The Dangerous Influence of Social Media on ADHD Self-Diagnosis: The Necessity for Professional Prognosis

Why does it seem like everyone has some kind of mental affliction in 2023? All over social media it looks to be many have found they have some kind of latent depression, social anxiety, or autism. However, it seems like Attention Deficit Hyperactive Disorder (ADHD) is the flavor of the month. In fact, as of March last year the Google search results for “ADHD” were the highest they have ever been (Abdelnour et al., 2022). As someone who was diagnosed with the disorder less than a year ago, it is nice to know that so many others have discovered they have discovered a hinderance that they can start to address. Yet, I feel some skepticism. Why have so many spoken up recently, and how did they learn about this? It seems that over the last three years social media sites, especially the platform TikTok, have seen a significant increase in the sharing of mental health awareness content. As of December 2023, videos on the platform featuring the #adhd hashtag have over 20 billion views (Bobby and Sandhu, 2023). Although a seemingly positive notion from afar, the sheer amount of information being shared about mental disorders can become overwhelming with how much misinformation there is on disorders like ADHD. Almost no posts are prefaced with medical warnings, suggestions are given out in a wanton fashion, and even genuinely harmful advice is being shared, with more than half of the professed information being misleading (Abdelnour et al., 2023). In addition, the short form videos found on these sites often “…don’t leave much room for nuance. Viewers in search of mental health information may find little more than a bullet list of symptoms” (Caron, 2022).  

These rapid distributions of information have led to many people self-diagnosing themselves as ADHD simply from videos that spoke to their apparent symptoms. Paula Coutinho, a mental health clinician with over 20 years of experience as a counsellor and a member of the Canadian ADHD Resource Alliance (CADDRA), has lent helpful insight into how the pursuit of ADHD diagnoses have changed since the advent of social media. She explained, “There has been an increased public interest in pursuing ADHD assessments, likely due to increased social media awareness like TikTok.” However, when using social media to learn more, she said, “With social media, misleading information could lead someone toward an inaccurate self-diagnose, which is not helpful.” Although there is a community and awareness benefit to learning about mental health through social media, ascribing a disorder to oneself is at least ignorant and at most directly harmful to their health. By sharing my own experience with social media and my diagnosis, this article will take a look at what ADHD is, what qualifies as a professional diagnosis, how people use the internet and social media as a tool for diagnosis, how this can be harmful with some positive caveats, and finally why a professional diagnosis is required to get proper treatment for ADHD. Ultimately, the increase in self-diagnoses of mental disabilities like ADHD through social media is dangerous and should be carried out by a medical professional. There needs to be a higher rate of professional help for ADHD through a medical provider, while taking one’s own due diligence to conduct research on their personal afflictions from this impairment as well.

What is ADHD?  

Attention Deficit Hyperactive Disorder is a mental affliction that affects 5-7% of youth and 2.5-6% of adults globally (Abdelnour et al., 2022). ADHD has been noted by different definitions in populations for over a hundred years but came into common focus in the 1950s with the prevalence of standardized schooling (Mangus et al., 2023). From its first observation in the Diagnostic and Statistical Manual of Mental Disorders in 1968, ADHD has been defined by the varying degrees of inattention and emotional instability exhibited by a person (Abdelnour et al., 2022). It is a highly heritable disorder brought about by genetic and environmental factors that are specified by the subtypes of inattentive, hyperactive, or a combination of both. In children, this can look like not paying attention to tasks, forgetfulness, excessive fidgeting, and interrupting others across various settings. For adults, this will often manifest as less pronounced versions of the former in addition to considerable procrastination and mood instability. Although most people express these signs, they must “have a highly detrimental effect on the person’s way of life” and “… interfere with daily life activities in order to be labeled as ‘ADHD’” (Magnus et al., 2023) However, due to its wide range of symptoms, ADHD has multiple comorbidities, including anxiety, depression, and conduct disorder. The treatment of ADHD can not only improve said affliction but alleviate the symptoms of these other disorders as well (Magnus et al., 2023). 

My Struggle with Self-Diagnosis 

I have always struggled with being present. I was often revelling in a fantasy in my head, far away from what was right in front of me. There were many activities I loved to do and would do so with vigor, but if anything did not excite me or it was something that I found difficult to do, it would be a painful internal struggle to complete the task. My emotions ran wild, and I often had people pester me for being overly sensitive. I would frequently experience a vicious cycle of wanting so badly to complete some homework or do something outside my comfort zone, but it felt like there were hooks in my side holding me back. I would beat myself up for not doing what I wanted to do, then engage in negative self-talk about how I clearly could never do it.  

This became exacerbated through the demands of high school life. I was verklempt, anxious, and alone. That is why when I found posts describing anxiety and depression on the website Reddit, I felt a comfort I had not experienced before. These online communities showed me there were others who struggled like I did, that I did not need to feel as upset as I did for who I was. I was completely taken in by this newfound world. At 18 I decided that I had anxiety and depression and approached my doctor at the time for his thoughts on this analysis. After some questioning, he seemed to agree with my enthusiasm, and I was put on anti-depressants for the next five years. I rejoiced in finally finding a cure to my misery. Like what many of the Reddit posters said, I was able to better deal with it. This only further ascribed the labels of being anxious and depressed I felt, and I held onto these with my life. I would not see otherwise. However, the effects of the medication lasted only so long.  

I noticed as I entered my twenties that my concentration and latent anxiety started to get worse, not better. I was confused, as the people on Reddit seemed far better once they got on their medication. In desperation, I tried some other non-medication quick fix tips for anxiety: deep breathing, eating less sugary foods, listing out short term goals. Nothing seemed to be working. My confusion over my mental health continued until I saw a few posts on the front page of Reddit referencing ADHD. My curiosity on the subject led me to hours of searching for different posts about people’s experiences and information on the disorder. From these descriptions I felt like much of what I felt was being described. However, I clearly had anxiety, so I did not let myself become defined by the disorder. Years passed, and my symptoms became increasingly obvious. As I saw ADHD become more popular on the Internet, I secretly felt more inclined toward the definition of the ailment. It all finally came to a head at 25 when my anxiety medication was actively disrupting my life. I decided to get off it and start anew. It was then that I brought up the idea of ADHD to my doctor passively, not expecting much. He reflected on my medical history and let me take the Adult ADHD Self-Report Scale (ASRS) to gauge if I had it or not. After a few days he let me know that I did have ADHD, and that I would get started on medication right away.  

Was this finally what I was looking for? It was nice to know about my disorder, so I went back to Reddit and checked for tips and tricks on how to manage it. Many people said the medication was what took most of their problems away, so I was looking forward to similar results. However, after over a year of trying five different pharmaceuticals, I felt that the negatives outweighed the positives. Instead, my doctor switched approaches and got me to see a counsellor who understood the disorder, which has been far more beneficial in handling my ADHD. I was surprised to realize how different or incorrect some of the information for ADHD I found through social media was. Although there were some helpful tips, it seemed like certain approaches found their way to the top through sensationalist presentation or an echo chamber effect that were deemed as the “definitive” way to deal with ADHD. Now, I realize that it was a great guide for me to think about my own mental health and to go see a doctor with symptoms I was experiencing so we could both assess a proper avenue for healing. It has taken much trial and error, and it is an ongoing process, but I am glad I got the professional help I needed to make my life that much better.  

A collection of statistical information pertaining to the mental health of teenagers, the use of the Internet for self-diagnosis, and how #adhd TikTok videos contain inaccurate and harmful information. (Created using Piktochart).

Methodology for Professional Diagnosis and Treatment  

The diagnosis for ADHD is accomplished by a family doctor or a registered psychologist. As there are no laboratory or radiologic tests designed for ADHD, diagnosis is done through questionnaires like the WEISS Symptom Record for children or the ASRS Self-Report Scale for adults along with one-on-one interviews by a practiced clinician. In certain instances, neuropsychological tests on brain function may also be used (Abdelnour et al., 2022). The professional will observe the patient’s signs and symptoms and validate them through informants in the patient’s life like teachers and parent. However, unless the clinician is professionally trained in ADHD diagnosis, this can occasionally result in over diagnosis with other disorders or a misdiagnosis of the condition (Magnus et al, 2023). Due to the nature of ADHD, there are high comorbidity rates with anxiety (33%), depression (17%), and autism (14%) (Abdelnour et al., 2022) Thus, it is imperative to get assessed by a professional who has a longstanding relationship with the patient, such as a patient’s regular doctor or a psychiatrist specialized in ADHD. Treatment is often a combination of behavioral family training, psychotherapy, mindfulness skill development, and medication. The medication prescribed is either stimulants or non-stimulants, with the former being effective for about 70% of patients (Magnus et al., 2023). Examples of the former would be amphetamine, often seen as Adderall or methylphenidate, commonly perceived as Concerta. For the latter, these would include guanfacine branded as Intuniv or atomoxetine under the name Strattera (Magnus et al., 2023). An adaptive education with the patient’s family and cognitive-behavioral training are used to develop emotional control and goal setting. As treatment is an ongoing process, a plan with clear goals needs to be continually evaluated with the patient’s family and their health care professionals to adapt to any changes in the patient for the management of their disorder (Magnus et al., 2023). An additional beneficial outcome is that when people are treated for ADHD, they are more likely to express positivity about the experience, encouraging others to be more open to getting diagnosed by a qualified clinician (Abdelnour et al., 2022). 

Using the Internet as a Self-Diagnosis Platform  

Nearly one third of US adults use the Internet for general health diagnosis (Plushcare, 2022). Although this is a seemingly high number, how an individual seeks help with their medical issues is dependent on the complexity of their own personality and goals (Pretorius, et al., 2019). Therefore, people will often seek information from multiple sources, of which the Internet is readily accessible for this purpose. Studies of youth who have grown up in a digitally inclined world have shown a multitude of reasons why this has come to be the case. Internationally, one in seven 10 to 19-year-olds suffer from a mental disorder, so it is understandable why many would reach towards this avenue of inquiry (Basch, 2022). In 2019, 82.5% of youth aged 18-25 used an Internet search for mental health concerns, while 12.1% used social media as their definitive source for information (Pretorius et al., 2019). They indicated that anonymity, ease of access, and a free cost of entry in a demographic that might not have the resources for professional care were the deciding factors for their browsing.  

However, there was a notable concern over the authenticity of the sources presented. Only 37% of youth found an internet search trustworthy, and 82.9% said simply seeing a trusted medical endorsement or references to scientific data before a resource would make it trustworthy (Pretorius et al., 2019). This expression of searching for one’s own health benefits and appreciating the honesty of the sources is shown to be “an important protective factor for young people’s mental health” (Pretorius et al., 2019). But how does one accurately assess the information they get from a general Google search? Although the Internet provides these factors it was deemed insufficient for meeting the mental health needs of the participants, and as such online information can “act as both a facilitator and a barrier to further help-seeking” (Pretorius et al., 2019). In a prophetic assertion, a 2018 study indicated that youth value the stories of peers who have similar experiences, as this lends a personal note to their concerns and allows them to learn at a pace that suits them. The researchers predicted that sites that did this, like YouTube, would grow over time in this aspect (Lal et al., 2018). Now, nearly all social media outlets feature some form of circulating mental health advocacy, medically backed or not.

The Rise of Social Media Use for Mental Health Inquiry  

Social media use has seen a significant proliferation over the past five years. The most notable platform to come from this rise is TikTok, a short-form video platform that found explosive popularity during the 2020 COVID-19 pandemic. TikTok now features 1.5 billion monthly active users and is the world’s most popular social media site in the adolescent and young adult demographic (Iqbal, 2023). With this growth came a similar rise in mental health concerns among youth, as the isolation of the global lockdown lent many to evaluating their own well-being. “Over the past ten years everyday demands have become far too much, especially since Covid, so it’s no wonder our brains have been stretched thin,” explains Ms. Coutinho. As a result, the number of posts that mentioned “mental health” went up 80.53% from 2019 to 2020 (Plushcare, 2022). This trend can be attributed to how social media provides social and mental reliability in troubling times (Abdelnour et al., 2022). As such, many beneficial movements like body positivity, acceptance of oneself, and the sharing of experiences and information of a multitude of mental afflictions have come from these sites. (Plushcare, 2022). These posts multiplied due to a series of reasons. Besides receiving positive feedback in the form of likes and comments, people wanted to learn more about a condition, reduce societal stigmas against it, form communities of support, and to encourage self-reflection about having a potential disorder (Plushcare, 2022).  

The posts under Chalene Johnson’s videos feature blanket advice for ADHD typically seen across most ADHD TikTok videos. She offers information on the disorder for adults and parents with no disclaimers or mentions of medical background. 780 thousand followers.

However, there are significant effects from learning about one’s own mental health from an indeterminably vast collection of non-regulated voices. A 2022 analysis of 500 TikTok videos with the #mentalhealthadvice and #mentalhealthtips hashtags was conducted by a group of medical professionals (Plushcare, 2022). Most of the content, approximately 83.7%, was found to be misleading. Additionally, 100% of the videos containing ADHD information had misleading elements. Over 54% of the advice was found to be sound, while 31% contained inaccurate and harmful information (Plushcare 2022). Furthermore, 91% of the creators of these videos did not have the pertinent credentials for the advice they were sharing and only 1% of videos had a disclaimer about a lack of medical background or to check in with a professional before the content was shown (Plushcare 2022). The majority of these videos had nearly 25 million views each. Examples of these videos are made by TikTok creators like Chalene Johnson and Connor DeWolfe. Although they can be entertaining, their videos about ADHD present generalized information that lacks specificity, frame the disorder as a kind of “superpower” neurotypical people do not have, and lack any medical disclaimers. Although a TikTok influencer only earns around $30 per one million views on their videos, they can earn hundreds of thousands of dollars per year from sponsored content or through the sales of their merchandise (Checkya, 2023). This can put an exploitative angle on the creation of mental health content through social media.

Connor DeWolfe’s videos often paint ADHD as a “superpower” and proclaim its effects as more beneficial and harmful. He often takes more of a humours approach to his content, which can be funny when viewed in a vacuum, but this can deter from any helpful information he may be sharing. His bio also features a link to his website, that simply sells merchandise and a “Mental Health” banner with links to the DSM classifications with no other sourcing or medical background on the page. 5.6 million followers.

How is This Harmful? Are There any Benefits?  

Although many social media posts about mental disorders can be shown in entertaining and perhaps even compassionate ways, the effects they cause can often be far from helpful. The misinformation and insufficient advice will often lead to a person misdiagnosing themselves, which can lead to health problems. It also stigmatizes the symptoms of ADHD like lack of attention, oversharing, and chronic misuse of time. (Plushcare, 2022). The posters sharing this content can lead one to waste time on information not relevant to them, purchasing products from influencers that are not guaranteed to help, and the delay or complete omission of seeking professional help (Plushcare, 2022). Repetitive long-term viewing of this content has also been shown to bring about negative mental health results, especially if it features harmful or triggering content such as self-harm or suicide (Basch, 2022). Making matters worse is a culture of purposefully self-diagnosing oneself to fit into a crowd. A 2023 New York Times article discovered that many youths are purposefully engaging in this debilitating practice, stating that having a mental disorder is “trendy” and “…considered a personality trait, rather than something you want to heal” (Caron, 2033). Ms. Coutinho references this herself, stating,  

“A self-diagnose of ADHD can be dangerous and misleading; it can prevent the person from pursuing an accurate and thorough assessment with a qualified family doctor or a psychiatrist ruling out other potential physical and mental health issues that impact a person’s attention and executive functioning. In addition, a person may experience appropriate sadness after, let’s say, losing a job or experiencing rejection, which is normal and appropriate human experience. Instead, self-diagnosing as clinically depressed can not only be misconstrued, but it can impact a person’s sense of agency and normalcy associated with a range of human emotions; the same is true for issues relating to attention.”  

The reasoning behind this seems to be an odd badge of pride and uniqueness among peers, but also a tangible way to describe themselves feeling different emotionally and wanting to know others who struggle in the same way (Caron, 2023). Although self-diagnosing is in itself harmful, aspects of mental health content can be beneficial for some. Many of these posts create a feeling of shared community which young people find meaning in, and the sheer amount of information and discussion about mental health has reduced the stigma across cultures (Basch, 2022). A 2022 study found that from over 100 mental health TikTok videos roughly 60% of the nearly thirty thousand comments were supportive of others in overcoming mental health challenges (Basch). In addition, there are professional clinicians with personal accounts that share their information on mental health. Dr. Hallowell, author of ADHD help books “Delivered from Distraction” and “ADHD 2.0”, is an example of this kind of practitioner. He regularly disseminates medically backed information on the disorder and directs his viewers to resources for further assistance.  

An example of a person on TikTok who posts beneficial content is Dr. Edward Hallowell, a distinguished psychiatrist in the ADHD field. He posts quick 60 second talks about ADHD with the hashtag #NedTalks, and links to helpful resources in his posts and his bio. 173.5 thousand followers.

The Need for a Professional Diagnosis  

Self-diagnosis and the consumption of mental health posts on social media pose a danger to consumers, especially those who are younger. Mental health professionals have noticed an increase in youth diagnosing themselves with mental disorders, leading to “avoiding a professional assessment and often embracing ineffective or inappropriate treatments” (Caron, 2023). This is exacerbated as the symptoms for mental disorders present themselves differently depending on age, a factor that is especially prevalent for ADHD (Caron, 2023). It is of importance to separate the patient from using the disorder as their whole identity, as it should be seen as the beginning of the path to understanding and getting proper treatment (Caron, 2023). As it is now, this over diagnosis epidemic in fact creates more barriers to clinical care and creates a harmful stigma to reaching out for professional help (Abdelnour et al., 2023). However, there are deterrents being placed in effect to help with this issue on platforms like TikTok and through calls for digital literacy from professionals. TikTok has invested in public disclaimers and guides to help people evaluate mental health advice online properly. However, there has been seemingly little impact from not only this approach, but the supportive messaging that is shared in these communities on social media as well (Basch, 2022). Instead, professionals suggest government and educational organizations should identify and display trusted resources through social media with links to resources and professionals who can help (Pretorius et al., 2023). There would also be easier access to peer-reviewed content made by professionals, in addition to reducing barriers for seeking professional help outside of social media to circumnavigate the issues of distrust of information and want for confidentiality. With professional help and accurate information, one can make effective decisions about their well-being and get the tailored help they can only get with meeting a clinician (Basch, 2022).

Information regarding TikTok’s influence on mental health as one of the world’s most used social media sites. Mental health creators on the platform post content without the proper credentials and positive feedback in the comments does not appear to contribute significantly to improving individuals’ mental health. (Created using Piktochart).

Conclusion

My success with my own ADHD diagnosis through my doctor is not just a one-off victory that should be thought of casually. In the face of the barrage of mental health information through social media, significant research shows the necessity of professional assistance for not just exploring a diagnosis, but the ongoing maintenance of one’s mental health. Although social media can contribute to misdiagnosis or attribution to incorrect descriptors, it is clear there is value in the anonymity, inclusivity, and mitigation of the stigma of mental health found on these platforms (Basch, 2022). However, this should be seen as more of a jumping-off point for one’s own introduction to seeking professional help, rather than a simple one-and-done self-diagnosis. While this may seem simple to initiate, there are still barriers to getting professional assistance. Under the Canada Health Act, all residents have access to a medical doctor without having to pay. However, mental health specialists, like counselors and psychiatrists, can cost up to $200 or more per visit (Rice, 2023). This can be a significant expense for most Canadians. In response, many political legislations like the Ontario NDP have addressed the issue, promising over $1.15 billion a year to make mental health care a universal coverage (Jones, 2022). Mental health concerns are being made far more commonplace, which can allow for those self-diagnosing in fear of not being able to afford proper assistance and the means to seek it. “There is a danger of self-diagnosing without the proper evaluative and thorough assessment by health experts,” Ms. Coutinho explains, “and that’s why we have psychiatrists and knowledgeable family physicians who spend years obtaining education, training, and professional experience to provide such help. Self-advocacy is important, as is the pursuit of assessments by qualified professionals instead of a TikTok 5 minutes self-assessment and landing at a self-diagnosis.”  

Paula Coutinho is a member of the Canadian ADHD Resource Alliance (CADDRA) and has worked as a registered clinical counsellor in Greater Vancouver for over 20 years. She supports and advocates for numerous individuals seeking resources for ADHD. She has completed graduate research on the intersection of mental health and technology.  

References 

​Abdelnour, E., Jansen, M. O., & Gold, J. A. (2022). ADHD Diagnostic Trends: Increased Recognition or Overdiagnosis? Missouri Medicine, 119(5), 467-473.  

Basch, C. H., Donelle, L., Fera, J., & Jaime, C. (2022). Deconstructing TikTok Videos on Mental Health: Cross-sectional, Descriptive Content Analysis. JMIR formative research, 6(5), e38340. 

Bobby, H., & Sandhu, A. (2023, May 3). ADHD on TikTok: Raising awareness or driving inaccurate self-diagnosis? BBC News. https://www.bbc.com/news/newsbeat-65457044 

Caron, C. (2022, October 29). Teens Turn to TikTok in Search of a Mental Health Diagnosis. The New York Times. https://www.nytimes.com/2022/10/29/well/mind/tiktok-mental-illness-diagnosis.html 

CheckYa. “How Much Money Can You Make on TikTok for 1 Million Views? [2023].” CheckYa Blog, 19 June 2023, checkya.com/blog/how-much-money-can-you make-on-tiktok-for-1million-views/.  

Iqbal, M. (2023, October 31st). TikTok Revenue and Usage Statistics (2023). Business of Apps. https://www.businessofapps.com/data/tik-tok-statistics/#:~:text=Source%3A%20TikTok%20Report- 

Jones, Allison. “Ontario NDP Promises Universal Mental Health Care; Estimate of $1.15B A …” National Post, Postmedia Network, 3 Apr. 2022, nationalpost.com/news/politics/ontario-ndp-promises-universal-mental-health-care-estimate-of-1-15b-a-year.  

Lal, S., Nguyen, V., & Theriault, J. (2018). Seeking mental health information and support online: experiences and perspectives of young people receiving treatment for first-episode psychosis. Early intervention in psychiatry, 12(3), 324–330. https://doi.org/10.1111/eip.12317 

Magnus, W., Nazir, S., Anilkumar, A. C., & Shaban, K. (2023). Attention Deficit Hyperactivity Disorder. In StatPearls. StatPearls Publishing. 

PlushCare Content Team. (2022, November 18). How Accurate is Mental Health Advice on TikTok? Retrieved from plushcare.com website: https://plushcare.com/blog/tiktok-mental-health/ 

Pretorius, C., Chambers, D., Cowan, B., & Coyle, D. (2019). Young People Seeking Help Online for Mental Health: Cross-Sectional Survey Study. JMIR mental health, 6(8), e13524. https://doi.org/10.2196/13524 

Rice, Megan. “How Much Does a Psychiatrist Cost without Insurance?” Talkspace, 10 Oct. 2023, www.talkspace.com/blog/how-much-does-a-psychiatrist-cost/#:~:text=According%20to%20Electronic%20Health%20Reporter,your%20care%20and%20therapy%20session.  

Individual interview was conducted with Dr. Paula Coutinho on November 13th, 2023 

TikTok Example Channel Sources: 

@chalenejohnson 

@connordewolfe 

@drhallowell