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The Luddite

An Anticapitalist Tech Blog


Why Do Teens Use TikTok for Mental Health Diagnoses?
November 2023
Two very sketchily drawn faces look at each other, and the space in between them is one of those inkblot texts, where depending on what you focus you see a different image. The negative space between their faces is a cup, which is the classic inkblot drawing.

People, especially young people, are diagnosing themselves on social media. This is a well-documented phenomenon. Even CNN Business, quite possibly the most mainstream possible source, has written about it:

A growing number of teens are turning to social platforms such as Instagram and TikTok for guidance, resources and support for their mental health, and to find conditions they think match their own – a trend that has alarmed parents, therapists and school counselors, according to interviews with CNN. Some teens start to follow creators who discuss their own mental health conditions, symptoms and treatments; others have come across posts with symptoms checklists to help decide if they meet the criteria for a diagnosis.

In order to analyze this alarming new trend among the youth, CNN Business turns to a series of experts,1 like Dr. Larry D. Mitnaul, the CEO of Be Well Academy, and Alexandra Hamlet, a psychologist. Hamlet suggests, among other things, that "social media companies should tweak algorithms to better detect when users are consuming too much content about a specific topic." Of course, spokespeople for the various social media companies also receive several paragraphs. We learn of Meta's "Well-being Creator Collective," or the steps TikTok has taken "to let users set regular screen time breaks and add safeguards."

About three-quarters of the way through the article, consisting almost entirely of obviously-bullshit, little ticky-tack technocratic ideas and fixes, half of which are literally corporate PR, they finally hit something interesting, almost as an afterthought.

Linden Taber, a school counselor in Chattanooga, Tennessee, said students are still reeling from the effects of a global pandemic, and many therapists and psychiatrists have months-long wait-lists – not to mention the financial inaccessibility of some of these services. [emphasis added]

"I've seen an increase in psychological vocabulary among teens … and I believe this is a step in the right direction because as a society, we’ve decreased stigmatization," she told CNN. "But we haven’t increased access to support. This leaves us, and especially teens, in a vacuum."

She argues that when a student self-diagnoses based on information they’ve seen on the internet, it can often feel "like a sentencing ... because there isn’t always a mental health professional there to walk them through the complexity of the diagnosis, dispel myths and misconceptions, or to offer hope."

Taber rightly points out that, now that we have increased awareness and decreased stigmatization2 of mental health, we've given kids a framework for understanding their struggles in the world, but that framework is supposed to function within a larger medical context, and we've failed to provide them with access to that. This is a crucial insight.

I argue that their self-diagnoses aren't wrong per se; it's that they're building their own theory from scratch with the tools we've given them. They're building a parallel framework, not misapplying the existing one. After all, it's the adults who are on an extended campaign to make teens aware of mental health, only to deny them access to the requisite care that we are telling them that they need. That doesn't make any sense. Left with half a theory and no solutions, thanks to the incompetence of adults, they are doing what they can to make sense of the world using what we have given them: awareness and social media.

Unfortunately, the failures of the adults, our failures, don't end there. If every generation is supposed to make the world better for the next one, we have catastrophically failed. The world we've made for them sucks, but somehow, we're now endlessly wringing our hands, probing them, hoping to find some new self-diagnosis trend or pronoun or gay book to blame for their malaise, as if the problem lies with them. As I will soon argue, this failure, our failure, is a political one, and in this, we have failed them twice over. Not only have we given them a worse world, but we have failed to give them the vocabulary to discuss it, though they are discussing it all the same, with the only words we've taught them.

In short, teens are rebelling, as is their nature, and as they damned well should. But here at The End of History, to which There Is No Alternative, self-diagnosis is the closest thing they have to rebellion. If politics is over, if our world as it exists today is as real and inevitable as gravity, then its rejection can only be understood as pathology.3

Conveniently, Marc Andreessen, a prominent tech venture capitalist and billionaire, just published the The Techno-Optimist Manifesto, which perfectly illustrates both our failure and our denial to recognize it as such. The document somehow manages to contain multitudes while simultaneously having little substance, though it's useful for an excerpt and maybe a footnote.4

We had a problem of starvation, so we invented the Green Revolution.
We had a problem of darkness, so we invented electric lighting.
We had a problem of cold, so we invented indoor heating.
We had a problem of heat, so we invented air conditioning.
We had a problem of isolation, so we invented the Internet.
We had a problem of pandemics, so we invented vaccines.
We have a problem of poverty, so we invent technology to create abundance.

Setting aside the mountain of problems with his other claims — rising food insecurity; light pollution is bad for humans, animal, and plants; the climate is actually very much out of control; the ineffective international response to the current pandemic; and rising poverty — Andreessen's claims about the internet solving isolation just don't fit the data. In reality, we Americans have never been more lonely. Our tragic, pervasive, and stubborn loneliness gives the lie to the predominant apolitical and techno-optimistic narrative that technological advances and progress are one in the same. A society filled with lonely people is fundamentally broken. It borders on oxymoronic. These supposed ambassadors of scientfic progress are so self-absorbed that they're blind to the actual, scientific evidence of the failure of their project.

But there are other, more critical, expressly political theories that not only fit the data, but predicted it well in advance. Contrast Andreessen with none other than Karl Marx, writing in 1844. Attempting to quote Marx directly while trying to keep these posts (relatively) succinct is a fool's errand, so I will summarize as best I can: Marx argues (among many other things) that working for someone else making a thing that you don't own or care about in exchange for money, which itself only matters to you because you can use it to buy things made by people you've never met and will never meet experiencing that very same thing, with which you are also in eternal competition, is an alienating way to organize a society. Because of course it is.

Not only does Marx's theory of alienation fit the data, but despite being almost 200 years old, it gives us a framework for understanding our loneliness. More modern writers, like Guy Debord, have expanded upon it, opening his 1968 book The Society of the Spectacle as follows:

In societies where modern conditions of production prevail, life is presented as an immense accumulation of spectacles. Everything that was directly lived has receded into a representation.

The spectacle is a perennially useful concept in the age of social media, despite predating Andreessen's so-called thoughts by a half-century. Debord argues that the spectacle is simultaneously a product or representation of society, but indistinguishable from society itself. "[I]ts means are simultaneously its ends. It is the sun which never sets over the empire of modern passivity. It covers the entire surface of the world and bathes endlessly in its own glory." Our society "is fundamentally spectaclist. In the spectacle, which is the image of the ruling economy, the goal is nothing, development everything. The spectacle aims at nothing other than itself."

The nature of the spectacle makes it difficult to summarize quickly, because "[t]o describe the spectacle, [...] one must artificially distinguish certain inseparable elements. When analyzing the spectacle one speaks, to some extent, the language of the spectacular itself." Trying anyway, consider the American presidential elections, specifically the so-called "debates."

The republican debates of 2015. 11 podiums with clowns behind them sit on a set. ronald reagan's plane behind them. 2024 republican debates. 8 podiums, each with its clown, in a semi-circle. the floor has a graphic representation of the presidential seal. it's a red white and blue soundstage. the back says fox news democracy 24 in, you guessed it, red white and blue

Understood within the context of a high school civics class, the framework through which our children are taught to understand these things, debates exist to inform the voters in our democracy. The candidates are asked about the pressing issues of the day, allowing us viewers to learn which of the candidates' policy preferences most closely align with ours. But seriously, look at them. Why is Ronald Reagan's airplane in the background? What are these game show sound stages? These are spectacle, consumed by a society which then itself is consumed by spectacle. We are literally ruled by spectacle. We are spectacle.

I am a millennial. I vaguely remember a time before the spectacle reached its current all-encompassing, most frenetic form in social media, but teens today are natives. Here's Debord again:

The spectacle is the moment when the commodity has attained the total occupation of social life. Not only is the relation to the commodity visible but it is all one sees: the world one sees is its world. Modern economic production extends its dictatorship extensively and intensively. [...] [S]ocial space is invaded by a continuous superimposition of geological layers of commodities. At this point in the "second industrial revolution," alienated consumption becomes for the masses a duty supplementary to alienated production. It is all the sold labor of a society which globally becomes the total commodity for which the cycle must be continued. For this to be done, the total commodity has to return as a fragment to the fragmented individual, absolutely separated from the productive forces operating as a whole.

Since Debord, this has only become more literally true, to the point of vulgarity. It is no longer a radical stance to say that human beings today are consumable commodities in a vast perverse spectacle. It's just obvious. Even the most ignorant internet user knows as much. People today are born with a mature commodified representation of themselves already waiting for them. Their pregnancy announcements and gender reveal stunts are them before they themselves are. They're bombarded by the relentless algorithmic homogenization that capital has created for them before they're even born, after which they become cosubstantial with it.

Situationists like Debord also identified a phenomenon they termed "recuperation." It's the process by which a radical and subversive idea is re-absorbed by mainstream society, which neuters it, commodifies it, and sells us back a palatable, unthreatening version of the original, like a Che Guevara t-shirt at WalMart, or a feminist Barbie movie. Teenagers, students, and young people in general are an important political force. A student's job is to learn, and learning has a tendency to question the status quo. Put a bunch of students, often of diverse backgrounds, in one place, a campus, and suddenly they can be a threat to governments, as they have been for over a century. The Situationists were involved with protests that almost brought down the French government in a multi-day clash with police forces, fueled, in large part, by students, including high school students.

Now, this seemingly innate teenage desire for change is being recuperated. Their unwillingness to accept the world as given to them is being transformed from a volatile political force. We've taught them that the world cannot be changed, and their desire for a different world can only ever be addressed by the fast-growing healthcare sector of the economy. Crucially, this doesn't mean that mental health diagnoses are never real, just like WalMart's Che Guevara t-shirts don't mean that Che Guevara wasn't real. I make no claims about mental health generally, outside of social media self-diagnosis. I argue that self-diagnosis is capitalism attempting to recuperate teenage angst, pushing them away from radical and subversive ideas and into fundamentally individualist ones, incapable of challenging power, thus converting agents of political change into, in their own minds, sick people in need of care, or from revolutionaries into consumers.

To examine this claim, consider the structural similarities between social media and self-diagnosis. Social media a tool for advertising — not just any advertising, but specifically targeted advertising. Its purpose, from a business perspective, is to sell ads. To do this, these companies collect our demographics, our experiences, our interests, our jobs, our health conditions, the languages we speak, the places we've been, and anything else that can possibly be gleaned from our internet usage in an attempt to perfectly describe each of us, so that, when we are using their site, we will see the perfect advertisement. In other words, it's already a diagnosis tool, but for consumerism.

At the same time as social media became ubiquitious, adults, often with institutional backing, actively campaigned to make kids aware of an entire taxonomy of mental health diagnoses, but we failed to follow through on the promises of care, support, and relief associated with it. We also gave them a tool explicitly designed to do diagnoses, albeit a different kind. Unsurprisingly, they put those two things together, combining them into a theory of their own. Mental health experts see it as a misapplication, but to the kids, I think it's an internally consistent theory that helps them make sense of a world that doesn't make any sense. It also happens to be a theory that robs them of agency. This is hardly a unique phenomenon; adults do this all the time.

It's an understandable reaction to coming of age in a world that is getting worse. The pandemic forced them into isolation for some of their formative years, during which they grew up watching adults throw tantrums at being asked to wear a cloth mask over their face. Climate change is here now, and it's getting worse quickly, but we, the older generations, do nothing, except we do worse than nothing, because if we actually were to do nothing, we'd burn fewer of the fossil fuels that we seem increasingly determined to use to guarantee our own comfort now at the expense of their future.

And they're struggling. Of course they are. There are countless articles about kids' mental health, and how bad it is. That's always how we, the adults, write about them. It's their mental health. They are sick. Why are they sick? Is it social media? Is it all their newfangled pronouns? Are parts of speech making my sweet little Korblynn unwell? Then, like in our opening example of these articles, parents, school counselors, and therapists — in short, all the adults — find it concerning that all these kids on TikTok are self-diagnosing. They can't even be sick right!

But we haven't given them any other way to talk about it. We don't teach kids Marx or Debord. They don't know about alienation, or commodity fetishism, or the spectacle. What little we do teach them about politics only makes it more confusing, as we've already seen with the "debates." What they do know is that when school didn't work for them, when the pandemic made them miserable, when they didn't fit neatly into their rigid, preordained existence as a commodity, we assumed that they must be sick, probably because some chemical was out of balance in their brain, so we took them to a doctor. The CDC estimates that 19% of kids between 12-17 received mental health treatment in the last 12 months. The average child today probably knows the uses and names of dozens of mental health prescription medications before they are taught the most basic vocabulary to understand and critique our society.

To illustrate both what I am arguing and what I am not arguing, I want to quote from what seems to be a pretty typical example of these self-diagnosis videos. I will modify it for anonymity, and I will not link to the video. I want to express nothing but solidarity for anyone trying to make sense of the world using the broken pieces they've been handed, in no small part, by people like me, an adult working in tech.

Having both ADHD and Autism creates a constant conflict between apparently contradictory traits. You might feel constant inner conflict with yourself. You might get frustrated with yourself. You may crave order and routine but you struggle to maintain it. You might get overstimulated as much as you get understimulated, and sometimes this might even happen at the same time, or in a very short space of time, which can be confusing and frustrating for yourself and probably also for others around you. These two sides of yourself sometimes have completely opposite desires and needs. This can result in what looks like apparently hypocritical behavior from the outside, although it makes perfect sense when you know what you're dealing with. Like, for example, needing everyone around you to be completely quiet and then making a lot of noise yourself.

These traits may balance each other out, not for everyone but for many people. The opposing actions of autistic and ADHD traits can even conceal each other. Struggles might not be always obvious because the social awkwardness of autism often kind of gives in to ADHD's sociability and chattiness. From the outside, this can appear as if you are just shy at first. Maybe you take your time warming up to people.

Anyone can see themselves in this. It's almost like a mental health horoscope, except instead of giving me a just-generic-enough prediction based on the moon and stars, it explains to just about anyone watching why they're so damned uncomfortable so much of the time. Discomfort, pain, awkwardness, and struggle are universal. I'm not surprised this resonates with people, especially after a lifelong exposure to a mental health awareness campaign that, if you twist it a bit, might sound like you're supposed to be a productive, happy, and healthy member of society, and feeling weird or bad or unproductive or even awkward could be a sign that there is something physiologically wrong with your brain.

I want to be crystal clear: This is not intended to invalidate anyone's mental health struggle, but to affirm each and every person's value as a part of our shared human struggle. No matter what we call it or how we decide to categorize it, to be human is to struggle, but we ought to struggle together. This is the very core of leftist politics, but the left's ideas are so marginalized that even most adults in the US have never been exposed to them. In the absence of a coherent, unified, and powerful left, one with a clearly articulated vision for a more pleasant, peaceful, and just world, capitalists have had free rein, and they've built the world we live in today. It's a lonely world with sad children. Even our dogs are sad. There are lots of ideas for how to make it better, but these ideas haven't made it to them,5 drowned out by the worthless and self-aggrandizing ramblings of capitalists like Andreessen, which form a hegemonic canon of apologia for a system reliant on human misery and ecological devastation. In response, teens are building their own critical theory, almost from scratch, using only the scant recuperated scraps that we've left them. They're doing this on social media, enemy territory, which is algorithmically undermining them while actively profiting off their efforts. It's a fundamentally individualist theory born of consumerism that precludes the radical solidarity we so desperately need.


1. Here, I use experts the way Herman and Chomsky use it in the third point of their "propaganda model."

2. It is far outside the scope of this blog, but the source of this stigma is itself an active and controversial topic of debate and research.

3. See Mark Fisher's Capitalist Realism (PDF warning).

4. I started writing a whole post responding to this manifesto, but in truth, there's not enough substance to merit one. It's a boring document that can only be understood as a justification of the status quo, from which no one benefits more than him. I do not doubt his sincerity any more than I doubt King Louis XIV's sincere belief in the divine right of kings, though I wish him a much, much shorter reign.

5. The kids, that is. The vast majority of dogs are already socialists.