TikTok has been called the therapist’s couch of Gen Z. But not all the #mentalhealth info checks out

It’s “scroller beware” on #mentalhealth TikTok, where content ranges from informed to misleading, and has the potential to be both helpful or harmful, mental health caregivers say.

Jonathan Shedler, a psychologist and clinical professor of psychiatry at the University of California, San Francisco, says he’s concerned about the quality of mental health information on social platforms.

“Unfortunately, what we now have is a lot of people who are representing psychology … who are influencers or digital marketers, who are not serious psychotherapists,” said Shedler, who holds a PhD in psychology from the University of Michigan.

“And as flashy and appealing as the messaging is … it’s really not a good source of information.”

Social media has been called the psychiatrist couch of Gen Z. There’s a seemingly bottomless well of self-proclaimed experts on platforms like TikTok and Instagram sharing content about how to establish boundaries, cope with being triggered, identify toxic behavior and sever ties with a narcissist.

Many mental health professionals have praised TikTok for destigmatizing mental illness and helping people who don’t have access to therapy. But the platform has also been criticized for encouraging self-diagnosis, over-using labels and for legitimizing misinformation.

More than half misleading

A study published by UBC in early 2022, found that, of the 100 most popular TikTok videos about ADHD, more than half — 52 per cent — were misleading. Another 27 per cent were found to be based on personal experience alone — as opposed to clinical expertise or research — and 21 per cent were classified as useful.

The report also found that the majority of the “useful” videos were created by health-care professionals.  

Shedler concedes that some could find value in such content — people who, for example, don’t realize they are on the autism spectrum or that they’re struggling with the symptoms of ADHD.

“If that’s a gateway to looking into it in a serious way, you know, with a professional, then it’s a good, helpful thing,” he said.

“I think we get into a problem when people are getting into the business of self-diagnosis, or letting some stranger social media influencer who’s never even met them give them a diagnosis. It’s not helpful to anyone.”

Courtney Tracy, a licensed clinical social worker in California, who posts online as “The Truth Doctor,” said she sees it a little differently.

Tracy, who holds a doctoral degree in psychology from California Southern University, said she shares the concern about pathologizing normal things, and labelling people arbitrarily. 

“At the same time, it is clear that we have been searching the world for language to describe our pain, and for so long that language was only pathologized and classified and stuck in a book,” she said.

If they learn some of that language on TikTok or Instagram, she asks, what’s the harm?

“You know, they’re not taking their own diagnosis and using that for claims for their insurance company or to get medications.”

Jeff Guenther, a licensed professional counsellor in Portland, Ore., said he’s not that concerned about unqualified people sharing mental health content online. He creates content for TikTok and Instagram as @therapyjeff. 

It may be a bit of a hot take, he says, but he believes “a lot of people that are on TikTok are really good critical thinkers, where they can look at a video and understand if this is a professional or not.”

Aesthne Hinchliffe of Chester, N.S., said they hope that’s the case.

But as someone whose therapist has helped them cope with grief and anxiety, Hinchliffe said they do have some concerns about some of the information they see on social media — particularly if it’s not held to any scrutiny.

“I guess my hesitance might be if people are maybe not digging further, maybe not seeing where the information is coming from, who is the source?” 

Hinchliffe said they prefer a more targeted approach to consuming mental health content, like listening to a reputable podcast, or following specific practitioners on social instead of scrolling through everything under hashtags like #mentalhealth or #therapytok.

But overall, they said, having so much discourse about mental health on social media is a positive thing, contributing to more candour about mental well-being in recent years.

“I would have been much less open about, you know, ‘Oh, I have a therapy appointment today’ 15 years ago. Now. I have no shame about saying I have a therapist.”

Hinchliffe said the social media discourse helps frame caring for one’s own mental health as being as important exercising or eating well.

Ignores wider contributing social issues

But P.E. Moskowitz says they have concerns about the emerging “diagnosis culture.” Moskowitz, a New York-based writer, runs a Substack publication called Mental Hellth, which challenges mainstream narratives around mental illness.

They say this discourse focuses on individual effort as opposed to collective responsibility. That leaves aside the broader public policy and societal issues that are so entwined with our mental wellness — or lack thereof, they said. 

Some people may be struggling in life because their wage is too low and rent too high, Moskowitz said, “but they internalize that by saying, ‘Oh, it’s just because I have XYZ disorder,’ then that kind of lets everything else off the hook.”

“And that’s really sad to me because it ignores how society does disable us. It ignores how society is the cause of our struggles.”

Another issue is the so-called weaponization of “therapy-speak” — whether that means someone calling any difference in opinion “gaslighting” or, as Moskowitz has observed, when a person’s diagnosis is used as “a kind of currency through which people dig their heels into the sand and can’t understand what anyone else is saying.”

Gaslighting describes a kind of psychological abuse where a victim is made to question the validity of their thoughts or their perception of reality.

Guenther said he agrees it’s “gross” and unhelpful when those terms are overused.

Still, even if the words are used clumsily or aggressively at times, Guenther said it’s a learning curve.

“I love to see that people are trying to use more therapeutic language,” he said. “I’m also old enough to remember that in the ’80s and ’90s it wasn’t called ‘therapy-speak.’ It was called ‘psychobabble.’

“And if you ever talked about your feelings, you were immediately told that you were doing some form of psychobabble, which dismissed you immediately.”