网爆门

A young person sits across from you in a therapy session, eyes bright with certainty. 鈥業 think I have ADHD鈥�, they say. 鈥極r perhaps it鈥檚 autism? Or borderline personality disorder? Or dissociative identity disorder?鈥� They鈥檝e come to this conclusion, not after a clinical assessment, but after watching a 60-second TikTok video.

The increasing use of TikTok among adolescents appears to be shaping the way some young people engage with and understand their mental health. Many are encountering videos that describe symptoms of conditions such as attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), borderline personality disorder (BPD), and dissociative identity disorder (DID).¹ However, research suggests that adolescents鈥� self-diagnosis may be inaccurate, potentially influenced by misleading information viewed online.聽

Professionals at PlushCare, a virtual healthcare platform, analysed 500 mental health-related TikTok videos, and found that 83.7% were misleading.² While the impact of this phenomenon on the broader mental health landscape is becoming clearer, less is known about how it plays out in the therapy room. Are young clients bringing these self-diagnoses to therapy? How are therapists responding? And what effect does this have on the therapeutic relationship?聽

As therapists, we know the critical role the therapeutic relationship plays in effective therapy, and with the rise of self-diagnosing on TikTok, I have begun to wonder how this phenomenon is affecting that relationship. We often consider the factors that can hinder the therapeutic alliance, and I have questioned whether self-diagnosis might be one of them. Could it be that young people, when they鈥檝e decided they have 鈥榓 diagnosis鈥� based on what they鈥檝e seen on TikTok, may struggle to trust their therapist? If they鈥檙e getting so聽much of their information online, might they be less open to the therapist鈥檚 perspective, especially if it challenges what they鈥檝e already 鈥榣earned鈥� from TikTok? These questions led me to investigate how TikTok-inspired self-diagnoses might be impacting our therapeutic relationships with young people.

Through the voices of five therapists working with adolescents, this article explores how TikTok self-diagnosis is manifesting in therapeutic spaces. All participants have been anonymised to protect their identities.聽

The appeal of self-diagnosis: identity and belonging聽

Discussions with therapists revealed that for many young people, TikTok provides more than entertainment 鈥� it鈥檚 a space where they feel seen. Adolescents who experience feelings of difference or distress may see themselves reflected in videos about ADHD, autism, or other neurological or mental health conditions, leading them to believe these diagnoses apply to them.聽

One therapist shared, 鈥楢 lot of young people I鈥檝e worked with say, 鈥淥h my God, I鈥檝e seen XYZ on TikTok, someone talking about ADHD or autism, and I鈥檓 like, this is me, this is how I feel.鈥澛�

While this can be validating, therapists found that it was leading some young people to strongly identify with the diagnosis before fully reflecting on their personal experiences. Erikson鈥檚 theory of identity development provides a valuable framework for examining the phenomenon of self-diagnosis in the context of TikTok. According to this theory, individuals advance through eight developmental stages, marked by conflicts pivotal to growth.³ These conflicts centre on either effectively nurturing, or failing, to cultivate crucial psychological attributes. Within this psychosocial framework, self-diagnosis may exacerbate what Erikson terms 鈥榠dentity distress鈥� during the 鈥榠dentity versus role confusion鈥� stage, which coincides with adolescence. This stage is characterised by individuals seeking to establish a sense of self and identity, and achieve independence, while identity distress results in prolonged uncertainty.聽

Researchers have acknowledged that exposure to diverse people and ideas through social media can overwhelm individuals with an overload of messages, potentially delaying identity formation.⁵ In relation to self-diagnosis, this suggests that exposure might heighten identity distress, and impede the development of a definitive identity.

Erikson argues that the search for individuality is especially strong during adolescence. He points out that young people explore various extremes before making decisions about their path. Consequently, adolescents engaging with TikTok may encounter extremes, precisely when they are most receptive to them, potentially explaining why they identify with extreme mental illnesses.聽

Psychologist James Marcia, known for his work on identity formation and the expansion of Erikson鈥檚 theory, explains how individuals navigate the complexities of identity formation.⁴ He proposes that adolescence is charactered, not by a state of identity resolution or confusion, but by the degree of exploration and commitment to various identities. Marcia classifies adolescence into four identity statuses 鈥� 鈥榠dentity diffusion鈥� refers to lack of commitment to any identity, often with minimal exploration. 鈥楩oreclosure鈥� is commitment to an identity without thorough exploration, often conforming to external influences. 鈥楳oratorium鈥� describes active exploration without firm commitment, while 鈥榠dentity achievement鈥� signifies successful resolution of the identity crisis through exploration and commitment.聽

In the context of self-diagnosis via TikTok, the immediacy and definitiveness of online content may encourage individuals to adopt diagnoses as part of their identity, without critically evaluating their experiences or exploration of alternatives. This may hinder the development of a coherent and authentic sense of self, trapping adolescents in the foreclosure stage of development.聽

Therapeutic exploration聽

This theory emphasises the importance of therapy to help adolescents explore their identities, and critically engage with what they encounter on TikTok. Based on interviews with therapists, the consensus was that adopting an open and non-judgmental approach is essential when addressing self-diagnosis influenced by TikTok. They emphasised the importance of allowing clients to explore their self-diagnoses without fear of dismissal. Some invited clients to share the TikTok videos in session, demonstrating interest in their perspective and fostering trust. This approach helped young people feel understood, while also creating an opportunity to analyse the content, question its accuracy, and differentiate between personal experiences and clinical diagnoses.聽

Therapists highlighted the importance of first understanding the client鈥檚 world, and validating their experiences before introducing psychoeducation. Once trust was established, they found it helpful to discuss topics such as TikTok鈥檚 algorithm, the complexities of diagnosis, and the risks of self-diagnosis. Additionally, guiding young people to focus on their own emotions and sensations, rather than identifying with broad online descriptions, was found to raise awareness about the risks of identifying with conditions suggested online.聽

Reflecting on these insights, it is important to acknowledge that TikTok is an integral part of young people鈥檚 lives. Dismissing it as an unreliable source, risks alienating them and stifling important conversations. At the same time, it鈥檚 essential to help young people recognise that much of the information on TikTok can be inaccurate or misleading, and that those sharing it may not be trained professionals. We can direct them to credible sources, recognising that TikTok also features respected professionals, thus helping young people to navigate the platform more critically, and connecting them with reputable, well-respected mental health experts.聽

The algorithm knows you better than you do聽

TikTok is not just a social media platform; it鈥檚 a powerful recommendation engine due to algorithms. These are data-processing techniques that analyse user behaviour to deliver personalised content to our screens. Once a user engages with mental health-related content, the algorithm continuously feeds them similar material, reinforcing specific narratives, and sometimes leading adolescents to over-identify with certain conditions. A therapist witnessed this firsthand, and shared with me an observation about their client, 鈥楾hey had instinctively thought about self-harm, then looked up content around it. Then the algorithm kept suggesting more of the same, and was almost suggesting ways of self-harming. It became a dangerous cycle.鈥櫬�

This highlights the powerful role TikTok鈥檚 algorithm plays in intensifying focus and negative patterns of behaviour. Therefore, given that many young people turn to TikTok as a source of mental health advice, psychoeducation plays a crucial role in a therapist鈥檚 work, helping adolescents to navigate online mental health content more thoughtfully. However, to effectively incorporate psychoeducation, we must have a solid understanding of how TikTok operates and the impact of its algorithm, enabling us to explain these dynamics clearly to our clients.聽

One therapist further observed that engagement with self-harm content was often tied to a sense of community. For example, a young person influenced by online content might seek a sense of belonging by mimicking the behaviour, in order to fit in with the online community. This highlights how TikTok can serve as more than just a platform for seeking a diagnosis; it emphasises the importance of understanding the underlying needs, such as the desire for connection. In such cases, it may be helpful for therapists to suggest other healthier, supportive communities for young people to connect with. For example, we could suggest content related to their other interests, so the algorithm curates more content around that topic, allowing the young person to discover a supportive community that shares their passion. This way, they can still connect with like-minded individuals online, but in a more constructive manner.聽

The challenges聽

The therapists I spoke to reported concerns about the way struggles are presented on platforms like TikTok, where generalised descriptions can lead young people to misattribute common experiences to clinical disorders. One therapist shared an example of a client who experienced fluctuating emotions and heightened moods throughout the day, and after turning to TikTok, decided these feelings pointed to borderline personality disorder. The therapist noted that this initially impacted the therapeutic relationship, as the client, strongly convinced of their self-diagnosis, was resistant to exploring alternative perspectives. However, most therapists viewed this as a natural part of the therapeutic process. Their experiences suggested that while young people often began therapy seeking confirmation of their self-diagnosis, the focus gradually shifted beyond the label, to explore their lived experiences and the underlying emotions that brought them to therapy in the first place. In essence, while a client鈥檚 strong belief in their self-diagnosis could add another layer to navigating the therapeutic relationship, this did not create long-lasting challenges. Therapists saw it as simply part of their client鈥檚 world, which naturally found its way into the sessions.聽

TikTok as a gateway to therapy聽

While concerns exist about misinterpretation of symptoms based on social media viewing, interviews with therapists revealed that self-diagnosis plays a key role in getting young people through the door of the therapy room, and encouraging deeper engagement in therapy once they鈥檙e there. One of the most striking insights from therapists was that TikTok is prompting young people to seek professional help when they might not have otherwise done so. Adolescents might come across mental health-related content, recognise elements of their own experiences, and start questioning, 鈥楧o I have this?鈥� This self-reflection can be the push they need to reach out for support.聽

As one therapist put it, 鈥業t gets people to ask for help and be like, 鈥渢his person [on TikTok] said stuff that I can really relate to, and I feel like I need to talk to someone and get some support [around that].鈥濃�櫬�

Instead of dismissing these self-diagnoses outright, therapists found that exploring them with clients helped to build trust. By validating their experiences and working through their concerns together, therapy became a space where young people felt heard rather than judged. Beyond just bringing young people into therapy, self-diagnosis was also found to strengthen the therapeutic process. Many therapists described a sense of camaraderie in the therapy room when clients arrived having done their own research. Rather than feeling lost or disconnected, these clients often felt more prepared to engage in meaningful discussions about their mental health.聽

Another therapist I interviewed, observed this dynamic firsthand. They said, 鈥榊oung people almost feel like, 鈥渙h, we鈥檙e all in this together. I know what this is.鈥� So, there is a sense of, 鈥淚 must tell the therapist鈥� I鈥檝e done my homework.鈥濃�� This sense of ownership over their own mental health journey meant that adolescents were often more engaged, more self-aware, and more motivated to work through their challenges.聽

Ultimately, therapists found that embracing discussions around self-diagnosis fostered stronger therapeutic relationships, and helped young people feel empowered in their mental health journey. Rather than seeing self-diagnosis as a hurdle, it can be viewed as an opportunity 鈥� to engage, connect, and help young people explore their struggles in a meaningful way.聽

The role of therapists in digital spaces聽

The widespread influence of TikTok on young people鈥檚 mental health narratives, and concerns about misinformation online, raise questions about whether we should be actively engaging with these digital spaces ourselves to correct the inaccuracies. However, the therapists I spoke to expressed hesitancy about joining platforms like TikTok, in terms of boundaries. A key concern was the risk of clients discovering their therapists on social media, potentially blurring traditional therapist-client boundaries and raising ethical questions. These social media challenges make it unclear where professional guidance ends and personal exposure begins, highlighting the need for clearer guidelines for therapists navigating digital spaces from professional bodies such as 网爆门. Without well-defined boundaries, there remains a significant risk of boundary-crossing,⁶ whether through clients accessing personal information about us or by misinterpreting online interactions.聽

Embracing the digital age of therapy聽

The popularity of TikTok is undeniably shaping the way young people understand their mental health and approach therapy. While it presents challenges, the benefits are apparent. TikTok is serving as a gateway for many young people to seek therapy, and providing an opportunity for deeper engagement and growth. As therapists, our role is to embrace its influence in a way that enhances the therapeutic relationship, helps clients to critically examine the content they consume, and create a safe space for self-exploration. Rather than attempting to remove TikTok from the therapeutic process, we should find ways to work with it, helping our clients to discover their own voices amid the noise.聽

However, this also raises an important question about the young people who are not seeking therapy. If TikTok is their primary source of mental health information, what is the impact when that information is inaccurate or misleading? This highlights a potential area for intervention, particularly for therapists working in schools. Could discussions about how mental health is presented online become part of school assemblies or educational programmes? Encouraging young people to approach social media content with a critical eye could help bridge the gap between online discourse and professional support, ensuring that they are not navigating their mental health journeys alone.聽

网爆门 Children, Young People and Families, June 2025