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Key points
- Social media is a platform for connection among teenagers; however, it can have unexpected outcomes.
- Identity exploration is normative for adolescence as is identifying with someone online.
- A clinical diagnosis is much different from identifying with an online correspondent's description of a disorder.
Social media has opened many opportunities for connection for people, including people who once felt like they didn't belong. Social media offers an outlet for people to find others like them and not feel so alone. For a while, Tumblr served this purpose, though other platforms such as Twitter, Instagram, and TikTok now provide these spaces as well. There are communities for everything imaginable, and these groups allow people to understand others and better understand themselves. The groups allow people to realize they are not alone. They also allow people to practice their performances of self.
Over 90 percent of teenagers report using social media, and 75 percent report having at least one active social media profile. Teens spend an average of 9 hours a day online.1 Gen Z comprises those born between 1997 and 2012, making them between 9 and 24 years old. Young people have more access to platforms that allow them to be aware of and understand what is happening in their world through unfiltered venues. Though this adolescent social awakening and connection are occurring on a larger scale via social media, what we are seeing is normative for adolescent and young adult development.
Teens Need to Try Different Identities
Erik Erikson postulated that teens are experiencing the Identity v. Role Confusion psychosocial crisis. During this stage, teens are gaining independence and looking towards their future. They are searching for a sense of self and identity through understanding their values and beliefs. Teens during this stage may try on a variety of identities to determine what fits right for them. (Millennial friends may remember their "emo phase" in adolescence). Social media has made this much easier as there is more access to communities and an easy ability to try on identities through anonymity. Social media also provides space for those who may not have physical spaces to inhabit as themselves.
Social media also has an uncanny way of making everyone feel understood for their specific, one of a kind, quirks. During adolescence, teens also enter the ‘no one understands me’ phase, which makes it much more exciting and emotional when they feel they have found someone who does. One community gaining a lot of traction with Gen Zers and their quest to understand themselves is the mental health community. At every turn on Facebook, Instagram, and TikTok, you will find mental health professionals, non-professionals, and people with lived experience of various mental health diagnoses working to educate and inform the public about mental health and wellness. In addition, you will find 15-second videos or beautifully crafted text-only posts describing symptoms and experiences of various diagnoses.
The Horoscope Effect
While this has opened many eyes to understanding mental health and fighting the stigma related to those who experience mental health struggles, it also seems to have created a horoscope effect. People read symptoms online or hear someone discuss their experience and feel connected to it so much so that they now believe they must have that same diagnosis. Now, of course, many people have, in fact, discovered that they are experiencing disorders such as anxiety, depression, and ADHD. However, a community of young people has begun to take these symptoms in as their own and proclaim to have many serious diagnoses that they may not actually have.
Diagnoses including attention-deficit/hyperactivity disorder, autism spectrum disorder, Tourette’s syndrome, and dissociative identity disorder have become highly popular on Instagram and TikTok. We have even seen an emergence in the identification of the not-yet-DSM-recognized high-functioning anxiety disorder. Identification with mental health diagnoses is not novel to Gen Z. Not too long ago, the public began using phrases such as, “I’m so OCD” to describe their affinity towards organization and order. The difference between then and now appears to be bold proclamations of having a diagnosis and expecting certain treatment or accommodations due to their self-proclaimed diagnoses.
What Makes a "Disorder"?
Millions of people in the world may experience mental health disorder symptoms but do not meet the criteria for a diagnosis. The primary reason being when a qualified professional is assessing to determine a diagnosis (for most diagnoses), they are looking for what the Diagnostic and Statistical Manual (DSM) calls “clinically significant impairment.” According to the DSM-IV manual, the clinically significant distress or impairment criterion:
…helps establish a threshold for the diagnosis of a disorder in those situations in which the symptomatic presentation by itself (particularly in its milder forms) is not inherently pathological and may be encountered in individuals for whom a diagnosis of “mental disorder” would be inappropriate. (p.7)2
The questions many professionals ponder when determining a diagnosis are, “What do your symptoms get in the way of in your daily life?” or “How are these symptoms impacting your ability to live your life in the ways you want?” So, while you may have difficulty sustaining attention, ignore details, struggle with organization, be forgetful, lose things, and avoid tasks requiring sustained mental effort, if this does not impact your functioning or interfere with the quality of your functioning, then you do not have an attention-deficit/hyperactivity disorder (inattentive type). The DSM-5 ADHD diagnostic criteria even include a "mild" specifier indicating that “symptoms result in no more than minor impairments.”3 So, while you may experience anxiety, depression, and deficits in social communication, this does not equate to an anxiety disorder, autism spectrum disorder, or major depressive disorder. Similarly, if you have a multi-faceted personality and various interests or styles, that does not necessarily mean you have multiple personality disorder.
Jellett and Muggleton's research on autism spectrum disorder digs into the central idea of traits and states, with the former being more stable and enduring and the latter a temporary way of being. They postulate the idea of classifying neurotypes separately from neurodevelopmental disorders.4 Further, they state, “the term 'autism spectrum disorder' could then become a transitory term applied to those with an 'autistic neurotype’ by where their symptoms are also currently causing impairment.” Thus, while millions of individuals may have an autistic neurotype, a more anxious demeanor, or attention deficits, it may be better to understand these individuals within a framework of states and dimensions rather than pathological traits.
"What’s Wrong with Me?"
We all must make room for the varying presentations we bring, including our interpersonal styles, brain function, and thresholds for distress. The rise in recognition of these areas has been a phenomenon. Unfortunately, though, it can result in crowding that limits access to necessary services for those who need them. Waitlists for autism testing can be upwards of two years in many states. A teenager proclaiming a diagnosis such as the extremely rare multiple personality disorder can be scary for parents to try to manage. It's important to acknowledge and affirm the normative experience of identity exploration for adolescents, and it's normal for teens experiencing distress or negative self-image to search for an explanation, reason, or diagnosis. They are asking themselves, “What is wrong with me?” The sense of urgency and necessity to claim a diagnosis appears to stem from a desire to "fit in." But teenagers may be socially awkward, or forgetful, or "weird," and that is fine. It doesn't have to mean something is "wrong" with you.
Facebook/LinkedIn image: Odua Images/Shutterstock
References
American Academy of Child & Adolescent Psychiatry. (2018, March). Social Media and Teens. Retrieved from American Academy of Child & Adolescent Psychiatry: American Academy of Child & Adolescent Psychiatry.
American Psychiatric Association. (2000). Diagnostic and statiscal manual of mental disorders (4th ed.).
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC.
Jellett, R., & Muggleton, J. (2021). Implications of Applying "Clinically Significant Impairment" to Autism Assessment: Commentary of Six Problems Encountered in Clinical Practice. J Autism Dev Disord. doi:10.1007/s10803-021-04988-9
In this article, the term ‘mental health disorder’ refers to medical definitions of diagnoses of the Diagnostic and Statistical Manual of Mental Disorders. This writer acknowledges the inherent pathology and stigmatization within the DSM. Additionally, while the DSM is a guide for clinical diagnosis, its primary goal is to streamline communication between mental health professionals and is not intended as a comprehensive descriptor for the various presentations of mental health disorders.
