pop up asking if you need help. You know, social media companies are trying to kind of incorporate some of these things, I think, because of that regulatory pressure from Washington. But at the end of the day, it's a little bit hard because some of these people are just - it's not against any kind of, like, terms and policies to share about your own mental health journey. And so I think it's, like - it's a little hard to regulate.

I will say another thing that I know these companies take pretty seriously is eating disorder content, which is so rampant on social media. TikTok came under fire for having a lot of this content in the feed, being distributed. And I know that they've since kind of banned a lot of it. So I think it's a bit of a whack-a-mole situation.

MARTIN: So before we let you go, given how long you've covered tech and how we use it, is this something that parents should be concerned about in some way? And is this something that you think tech companies should do - should be paying more attention to?

LORENZ: In terms of the, like, diagnoses of things, I think it's just really important to have these open conversations with your kid, you know, and say, like, hey, well, what do you think? Or why do you think that? You know, so many people - when I was looking into doing a different story kind of related to this last year, I talked to one therapist, and she was saying, you know, so many people come on to TikTok looking for, you know, what's wrong with them. And they might get - think that they have a diagnosis and then kind of come to the therapist. And it actually turns out there is very much something going on. It might not be what they think it is, but it got - it's what got them in the door, you know, to see someone.

And so I think parents need to, like, be comfortable taking that second step instead of just dismissing their child's concerns. Oh, you saw a bunch of those videos on TikTok. But that's nonsense. You know, say, hey, why do you feel like that stuff is resonating so much? And how can I help you solve some of these problems?

MARTIN: And then the tech companies - do you think that there's more they need to be paying attention to?

LORENZ: What the tech companies - they need to focus on is surfacing relevant information. You know, if you search the hashtag #ADHD, for instance, sometimes you don't always get the most relevant information. And so I think, you know, maybe they need to be highlighting, you know, like, sort of experts and vetted experts and make sure that there's not disinformation flowing around. I think some of the stuff can just be, yeah, so subjective. I would love for them to have hubs for some of these different things and really, you know, integrate some of the doctors that are using these platforms already to kind of provide, you know, valuable and fact-checked information.

MARTIN: That's Taylor Lorenz. She reports on tech and culture, and she's currently writing a book about the world of online creators. Taylor Lorenz, thanks so much for your time.

LORENZ: Thanks for having me.

MARTIN: And let's say this. If you or someone you know may be considering suicide, please contact the National Suicide Prevention Lifeline at 1-800-273-8255 or the Crisis Text Line by texting HOME to 741741.

(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.

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