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HealthTikTok

‘Munchausen by Internet’ and the dangers of self-diagnosing mental health issues on TikTok

Sophie Mellor
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Sophie Mellor
Sophie Mellor
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Sophie Mellor
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Sophie Mellor
Sophie Mellor
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September 4, 2021, 10:00 AM ET
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Down the rabbit hole that is mental health TikTok—a place where people with disabilities and mental illnesses can come to vent, joke, and relate to others about the troubles of what it means to exist with a disorder or disease—you will be asked a series of questions to see where you might fit in.

Do you feel restless? Do you find it hard to pay attention and often interrupt others while they’re talking? Do you have trouble maintaining relationships? Then you might have ADHD, these videos say.

Do you think everyone is judging you? Are you a perfectionist and a people pleaser? Do you avoid eye contact? Then you might have anxiety, they say.

Do you feel disconnected from the world around you? Or are there multiple living beings inside your one body that you can’t control? Then it could be dissociation, dissociative identity disorder, or maybe bipolar disorder, according to the videos.

As mental health awareness improves, there comes a troubling trend of young people diagnosing themselves with a mental illness, which can be a mood, personality, or anxiety disorder, but can also range to disabilities like autism or Tourette’s. And while some may relish finally being able to relate to feelings that they’re having, others might be creating new problems in their own minds.

This is mental illness and disability appropriation: the perfect marriage between the rise in mental health awareness in the midst of an 18-month–long pandemic and the unabating teenage desire to be different and unique.

Where it started

Mental health has never been so openly discussed. And a lot of this is driven by a generational shift.

Generation Z faced school closures, fragmented social structures, and increased levels of depression and anxiety, which all came along with a period of isolation that kept them glued to their phones. A recent survey by Mental Health America found that 54% of kids between the ages of 11 and 17 reported frequent suicidal thoughts or self-harm in the previous two weeks—the highest rate since it began screening in 2014.  

Mental illness had the perfect breeding ground in which to propagate. As a result, people went online to vent, and mental health–related content on places like TikTok took off—providing a sense of community and belonging to people suffering from these afflictions.

People who have ADHD flocked under #ADHD to vent about the troubles of zoning out, their need to release sudden bursts of energy, or even how their lack of object permanence contributed to the challenges of managing clutter. Under #depressedtok, people posted videos of finally cleaning up their rooms after being too lethargic to deal with it for months.

Using YouTube, Tiktok, and other social media as a tool for those with mental health issues is “brilliant” says Jessica Jayne, a YouTuber and spokesperson for Mind, a mental health charity based in the U.K. “It’s basically a peer support group online,” she says.

And it is a good thing. Rosie Weatherley, information content manager at Mind, says people sharing their own experiences of mental health problems is “hugely important,” as it can prompt others “to share their own experiences, or seek help, especially if it’s someone high-profile.”

However, she does warn that sharing mental health online is great—“as long as it’s made clear that it’s an individual’s personal experience, and doesn’t constitute medical advice or expertise.”

‘Munchausen by Internet’

The viral potential of mental health posts and the extolling of mental illness and disability has spurred on some fakery, which Marc Feldman in 2000 coined as “Munchausen by Internet.”

It ranges from misinformation like TikTok’s “People who you didn’t know had autism,” making loose claims that Anthony Hopkins and Lionel Messi both suffer from the disability, to videos of people actively “having panic attacks” behind specially curated ring lights.

One common culprit is Tourette’s, which has been in the limelight owing to the rising number of reports of people, especially female teenagers, “catching” the disorder after watching videos online. In March 2021, a letter to the British Medical Journal found the number of expected referrals for Tourette’s had doubled in the past few months and warned of a spike in tic disorders among teenage girls.

The teenage girls reported they had increased their consumption of such videos prior to symptom onset as well as posted videos and information about their Tourette’s movements on social media sites. “They report that they gain peer support, recognition, and a sense of belonging from this exposure. This attention and support may be inadvertently reinforcing and maintaining symptoms,” the researchers wrote.

Similar reports of rising cases were found in Texas and Alberta, Canada, which led an academic article to dub the phenomenon “a pandemic within a pandemic.”

The downsides and upsides of self-diagnosing

Self-diagnosing as a concept is dubious. People note that diagnosis of mental health disorders has historically been the privilege of white, upper-class people, so excluding someone from diagnosis is not only ableist but also classist, sexist and racist.

if you're white saying that "self diagnosis is bad" you're both racist and classist in one swoop

— 💜 pikmin yaoi 💜 (@asterysms) July 20, 2020

Experts tend to agree. Weatherley of Mind says, “It’s really important if we’re using language like ‘self-diagnosis’ that we don’t downplay the valid and real experiences of people who aren’t able to access appropriate health care,” whether that’s because of cost, waiting lists, prejudice, or not being taken seriously.

Feldman calls individuals with “Munchausen by Internet” both “troubling” and “troubled,” in Vice. People who claim to have a mental illness or disability are still suffering, although from a condition different from the one they adopt. He also said false claims subject actual sufferers to skepticism and condemnation.

Some groups are out for blood. Subreddits like r/fakedisordercringe, which has long been dedicated to outing posers online, polices illnesses in a way that often verges on bullying and has led to doxxing—posting someone’s, often young kids’, private information online.

The market is also trying to self-correct, with a number of mental health professionals going viral online to combat misinformation and educate young people about mental health.

In the end, experts say, this phenomenon may be a positive sign of a culture more open to mental illness and disability. A problem like this can only occur at a time in which people are ready to talk openly about mental health.

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Sophie Mellor
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