When it becomes risky for teens to diagnose their mental health online

A girl looks down at her phone as she scrolls TikTok.

This scenario probably sounds familiar to teens who spend any amount of time online: A high schooler worried about their well-being, noticing symptoms like increasing sadnesses or withdrawal, turns to the internet and social media for answers, only to feel more lost afterward.

Perhaps their favorite influencer posted a TikTok about a new mental health diagnosis they received, and all the symptoms match what the high schooler is experiencing. The teen might assume they, too, have obsessive-compulsive disorder or complex post-traumatic stress disorder.

Further googling may convince them this is the case. Or perhaps the influencer's next video focuses on how certain types of behavior are, in fact, a "trauma response," and the high schooler relates to the examples, exacerbating any sense that they're a broken person.

Suddenly, the teen feels like they understand themselves better, but they also likely have no real direction or support for what comes next. The self-diagnosis of conditions and behaviors may come to define them, even if they've never seen a mental health professional or received care. Rather than feeling empowered, they might instead experience hopelessness and heightened anxiousness, while also limiting their understanding of their feelings under the assumption of a specific condition.

While there are benefits to having access to mental health information on the internet, teens may be particularly vulnerable to the risks of self-diagnosis — especially when seeking answers from unreliable sources and digesting information from a vulnerable position. A new book authored by the nonprofit advocacy organization Mental Health America aims to steer teens away from that possibility.

Where to Start: A Survival Guide to Anxiety, Depression, and Other Mental Health Challenges offers basic definitions of common conditions, in language that's accessible to younger readers. It also provides resources for seeking treatment and support.

"It's not to knock the other things that are out there on the internet, but the reality is that anybody can go online and create something that says, 'These are the things that maybe you should be looking at,' and it may not be the best information," says Dr. America Paredes, Chief Social Impact Officer for Mental Health America.

Why it's so tempting to self-diagnose using the internet

There are many reasons why adults and teens alike consult the internet and social media to answer mental health questions. Healthcare is inaccessible and unaffordable for many, and inconvenient and intimidating for even more. Mental health professionals often don't even accept insurance, and out-of-pocket treatment can cost upwards of $200 per hour, depending on where they practice.

But that assumes seeking professional care is the goal. Someone who's expecting to face stigma and judgment for experiencing mental health challenges may instead try to cope on their own, using the internet as their guide.

Indeed, this initially works well for many, especially teens who may feel shy about sharing their struggles with friends or family members. What they often get online, says Paredes, is validation of their experiences, which can be a tremendous relief if they've felt isolated and alone.

"We know youth are looking for information," she says. "When we go searching for something, on the internet, on social, you will find something that validates whatever you're feeling."

"When we go searching for something, on the internet, on social, you will find something that validates whatever you're feeling."
- Dr. America Paredes, Chief Social Impact Officer for Mental Health America

Paredes notes that this dynamic intensifies on social media, because the algorithm "provides you something that really supports whatever you're looking for." Consider how following one influencer on a certain topic, like anxiety, opens the algorithmic door to numerous other social media accounts of varying quality.

Seeking and feeling validation from social media mental health content isn't necessarily bad. After all, plenty of creators and their followers find it empowering and helpful to talk about their lived experience with mental health conditions.

Yet, being part of the audience can also stop youth from reflecting on what they should do next. They may become an observer to an influencer's mental health journey instead of beginning their own.

Similarly, when creators and influencers use phrases like "trauma response" to describe behavior a teen thought was normal, like staying busy all the time or spacing out, a teen might start to feel uncertain or worried about their well-being in cases when that might not be warranted.

While childhood trauma is actually widely prevalent, according to research, much of the social media content about "trauma responses" doesn't point youth to actionable, science-based information about how to learn more about that phenomenon. Some creators may even use that phrase to rank higher in the platform's algorithm, a possibility that may not be clear to teens.

What to do instead of diagnosing yourself

Paredes recommends that teens pause and consider what they're seeing online before they integrate that information into their identity, which can include claiming a diagnosis without being evaluated by a mental health professional.

"It can be useful as a guiding step to finding important...information, but again you have to be very conscientious of how this language is being used and how you're interpreting it," says Paredes.

Once a teen has reflected on what they've seen, they can start thinking about potential next steps. Paredes says this may include taking one of numerous mental health screening tests developed to identify conditions like depression, anxiety, bipolar disorder, and eating disorders.

Mental Health America's website hosts its own collection of evidence-based screeners. In 2022, nearly 40 percent of those who completed a screener in the U.S. were under 18. Paredes stresses that screeners do not provide a diagnosis but instead offer clarity about whether a person may be experiencing symptoms of a clinical disorder or condition.

Teens should also beware of completing online tests or quizzes provided by for-profit companies. A popular "childhood trauma test" that circulated on TikTok last year ended up being a way for a private company to capture user data and potentially share it with third parties.

Once a teen has completed a screener, Paredes recommends talking to a trusted adult about the results. While a minor will need parental permission to pursue a medical evaluation, they can still talk to a relative, coach, teacher, or another adult if they don't feel comfortable discussing the subject with their parents or caregivers.

When the screener doesn't indicate that a teen is experiencing a mental health condition, they should still consider talking about their concerns rather than dismissing them. In general, Paredes says "warmlines," or listening lines offering connection with trained peers and mental health advocates, can offer emotional support when a caller isn't in crisis. (The website warmline.org has a directory of warmlines by state.)

Where to Start, the new book authored by Mental Health America, also contains recommendations and worksheets for further exploring mental health challenges and treatment. Paredes is hopeful that it will give teens an alternative to troubleshooting their concerns online, where there's plenty of information but often little direction.

"The decision to maybe request help, and ask for help, and then ultimately receive help in some way — not just from a professional but from other folks in your life — that's the stuff that's not really shared on social," says Paredes. "We don't see that as often, but I would love to see that."

If you're feeling suicidal or experiencing a mental health crisis, please talk to somebody. You can reach the 988 Suicide and Crisis Lifeline at 988; the Trans Lifeline at 877-565-8860; or the Trevor Project at 866-488-7386. Text "START" to Crisis Text Line at 741-741. Contact the NAMI HelpLine at 1-800-950-NAMI, Monday through Friday from 10:00 a.m. – 10:00 p.m. ET, or email info@nami.org. If you don't like the phone, consider using the 988 Suicide and Crisis Lifeline Chat at crisischat.org. Here is a list of international resources.

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