These days, more and more youngsters are turning to social media platforms such as TikTok for advice on everything from how to perform the latest K-pop dance moves to hacks on producing the perfect winged eyeliner.
But should they be taking advice from social media influencers on more serious issues, such as mental health?
A recent study published by researchers in British Columbia, Canada, found that the 100 most popular TikTok videos tagged #ADHD clocked up a total of almost half a billion views.
ADHD (attention deficit/hyperactivity disorder) is clearly on TikTok users’ minds. But what is the quality of information given out online, and what does it mean for the people who consume it?
It's important to note that ADHD has historically been considered by psychiatry, clinical psychology and mental health professionals to be a serious neurodevelopmental disorder that requires a professional clinical diagnosis.
Broadly speaking, the research team found that the TikToks lacked nuance, and that the majority of videos focused on people’s lived experience of ADHD and on the symptoms they had.
Having symptoms that can be attributed to ADHD doesn’t necessarily mean that you have it, though. And similarly, not everyone with ADHD has the same set of symptoms.
The team also noted that around half of the videos studied focused on symptoms that aren’t closely associated with ADHD to begin with.
Of course, both deliberate and accidental misinformation can be damaging, and although ADHD can bring certain strengths for many, it has historically been seen to be a psychiatric concern. For some, it can have a significant impact on their lives.
Examples are repeatedly being fired from jobs for being unable to follow instructions and arrive on time; being unable to sustain relationships due to difficulties interacting with others and finding it difficult to follow through on intended actions.
Not everyone with ADHD will suffer from these impairments to this degree, but they are a part of the diagnostic criteria.
Professional diagnosis
So, how is ADHD clinically diagnosed? There are two main sets of rules that medical professionals can use to diagnose ADHD found in the ICD-11 and the DSM-5 manuals that classify various health conditions.
In the UK, a qualified health professional, usually a psychologist or psychiatrist, uses these criteria to make a diagnosis.
The three core traits of ADHD – inattention, impulsivity and hyperactivity – can occur in various combinations and the manuals list the symptoms under each trait, explaining what they might look like in terms of observable behaviour.
The key thing for diagnosis is that the symptoms occur frequently and cause significant problems in daily life.
What this looks like can change from place to place and over the course of someone’s life. Because ADHD is considered to be a difference in brain development, an assessment will ask about a person’s childhood – symptoms need to have been evident before they reached the age of 12.
Though diagnosis is important, it’s not essential for everyone. Having a diagnosis can give a person an explanation for why they may have felt different to others their whole life, give them a sense of identity, and a more complete profile of their strengths and areas of challenge.
Medically, diagnosis can also provide a gateway to treatment or support. The recommended treatment will be based on previous evidence of what has been successful for others and can include medication or behavioural therapy.
Sometimes, however, there’s little medical treatment that can be offered and so advice is given to enable those with ADHD to change their environments to reduce its impact. In fact, some of the TikToks did give tips based on the creators’ lived experiences.
Diagnosis is also a prognosis: studies following people with ADHD can raise awareness of risks, protective factors and commonly co-occurring health conditions to be aware of.
Medical diagnoses also extend into other areas of life, for example, providing evidence for benefits if a person is unable to work due to the disabling effect of their symptoms or enabling them to request specialised educational resources.
But why, then, are young people seeking medical advice on social media platforms? Increasingly, this is how people get their news and manage many aspects of their lives, so we shouldn't really be surprised.
The issue may be that there aren’t many mental health professionals creating content and sharing it on the most popular platforms. None of the top-100 videos in the study were created by someone qualified to diagnose ADHD.
That responsibility is on the scientists to share what they find from their work as widely as possible.
Scientists are used to writing papers and, these days, writing blogs or appearing on podcasts.
But TikTok has a reputation of being for young people, and many of us are concerned that nobody will watch our content if we don’t have slick editing, conveying what we think you need to hear in bites of 40 seconds (the average length of the #ADHD TikToks studied).
So, medical professionals need to work with those who are comfortable with the latest platforms, ideally those with lived experience of ADHD, to help co-produce content people are searching for that has genuine educational and awareness-raising value.
We also need to consider the cost of producing this type of content, as many of these professionals are funded by taxpayers.
Read more:
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Context and considerations
While the TikTok study was well conducted and carefully analysed, as with all science, it comes with limitations. The videos were captured using a search for #ADHD on a single day in 2023 and sorted by popularity.
This isn't even a drop in the ocean of TikTok and so is unlikely to represent all content.
In a lot of cases, the motivation behind the creators making the TikToks was unclear from the data captured by the research team. But they did find that half of the creators were potentially making money from their views.
So what’s next for mental health and neurodiversity professionals on TikTok? It’s not a case of ‘fighting’ the influencers, but I do think we need to do better.
Professionals and scientists need to present their knowledge to the world in an easily digestible format, to catch viewers’ attention – especially viewers who may have ADHD.
If we’re fighting anything, it’s probably the algorithms at work behind such sites, monitoring how many milliseconds we spend on each piece of content, and pushing more similar content our way.
The top-100 videos in the study were mostly people describing their lived experience of ADHD and the value of that shouldn’t be understated.
TikTok might not be the best place to get diagnosis information, however, and we should all be critical of what we watch, as it could influence someone to think they do have ADHD despite not having a medical diagnosis.
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