Virtual Checkup Doesn't Check Out

By Ivy Song, M.D., Eunice Y. Yuen, M.D., Ph.D., and members of the Child Psychiatry Committee at the Group for the Advancement of Psychiatry

Alexis is a 13-year-old girl navigating the intricate landscape of adolescence. Her early home life was characterized by neglect and domestic violence, leaving emotional scars that are now expressed in various ways. Alexis has symptoms of complex trauma, including difficulty concentrating, intrusive thoughts, irritability, impulsivity, anxiety, trouble forming close relationships, and social awkwardness.

As she tries to make sense of complex emotions and behaviors arising from past trauma, TikTok has become her canvas for self-diagnosis. After hours of searching TikTok videos and YouTube channels discussing mental health symptoms and diagnoses, she diagnoses herself with autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD).

Through a series of candid TikTok video posts, Alexis began sharing her personal struggles and how she deals with them, attributing her problems to ASD and ADHD. The online community responds with a mix of support and skepticism, with viewers weighing in on her self-diagnosis journey. Some relate to Alexis’ experiences, forming a virtual support network; others express concern about self-diagnosis without professional guidance. Nevertheless, Alexis’ symptoms remain concerning to her, even after self-diagnosis, and she becomes more confused and hopeless about finding answers to alleviate her mental distress.

Adolescents increasingly seek insights into their emotions, thoughts, and behaviors using social media platforms. Alexis is deeply immersed in the digital world, spending much time on social media. Her challenges in daily functioning and difficulties establishing social connections prompt her to look for answers, support, and a sense of belonging within online communities.

However, Alexis may come to believe she has disorders she does not have. The complex trauma she experienced led to a range of symptoms that are broad and non-specific. Thus, some of her trauma-related symptoms might resemble ADHD and ASD, which might seem a good fit to those without specialized training. Misinformation may get in the way of getting the treatment she needs.

Why Teens Self-Diagnose

Increasingly, people turn to the internet with questions about mental health; social media apps like TikTok, forums like Reddit, and AI-powered apps offer ways to self-diagnose. Adolescents are not immune from this phenomenon.

Adolescence is characterized by self-exploration, identity formation, and a need for social belonging; it is also when some mental health disorders first emerge. Therefore, adolescents have many reasons to explore questions about feelings, relationships, and behaviors. Given that today’s adolescents generally spend much of their lives online, their primary sources of information are often social media platforms.

In addition to information, social media platforms also may provide a sense of community, allowing people to feel connected and accepted. Some individuals may gravitate towards mental health diagnoses offering a sense of community or belonging, one example being the “neurodiversity” movement.

Another reason teens like Alexis turn to the internet is difficult or negative past encounters with the medical system and mental health treatment. Such experiences could reinforce a tendency to avoid healthcare systems and self-diagnose.

Why Self-Diagnosis Is Potentially Problematic

A 2024 study of more than 1,000 high school students showed that 55% of teens used social media to diagnose their mental health conditions. Teens most commonly self-diagnose attention deficit/hyperactivity disorder, autism spectrum disorder, obsessive compulsive disorder, tic disorders, anxiety disorders, and dissociative identity disorder. Self-diagnosis could be influenced by what is seen on social media or what their friends are talking about. Teens may be inundated with information from social media influencers who highlight some mental health diagnoses, unaware of other possible diagnoses.

Self-diagnosing behavior is problematic because mental health conditions are difficult to diagnose for a number of reasons:

• Individuals may have more than one diagnosis;
• Different diagnoses may have overlapping symptoms;
• A single diagnosis may manifest with a variety of different behaviors.

Disentangling normal adolescent developmental issues from serious mental health problems is complex and requires thorough evaluation by professionals, rather than a checklist of symptoms. Symptoms of trauma can resemble other mental health conditions such as ADHD. A trained expert is often required to make an accurate diagnosis.

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What Teens, Parents, and Clinicians Should Know

What Teens Should Know

• Understand the process of diagnosis and treatment.
  • Signs and symptoms associated with certain psychiatric conditions could be complex; diagnosis may be not straightforward.
  • Effective treatments depend upon accurate diagnosis and should be personalized, based on specific symptoms and life situations. There is no “one size fits all” solution.

• Seek reliable sources.
  • While peer support matters, appropriate assessment and treatment options are more reliably provided by licensed professionals.
  • Reach out to trusted adults: parents, extended family members, coaches, school counselors, primary care providers, or teachers.

• Beware of turning to the internet for self-diagnosis.
  • Trolling, harsh criticisms, and cyberbullying occur in the virtual world. These can erode self-esteem and be traumatic, increasing vulnerability.
  • Normal human suggestibility may lead to identifying with a specific diagnosis or even producing or intensifying symptoms that were not problematic before.

What Parents Should Know

• Avoid using specific mental health diagnostic terms at home.
  • Don’t describe mood swings as “bipolar,” because this may be an inaccurate diagnosis.
  • Don’t use pejorative terms such as referring to behaviors that seem out of control as “crazy.”
  • Labeling behaviors may hurt a teen's feelings.
  • Teens might mimic parental behavior and start self-labeling.
• Pay attention if a teen is self-labeling with diagnoses.
  • An adolescent could be trying to communicate something important.
  • Parents observing symptoms and potential mental health problems should seek professional mental health care for teens.
  • When parents do not notice symptoms, teen concerns should not be dismissed. They might reflect deeper issues not yet shared.
  • Avoid critical and speculative conclusions such as “you are making excuses not to work” or “you are just being lazy” or “manipulative.” These may cause teens to feel misunderstood and shut down communication.
• While parents cannot control who teens follow on social media, they can suggest following licensed professionals.
  • Some influencers on social media, like licensed psychiatrists and therapists, share more accurate information than do non-professionals.
  • Encourage open discussions at home. What have teens seen on the social media accounts they follow? How did it affect them? How do they relate content to themselves?

What Clinicians Should Know

• Collaborate with schools to provide accurate education about mental health conditions, mental health care access, and resources to students, teachers, and parents.
• Collaborate with community organizations, local religious institutions, and other groups to provide broader mental health education for parents and caregivers.

Conclusion

Self-diagnosis in teens is on the rise, driven by multiple factors, including easy access to online information, increasing awareness of mental health conditions, and the potential to find community and connection on the internet.

While social media platforms offer community and support, they can also lead to misinterpretation of mental health symptoms and inaccurate diagnosing of mental health conditions.

Clinicians can help discourage self-diagnosis by promoting awareness of the diagnostic process and encouraging reliance on licensed professionals for accurate assessment and treatment. Parents can support teens by avoiding critical language, listening empathically, and fostering open discussions about mental health. Together, parents and mental health professionals can help ensure that teens receive appropriate care in today's digital age.