How mental health became a social media minefield
When I first downloaded TikTok, in the fall of 2018, it only took a few days for my algorithm to figure out that I have ADHD. To be fair, this isn’t all that impressive, as TikTok and the rest of the internet make it extremely difficult to focus on a single thing for more than five seconds — there is simply so much stuff to look at! — and it’s certainly possible to argue that anyone who spends enough time online may experience some of the symptoms that help psychologists diagnose patients .
Videos would show up on my For You page with captions like “Hidden signs you’re ADHD” and “what my ADHD brain feels like,” and I’d roll my eyes because I knew what was coming: They’d reference common attributes of the modern mind — difficulty focusing and difficulty switching tasks, difficulty completing boring tasks and difficulty completing difficult tasks — and finish by saying, “If you relate to this, congrats! You probably have attention-deficit hyperactivity disorder.”
The nebulous definition of ADHD, and Big Pharma’s push to diagnose and treat it, has made the disorder’s very existence the subject of intense cultural debate since before I was born. Were we overdiagnosing neurotypical brain functions? Were we overmedicating children who were simply acting like children? Was it all the health care industry’s fault? This line of questioning is a touchy subject for plenty of people who have found meaning and identity and medical help from their diagnosis. It has also turned discussions around ADHD and psychological conditions with similar symptoms — generalized anxiety disorder, depression, autism spectrum disorder — into land mines, capable of turning a good-faith debate into an endless back-and-forth of ad hominem attacks.
But in the past decade, as social media has forced billions of us to virtually bump into people we never would have otherwise, many of us have also found the need to categorize people into recognizable boxes. One way to do so is by seizing on common human behaviors to name — gaslighting, emotional labor, trauma, parasocial relationships , “empath” as a noun — then disseminating them until they cease to mean much at all. We end up treating mental illness like a subculture, complete with its own vocabulary that only those in the know can use and weaponize.
It often looks like this: On August 26, a woman posted a TikTok suggesting that “excessive reading” in childhood was considered a “dissociative behavior.” In the video, she turns to the camera and shakes her head as if having a sudden, life-altering realization that explains the trajectory of her life; the comments are flooded with people experiencing the same aha moment. “12th grade reading level in 5th grade you say? Damn … #trauma,” wrote one. “At this point all the character traits I have are just my neurodivergence [atypical mental function],” wrote another. (This wasn’t even the first time this discourse happened .)
@juliannekelsch Maybe dissociative but worth it! #author #reader #booktok #authortok #writertok
♬ Just Dance – Lady Gaga The responses were not quite as kind once the discussion moved over to Twitter, after writer Jeanna Kadlec tweeted about how she related to the TikTok. Quote tweets ranged from frustrated (“y’all are still absolutely battering any kind of meaning out of the word ‘dissociation’ i see”) to darkly satirical (“oh, you read? that actually means you are mentally ill and abused. i have a huge brain.”) to earnest (“TikTok has pathologized every single behavior and personality trait, which perhaps has done less to destigmatize mental illness and more to dilute it to meaninglessness”).
Consume too much of the mental health internet and it becomes difficult to even understand what anyone is saying. “There is no strict frontier between what is pathological and what is not,” explains Joël Billieux, a professor of clinical psychology and psychopathology at the University of Lausanne in Switzerland. “It’s the way people live them [mental health conditions] and the meaning they give to them, which could result in psychological suffering or difficulties.”
At the risk of, well, over-pathologizing, it basically seems like there are two types of people: those who tend to appreciate and identify with this kind of internet diagnosis — “[X] behavior is actually a trauma response!” does legitimately make sense for some people and helps them live a happier life — and those who find it not just annoying but potentially harmful, stigmatizing, and unscientific. Nowhere on the internet — at least nowhere that I have come across — have those two types of people ever found much common ground, thereby making such discussions highly unpleasant and unproductive. It’s a terrible loop that we seem destined to replay forever. Is it doing us any good?
“It sucks” is the prevailing theory about the internet now, and this is not wrong. There are all kinds of guesses as to why it might be: According to legal scholar and coiner of the phrase “net neutrality” Tim Wu, it’s because of media consolidation and chumboxes; according to author Roxane Gay, it’s because of our tendency to presume the worst in others . Tech journalist Charlie Warzel says it’s because of platform-enabled context collapse , while Atlantic columnist Caitlin Flanagan blames Twitter . Perhaps it’s the never-ending mudslide of algorithmically generated content that leaves individuals stuck under a pile of hatred and extremism , or the ”Like” button , or maybe it’s Congress’s fault .
All of these things are likely true to some extent, but the theory I’ve been thinking about lately is what the writer P.E. Moskowitz calls the “BuzzFeedification of mental health” and which I’d argue can also be widened to the BuzzFeedification of identity (no shade to BuzzFeed or its quizzes, of course, which provide a great service to the procrastinating).
“The internet is basically a categorization machine, so part of me thinks it’s inherent to the internet, or at least inherent to corporate social media, where we all feel so overwhelmed by the vastness of the space and the number of people we interact with that we must whittle ourselves down into categories,” Moskowitz told me over email. “ADHD, bipolar, whatever it may be, become micro communities we can find safety and meaning in.”
Self-selective processes are natural for human beings, and they can obviously be quite useful on the internet, where some amount of gatekeeping is necessary to foster a certain environment. Groups for people whom society often marginalizes — like, say, those with mental illness or who share a common history of trauma — must enforce an element of exclusivity in order to be useful. The trouble starts when, Moskowitz argues, these identity markers are used as a rhetorical tool.
Moskowitz was the subject of this sort of vitriol in early August, when they posted a photo of their Tetris-like parallel parking job. The photo went viral on Twitter , with dozens of people quote-tweeting and replying that Moskowitz was ableist for failing to consider the cars that now might have a difficult time exiting their spot. They were also called a “malignant narcissist” (not an actual term psychologists would use) by someone who explained that they knew a malignant narcissist when they saw one because, they said, they’d been raised by a malignant narcissist.
i am being cancelled for being good at parallel parking pic.twitter.com/WzEKOHpM0N
— ☺︎ p.e. ☺︎ moskowitz ☺︎ (@_pem_pem) July 3, 2021 “I see it most when people want to win arguments — they pathologize themselves to give themselves authority (‘I have XYZ disorder therefore you must listen to me’ or ‘You are being XYZ horrible thing — racist, classist, narcissist, whatever — therefore you’re wrong’),” Moskowitz says. “The categorization allows for a flattening of nuance. You can’t argue with someone calling you a sexist or a sociopath or whatever, and you can’t argue with someone who bases the entirety of their argument in their personal experience.”
This instinct has only intensified over the past 18 months. Amanda Brennan, an internet trend expert at XX Artists, has observed the ways that, after sitting with themselves and reflecting during the isolation of the pandemic, many people have come to monumental realizations about their gender, sexuality, mental health, and identity. “It feels good to say, ‘Here’s a set of predetermined things that I can try on like a hat, and if it fits, it fits,” she says. “It’s like the closet scene in Clueless : You try it on and see how it feels.” (My favorite example of this: a TikTok that reads “when it was supposed to just be 2 weeks on Zoom but now you’re bisexual.”)
One place that Brennan sees it take on some rather unhelpful forms is in fandom discourse — for instance, in May, when Vice journalist Gita Jackson made an offhand tweet about the Harry Potter character Hermione Granger being “annoying” and a “know-it-all” and was then accused of being ableist because some of them felt that Hermione is “coded as autistic.” As the comics news website CBR pointed out , “Jackson is neurodivergent, and the people accusing them of ableism on Twitter seemed to care more about defending a supposedly neurodivergent fictional character than respecting the real neurodivergent person they were talking to.”
Yet it can be an extremely human reaction to defend our own worldviews. “When people are really involved in a fandom, they’re going to see these heavy things from their life in the things that they love because they want to feel more connected to it,” explains Brennan. But sometimes “it starts to become, ‘Well, my headcanon [an individual’s belief about a fictional text that is not canonical to the story] is what matters most, so I’m going to argue that XYZ is X-coded.’ It’s almost like, ‘I want to be seen by this thing that I love, so I’m going to read it this way, and no one else can fight me on it.’”
What we’re talking about here is the problem of being, as it’s often called, “chronically online.” “What’s the most chronically online take you’ve ever seen on the internet?” begins an immensely popular TikTok audio where users can respond and give their own examples. The most common are almost exclusively instances of pathologizing unremarkable behavior: a Reddit comment that suggested a woman was “grooming” her boyfriend because they started dating when she was 19 and he was 18; a video where “cakegender” was given its own pride flag meant to represent “people who feel light and fluffy.”
@cabbagionexus #stitch with @sorrel.hartley we need to enact grass touching laws. #chronicallyonline #badtake #aita
♬ original sound – Cabbagio Nexus It’s difficult to talk about this sort of discursive overreach without sounding like a far-right reactionary; indeed, criticisms of over-pathologization have come from conservatives who argue that, to generalize, it’s all just a bunch of self-obsessed liberal snowflake eggheads. “One of the biggest problems is that the far right has correctly identified that this is happening — that the discourse and identity policing has gotten out of control,” Moskowitz tells me, to the point where it becomes hard for others to push back against it without sounding as though you’re siding with an ideology they don’t adhere to. “There needs to be a strong, leftist stance of ‘we’re not going to do this identity-pathology policing thing anymore, but that doesn’t make us reactionaries.’”
