Funding for To The Contrary provided by: This week on To The Contrary: The positive about mental health information being on social media, in genera is that its raising awareness.

But some of the negative things could be that the content isn't vetted, and it could make people feel worse about their own symptoms.

Hello, I'm Bonnie Erbé.

Welcome to To The Contrary, a discussion of news and social trends from diverse perspectives.

TikTok has become a popular place to share symptoms and advice for people seeking information about mental illness.

Some critics warn against potential harm.

This can be especially relevant for women who are more likely to be diagnosed with anxiety and depression, and whose ADHD is more likely to go undiagnosed.

New research shows the majority of videos about ADHD on TikTok are scientifically inaccurate.

One of the issues is cost.

Social media are free to access, which expands the audience for people of color.

With us to discuss this is Dr. Amori Mikami, one of the authors of the study, and Dr. Joanne Broder, a Fellow of the American Psychological Association.

Hello to both of you, and thank you for joining us.

Thank you, Bonnie.

It's an honor to be here.

Thank you.

Thanks for—thanks to both of you for coming.

So let's get right into it.

First, let's start with gender and color differences.

How are the results of this study?

What are the result and what does that tell us about gender?

Different interpretations of things affecting gender and racial interpretations of things affecting race.

I was one of two psychologists who rated the top 100 video with the hashtag ADHD on TikTok.

We found that only about half of them align with DSM diagnostic criteria for ADHD.

Similarly, among those that promoted a treatment, only about half of them were treatments that professionals consider to be empirically supported.

Then we showed young adults some of the psychologists rated videos.

The young adults who generally watched more ADHD TikToks thought these videos were better quality, and they also tended to overestimate the population prevalence of ADHD more and think that people with ADHD had more severe symptoms.

After watching the TikToks we showed them, people with a self diagnosis of ADHD became more confident that they had ADHD, while people with no suspicion of ADHD also started to wonder mor if they might, in fact, have ADH You know, ADHD is underdiagnosed or misdiagnosed more often in women.

We also know that racialized people, at least in the United States and Canada, tend to also be misdiagnose or are underdiagnosed with ADHD.

So, the reason why I think this is relevant is that if the typical sources of mental health information or health care have access barriers for those groups, then it probably makes sense that a source like TikTok might be more accessible and relatable.

Now what you said—it' misdiagnosed and underdiagnosed in the general population.

Either one of you, or both of you—why?

Why is that?

Not just ADHD, but I think a lot of mental health issues, in general, are really misused in the media and exaggerated.

You know, like, let's say if somebody does something that's selfish, all of a sudden they're a narcissist.

Or if something, you know, feels, you know, pain or is remembering something, you know, an incident—now, they have PTSD.

I've also seen the term toxic trait really misused in the media, like really credible.

For instance, I saw a credible influencer saying, you know, my toxic trait is that I'll order a cup of coffee that's too— a large cup of coffee and not finish it.

Come on.

And this isn't this isn't a mental health expert.

This is somebody delivering content about other stuff.

So about lifestyle, you know, content.

So it's kind of like this person's hearing wrong information so then they're delivering it incorrectly.

Maybe not maliciously.

You know, that's your misinformation example.

Maybe not maliciously.

So now you have people, you know, listening to this credible expert on other—on other topics, and then they're startin to misuse the word toxic trait.

Well, my toxic trait is that I'm always early.

I always show up early to events.

Is that really a toxic trait?

It sounds like an overuse o the word, to me, as a non-expert Yeah, it doesn't sound toxic.

It sounds like it's a bit of a proble or a bit of a misunderstanding.

Well, going back to your question about why it is that women or girls or racialized folks might be misdiagnosed or underdiagnosed, I think it relates to a lot of the barriers that we have to accessing equitable access of health care, in the United States and in Canada, too, which is where I now live.

There's, you know, financial barriers.

But even beyond that, like logistical barriers in terms of knowing how to navigate the complicated, complicated system, making an appointment, getting to an appointment, taking off work or having childcare responsibilities that might, you know, interfere from you going to that appointment.

And then there's the whole, divide and the importance of, like, finding a provider who understands you, relates to you and your lived experience, particularly if you have marginalized or stigmatized identities, a provider who who speaks your languag and can be culturally competent in talking to you so that you can imagine tha these, these gaps are, are huge.

And women, you know, in particular also do have a history of being ignored or in the, in the medical system or having their concerns not taken seriously.

So I do think this is part of it.

I also thin some of it is that ADHD in girls relative to boys tends to be more likely to be the inattentive type, you know, the daydreaming lost in your thoughts.

Whereas in boys, they're more likely to be—statistically, be running around and interrupting people and also having those co-occurring conduct problems like fighting, aggression.

And that's the stuff that really catches the attention of parents and teachers and gets you referred to the school psychologist pretty fast.

So you know, those are somewhat I think, some of the challenges are in equitable diagnosis and access to treatment.

Is there anything good about this trend, even if the net, so to speak, is drawing in too many people who—who are not affected by these psychological conditions whatever you want to call them.

The positive about mental health information being on social media in general is that it's raising awareness.

You know, I think—think about it its—it's almost like it's being delivered.

You know, if—if DoorDash suddenly just showed up at the studio delivering a food you've never tried, you might try it.

So people are getting information, and they're being exposed to content, and it might be relatable to them.

Oh, that—that might be—that sounds like my uncle.

That sounds like my friend.

So they might— So they're learning about it.

Where—at least they're being exposed to it.

I mean, the good—they're being exposed to it.

I think it's what they're doing next with the information.

You know, it's kind of like, okay you're learning about this term.

You're learning about, you know, like you're learning about, let's say, narcissism, you're learning about ADHD.

So rather than just listening to what you hear on TikTok or Instagram, you know, when you do a dig deep, you know, when you're, let's say, oh I want to learn more about this.

And so I'm going to Google it.

Are you going to the right sources?

Are you going to source like the American Psychological Association, the National Institute of Health?

You know, like there's a lot of credible incredible, you know, nonprofits that specialize in these, you know, in different subtopics and different subspecialties and issues.

So it's a matter of, let's say, the consumer of the content going, you know, like kind of being exposed to it and taking it, you know, and learning about i in, in a smart way and knowing— —being media literate and learning how to learn more from credible resources.

What are the positive sides of what some may consider too much exposure to information about brand new psychological conditions, diseases, whatever you want to call them.

At a time when even the experts in this field are still feeling their way through what is going on out there.

Right, well, I do think that there are some positives to this trend.

For instance, people are—feel seen or feel heard in ways that they often haven't before or haven't from the traditional health care system or from mental health professionals.

It can also be a way for people to find community of others with similar lived experiences, and I think it can really be a way to humanize some of these, you know clinical disorders or conditions that can be very stigmatize or can just sound very detached and, you know, put a human face on it.

Well, are there other possible problems?

As Doctor Broder pointed out earlier, of some practitioner or somewhere, suggesting rather, drastic, very drastic measures, to a large audience?

Yes, I mean, there are.

There's big problem with misinformation.

As Doctor Broder noted, I think, you know, TikTok, it's—it's not vetted.

So, anybody can really put any content on.

It can be difficult to remove content that is judged to be or people think is inaccurate.

And, you know, another thing is, I think that just the incentive structure in TikTok is such that, even when content creators really are getting on to share their experiences and to help others, it's—it's— —so it's hard to not be motivated by getting, trying to get more likes and more views and more engagement with your content.

And so I just think that sometimes that motivation runs counter to trying to put out like the information that at least mental health professionals would consider to be most scientifically accurate.

And instead it, you know, i pulls for things that are funny and—or short or sometimes outrageous or dramatic, even enraging because that's the type of thing that gets attention.

I was going to say, yeah, to—to add to that, you know, I know that really— —I know it's—everyone's all about the likes.

It's all about, you know, what's going to go viral.

And the one thing that, you know, my team at the America Psychological Association, one, our biggest recommendation is think before you post You know, think before you post.

Make sure, you know, it's peer reviewed.

Don't be emotional, and think about like, what is my intention?

You know, what is my intention of this post?

You know, if I'm to inform, then, you know, maybe I need to dial back the drama because we are talking about a person.

We often tell clients in therapy when they are coming across their own automatic thoughts or experiencing things in the world, and they don't know what to make of them.

We encourage them to ask themselves, is it accurate?

Is it fair, and is it helpful?

And so I think that, you know, as Doctor Broder was saying, approaching, I hope that people could approach social media more intentionally and more mindfully where they are, you know, keeping—keeping track of or just having an awareness of what they're consuming and how it's making them feel and the effect on the and evaluating that critically.

But I want to underscore here that I don't think the problem is with the consumers, though, women or men or racialized or white folks that are, consuming the content.

The problem, I think, is with the mental health system.

And again, I do think it's the—its the barriers to access and to, you know, helpful information that's culturally competent.

That is what is creating the need for TikTok misinformation, or mental health information, to began with.

The introduction is good because it's a place to become, to be seen or exposure.

And, you know, the hope is that there's also solutions and other resources and other community.

So it's a start.

It's a start.

If—it's, you know, it's kind of—it's better than nothing.

You know, think about before social media.

And you know, we were talking about, like, traditional media when people only had, you know, television.

You know, print, to rely on.

But, you know, traditional media does have fact checkers, peer reviewers, you know, peopl who are vetting the information.

Where on social media, again, it's— —you know, I think it's— —it's not always, it's not always vetted.

What is somebody supposed to say to themselves if they hear somethin that could be upsetting to them?

Both of you, please.

I think too, it's taking it for what it is.

You know, it's—it's—this is something I saw on TikTok.

This is something I saw on, you know, the gram.

And I would say, you know, take a step back, go to credible sites and sources and, you know, look for, you know, there might be, and there might be a specialist in your communit that could help deal with that.

Yeah.

It's a good question.

Honestly, I, I wonder sometimes if TikTok mental health information, consuming that, it's—it's kind of like doomscrolling.

There's, you know, doing it a little bit is— —can actually be quite helpful.

You know, there's a certain extent to which doomscrolling a little bit is helpful.

You get exposed to what's going on in the world.

You don't want to live your life with your head in the sand.

But, if you—you can take it to extreme and there gets to be a point, and it might be a slightly different point for different people, but there gets—ther gets to be a point where, it's, it's no longer helpful, you know, either because it's, it's contributing.

Well, you know, beyond contributing misinformation, I think sometimes, at leas from what our study suggests, is that at least for some people, watching a lot of ADHD content on TikTok can make them feel worse about their own symptoms, potentially because they ar looking at things in their life that maybe they hadn't really thought of before as a sympto of psychopathology or a problem.

But because it's displayed that way on TikTok, they start to, you know, they start to think that maybe this is a sign that I have a disorder, maybe this, maybe this is an issue.

So—so I do think it might be, a question of amount.

I think in timing as well.

I think, you know, I think if you're also consuming this before you go to bed or before you're going, you know, like—time when you're going to ruminate on it.

So, I think it's also a matter of putting boundaries.

You know, a lot of people don't put boundaries around the social—their content and when they're consuming their content.

Yeah, this is really hard to do.

You know, it's—its— —and I don't think this is just about mental health information on TikTok.

This probably applies more broadly to most people's social media use.

I mean, social media was made to try to keep people engaged and on it as long as possible.

You know, this is—its a product.

They want you to consume the product.

So I think that the goal here, which is hard, is to be—I wish that people could be, and I'm working on this myself too, you know, not immune to this—is to be more mindful and intentional about the way that you're using social media.

And again, asking yourself, is this helpful?

How is this making me feel?

Is this productive and good for my life and my mental health?

Disinformation and misinformation.

Each of you, please.

What's the difference?

How does your average everyday consumer avoid the disinformation?

Disinformation is more intentional.

Like I'm going to put something false out there.

You know, misinformation is more of a misunderstanding.

Yeah, it's kind of like I—this is how I'm interpreting it.

And then, so I'm going to forward it and endorse it, even though I might not understand it or I haven't investigated it.

Disinformation is like, oh yeah, I'm purposely trying to start something.

How do you advise your own clients or your own acquaintances to use— How do they find out, for example, that some sites are monitored for correct information and others just simply aren't?

Anything you see, just take a moment to reflect on this.

Is this, you know, is this helpful, fair and accurate?

And, don't—don't stop there.

So, TikTok or whatever—it—really any social media site, it can be, it can be great sometimes in that some people say that they, they saw themself in a video of somebody talking about their ADHD, and they really had never thought about that they had ADHD before but then they started to wonder.

And I think that can actually be, because obviously people are misdiagnosed or undiagnosed, that can actually be a very good thing if the person then stops, evaluates, does more research, you know maybe, provided of course, they have the access to this.

They seek out a mental health professional and, you know, they could say, bring it to a mental health professional and say, hey, I saw this on TikTok and it started to make me wonder, and it wanted, you know, it motivated me to get a more formal or thorough evaluation.

So, I think that's actually a good outcome.

But the more negative outcome is when people, just, you know, they hear things and then they decide that it applies to them and then they stop there.

Doctors, to both of you, please, anxiety and depression seem to be, perhaps, diagnosed more differently in the—in the two genders.

I'm sure there are racial differences, too.

What are those differences?

And how should people who are just sitting at home with a laptop, find out what website are likely to be more reliable?

While anxiety and depression, as you noted, they are more commonl diagnosed in women than in men.

And, you know, there— —there could be a lot of reasons for that.

But, you know, like ADHD, one possibility is that this is an area where men are going mor underdiagnosed or misdiagnosed, possibly because of gender norms and socialization.

Being that it's less appropriate to express those types of, you know, sad or anxious feelings.

In terms of where to turn to for—for help.

Yeah.

I mean, if, if going to a mental health professional isn't feasible or accessible or, you know, sometimes, there's really long waitlists, too.

I would say think about the sources of the information that you're—you're finding online.

Look for a trusted source.

I mean, organizations like APA, Dr. Broders association, and theres others too, often put out fact sheets or public, yeah, public psychoeducation about different disorders or different conditions.

So that's probably a good place to start if you're looking for things that are—have been more vetted by the scientific community.

And Dr. Broder, your thoughts, particularly with regard to racial differences, different communities, different cultures in—in America and Canada, everywhere?

It depends.

It depends on language and access and kind of who, kind of who is influence and different—who's being—who's a source of influence in different cultures.

So again and I think it's going back to, you know, the credibility.

Lik if you're exposed to something, it's—it's a matter of, you know, learning: a) distinguishing is this fact and research or is this somebody's opinion?

And again, like, kind of going into, like, learning, like, some of the other, like, website and some of the other, like, the the non-profits, the—like the government websites that, you know, you know do researc and where you could learn more.

Great, very interesting and—an— and last question for both of yo but I want you both to—to join in on this topic, which is, how do traditional and social media differ from each other in terms of the treatment of this very important, very personal, very widespread issue?

Well, I think that, social media is so popular, particularly among young people, because it is so very—not just accessible, but it's also very relatable.

You know, you have content creators who have lived experience and speaking about that for the most part, and in many cases, they are more likely to look like or share similar identities to the the folks who are the consumers.

And that's huge.

You know, you asked about it, what racialized people can do in terms of coming you know, finding scientifically accurate information.

And this is—I guess I just wanted to say, I feel lik this is a very complex problem, that we just have to acknowledge the long history and continued ongoing racism in the medical profession.

And there have been many wrongs done and I think continue to be perpetuated.

And it's infused even you know, in all of our training I think, I think we've made a lot of strides recently i improving our cultural humility and cultural confidence.

But, it's hard to overcome, a long history and tradition.

And so, if there's mistrust from some communities or some racialized communities of the field, you know, I, I sure understand why.

We need to acknowledge that and own that if there's also a problem that racialized folks might look at psychologists and generally not see themselves represented or represented as well.

You know, that's—that's a problem that's very complex and hard to fix.

But it is also on our field, I think, to fix it.

And have I given you enough time, Dr. Broder, to answer this point, or would you like to?

Yeah.

Very quickly.

Again, it's—it's exposure.

I think social media gives exposure in places where people wouldn't have exposure.

Not everybody's going to watch that talk show and see the expert come on.

Not everyone is going to pick up a magazine or a newspaper and read that kind of data, whereas they did in the past, but social media, again, think of it, it's—it's constantly being delivered to us.

Wonderful.

Okay.

And—and for—for that reason, if for nothing else, it's so much more widely available and for good reasons and for bad.

Sometimes, that's a good thing and sometimes that's a bad thing.

I want to thank you both so much for joining us for this edition of To The Contrary.

That's it for this edition, and keep the conversation going on our social media platforms X, Facebook, Instagram and TikTok.

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