Performative Mental Illness
Performative Mental Illness: When Self-Diagnosis Becomes Self-Presentation
Performative Mental Illness: When Self-Diagnosis Becomes Self-Presentation
DESCRIPTION: On TikTok and Instagram, mental health diagnoses have become markers of identity. Why platform logic rewards visible suffering, what the Barnum effect has to do with it, and who benefits from this self-presentation.
Performative Mental Illness: When the symptom becomes a stage
On social media, disclosing a mental health diagnosis has become a form of self-expression. The platform rewards visible suffering with reach; self-diagnosis becomes a sign of belonging and a marker of identity. This article explores how the attention economy transforms suffering into social capital, why professionals are cautious about self-diagnosis, and what the dramatisation does to the genuine suffering of those who do not seek the limelight.
The diagnosis has become a prop in a narrative.
There is a certain type of video that almost everyone who opens TikTok is familiar with. A young person looks into the front-facing camera, soft text floats over the image, and a melancholic soundtrack plays in the background. Then comes the revelation: a diagnosis, often ADHD, autism, a dissociative disorder or complex trauma. The format is familiar because it works. It creates a sense of closeness, invites viewers to identify with the subject, and rakes in views.
In these videos, something fundamental shifts. Mental illness is presented not as something someone has and struggles with, but as something someone is. The diagnosis becomes the core of a public narrative about the self, a prop through which a sense of belonging, uniqueness and moral vulnerability can be established simultaneously. The symptom is given a platform.
It is important to make a distinction right from the start. There are a great many people who speak honestly about their suffering on social media, who feel less alone as a result, and who give others the initial impetus to seek help. This is not about them. It is about the logic of the platform, which turns visible suffering into a tradable commodity, and about the cultural incentives that arise from this.
The attention economy transforms suffering into social capital.
Social media sells attention. The algorithm rewards content that makes people linger, comment and share, and suffering reliably fulfils these criteria. A visible symptom is emotionally charged; it elicits both sympathy and controversy, and can be recounted in a matter of seconds. As a result, disclosing a mental health condition becomes a format favoured by the platform’s logic.
In this economy, suffering is transformed into social capital. Those who talk about their diagnosis receive encouragement, followers and a sense of being seen. At first glance, this is human and understandable. It becomes problematic, however, when the reward structure creates an incentive to put one’s suffering on display, to exaggerate it and to refine it aesthetically, because that is precisely what increases reach. It is the well-staged symptom that is rewarded; recovery brings no reach.
This creates a silent pressure that hardly anyone speaks of openly. Those who recover lose their material. Those whose condition stabilises have less to say. The attention economy has no interest in the story ending; it needs the ongoing series. For mental health, this is a paradoxical situation, because the platform’s economic incentive runs counter to the therapeutic goal.
Self-diagnosis and clinical diagnosis are two distinct things.
A clinical assessment is a complex process. It uses the criteria of the DSM or ICD, examines the patient’s medical history, assesses the progression of symptoms over time, and asks the crucial question: what other condition, what life situation, or what temporary stressor could explain the same symptoms? Concentration problems, for example, are associated with ADHD, but they are equally associated with depression, anxiety, lack of sleep, trauma, and simply being overwhelmed.
It is precisely this scrutiny that is missing from self-diagnosis in front of a screen. A short video provides a list of symptoms and the corresponding category straight away. It does not ask about context, it is unaware of the patient’s medical history, and it does not distinguish between a clinically significant disorder and a normal human experience. Yet a symptom on its own says very little. It is only the pattern, the duration and the level of distress that turn a characteristic into a disorder.
The figures show just how wide the gap is. A study published in PLOS One in 2025, which analysed the hundred most-viewed ADHD videos on TikTok, concluded that fewer than half of the statements met the diagnostic criteria. As the authors noted, a large proportion of the false claims described a perfectly normal human experience rather than a clinical symptom. Anyone who classifies themselves based on such content adopts a supposedly fitting category that often does not stand up to scrutiny.
The Barnum effect turns any vague list of symptoms into a mirror.
Why do these lists feel so accurate? Part of the answer lies in an old psychological experiment. The Barnum effect, named after the showman P. T. Barnum and also known as the Forer effect, describes the tendency to perceive vague and generalised descriptions as personally accurate. The psychologist Bertram Forer demonstrated this as early as 1949, when he gave test subjects the same character description compiled from an astrology book, and they rated it on average as an almost perfect fit.
The symptom lists found in pop psychology work on the same principle. Statements such as ‘You tend to lose your train of thought easily’, ‘You quickly feel exhausted in large groups’ or ‘You lie awake at night mulling over past conversations’ apply to almost everyone at some point. They are broad enough to be relatable, and specific enough to seem like a personal revelation. The sense of recognition is genuine, but its cause lies in the way the statement is constructed, not in a hidden condition.
The effect is amplified when the description comes from a perceived authority figure and is phrased in positive or flattering terms. A video that explains everyday behaviour as a sign of high sensitivity, neurodiversity or a particular nervous system offers both at once: an explanation for one’s own difficulties and a boost to one’s self-esteem. This cognitive aspect of self-diagnosis – the confusion of a general statement with a personal description – is the subject of the article on hypervigilant cognition. What is of interest here is the next stage: what happens when this recognition is publicly displayed and developed into an identity.
Young people construct their identity from the available categories.
Adolescence and early adulthood are the phases in which identity is sought and tested. Who am I, where do I belong, what explains my idiosyncrasies? These questions are normal and necessary from a developmental psychology perspective. What has changed is the range of sources from which the answers are drawn today. For many young people, social media provides the largest repository of self-descriptions, and a large part of this repository consists of psychological categories.
In this search, a diagnosis serves several purposes at once. It explains experiences that previously felt vague and shameful. It fosters a sense of belonging to a community that speaks the same language. And it confers a special status that is considered valuable in a culture of self-optimisation. Research into self-diagnosis among young people on TikTok describes precisely these motives: identity and a sense of belonging drive the adoption of a diagnosis, often following videos by popular creators.
Some observers speak of a subculture of the ‘sick role’, in which adopting a symptom becomes the entry ticket. This describes the incentive system within which young people operate. If visibility is linked to suffering and belonging to a shared diagnosis, then it follows that young people will develop precisely these signs. They do what their environment rewards.
Looping effects: the category shapes the behaviour it describes
The philosopher of science Ian Hacking coined a precise term for this phenomenon. Psychological categories are what he calls ‘interactive species’. Unlike a stone or an electron, a person knows that they are being classified, and this knowledge changes them. Hacking speaks of ‘looping effects’ and of ‘making up people’: a classification gives rise to a new kind of personality; people align themselves with the description, and in doing so they ultimately change the category itself.
On social media, this loop runs at breakneck speed. A video defines what ADHD, autism or a dissociative disorder look like, which gestures are associated with them, and which phrases are used. Those who identify with the category adopt these markers, film themselves doing so, and thereby feed into the next round of descriptions. Research shows that a significant proportion of the characteristics that young people attribute to a diagnosis in their videos do not actually meet the professional criteria. In the process, the category is redefined.
This feedback loop is problematic because it shapes real-life experiences. Anyone who is convinced they have a particular disorder interprets ambiguous experiences in the light of that belief, focuses their attention on the relevant symptoms and unconsciously practises the expected behaviours. This is neither simulation nor deliberate deception. It is the perfectly normal way in which a publicly shared category becomes a private reality and gives rise to the behaviour it purports to describe.
The aesthetics of the symptom make suffering consumable
The aesthetics of suffering circulate on these platforms. The symptom appears filtered, bathed in soft light, accompanied by a suitable soundtrack and cast into a recognisable image format. A visual grammar of mental illness has emerged: the hunched posture, the gaze looking just past the camera, the composed sadness. These images are designed to be shared.
In this presentation, a subtle shift takes place. Suffering becomes consumable; it turns into a mood that can be viewed and ‘liked’. A dissociative disorder, which is distressing and limiting in real life, is transformed in the video into a fascinating spectacle in which the creator switches between identities in front of the camera. What is clinically severe and often associated with shame becomes an alluring performance. The aesthetic smooths over the condition until it is stripped of its own gravity.
This transformation has consequences. A condition that only gains recognition through its staging must adapt to the form of that staging. It becomes shorter, more striking, more visually powerful. The quiet, arduous and unphotogenic aspects of an illness – the long endurance, the setbacks, the exhaustion without drama – fall out of the picture because they do not generate reach. What remains visible is what can be shown to good effect.
Who benefits from the performance?
Who benefits from the performance of suffering? First and foremost, it benefits the platform, which demands attention every second, regardless of whether the content helps or harms. The article on the influence of social media, ‘likes’ and attention spans shows that the business model is designed to foster engagement, and emotionally charged suffering reliably does. The platform’s economy is the real beneficiary.
Secondly, it benefits a group of creators and a growing industry surrounding them, which turns diagnoses into content, reach and products for sale. There are coaching sessions, courses, merchandise and books that capitalise on the longing for explanation and a sense of belonging. Self-diagnosis is a raw material for this environment that can be reliably replenished, because the audience is young, insecure and searching for a name for their experience.
For the individual, this performance is beneficial in the short term but harmful in the long term. In the short term, it provides recognition, a sense of belonging and a feeling of control over a vague inner state. In the long term, it ties self-esteem to a public ‘sick role’ from which it is difficult to break free, as doing so would mean losing attention and a sense of community. Those who define themselves by their diagnosis and are rewarded for it have little incentive to leave it behind.
What this ‘performance’ does to the genuine suffering of those who do not seek the limelight
The most serious objection concerns those who remain silent. There are many people with ADHD, autism, trauma or a dissociative disorder who do not seek the limelight, who bear their condition as a burden and for whom the strain of daily life leaves them with scarcely any energy to put themselves out there. For them, this mass dramatisation has a bitter consequence. Their condition is declared a trend, and nobody takes a trend entirely seriously.
When a diagnosis becomes a buzzword, it loses its weight. Surveys suggest that a significant proportion of young adults suspect they have ADHD, whilst the actual prevalence is far lower. Ultimately, this inflation of the term affects those actually affected. They face the suspicion that they are merely following a fad. Their professional diagnosis, hard-won over many years, is placed alongside the self-labelling seen in videos, and public perception is increasingly failing to distinguish between the two.
At the same time, it puts a strain on the healthcare system. Where demand for assessment is rising due to viral content and is mixed with false expectations, waiting times are lengthening, and mental health resources are becoming scarcer for those who need them most urgently. The aestheticisation of the symptom is therefore no harmless game. It diverts attention and resources away from the places where the suffering actually occurs – without a platform and without a wide reach.
Taking it seriously means looking closely, not just going with the flow.
None of this implies any contempt for the people who share their stories on social media. The impulse behind many of these videos is genuine: the desire to be understood, to belong, and to put a name to one’s own experience. Taking this impulse seriously means not leaving it to the logic of the platform and the attention economy, which transform it into a product. Those who are truly suffering deserve more than reach.
Taking it seriously also means keeping alive the distinction between recognition and diagnosis. A video can be a valuable first step towards coming to terms with one’s own experiences. It can prompt clinical diagnosis. A specialist carries out the assessment itself. The path from a symptom to a diagnosis involves context, progression and patient assessment by a person who listens and asks questions – not by an algorithm that rewards what is easiest to demonstrate.
And, ultimately, taking something seriously means not sidestepping the question of its benefits. As long as the platform rewards visible suffering with reach, it will prioritise the symptom and overlook recovery. Recognising this incentive structure is the first step towards escaping it, both for those affected and for everyone watching. Genuine suffering needs a space where it does not have to be ‘performed’ to be heard.
The key points in brief
• On social media, mental health diagnoses have in many cases become markers of identity and a means of self-presentation. The logic of the platform rewards visible suffering with reach and transforms it into social capital.
• Self-diagnosis and clinical diagnosis are different. A clinical assessment, using the DSM or ICD, examines context, progression and other possibilities. A video merely provides a list of symptoms. Less than half of the popular ADHD content on TikTok meets the diagnostic criteria.
• The Barnum effect explains why vague lists of symptoms seem like a personal description: they are broad enough to apply to almost anyone, yet still feel personalised.
• Identity and a sense of belonging drive young people in particular towards self-diagnosis. Ian Hacking’s ‘looping effects’ show how a shared category shapes the behaviour it describes.
• This performance primarily benefits the platform and the content industry. It harms those affected who are not seeking the limelight, as their real condition is trivialised by being turned into a trend, and the burden on healthcare services is further increased.
• Genuine suffering deserves to be taken seriously. A viral video may serve as a catalyst, but it is no substitute for a professional assessment.
Sources
• Reality’s Last Stand: Social Media and the Rise of Performative Mental Illness. https://www.realityslaststand.com/p/social-media-and-the-rise-of-performative
• Young Adults on Mental Health on Instagram and TikTok: Self-Care, Self-Diagnosis and Performances of the Mentally Healthy Self. PMC. https://pmc.ncbi.nlm.nih.gov/articles/PMC11859696/
• Study explores why teenagers self-diagnose mental health conditions through TikTok content. News-Medical. https://www.news-medical.net/news/20241018/Study-explores-why-teens-self-diagnose-mental-health-conditions-through-TikTok-content.aspx
• Karasavva et al. (2025): A double-edged hashtag: Evaluation of #ADHD-related TikTok content and its associations with perceptions of ADHD. PLOS One. https://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0319335
• TikTok-inspired self-diagnosis and its implications for educational psychology practice. Educational Psychology in Practice. https://www.tandfonline.com/doi/full/10.1080/02667363.2024.2409451
• Barnum effect. Wikipedia. https://en.wikipedia.org/wiki/Barnum_effect
• Ian Hacking: Making Up People. London Review of Books. https://www.lrb.co.uk/the-paper/v28/n16/ian-hacking/making-up-people
• Tsou, J. Y.: Hacking on Looping Effects and Kinds of People. PhilSci Archive. https://philsci-archive.pitt.edu/25137/1/Tsou-2025-Hacking-Monist-Preprint.pdf
• TikTok Diagnoses: When Mental Health Awareness Turns Into Identity. AMFM Mental Health Treatment. https://amfmtreatment.com/blog/tik-tok-trends-bring-rise-to-mental-health-self-diagnosis/
• Dr TikTok: The Impacts of Misinformation on Mental Health Self-Diagnosis. Petrie-Flom Centre, Harvard Law School. https://petrieflom.law.harvard.edu/2025/04/02/dr-tiktok-the-impacts-of-misinformation-on-mental-health-self-diagnosis
Related:
Hypervigilant cognition and social media self-diagnoses: TikTok, pop psychology and mental health
Toxic terms in everyday life: therapy speak, pop psychology, relationships
Gaslighting and manipulation: recognising and defending yourself
The influence of social media: manipulation, likes and attention spans
DESCRIPTION: On TikTok and Instagram, mental health diagnoses have become markers of identity. Why platform logic rewards visible suffering, what the Barnum effect has to do with it, and who benefits from this self-presentation.
Performative Mental Illness: When the symptom becomes a stage
On social media, disclosing a mental health diagnosis has become a form of self-expression. The platform rewards visible suffering with reach; self-diagnosis becomes a sign of belonging and a marker of identity. This article explores how the attention economy transforms suffering into social capital, why professionals are cautious about self-diagnosis, and what the dramatisation does to the genuine suffering of those who do not seek the limelight.
The diagnosis has become a prop in a narrative.
There is a certain type of video that almost everyone who opens TikTok is familiar with. A young person looks into the front-facing camera, soft text floats over the image, and a melancholic soundtrack plays in the background. Then comes the revelation: a diagnosis, often ADHD, autism, a dissociative disorder or complex trauma. The format is familiar because it works. It creates a sense of closeness, invites viewers to identify with the subject, and rakes in views.
In these videos, something fundamental shifts. Mental illness is presented not as something someone has and struggles with, but as something someone is. The diagnosis becomes the core of a public narrative about the self, a prop through which a sense of belonging, uniqueness and moral vulnerability can be established simultaneously. The symptom is given a platform.
It is important to make a distinction right from the start. There are a great many people who speak honestly about their suffering on social media, who feel less alone as a result, and who give others the initial impetus to seek help. This is not about them. It is about the logic of the platform, which turns visible suffering into a tradable commodity, and about the cultural incentives that arise from this.
The attention economy transforms suffering into social capital.
Social media sells attention. The algorithm rewards content that makes people linger, comment and share, and suffering reliably fulfils these criteria. A visible symptom is emotionally charged; it elicits both sympathy and controversy, and can be recounted in a matter of seconds. As a result, disclosing a mental health condition becomes a format favoured by the platform’s logic.
In this economy, suffering is transformed into social capital. Those who talk about their diagnosis receive encouragement, followers and a sense of being seen. At first glance, this is human and understandable. It becomes problematic, however, when the reward structure creates an incentive to put one’s suffering on display, to exaggerate it and to refine it aesthetically, because that is precisely what increases reach. It is the well-staged symptom that is rewarded; recovery brings no reach.
This creates a silent pressure that hardly anyone speaks of openly. Those who recover lose their material. Those whose condition stabilises have less to say. The attention economy has no interest in the story ending; it needs the ongoing series. For mental health, this is a paradoxical situation, because the platform’s economic incentive runs counter to the therapeutic goal.
Self-diagnosis and clinical diagnosis are two distinct things.
A clinical assessment is a complex process. It uses the criteria of the DSM or ICD, examines the patient’s medical history, assesses the progression of symptoms over time, and asks the crucial question: what other condition, what life situation, or what temporary stressor could explain the same symptoms? Concentration problems, for example, are associated with ADHD, but they are equally associated with depression, anxiety, lack of sleep, trauma, and simply being overwhelmed.
It is precisely this scrutiny that is missing from self-diagnosis in front of a screen. A short video provides a list of symptoms and the corresponding category straight away. It does not ask about context, it is unaware of the patient’s medical history, and it does not distinguish between a clinically significant disorder and a normal human experience. Yet a symptom on its own says very little. It is only the pattern, the duration and the level of distress that turn a characteristic into a disorder.
The figures show just how wide the gap is. A study published in PLOS One in 2025, which analysed the hundred most-viewed ADHD videos on TikTok, concluded that fewer than half of the statements met the diagnostic criteria. As the authors noted, a large proportion of the false claims described a perfectly normal human experience rather than a clinical symptom. Anyone who classifies themselves based on such content adopts a supposedly fitting category that often does not stand up to scrutiny.
The Barnum effect turns any vague list of symptoms into a mirror.
Why do these lists feel so accurate? Part of the answer lies in an old psychological experiment. The Barnum effect, named after the showman P. T. Barnum and also known as the Forer effect, describes the tendency to perceive vague and generalised descriptions as personally accurate. The psychologist Bertram Forer demonstrated this as early as 1949, when he gave test subjects the same character description compiled from an astrology book, and they rated it on average as an almost perfect fit.
The symptom lists found in pop psychology work on the same principle. Statements such as ‘You tend to lose your train of thought easily’, ‘You quickly feel exhausted in large groups’ or ‘You lie awake at night mulling over past conversations’ apply to almost everyone at some point. They are broad enough to be relatable, and specific enough to seem like a personal revelation. The sense of recognition is genuine, but its cause lies in the way the statement is constructed, not in a hidden condition.
The effect is amplified when the description comes from a perceived authority figure and is phrased in positive or flattering terms. A video that explains everyday behaviour as a sign of high sensitivity, neurodiversity or a particular nervous system offers both at once: an explanation for one’s own difficulties and a boost to one’s self-esteem. This cognitive aspect of self-diagnosis – the confusion of a general statement with a personal description – is the subject of the article on hypervigilant cognition. What is of interest here is the next stage: what happens when this recognition is publicly displayed and developed into an identity.
Young people construct their identity from the available categories.
Adolescence and early adulthood are the phases in which identity is sought and tested. Who am I, where do I belong, what explains my idiosyncrasies? These questions are normal and necessary from a developmental psychology perspective. What has changed is the range of sources from which the answers are drawn today. For many young people, social media provides the largest repository of self-descriptions, and a large part of this repository consists of psychological categories.
In this search, a diagnosis serves several purposes at once. It explains experiences that previously felt vague and shameful. It fosters a sense of belonging to a community that speaks the same language. And it confers a special status that is considered valuable in a culture of self-optimisation. Research into self-diagnosis among young people on TikTok describes precisely these motives: identity and a sense of belonging drive the adoption of a diagnosis, often following videos by popular creators.
Some observers speak of a subculture of the ‘sick role’, in which adopting a symptom becomes the entry ticket. This describes the incentive system within which young people operate. If visibility is linked to suffering and belonging to a shared diagnosis, then it follows that young people will develop precisely these signs. They do what their environment rewards.
Looping effects: the category shapes the behaviour it describes
The philosopher of science Ian Hacking coined a precise term for this phenomenon. Psychological categories are what he calls ‘interactive species’. Unlike a stone or an electron, a person knows that they are being classified, and this knowledge changes them. Hacking speaks of ‘looping effects’ and of ‘making up people’: a classification gives rise to a new kind of personality; people align themselves with the description, and in doing so they ultimately change the category itself.
On social media, this loop runs at breakneck speed. A video defines what ADHD, autism or a dissociative disorder look like, which gestures are associated with them, and which phrases are used. Those who identify with the category adopt these markers, film themselves doing so, and thereby feed into the next round of descriptions. Research shows that a significant proportion of the characteristics that young people attribute to a diagnosis in their videos do not actually meet the professional criteria. In the process, the category is redefined.
This feedback loop is problematic because it shapes real-life experiences. Anyone who is convinced they have a particular disorder interprets ambiguous experiences in the light of that belief, focuses their attention on the relevant symptoms and unconsciously practises the expected behaviours. This is neither simulation nor deliberate deception. It is the perfectly normal way in which a publicly shared category becomes a private reality and gives rise to the behaviour it purports to describe.
The aesthetics of the symptom make suffering consumable
The aesthetics of suffering circulate on these platforms. The symptom appears filtered, bathed in soft light, accompanied by a suitable soundtrack and cast into a recognisable image format. A visual grammar of mental illness has emerged: the hunched posture, the gaze looking just past the camera, the composed sadness. These images are designed to be shared.
In this presentation, a subtle shift takes place. Suffering becomes consumable; it turns into a mood that can be viewed and ‘liked’. A dissociative disorder, which is distressing and limiting in real life, is transformed in the video into a fascinating spectacle in which the creator switches between identities in front of the camera. What is clinically severe and often associated with shame becomes an alluring performance. The aesthetic smooths over the condition until it is stripped of its own gravity.
This transformation has consequences. A condition that only gains recognition through its staging must adapt to the form of that staging. It becomes shorter, more striking, more visually powerful. The quiet, arduous and unphotogenic aspects of an illness – the long endurance, the setbacks, the exhaustion without drama – fall out of the picture because they do not generate reach. What remains visible is what can be shown to good effect.
Who benefits from the performance?
Who benefits from the performance of suffering? First and foremost, it benefits the platform, which demands attention every second, regardless of whether the content helps or harms. The article on the influence of social media, ‘likes’ and attention spans shows that the business model is designed to foster engagement, and emotionally charged suffering reliably does. The platform’s economy is the real beneficiary.
Secondly, it benefits a group of creators and a growing industry surrounding them, which turns diagnoses into content, reach and products for sale. There are coaching sessions, courses, merchandise and books that capitalise on the longing for explanation and a sense of belonging. Self-diagnosis is a raw material for this environment that can be reliably replenished, because the audience is young, insecure and searching for a name for their experience.
For the individual, this performance is beneficial in the short term but harmful in the long term. In the short term, it provides recognition, a sense of belonging and a feeling of control over a vague inner state. In the long term, it ties self-esteem to a public ‘sick role’ from which it is difficult to break free, as doing so would mean losing attention and a sense of community. Those who define themselves by their diagnosis and are rewarded for it have little incentive to leave it behind.
What this ‘performance’ does to the genuine suffering of those who do not seek the limelight
The most serious objection concerns those who remain silent. There are many people with ADHD, autism, trauma or a dissociative disorder who do not seek the limelight, who bear their condition as a burden and for whom the strain of daily life leaves them with scarcely any energy to put themselves out there. For them, this mass dramatisation has a bitter consequence. Their condition is declared a trend, and nobody takes a trend entirely seriously.
When a diagnosis becomes a buzzword, it loses its weight. Surveys suggest that a significant proportion of young adults suspect they have ADHD, whilst the actual prevalence is far lower. Ultimately, this inflation of the term affects those actually affected. They face the suspicion that they are merely following a fad. Their professional diagnosis, hard-won over many years, is placed alongside the self-labelling seen in videos, and public perception is increasingly failing to distinguish between the two.
At the same time, it puts a strain on the healthcare system. Where demand for assessment is rising due to viral content and is mixed with false expectations, waiting times are lengthening, and mental health resources are becoming scarcer for those who need them most urgently. The aestheticisation of the symptom is therefore no harmless game. It diverts attention and resources away from the places where the suffering actually occurs – without a platform and without a wide reach.
Taking it seriously means looking closely, not just going with the flow.
None of this implies any contempt for the people who share their stories on social media. The impulse behind many of these videos is genuine: the desire to be understood, to belong, and to put a name to one’s own experience. Taking this impulse seriously means not leaving it to the logic of the platform and the attention economy, which transform it into a product. Those who are truly suffering deserve more than reach.
Taking it seriously also means keeping alive the distinction between recognition and diagnosis. A video can be a valuable first step towards coming to terms with one’s own experiences. It can prompt clinical diagnosis. A specialist carries out the assessment itself. The path from a symptom to a diagnosis involves context, progression and patient assessment by a person who listens and asks questions – not by an algorithm that rewards what is easiest to demonstrate.
And, ultimately, taking something seriously means not sidestepping the question of its benefits. As long as the platform rewards visible suffering with reach, it will prioritise the symptom and overlook recovery. Recognising this incentive structure is the first step towards escaping it, both for those affected and for everyone watching. Genuine suffering needs a space where it does not have to be ‘performed’ to be heard.
The key points in brief
• On social media, mental health diagnoses have in many cases become markers of identity and a means of self-presentation. The logic of the platform rewards visible suffering with reach and transforms it into social capital.
• Self-diagnosis and clinical diagnosis are different. A clinical assessment, using the DSM or ICD, examines context, progression and other possibilities. A video merely provides a list of symptoms. Less than half of the popular ADHD content on TikTok meets the diagnostic criteria.
• The Barnum effect explains why vague lists of symptoms seem like a personal description: they are broad enough to apply to almost anyone, yet still feel personalised.
• Identity and a sense of belonging drive young people in particular towards self-diagnosis. Ian Hacking’s ‘looping effects’ show how a shared category shapes the behaviour it describes.
• This performance primarily benefits the platform and the content industry. It harms those affected who are not seeking the limelight, as their real condition is trivialised by being turned into a trend, and the burden on healthcare services is further increased.
• Genuine suffering deserves to be taken seriously. A viral video may serve as a catalyst, but it is no substitute for a professional assessment.
Sources
• Reality’s Last Stand: Social Media and the Rise of Performative Mental Illness. https://www.realityslaststand.com/p/social-media-and-the-rise-of-performative
• Young Adults on Mental Health on Instagram and TikTok: Self-Care, Self-Diagnosis and Performances of the Mentally Healthy Self. PMC. https://pmc.ncbi.nlm.nih.gov/articles/PMC11859696/
• Study explores why teenagers self-diagnose mental health conditions through TikTok content. News-Medical. https://www.news-medical.net/news/20241018/Study-explores-why-teens-self-diagnose-mental-health-conditions-through-TikTok-content.aspx
• Karasavva et al. (2025): A double-edged hashtag: Evaluation of #ADHD-related TikTok content and its associations with perceptions of ADHD. PLOS One. https://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0319335
• TikTok-inspired self-diagnosis and its implications for educational psychology practice. Educational Psychology in Practice. https://www.tandfonline.com/doi/full/10.1080/02667363.2024.2409451
• Barnum effect. Wikipedia. https://en.wikipedia.org/wiki/Barnum_effect
• Ian Hacking: Making Up People. London Review of Books. https://www.lrb.co.uk/the-paper/v28/n16/ian-hacking/making-up-people
• Tsou, J. Y.: Hacking on Looping Effects and Kinds of People. PhilSci Archive. https://philsci-archive.pitt.edu/25137/1/Tsou-2025-Hacking-Monist-Preprint.pdf
• TikTok Diagnoses: When Mental Health Awareness Turns Into Identity. AMFM Mental Health Treatment. https://amfmtreatment.com/blog/tik-tok-trends-bring-rise-to-mental-health-self-diagnosis/
• Dr TikTok: The Impacts of Misinformation on Mental Health Self-Diagnosis. Petrie-Flom Centre, Harvard Law School. https://petrieflom.law.harvard.edu/2025/04/02/dr-tiktok-the-impacts-of-misinformation-on-mental-health-self-diagnosis
Related:
Hypervigilant cognition and social media self-diagnoses: TikTok, pop psychology and mental health
Toxic terms in everyday life: therapy speak, pop psychology, relationships
Gaslighting and manipulation: recognising and defending yourself
The influence of social media: manipulation, likes and attention spans