At first, guidance counselor Melissa Millington was baffled when more than one student at her Missouri high school claimed to have or showed symptoms of dissociative identity disorder, an exceedingly rare condition previously called multiple personality disorder, dramatized in movies like “Sybil” and “Fight Club.”
Not long after that development, it was Tourette’s syndrome. Students who had never showed signs of the neurological disorder before mimicked its signature involuntary movements or tics and barked or yelled in class.
These days, students who have never exhibited autism spectrum disorder are adamant that they have it—despite the lack of a professional diagnosis. One even brought notecards with instructions in case she suddenly became nonverbal at school—never a problem for her before, Millington said.
It didn’t take much detective work for Millington to figure out where her students were learning about these mental health and neurological conditions: TikTok, the same social media video platform where influencers hawk strawberry makeup or show off homemade baked feta pasta.
Tiktok is “their WebMD,” said Millington.
‘All they’re doing is adopting this label’
Teenagers’ interest in using social platforms to research mental health conditions and learning and thinking differences likely stems from the big questions that define adolescence, educators said.
“These students, they’re trying to find out who they are,” Millington said. “Because that’s what you do in the teen years, you’re trying to figure out: Where do I fit in society? Who am I going to be?”
But through TikTok and other social sites, some have made the leap from a developmentally appropriate search for identity to another signature teenage move: “’Oh, well, this sounds like fun. I think I’m gonna say that I’m dissociating in class, because I don’t want to do this algebra assignment,’” Millington said.
Classroom disruptions can be a big problem created by this self-diagnosis trend: Millington had to clear a room for two hours for the student who claimed to have multiple personalities, until she dropped the charade.
But students may also miss out on needed services for real conditions when they jump to the wrong diagnosis or decide to act out a syndrome they don’t have, educators and experts say.
Students may search for mental health information on social media sites if “they’re recognizing something in themselves that either they don’t like or that might be, like, wrong,” Millington said. “But if there is something [real] going on, they’re not getting the proper help. All they’re doing is adopting this label.”
Nearly two-thirds—65 percent—of district and school leaders and teachers surveyed by the EdWeek Research Center said their students “sometimes” or “frequently” use social media to diagnose their own mental health conditions.
An even higher percentage—68 percent—said students use social media to diagnose others’ mental health conditions. The nationally representative survey of 595 educators was conducted from Dec. 21, 2023, to Jan. 2.
Meanwhile, 55 percent of high school students who responded to a separate survey said they have used social media to diagnose their own mental health conditions at least once, including more than a quarter—28 percent—who said they do it “sometimes” and 10 percent who said they do it “all the time.”
Fifty-two percent of teens said they use social media to diagnose others’ mental health conditions, including 11 percent who say they do so “all the time.” The survey of 1,056 high schoolers was conducted from Feb. 9 to March 4.
The phenomenon is happening as early as elementary school, said Kristen Nye, a counselor at Anna P. Mote Elementary School in Wilmington, Del.
Recently, for the first time in her nearly two-decade career, she’s hearing 3rd, 4th, and 5th graders “say things like ‘I have anxiety’ or ‘I have depression,’” Nye said. “The amount of stuff that they’re aware of because of TikTok is insane.”
TikTok did not respond to questions from Education Week about the platform’s impact on children’s mental health.
The company told CNN last year that users can put safeguards in place limiting the amount of time they spend on the platform. TikTok has also removed numerous videos on suicide and self-harm.
“One of our most important commitments is supporting the safety and well-being of teens, and we recognize this work is never finished,” TikTok told CNN.
The U.S. House of Representatives recently voted overwhelmingly to force TikTok’s parent company, ByteDance, to sell the platform or face a ban, with some lawmakers citing its impact on youth mental health. It is unclear if the Senate will follow suit.
‘It feels so good to be seen’
On the positive side, social media has helped take much of the shame out of discussing mental health topics, which were considered taboo or at least TMI—too much information—not long ago.
In fact, 72 percent of educators say social media has made it easier for students to acknowledge mental health challenges, according to the EdWeek Research Center survey.
Many high school students agree. “I think a lot of the recent shifts that it’s OK to discuss mental health—discussing anxiety and depression—have been because of social media,” said Shreeya Gogia, a high school senior in Texas and a facilitator for the National Association of Secondary School Principals’ Student Leadership Network on Mental Health.
One social trend of the moment: posting five things that you struggle with that are related to mental health, Gogia said.
“A lot of the comments of the viral posts are people connecting, like, ‘Oh, yeah, I struggle with the same issue, too,’” she said. “‘And it feels so good to be seen.’”
Even with much of the stigma on mental health lifted, “a lot of people aren’t willing to have those conversations with their friends. So, seeing it on social media is an anonymous way to feel validated,” Gogia added.
But while a minute-long TikTok video may provide students with a brief introduction to what anxiety or depression looks like, it can’t paint a nuanced picture of those conditions.
“We’ve normalized coming to the counselor, that everybody needs help sometimes. And it’s OK to not be OK. I think social media has helped in that regard,” Nye said. But she added that content on anxiety, depression, autism, and other conditions without “proper education has kind of skewed their thoughts about” mental health and neurodiversity.
Finding ‘a buzzword that fits’
Adopting—and especially, internalizing—the wrong diagnosis could confuse students or lead them to seek inappropriate treatment, educators caution.
Recently, one of Nye’s students kept trying to find “a buzzword that fit” the serious mental health challenges they were experiencing, she said. The student “would say ‘Oh, maybe I need to talk to my doctor about being bipolar or about depression.’” Nye, however, thought the student’s symptoms were trauma-based.
Social media can make the situation worse: TikTok’s algorithm bases what users see next on the content they’ve already engaged with. That means that if a student thinks they might have, for instance, bipolar disorder, they can quickly wind up in a “bipolar wormhole,” where the platform constantly showcases videos about the condition, said Christine Elgersma, the senior editor of learning content strategy at Common Sense Media, which examines the impact of technology on children.
That could serve to confirm their hunch—even if it’s incorrect.
Autism self diagnoses may have caught on, in part, Millington believes, because students—particularly after the isolation of the pandemic—are finding that they have “trouble socially communicating with other people because everything they do is behind a screen,” she said.
She wonders if anxiety might be a more accurate diagnosis for some of those students. Or if it could “just boil down to teen years suck.”
While some of the people posting about mental health on TikTok are basing their advice on their own experiences or are citing research, others have an ulterior motive: personal profit, Elgersma said. That can be true even for influencers with real professional credentials.
“These people might be pushing a particular supplement, not because it has specific efficacy but because they’re making money, and they don’t have anybody’s best interests at heart necessarily,” Elgersma said.
That is the case even though certain supplements or medications showcased in popular TikTok videos might not interact well with a student’s underlying health condition or other medications.
And some of Millington’s students have even gone off their doctor-prescribed psychiatric drugs because a TikTok influencer told them a specific supplement would be as, or more, effective.
‘You have to check your source’
Millington has done some on-the-spot mental health media literacy. She’ll tell students, “Just like if you were going to do an English research paper, you have to check your source,” she said. “Is this reputable? Is it an actual doctor, hospital, [National Alliance on Mental Illness], things like that? Or is this just some person that’s got 7 million followers because they make a lot of content?”
Nye tells her students to check if the people they are getting their information from post bios with links to respected sites and whether their posts are sponsored.
She also asks them to examine whether an influencer posts about a variety of subjects—dance videos, funny trips to the dentist—alongside the occasional mental health testimonial.
Someone sharing on a broad range of topics “seems like a real person,” Nye said. And one who is “really focused [on a single topic] seems ‘sus,’ as the kids would say,” she explained, using Gen Z slang for “suspect.”
Educators shouldn’t flat out dismiss TikTok, Snapchat, Instagram Reels, or any social platform where students are getting their mental health advice.
That’s likely to make students “very defensive,” Nye said. In fact, she suggests educators—even those who are not fans of social media—"stay up to date with what app students are using to find out information,” she said. “It’ll help you make connections with kids.”
Educators also should be curious, Elgersma said. Why did the student connect with that content? What resonated?
And educators—with help from students—can also create the kind of content that they want teens to see on social media: videos with clear and accurate messaging about how to handle difficult moments.
Nye has already made an Instagram Reel showcasing her office and highlighting the kinds of mental health supports she provides to students.
Now, she’s working on “a dance one but, like, with cool mental health” information, she said. “Maybe we could be the voice of reason in all of this.”
Data analysis for this article was provided by the EdWeek Research Center. Learn more about the center’s work.
