Can you really self-diagnose ADHD? It’s complicated.
Kann man wirklich selbst eine ADHS-Diagnose stellen? Es ist kompliziert.
Since it was posted in 2021, the TikTok video that sparked the debate about self-diagnosis of ADHD has amassed over nine million views. Perhaps you’ve seen it yourself: a person in a tie-dye Thrasher t-shirt points to a speech bubble above their head which says, “Things you didn’t realize could be ADHD.” Over the next 60 seconds, various symptoms are listed: anger over trivial things, restlessness, difficulty with rejection, unconscious noises, pressure to compete, and hyperfocus on one’s own interests.
If you scroll through the comments on the video, it feels a bit like you’re on an archaeological dig – as if you’re traveling back in time and discovering the aftershocks first, then the trigger. At the top of the comments, the person who posted the video in the first place warns others against self-diagnosis. “People… it’s totally okay to empathize with problems… but it’s not okay to self-diagnose and tell others that you have ADHD.” As you continue scrolling, you read more and more comments from people stressing the same thing – that no one should suspect they have ADHD just because of a video. But then, further down, you realize that many people are doing exactly that and writing things like, “Wait, this sudden/anxious shaking isn’t normal?” or “I didn’t know I had ADHD” or “I… I think… I have ADHD.”
A similar dynamic plays out in the comment sections of videos about other illnesses or disorders: half of the comments ask people not to self-diagnose, while the other half eagerly make their own diagnoses. You find this contrast just as much in videos about trauma, autism, personality disorders, and so on. Sometimes the comments simply express identification with the content (“That sounds just like me!” or “Doesn’t everyone do this?”). But often, especially under more popular videos, other voices speak up and emphasize that the video wasn’t created by experts or that the symptoms mentioned are very loosely defined and can be applied to anyone.
But in the case of this ADHD video, the conflict between self-diagnosers and those warning against it is so loud that you might think the entire Gen Z is convinced, thanks to TikTok, that every tiny habit is a symptom of some mental illness. But can ADHD actually be self-diagnosed? And would it be so bad if it happened because of a TikTok?
The pros and cons of TikTok self-diagnosis
„I find it positive that the topic is so big on TikTok“, says Dr. Kim Heyes, lecturer in health and social justice at Manchester Metropolitan University. “In every society – all over the world – we are told that we should address the stigmatization of mental health problems. But hardly anyone talks about what these problems actually look like. That’s exactly what I love about these TikToks and online forums like Reddit.” It provides better general knowledge about mental health when people openly share how their anxiety disorder or ADHD manifests, according to Dr. Heyes. In her opinion, this is a good thing.
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She, for one, is not bothered by the fact that some users might believe they have this or that condition after watching such videos. “If someone finds a TikTok that exactly reflects their own experience, that person will surely not only find information on TikTok,” says Dr. Heyes. “They will surely also look for other information online.” And this research will either refute or confirm the initial suspicion – and if the person continues to believe that the self-diagnosis might be correct, they will probably seek help from their own environment or doctors.
However, when it comes to medical treatment, there is reason to be cautious, emphasizes Dr. Heyes. “The medical treatment of mental disorders often has enormous side effects. So, if the therapy is not carefully monitored, it can be very dangerous,” she says. However, she believes that only a few people who self-diagnose themselves would actually receive the psychiatric medication that could potentially treat their symptoms.
However, there are experts who consider TikTok self-diagnosis to be potentially harmful. “That’s a gray area,” explains Dr. Inna Kanevsky, Professor of Psychology at San Diego Mesa College. Dr. Kanevsky emphasizes that she is not a clinical psychologist and therefore does not diagnose anyone. On TikTok, she has over a million followers and regularly posts stitches, duets, or responses to videos that she believes are spreading misinformation about mental health. “I notice this trend [towards self-diagnosis] and I’m worried about it,” she says.
Dr. Kanevsky admits that there are indeed mental disorders that are clearly underdiagnosed. “For example, when it comes to ADHD or autism, both were ignored in people who were assigned female at birth for years. This was due to the misconception that ADHD and autism only affect boys and men, and to the fact that doctors did not understand to what extent both manifest differently in women,” she says. “So, I don’t want to say that you should never listen to what is being told on TikTok, or that you shouldn’t self-diagnose, or that a therapist should always do it.”
However, Dr. Kanevsky is indeed bothered by videos whose creators seemingly want people to diagnose themselves based on this content – such as videos that call for raising a finger in the comments if viewers can identify with this or that experience. “Many of the ‘symptoms’ listed in such videos are not actually symptoms of these conditions,” she says. “They may well occur in those affected, but also outside of these conditions.”
Vertrauen ist gut, Kontrolle ist besser
Kurz gesagt: TikTok-Videos können niemals echten medizinischen Rat ersetzen – aber das bedeutet nicht, dass es in der App keine hilfreichen Informationen gibt. Du solltest jedoch alles kritisch hinterfragen und selbst recherchieren. “Ich sage immer: Vertrauen ist gut, Kontrolle ist besser”, sagt die Psychologin Dr. Lesley Cook, die selbst Inhalte auf TikTok postet. “Es gibt Leute, die absichtlich falsche Informationen verbreiten und Leute, die sich für Experten halten, aber über Themen sprechen, von denen sie nicht vollständig verstehen.”
TikTok-Videos werden nicht zwangsläufig auf ihren Wahrheitsgehalt überprüft. Unabhängig davon, ob ein Video absichtlich oder unbeabsichtigt falsche Informationen enthält, kann irreführender Inhalt viel Verwirrung stiften und dazu führen, dass wir der medizinischen Community weniger Vertrauen schenken. “Wenn eine Person ein Video sieht, das behauptet, sie habe ADHS, und sie sich dann ärztlich untersuchen lässt und erfährt, dass sie kein ADHS hat, kann das das Vertrauen in die medizinische Autorität untergraben”, sagt Dr. Cook. “Vielleicht denkt diese Person danach: ‘Ärzte haben keine Ahnung, wovon sie reden’.”
Obwohl soziale Medien niemals deine primäre Quelle für medizinische Informationen sein sollten, hält Dr. Cook die Selbst-Diagnose gelegentlich für legitim. Da das Gesundheitssystem in vielen Ländern immer noch besser situierte Menschen bevorzugt, findet sie es in Ordnung, sich diesem System zu entziehen – vorausgesetzt, man macht es auf informierte und verantwortungsbewusste Weise und nicht nur auf TikTok.
Paige Layle, bekannt als @paigelayle auf TikTok, wo sie 2,6 Millionen Follower hat, unterstützt ebenfalls die Selbst-Diagnose – ebenso wie Dr. Cook, aber auch außerhalb von TikTok. Layle erhielt kurz nach ihrem 15. Geburtstag die Diagnose Autismus, nachdem sie einen Suizidversuch zu einem Kinderpsychiater geführt hatte. Fünf Jahre später hat sie ihre Anhänger hauptsächlich durch Beiträge zur Neurodiversität aufgebaut. “Ich begann über Autismus zu sprechen, weil viele Leute auf TikTok das Wort ‘Autismus’ als Synonym für ‘dumm’ benutzten”, erzählt Layle. “Also habe ich ein Video darüber gepostet und es war das erste, das mehr als 100 Likes bekam. Nach einer Weile waren es über 100.000. Damals wurde mir klar, dass viele Leute diese Informationen wollen oder brauchen – und ich kann sie ihnen geben.”
Layle stellt keine Videos zur Selbst-Diagnose zur Verfügung, bei denen sich Menschen melden sollen, die sich darin wiedererkennen. Sie konzentriert sich darauf, Informationen über Autismus zu teilen und eine Community aufzubauen. “Eine Selbst-Diagnose ist legitim und sollte es auch sein. Es gibt viele Gründe, warum jemand keine klinische Diagnose bekommen kann”, sagt sie. “Mir ist jedoch wichtig: Nutze mehrere glaubwürdige Quellen, um dich zu informieren. Nicht nur mich!” Alle, die unter ihren Videos den Verdacht äußern, selbst autistisch zu sein, verweist sie auf eines ihrer YouTube-Videos “für deine nächsten Schritte, einschließlich Tipps zur Selbst-Diagnose und Ratschlägen für ein ärztliches Untersuchungsgespräch”. (Auch Dr. Kanevsky hat auf ihrem TikTok-Account Tipps für Menschen gesammelt, die sich keine mentale Gesundheitsversorgung leisten können.)
Hurdles in Treatment & Medication
One reason why it is helpful to seek a professional diagnosis is the possibility of a safe and effective treatment plan. Dr. Kanevsky and Dr. Cook warn that there are numerous misinformation circulating on TikTok about supposed treatment options for various mental illnesses, as well as false information about symptoms. “Some people, for example, give advice on diets that are not scientifically based and do not help at all. Or they recommend supplements that should not be taken without medical supervision,” says Dr. Kanevsky. “So, you may not find solutions that can really help you in this way.” According to Dr. Cook, she has even seen people on TikTok urging ADHD sufferers to exchange their medication for the dietary supplement L-Tyrosine. “That worries me,” she says.
Although Dr. Cook emphasizes that not everyone necessarily needs a clinical diagnosis, it can limit access to helpful resources and treatment options for those affected, especially young people. Furthermore, they may miss the chance to be considered differently based on their specific needs, for example, in school. That is exactly why Layle wishes that self-diagnosis would be enough to get such adjustments. “Ultimately, it comes down to a lack of resources: we prioritize who should receive help. But every person who could benefit from such accommodations should get them, regardless of whether they can prove it with a very expensive medical report,” she says. Dr. Kanevsky adds, “If individuals do not undergo a professional examination, they prevent themselves from being considered differently due to their illness or disorder.”
The experts agree that it is perfectly okay to watch TikToks about mental illnesses and recognize yourself in them. It is also okay to post these videos. Speaking openly about it helps reduce the stigma surrounding these diseases or disorders and gives those affected a community they need. However, such videos can never capture the whole picture – especially when you consider that anyone can post on TikTok and that the algorithm is designed to show you videos that are similar to the ones you have already interacted with. As a result, you are only shown a few opposing viewpoints.
If you find yourself wondering if you could have this or that disease after watching a video about it, you should only consider this suspicion as a starting point – not a diagnosis. Make sure that the people you listen to or watch (including on TikTok!) are licensed professionals, ideally experts in their field, says Dr. Cook. Get information about the illness from various reputable medical sources and, if possible, ask your doctors for advice. As Dr. Cook says, “The people who watch my content deserve more than a one-minute video. They deserve the undivided attention of an expert.”
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