Is Social Media Reflecting Our Pathology or Adding to It?

Social Media and Mental Health

Social media has become an open forum for discussing and sharing stories about mental health. For many, this has been positive, perhaps even a lifesaving, as it helps people connect with others who have similar experiences and find places where one does not feel alone. According to an article in Health Education and Behavior, more than 70% of social media use is related to connecting with others, receiving news content, sharing information, and entertainment (Bekula et al., 2019). Their study of 1,027 adults also found that routine social media use is associated with positive outcomes like increased well-being. Previously, Brailovskaia and Margraf (2016) found similar positive results from social media use, with many users in their study reporting higher levels of both extroversion and self-esteem.

But as I wrote about in Social Media Use is Related to Both Ill-Being and Well-Being, like any technology, social media can be both a tool and a tyrant. For example, a few years ago a large survey of adults found that 44% of Americans self-diagnose instead of seeing a healthcare professional (Zimmerman, 2018). While some websites are respected when it comes to looking up symptoms and narrowing down diagnoses, many are not and users are not trained in how to interpret and apply what they read, even if the information is accurate. It is very easy to get lost in the virtual sea of information regarding physical and mental disorders.

Speaking of getting lost, a recent article in the Wall Street Journal (WSJ; Jargon, 2021) investigated social media behaviors and how they fit into the algorithms that determines what will show up in your feed. They reported that TikTok tracks not only what you watch, but how long you watch, when and how you rewind or re-watch, and where you pause. This information "drives you deep into rabbit holes of content that are hard to escape." While all users start their journey with popular videos about funny dogs or something similarly popular and benign, the algorithm soon learns your interests and before you realize it, TikTok is pushing you videos that will keep you engaged based on what and how you watch.

To better understand how this works, the WSJ created a large number of bot accounts to try to map how TikTok moves users through the application. For example, one bot lingered in the general area for while but then they had the bot user fully watch a 35 second video about losing someone important in your life. Then they watched it a second time. The WSJ surmises that TikTok uses this information, much like a psychological test, and makes assumptions about who you are and what will hold your attention. It considers the author of the video, what that user views, the soundtrack in the video, the video description, and the hashtags. They also track your location and other data about you that they get from your phone. This allows them to create a profile of you that content is then filtered through.

After watching this one 35 second video about loss twice (70 seconds on TikTok), the number of 'sad' videos were increased within the bot user's feed. By 15 minutes in, very specific videos about love and loss were seen regularly for this particular bot user. After 36 minutes of the bot's journey, the video feed is a "deluge of depressive content, 93% of videos shown to the account are about sadness or depression." Once the focus happens, it is difficult to escape.

As you engage with the app, your personality profile is adjusted. If you stop clicking on "sad" videos, for example, you will see less of them in your feed. The bots that did not watch the full 35 second video twice, did not end up with majority "sad" videos. So is TikTok capturing our true personality, or maybe just a current state? And sometimes we watch things for reasons beyond the reach of the algorithm. Is social media reflecting our pathology or adding to it?

More illness or More Awareness?

In many ways social media has been a triumph. This new way to socialize has likely helped millions of people better understand and get treatment for their mental health concerns. Gen Z is the most mental health focused of any generation and has pushed us forward in terms of normalizing mental health problems and the need for self-care and professional intervention. As the currently popular saying goes, "It's OK not to be OK."

This trend is showing up in actual diagnoses too. In the 1980s, 5% of children were diagnosed with ADHD - one in 20. By 2019, this number has doubled - in research from 2016-2019, 13% of boys and 6% of girls had received a diagnosis of ADHD, averaging out to about 9.8% for all children. (Source: CDC).

But is this increase in diagnoses related to the increased awareness and normalization of mental illness brought about by, among other things, the Internet, social media, and Gen Zers? Is it related to increased self-diagnosis, which could be both good or bad? Is social media reflecting our pathology and therefore creating awareness and avenues for help? Or is it creating more pathology? After all, social media can be both a tool and a tyrant.

There are more ways to get information about mental health online that most adults alive today would never have imagined. In social media alone, not counting websites, the hashtag #BPD (short for  Borderline Personality Disorder) has over 3.7 billion views. #bipolar has about 2 billion, and #DID (short for Dissociative Identity Disorder, previously Multiple Personality Disorder), has over 1.5 billion views according to a recent article in the New York Post. The article explored the question, does social media encourage healthy young people to self-diagnose? And once you assume you have a disorder, how does this new knowledge impact how you think about yourself? How does it impact your relationships and your view of the world?

Psychologists who work with adolescents and young adults are spending more time confirming, or in some cases countering, the information their clients find online. I spoke with one psychologist who said nearly half of the calls they get from parents are about social media usage and its relationship to the mental health of their children - many are about diagnosis. These phone calls or emails often begin with "I (or my child) saw a video (or read a post) on social media..." and often end with"...could my child have this disorder?" For many of these children and their parents, these videos provide a place to learn about themselves and to find a helpful community. Social media can be a tool to connect people with similar others and with treatment providers. But for others, it may be more of a tyrant and pathologize normal thoughts, feelings, and behaviors or perhaps even worsen symptoms that are already present. Consider a feed focused 93% on sadness and how this might impact your mental health, especially if you are already experiencing sadness.

What to Do About It: Positive Use of Social Media

Research is consistently showing us that social media use can have both positive and negative impacts on our mental health. To help ensure that you are in control of both your social media use and your mental health, here are four things you can do right now:

  1. Start with the End in Mind.

    We know that when used to solve problems, answer questions, or explore interests social media use can lead to increased self-esteem. To counter the negatives, be purposeful about your social media use by asking yourself why am I doing this right now and what am I hoping to get out of it.

  2. Be Yourself.

    When we modify our true selves to appear better when we are online, the result is increased narcissism, lower self-esteem, and poorer interpersonal relationships in the real world. Being yourself allows others to engage with you because of you, not because of a persona.

  3. Diversify Your Interests.

    Diversity of interests seems to be an important factor as well. When our focus is narrowed we lose context. When using social media, consider limiting the time you spend randomly scrolling and instead focus on a few different areas of interest. This way you can make decisions about how you want to spend your time rather than allowing the social media algorithms to trap you on a single topic.

  4. Focus on What Nourishes You.

    Also, as you think about areas you want to focus on, consider those things that bring you joy. It's okay to learn about depression, but learn about happiness too. While using social media, consider focusing on several of these positive interests to help the algorithm get to know what nourishes you and to show you more of this positive content.

From a community standpoint, we also need better education about social media usage and its impact as well as more research on how to use social media to help its users flourish.


References

Bekula, M. A., McCloud, R. F., & Viswanath, K. (2019). Association of social media use with social well-being, positive mental health, and self-rated health: Disentangling routine use from emotional connection to use. https://doi.org/10.1177/1090198119863768

Brailovskaia J, Margraf J (2016).  Comparing Facebook Users and Facebook Non-Users: Relationship between Personality Traits and Mental Health Variables – An Exploratory Study. PLoS ONE 11(12): e0166999. https://doi.org/10.1371/journal.pone.0166999

Center for Disease Control [CDC] (nd). Data and statistics about ADHD. Retrieved from https://www.cdc.gov/ncbddd/adhd/data.html

Jargon, J. (2021). TikTok diagnosis videos leave some teens thinking they have rare mental disorders. Retrieved from https://www.wsj.com/articles/tiktok-diagnosis-videos-leave-some-teens-thinking-they-have-rare-mental-disorders-11640514602.

Schlott, R. How TikTok has become a dangerous breeding ground for mental disorders. Retrieved from https://nypost.com/2022/03/12/tiktok-has-become-a-dangerous-mental-disorder-breeding-ground/.

van Zoonen, W., Treem, J. W., & ter Hoeven, C. L. (2022). A tool and a tyrant: Social media and well-being in organizational contexts. Current Opinion in Psychology, 45, 101300. https://doi.org/10.1016/j.copsyc.2022.101300

Zimmerman, B. (2018). Survey: 44% of Americans self-diagnose online instead of visiting medical professional. Retrieved from https://www.beckershospitalreview.com/quality/survey-44-of-americans-self-diagnose-online-instead-of-visiting-medical-professional.html.

About Christopher L. Heffner, PsyD, PhD

Dr. Heffner is a Professor of Clinical Psychology at Antioch University where he teaches Cognitive Behavior and Solution-Focused Therapy, Clinical Supervision, and Community Psychology. His research focuses on strength-based interventions, resilience, and well-being.