When the psychiatrist tells his family that he has depression, they look at him like a crazy man. Can’t blame them for reacting like that because depression was a really strange, weird, and alien word in their world. It’s like Galileo trying to explain to the people of his time that the earth was not the center of the universe. It’s like Darwin trying to explain to us that we come from some apes. The psychiatrist is trying to explain that depression is just another type of illness, like a cold. But if you catch a cold? Because you were running in the rain yesterday. Please don’t do that again, or you run the risk of catching it again. Caught a depression? What went wrong? What shouldn’t he do again to not catch it again? Is he wrong? Are they wrong? Are you wrong? Mental illnesses and neurodivergents are not really a concept at our parent’s age. At that time, the only thing you can do is be crazy. And to be crazy is to be either locked up in an asylum or shunned by the whole community. That’s why I love social media. People usually think that I hate social media because of how many posts I dedicate to trash-talking them, but deep down, I believe they did some good for humanity despite all their flaws. One of them is raising awareness about mental illnesses and neurodivergence. People talk about all kinds of things on social media; Social media gives everyone a talking stage, no matter how smart, how stupid, or how wrong in the head you are, and thus, awareness for neurodivergence and mental illnesses rises as fast as a horny man. There are all kinds of people coming out of their shells, and sharing their stories and experiences on social media, some are happy, some are depressed, some have ADHD, and some are psychopathic killers. Social media helps people feel that these “disorders” are not that weird and that there’s always help and understanding. But the downside of social media is that soon enough, everything that goes viral gets farmed for engagement. It turned into something that needs to be shoved into your eyes for under 30 seconds. I blamed TikTok for that. Neurodivergence and mental illnesses First, in honor of Hippocrates, let’s learn the basics of the difference between neurodivergence and mental illnesses. Neurodivergence and mental illnesses are distinct yet sometimes overlapping concepts within the realm of mental health. Neurodivergence is not really a well-known concept; the word doesn’t even exist in Vietnamese. So, many people jump on the assumption train and just see neurodivergence as another type of mental illness, which is unfair and not true. Neurodivergence refers to the natural variations in the human brain's functioning, encompassing conditions like autism, ADHD, dyslexia, and Tourette syndrome. These differences are seen as part of the normal spectrum of human diversity, with an emphasis on embracing and accommodating these variations rather than treating them as disorders. In contrast, mental illnesses, such as major depressive disorder, generalized anxiety disorder, bipolar disorder, and schizophrenia, are considered medical conditions that cause significant distress or impairment in daily life, requiring treatment and management through medication, therapy, and lifestyle changes. While neurodivergent conditions highlight unique strengths and alternative ways of thinking and interacting, mental illnesses focus on symptom alleviation and improving overall well-being. An individual can be both neurodivergent and have a mental illness, having the best of both worlds, having a cake and also eating it. Understanding these differences is necessary. Did TikTok just give me ADHD? Could TikTok, the social-media platform for sharing short videos, one day replace your psychologist? Probably not, but its skyrocketing popularity as a tool for self-diagnosing mental health disorders is a big reason it's outpacing competitors like Snapchat, Pinterest, and Twitter. TikTok has become the fifth most popular social media platform overall and the second most popular after YouTube among teenagers. According to Statista, TikTok’s meteoric rise to social media stardom happened during the coronavirus pandemic, with a whopping 180% growth among users aged 15–25. This age group was hit hard like a truck by the isolation, anxiety, and general unwellness caused by lockdowns, so it's no surprise that more teens and young adults turned to TikTok to learn about mental health disorders and to self-diagnose conditions like autism, ADHD, borderline personality disorder, dissociative identity disorder, OCD, and others. It makes sense that these users would start sharing their stories online, and those stories gained traction because many others could relate. This model works. Some users even turned into content creators and monetized the heck out of it. 1. Self-diagnosis as a sensible TikTok practice Despite TikTok’s shortcomings, research suggests that its practicality as a diagnostic tool may not be the only reason for its popularity. Sociologist Joseph Davis, who directs the Picturing the Human Project for UVA’s Institute for Advanced Studies in Culture, explores questions at the intersection of self, morality, and cultural change. Davis has talked to many people of different ages and found that calling their struggles a mental health condition helps them understand and explain what they're going through. Young people have always looked at others to judge their own worth. In the past, before the internet and social media, they only compared themselves to the people around them, so their feelings of distress were limited because, you know, you cannot physically meet that many people in real life. Social media rewards people for showcasing their lives on the net. Davis explains that now, with social media, the comparison never ends. Every morning, you scroll through your social media and see picture after picture of other people's lives. Everyone else seems better looking, more successful, and more exciting. This makes you feel like you're not good enough in many more ways than before. Why are you still scrolling? And while social media offers young people new ways to feel bad about themselves, it also offers them a way to connect with others who share similar experiences. Diagnostic categories serve as a framework for talking about frustrating, troubling, and disappointing experiences and can serve as a focal point for communities where people can share those experiences with a sympathetic and supportive audience. But it’s important to recognize, Davis said, that even though young people are using these diagnostic categories to describe their struggles, that does not necessarily suggest that there’s a real medical problem. “When I asked the people I interviewed if they thought they were suffering from a mental illness, virtually all said ‘No,’” Davis said, but he also noticed the subjects he interviewed lacked a rich emotional vocabulary. “We’ve medicalized emotional distress by putting it into flat, homogeneous categories like depression and anxiety, and people have really picked up on that. The clinical terms are replacing our emotion words as well as other ways of talking about difference.” There are very high rates of anxiety and depression among teens and young adults. While it is important that they seek information about mental health and feel more able to discuss the topic with others, Davis observes that much of the suffering they experience is different from that caused by mental health disorders. Davis finds it concerning that everyday suffering is increasingly being described using medical terms. This trend not only leads to the over-prescription of medications and a lack of proper treatment planning and moderation but also hinders our ability to understand and learn from our experiences. Davis acknowledges that there are those who truly need help from trained therapists, but for those who are looking for ways to deal with the kind of distress that most of us can relate to, the alternative may just lie in using these experiences to build deeper connections with those around us. Nowadays, many people are quick to label their behaviors as signs of mental health conditions, often with a TikTok diagnosis rather than a formal one. This trend overshadows the real struggles of those who genuinely suffer from conditions like depression or ADHD. It's as if the lines between normal ups and downs and serious mental health issues are becoming blurred, making it harder to understand and address the true extent of these disorders. “You’re different and special just because you’re different and special, regardless of these conditions.” - a quote I probably stole from a movie I watched too long ago It's understandable that people might feel the need to explain their differences or struggles by identifying with mental health terms they've read about or heard others talk about. It's a way for them to make sense of their experiences and find a sense of belonging or understanding. But the argument here isn’t that straightforward. Maybe people don't have the psychiatric expertise, but if they're not hurting anyone, there's no harm in letting people explore ADHD in the privacy of their own backyard, right? The answer isn't really all that clear. Online opinioners have given the conversation frustratingly high stakes. That includes me. For now, I'm not going to say whether or not that's a good thing or a bad thing. First, because the answer probably isn't that simple, and second, because I'm not here to make strong moral judgments. I’m here to let you know that both sides suck equally. On the other hand, not that many people are talking about the millions, maybe even billions, of people who have strong hesitations against self-diagnosis because they all have one thing in common. They believe that psychiatric institutions have the final authority to dictate reality. You don't have to agree with me, but I hope I've at least have made you reflect on why you believe the things that you do. And hey, at least you believe in something. 2. a formal diagnosis is not for everyone I’m guilty every time I tell someone to check up with a psychiatrist. Because that smells like privilege talking. A formal diagnosis is not for everyone. First, last time I checked, a diagnosis for any mental health condition costs an arm and a leg. Not literally. Even under the glorious Communist regime, the average price for a psychiatrist is well beyond the reach of an average college student. There are just too many things to be depressed about at this time and age; adding “psychiatrist cost” to the list doesn’t actually help. If only there was a system built up to help people finance their treatment, right? So, it’s sensible that people would rather diagnose and treat the disorders themselves. Second, it seems that many mental health professionals have different types of training and may subscribe to biased conceptions of what neurodivergent is. There are countless stories of people seeking a depression diagnosis who get rejected and dismissed by mental health professionals because they appear too cheerful or are too good at conversation. But mental health professionals and institutions are unbiased and objective measures of personal experience, right? Right. Let’s discuss this in detail in the next part because I have so much to say about it. And finally, a formal diagnosis of a mental health condition isn't always beneficial. You may have noticed that there's a kind of tarnish associated with mental health, and not everyone wants to carry the tarnish and weight associated with this label. If it isn't super necessary to have that label, you’re probably better off not having it, especially if it can interfere with your life in ways you didn't expect. For example, have you ever thought about immigrating to New Zealand? Well, an autism diagnosis pretty much bans you from becoming a citizen if the cost of treatment exceeds a certain threshold. Even if immigrating to "Kiwiland” isn't on your to-do list, there's still plenty of other ways a diagnosis might impact your life. Some people's applications to adopt children get denied because of their diagnosis. Others have had custody of their children threatened because of the whole stigma thing. There's this unfounded assumption that people with diagnosed disabilities or conditions inherently don't have the autonomy to care for themselves or others. Remember Britney Spears and her father? Yet, the infantilization of disabled and diagnosed people continues. States like Missouri are trying to restrict gender-affirming care for those diagnosed with autism. Maybe adopting a child, moving to New Zealand, or transitioning your gender wasn’t on the top of your bucket list, but these are just some of the ways a formal diagnosis might not always lead to the best outcomes. Regardless of where you stand, we should at least agree that people deserve access to accommodations for a decent life, with or without a formal diagnosis. We know institutions are biased, and we shouldn't let that hinder meeting people's legitimate needs. This means no doubting individuals who claim a marginalized identity, no commenting on other people’s posts, “but do you have a diagnosis, tho?”. On the other hand, no one should use their identity as an excuse to avoid accountability for their actions, so if you suck, it’s because you suck ass. Does that sound good? Great. 3. Why you shouldn’t trust your psychiatrist that much Let me let you in on a secret. Whether you’re neurodivergent or maybe even a little wrong in the head, they’re all… drum rolls A social construct. "But, Duy, what is a social construct?” my dear readers asked. Duy kindly answered, “a social construct is basically something we inherently agreed to believe in together as a society, like money, marriage, or Elon Musk being a moron. This isn't to say that they aren't real or have no basis in reality. But when discussing things that are deemed social constructs, it’s important to take into account the cultures and time periods that they've been a part of.” Well, that’s a lengthy explanation. But surely things like neurodivergences are firm structures we can observe in the brain. They must have concretely studied mechanisms and consistently defined patterns. Right? The reason I argue that neurodivergences are social constructs is because what’s important is not just about fancy-name chemicals or how your brain is wired but also about how society defines and treats those who don't fit into its idea of normal. In ancient times, when knowing how to count was seen as a basic witchcraft lesson, any advanced knowledge like science or mathematics was collectively frowned upon by society. Any person displaying any signs of mental illness is considered to be possessed by demons, witches, etc. And what do you do with people possessed by demons? Thank God that we have progressed far away from that. But the attitude of society towards “different,” “disordered” people hasn’t changed that much. Back when psychology and psychiatry were just getting started, they came up with ideas about what "normal" human behavior should look like. If you didn't fit into their neat little boxes, you were considered different or "other." Your struggles got slapped with the label of mental illness and were seen as biological glitches to be fixed. This approach made you feel less like a person and more like a walking bundle of symptoms. Psychiatrists, armed with their new titles, suddenly had the power to define what it meant to be human. A normal one. Michel Foucault, in his essay "Psychiatric Power," talks about how madness was rebranded in terms of behavior and common sense. If you made mistakes, had wild ideas, saw things that weren't there, or got lost in your imagination, you got stamped with the "abnormal" label. Society's idea of normality was shoved down your throat, making your unique quirks seem like “disorders.” So, if you had an imaginary friend, you weren't just fun at parties anymore—you were a problem to be solved. This shift meant that madness became something for doctors to study. If you got a mental illness diagnosis, it was like a big sign saying you didn’t understand your own mind and couldn’t control it. Being labeled mentally ill was like getting a stamp that said you were less human, losing your independence and ability to decide for yourself. So, when people say mental illness is a social construct, they're saying that society and the power structures within psychiatry have shaped what we see as mental illness. It's kind of like a system that's more about turning people into productive members of society than about the messy, sometimes painful process involved. It doesn't always consider the impact on the person or how patients' own perspectives might actually help when working with psychiatric experts. In other words, it’s like focusing on making the train run on time without thinking about the bumpy ride for the passengers. If there's one takeaway from this dive into the history and philosophy of modern psychiatry, it's that concepts like mental illness, disability, and disorder aren't fixed truths—they're shaped by culture. Our understanding of these conditions often excludes the voices and experiences of disabled or neurodivergent individuals from contributing to the expertise that defines them. If we acknowledge that our grasp of reality is filtered through social constructs, then it follows that constructing reality should involve a democratic process. Psychiatrists and psychologists shouldn't have a monopoly on defining what is real or normal. It's important to note that professionals in these fields aren't a secret society bent on maintaining control. However, the production of scientific knowledge about humanity is heavily influenced by social factors. Thanks to the advocacy of disabled and neurodivergent activists, along with critical theorists like Foucault who challenge institutional norms, there's a growing movement within psychiatry and psychology to question established knowledge. This shift is pushing for more inclusive and diverse perspectives in shaping our understanding of mental health and human behavior. If psychiatric knowledge is as socially contingent and unfixed as I've just claimed it is, as people have been claiming for hundreds of years, then there are serious conflicts and contradictions within psychiatry that need to be resolved. A 2017 article in the Journal of Disability Studies documents the fact that the legitimacy of psychiatric knowledge is still an active and inconclusive discussion. Imagine if psychiatric institutional knowledge were the teachings of gods, then the DSM would be their holy scripture—the Bible of mental health. The DSM, churned out by the American Psychiatric Association (APA), is like the ultimate guidebook for healthcare professionals to diagnose all sorts of mental quirks and conditions. But here's the thing: there have been more editions of the DSM than there are flavors of your favourite instant noodle brand. And each edition reflects the beliefs of its authors about what's normal and what's not. It's supposed to help docs slap on labels consistently, but it's about as controversial as pineapple on pizza. Even mental health experts can't seem to agree on whether the DSM's categories are spot-on or just blurry. Some say it's like trying to wrangle cats—too many ways to interpret what's going on up there in our heads. It's like they're trying to fit everyone into boxes that keep changing shape faster than a TikTok trend. So, next time someone says they've been diagnosed, just remember that it might be as rock-solid as getting a weather forecast from your local meteorologist. Psychiatric diagnosis: part science, part art, and a whole lot of head-scratching. A really good look again at ADHD Let's give ADHD another look. What do psychologists look for when diagnosing ADHD? They must be super objective and exist totally independently of social norms. Luckily, they carry copies of the DSM-5 like a Bible, so let's open it up. I quote, Fuck. What does it mean to have a deficit in attention and focus with ADHD? And what about an abnormal level of hyperactivity or impulsiveness? Do we have an anchor to evaluate? Rather than our biases. The thing with neurodivergence is that we know too little about them but are too eager to pretend that we know all about them. Well, um, we kind of don't know what ADHD is. The same is applied to autism. There isn't one thing that all autistic people have in common. There isn't any one brain marker, any one gene, or one experience. ADHD is a collection of behaviors and experiences that institutions have decided to label as disordered. Can you find ADHD symptoms written on the brain? I sure wish so. And no, creating a TikTok account won't magically give you ADHD. It's not something you can astrology your way into either. How we define ADHD is, well, socio-cultural. But surely, ADHD isn't just a collection of traits. Surely, there's something in the ADHD brain that unites every person with a diagnosis. Surely there's some fundamental difference, right? Or else, how can we consider ADHD to be a neurodevelopmental disorder if order isn't tied to the brain but to social context? When you start to investigate other mental conditions, you'll start to notice similar things. A lot of what connects neurodivergence isn't actually a firm material neuroscientific boundary but a socially determined and politically contested list. However, in contrast with many other disorders of the brain—for example, neurodegenerative diseases such as Parkinson's or Alzheimer's diseases—ADHD lacks any clear unifying pathology at the molecular, cellular, or system levels. And you can sure as hell bet that there are critical scholars who reject this idea that ADHD is a natural kind or an existing thing that is waiting to be found. There are people who have tried to theorize that depression has one unifying trait. These psychiatrists will cling to theories that uphold psychiatric legitimacy, even if these theories blatantly demonstrate the ways the system will maintain its own unreason in the name of declaring others unreasonable. It's time to stop pretending like we have a firm scientific understanding of neurodivergent identities and, therefore, the right to self-righteously gatekeep their meaning. These identities, like all identities, are shaped by society. The label holds a lot of power, uniting neurodivergent communities and enabling people to receive institutional support. The concept of social construction doesn’t deny this power; it just points out that these categories aren’t discovered in nature like hidden treasures. The reality of ADHD isn’t some universal truth waiting to be uncovered because ADHD, neurodivergence, and mental conditions are intertwined with social life, culture, ideology, and power. What we call ADHD is dependent on the time and era, constantly evolving like the latest fashion trends. That mix of neurological traits has always been around in one form or another, but society keeps changing which ones are considered impairments or maladjustments based on the context, which is often as invisible to us as water is to fish. Even though it’s been proven repeatedly that social context shapes all these categories, part of me still believes that well-practiced institutions, including psychiatry, are the best tools we have, at least at this period. I mean, shouldn’t we strive for a democratically effective truth? Yet, I can’t shake the knowledge that as long as humans use language to describe and categorize things, reality will always be socially constructed and limited, like trying to define the world through a never-ending game of Telephone. Our best bet on our own sanity My intention in highlighting these ideas is not to suggest that one random person's word is as reliable as any institution or that your TikTok feed is better than the DSM for identifying helpful mental health resources. However, before we criticize TikTok by blindly upholding the authority of psychiatric knowledge as the ultimate arbiter of reality, we need to recognize that both a stupid TikTok and psychiatric knowledge come with their own cultural baggage. I don't think these two cultural products are on a level playing field, but that's not because I believe mental illness is a real, biological, natural object waiting for some self-important psychiatrist to discover. If there's any reason I might be inclined to uphold the legitimacy of a psychiatric diagnosis, it's because I've personally seen people benefit from the labels and resources provided by psychiatrists and therapists. These professionals have helped individuals understand their struggles and find paths to improvement that they might not have discovered on their own. At this point, any critical person might say, "Sure, a lot of people feel better after psychiatric help, but is that just because it was the only legitimate option presented to them? And what about the countless individuals who have felt alienated, misunderstood, or even harmed by psychiatric institutions?" It's crucial to acknowledge that while psychiatric care has its successes, it also has significant shortcomings and has not been a one-size-fits-all solution. Many people have felt invalidated or stigmatized by the system, raising questions about the inclusivity and effectiveness of traditional psychiatric approaches. It makes sense why people have negative reactions to self-diagnosis. If these institutions give the legitimacy of our experience and form the foundation of how we see ourselves, it's natural to defend them instinctively. But philosophers and sociologists keep revealing that these identities aren’t ingrained in the universe or encoded in our DNA. These labels are just society's way of making sense of our personal stories in the broader context of history. Think about it like this: if our sense of self is shaped by power dynamics, then the battle to define our identity is a political one. The way we see mental illness or neurodivergence, is politically defined. ADHD or depression isn’t a concrete, biological structure; it’s a label created and influenced by society. So, when people push back against self-diagnosis, it’s not just about the accuracy of the diagnosis; it’s about who gets to control the narrative of our identities. And if you resonate with the ADHD way of interacting with the world, you'll probably know pretty early on if you're neurodivergent. Psychiatry often takes this experience, labels it as a disorder, and then tries to 'correct' it, which can feel dehumanizing. But if you're like me and want society to be inclusive so that everyone has the opportunity to live a good life, is this really the best way to understand neurodivergence? Should we really see it as an innocent abnormality that only psychiatric institutions can understand and fix? How useful is it to pathologize and control something that's essentially a political struggle? Shouldn't everyone have the right to access different tools for self-expression if they need them? Pathologizing that need just continues to perpetuate the control and power of psychiatric institutions. Sure, institutions—no matter how flawed—often use their power to help people get the resources they need. And yes, labels can help identify who needs resources. I'm not trying to discredit those who've been helped by psychiatry or who find comfort in the labels society gives them. But we should also reflect on the histories and assumptions that sustain these institutions. When people dismiss self-diagnosis, is it out of genuine concern for neurodivergent people and mental health? Or is it because of an uncritical belief in the ultimate authority of non-neurodivergent individuals to define the truth about neurodivergence? Sometimes, it seems like some neurodivergent people react negatively to self-diagnosis because of a "they haven't suffered like I have" mentality. But let's consider two things: first, we don't have to view our experiences purely through a negative lens. ADHD, for instance, offers a unique perspective on the world that isn't solely about challenges. Sure, maybe people have developed eye strain from neglecting basic bodily functions while hyperfocused on a project, but they also kind of thrived in that environment. Second, social alienation and suffering often drive self-diagnosed individuals to seek a label. Most self-diagnosed people aren't looking for a trendy identity, and if they are, maybe they're 10 years old. Why argue with a 10-year-old? We all have unique narratives of existence. Our individual ways of being and personal histories develop over time. Society categorizes, defines, and gives these experiences a history and social meaning. Knowing your identity has a history can be empowering; it's something we long for. But we end up understanding ourselves and our stories in ways defined by those in power. So let’s not do that. When the psychiatrist tells his family that he has depression, they look at him like a crazy man. Can’t blame them for reacting like that because depression was a really strange, weird, and alien word in their world. It’s like Galileo trying to explain to the people of his time that the earth was not the center of the universe. It’s like Darwin trying to explain to us that we come from some apes. The psychiatrist is trying to explain that depression is just another type of illness, like a cold. But if you catch a cold? Because you were running in the rain yesterday. Please don’t do that again, or you run the risk of catching it again. Caught a depression? What went wrong? What shouldn’t he do again to not catch it again? Is he wrong? Are they wrong? Are you wrong? Mental illnesses and neurodivergents are not really a concept at our parent’s age. At that time, the only thing you can do is be crazy. And to be crazy is to be either locked up in an asylum or shunned by the whole community. That’s why I love social media. People usually think that I hate social media because of how many posts I dedicate to trash-talking them, but deep down, I believe they did some good for humanity despite all their flaws. One of them is raising awareness about mental illnesses and neurodivergence. People talk about all kinds of things on social media; Social media gives everyone a talking stage, no matter how smart, how stupid, or how wrong in the head you are, and thus, awareness for neurodivergence and mental illnesses rises as fast as a horny man. There are all kinds of people coming out of their shells, and sharing their stories and experiences on social media, some are happy, some are depressed, some have ADHD, and some are psychopathic killers. Social media helps people feel that these “disorders” are not that weird and that there’s always help and understanding. But the downside of social media is that soon enough, everything that goes viral gets farmed for engagement. It turned into something that needs to be shoved into your eyes for under 30 seconds. I blamed TikTok for that. Neurodivergence and mental illnesses First, in honor of Hippocrates, let’s learn the basics of the difference between neurodivergence and mental illnesses. Neurodivergence and mental illnesses are distinct yet sometimes overlapping concepts within the realm of mental health. Neurodivergence is not really a well-known concept; the word doesn’t even exist in Vietnamese. So, many people jump on the assumption train and just see neurodivergence as another type of mental illness, which is unfair and not true. Neurodivergence refers to the natural variations in the human brain's functioning, encompassing conditions like autism, ADHD, dyslexia, and Tourette syndrome. These differences are seen as part of the normal spectrum of human diversity, with an emphasis on embracing and accommodating these variations rather than treating them as disorders. In contrast, mental illnesses, such as major depressive disorder, generalized anxiety disorder, bipolar disorder, and schizophrenia, are considered medical conditions that cause significant distress or impairment in daily life, requiring treatment and management through medication, therapy, and lifestyle changes. While neurodivergent conditions highlight unique strengths and alternative ways of thinking and interacting, mental illnesses focus on symptom alleviation and improving overall well-being. An individual can be both neurodivergent and have a mental illness, having the best of both worlds, having a cake and also eating it. Understanding these differences is necessary. Did TikTok just give me ADHD? Could TikTok, the social-media platform for sharing short videos, one day replace your psychologist? Probably not, but its skyrocketing popularity as a tool for self-diagnosing mental health disorders is a big reason it's outpacing competitors like Snapchat, Pinterest, and Twitter. TikTok has become the fifth most popular social media platform overall and the second most popular after YouTube among teenagers. According to Statista, TikTok’s meteoric rise to social media stardom happened during the coronavirus pandemic, with a whopping 180% growth among users aged 15–25. This age group was hit hard like a truck by the isolation, anxiety, and general unwellness caused by lockdowns, so it's no surprise that more teens and young adults turned to TikTok to learn about mental health disorders and to self-diagnose conditions like autism, ADHD, borderline personality disorder, dissociative identity disorder, OCD, and others. It makes sense that these users would start sharing their stories online, and those stories gained traction because many others could relate. This model works. Some users even turned into content creators and monetized the heck out of it. 1. Self-diagnosis as a sensible TikTok practice Despite TikTok’s shortcomings, research suggests that its practicality as a diagnostic tool may not be the only reason for its popularity. Sociologist Joseph Davis, who directs the Picturing the Human Project for UVA’s Institute for Advanced Studies in Culture, explores questions at the intersection of self, morality, and cultural change. Davis has talked to many people of different ages and found that calling their struggles a mental health condition helps them understand and explain what they're going through. Young people have always looked at others to judge their own worth. In the past, before the internet and social media, they only compared themselves to the people around them, so their feelings of distress were limited because, you know, you cannot physically meet that many people in real life. Social media rewards people for showcasing their lives on the net. Davis explains that now, with social media, the comparison never ends. Every morning, you scroll through your social media and see picture after picture of other people's lives. Everyone else seems better looking, more successful, and more exciting. This makes you feel like you're not good enough in many more ways than before. Why are you still scrolling? And while social media offers young people new ways to feel bad about themselves, it also offers them a way to connect with others who share similar experiences. Diagnostic categories serve as a framework for talking about frustrating, troubling, and disappointing experiences and can serve as a focal point for communities where people can share those experiences with a sympathetic and supportive audience. But it’s important to recognize, Davis said, that even though young people are using these diagnostic categories to describe their struggles, that does not necessarily suggest that there’s a real medical problem. “When I asked the people I interviewed if they thought they were suffering from a mental illness, virtually all said ‘No,’” Davis said, but he also noticed the subjects he interviewed lacked a rich emotional vocabulary. “We’ve medicalized emotional distress by putting it into flat, homogeneous categories like depression and anxiety, and people have really picked up on that. The clinical terms are replacing our emotion words as well as other ways of talking about difference.” “When I asked the people I interviewed if they thought they were suffering from a mental illness, virtually all said ‘No,’” Davis said, but he also noticed the subjects he interviewed lacked a rich emotional vocabulary. “We’ve medicalized emotional distress by putting it into flat, homogeneous categories like depression and anxiety, and people have really picked up on that. The clinical terms are replacing our emotion words as well as other ways of talking about difference.” There are very high rates of anxiety and depression among teens and young adults. While it is important that they seek information about mental health and feel more able to discuss the topic with others, Davis observes that much of the suffering they experience is different from that caused by mental health disorders. Davis finds it concerning that everyday suffering is increasingly being described using medical terms. This trend not only leads to the over-prescription of medications and a lack of proper treatment planning and moderation but also hinders our ability to understand and learn from our experiences. Davis acknowledges that there are those who truly need help from trained therapists, but for those who are looking for ways to deal with the kind of distress that most of us can relate to, the alternative may just lie in using these experiences to build deeper connections with those around us. Nowadays, many people are quick to label their behaviors as signs of mental health conditions, often with a TikTok diagnosis rather than a formal one. This trend overshadows the real struggles of those who genuinely suffer from conditions like depression or ADHD. It's as if the lines between normal ups and downs and serious mental health issues are becoming blurred, making it harder to understand and address the true extent of these disorders. “You’re different and special just because you’re different and special, regardless of these conditions.” - a quote I probably stole from a movie I watched too long ago “You’re different and special just because you’re different and special, regardless of these conditions.” - a quote I probably stole from a movie I watched too long ago It's understandable that people might feel the need to explain their differences or struggles by identifying with mental health terms they've read about or heard others talk about. It's a way for them to make sense of their experiences and find a sense of belonging or understanding. But the argument here isn’t that straightforward. Maybe people don't have the psychiatric expertise, but if they're not hurting anyone, there's no harm in letting people explore ADHD in the privacy of their own backyard, right? The answer isn't really all that clear. Online opinioners have given the conversation frustratingly high stakes. That includes me. For now, I'm not going to say whether or not that's a good thing or a bad thing. First, because the answer probably isn't that simple, and second, because I'm not here to make strong moral judgments. I’m here to let you know that both sides suck equally. On the other hand, not that many people are talking about the millions, maybe even billions, of people who have strong hesitations against self-diagnosis because they all have one thing in common. They believe that psychiatric institutions have the final authority to dictate reality. You don't have to agree with me, but I hope I've at least have made you reflect on why you believe the things that you do. And hey, at least you believe in something. 2. a formal diagnosis is not for everyone I’m guilty every time I tell someone to check up with a psychiatrist. Because that smells like privilege talking. A formal diagnosis is not for everyone. First, last time I checked, a diagnosis for any mental health condition costs an arm and a leg. Not literally. Even under the glorious Communist regime, the average price for a psychiatrist is well beyond the reach of an average college student. There are just too many things to be depressed about at this time and age; adding “psychiatrist cost” to the list doesn’t actually help. If only there was a system built up to help people finance their treatment, right? So, it’s sensible that people would rather diagnose and treat the disorders themselves. Second, it seems that many mental health professionals have different types of training and may subscribe to biased conceptions of what neurodivergent is. There are countless stories of people seeking a depression diagnosis who get rejected and dismissed by mental health professionals because they appear too cheerful or are too good at conversation. But mental health professionals and institutions are unbiased and objective measures of personal experience, right? Right. Let’s discuss this in detail in the next part because I have so much to say about it. And finally, a formal diagnosis of a mental health condition isn't always beneficial. You may have noticed that there's a kind of tarnish associated with mental health, and not everyone wants to carry the tarnish and weight associated with this label. If it isn't super necessary to have that label, you’re probably better off not having it, especially if it can interfere with your life in ways you didn't expect. For example, have you ever thought about immigrating to New Zealand? Well, an autism diagnosis pretty much bans you from becoming a citizen if the cost of treatment exceeds a certain threshold. Even if immigrating to "Kiwiland” isn't on your to-do list, there's still plenty of other ways a diagnosis might impact your life. Some people's applications to adopt children get denied because of their diagnosis. Others have had custody of their children threatened because of the whole stigma thing. There's this unfounded assumption that people with diagnosed disabilities or conditions inherently don't have the autonomy to care for themselves or others. Remember Britney Spears and her father? Yet, the infantilization of disabled and diagnosed people continues. States like Missouri are trying to restrict gender-affirming care for those diagnosed with autism. Maybe adopting a child, moving to New Zealand, or transitioning your gender wasn’t on the top of your bucket list, but these are just some of the ways a formal diagnosis might not always lead to the best outcomes. Regardless of where you stand, we should at least agree that people deserve access to accommodations for a decent life, with or without a formal diagnosis. We know institutions are biased, and we shouldn't let that hinder meeting people's legitimate needs. This means no doubting individuals who claim a marginalized identity, no commenting on other people’s posts, “but do you have a diagnosis, tho?”. On the other hand, no one should use their identity as an excuse to avoid accountability for their actions, so if you suck, it’s because you suck ass. Does that sound good? Great. 3. Why you shouldn’t trust your psychiatrist that much Let me let you in on a secret. Whether you’re neurodivergent or maybe even a little wrong in the head, they’re all… drum rolls drum rolls A social construct. "But, Duy, what is a social construct?” my dear readers asked. Duy kindly answered, “a social construct is basically something we inherently agreed to believe in together as a society, like money, marriage, or Elon Musk being a moron. This isn't to say that they aren't real or have no basis in reality. But when discussing things that are deemed social constructs, it’s important to take into account the cultures and time periods that they've been a part of.” Well, that’s a lengthy explanation. But surely things like neurodivergences are firm structures we can observe in the brain. They must have concretely studied mechanisms and consistently defined patterns. Right? The reason I argue that neurodivergences are social constructs is because what’s important is not just about fancy-name chemicals or how your brain is wired but also about how society defines and treats those who don't fit into its idea of normal. In ancient times, when knowing how to count was seen as a basic witchcraft lesson, any advanced knowledge like science or mathematics was collectively frowned upon by society. Any person displaying any signs of mental illness is considered to be possessed by demons, witches, etc. And what do you do with people possessed by demons? Thank God that we have progressed far away from that. But the attitude of society towards “different,” “disordered” people hasn’t changed that much. Back when psychology and psychiatry were just getting started , they came up with ideas about what "normal" human behavior should look like. If you didn't fit into their neat little boxes, you were considered different or "other." Your struggles got slapped with the label of mental illness and were seen as biological glitches to be fixed. This approach made you feel less like a person and more like a walking bundle of symptoms. getting started Psychiatrists, armed with their new titles, suddenly had the power to define what it meant to be human. A normal one. Michel Foucault, in his essay " Psychiatric Power ," talks about how madness was rebranded in terms of behavior and common sense. If you made mistakes, had wild ideas, saw things that weren't there, or got lost in your imagination, you got stamped with the "abnormal" label. Society's idea of normality was shoved down your throat, making your unique quirks seem like “disorders.” So, if you had an imaginary friend, you weren't just fun at parties anymore—you were a problem to be solved. Psychiatric Power This shift meant that madness became something for doctors to study. If you got a mental illness diagnosis, it was like a big sign saying you didn’t understand your own mind and couldn’t control it. Being labeled mentally ill was like getting a stamp that said you were less human, losing your independence and ability to decide for yourself. So, when people say mental illness is a social construct, they're saying that society and the power structures within psychiatry have shaped what we see as mental illness. It's kind of like a system that's more about turning people into productive members of society than about the messy, sometimes painful process involved. It doesn't always consider the impact on the person or how patients' own perspectives might actually help when working with psychiatric experts. In other words, it’s like focusing on making the train run on time without thinking about the bumpy ride for the passengers. If there's one takeaway from this dive into the history and philosophy of modern psychiatry, it's that concepts like mental illness, disability, and disorder aren't fixed truths—they're shaped by culture. Our understanding of these conditions often excludes the voices and experiences of disabled or neurodivergent individuals from contributing to the expertise that defines them. If we acknowledge that our grasp of reality is filtered through social constructs, then it follows that constructing reality should involve a democratic process. Psychiatrists and psychologists shouldn't have a monopoly on defining what is real or normal. It's important to note that professionals in these fields aren't a secret society bent on maintaining control. However, the production of scientific knowledge about humanity is heavily influenced by social factors. Thanks to the advocacy of disabled and neurodivergent activists, along with critical theorists like Foucault who challenge institutional norms, there's a growing movement within psychiatry and psychology to question established knowledge. This shift is pushing for more inclusive and diverse perspectives in shaping our understanding of mental health and human behavior. If psychiatric knowledge is as socially contingent and unfixed as I've just claimed it is, as people have been claiming for hundreds of years, then there are serious conflicts and contradictions within psychiatry that need to be resolved. A 2017 article in the Journal of Disability Studies documents the fact that the legitimacy of psychiatric knowledge is still an active and inconclusive discussion. A 2017 article in the Journal of Disability Studies documents Imagine if psychiatric institutional knowledge were the teachings of gods, then the DSM would be their holy scripture—the Bible of mental health. The DSM, churned out by the American Psychiatric Association (APA), is like the ultimate guidebook for healthcare professionals to diagnose all sorts of mental quirks and conditions. But here's the thing: there have been more editions of the DSM than there are flavors of your favourite instant noodle brand. And each edition reflects the beliefs of its authors about what's normal and what's not. It's supposed to help docs slap on labels consistently, but it's about as controversial as pineapple on pizza. Even mental health experts can't seem to agree on whether the DSM's categories are spot-on or just blurry. Some say it's like trying to wrangle cats—too many ways to interpret what's going on up there in our heads. It's like they're trying to fit everyone into boxes that keep changing shape faster than a TikTok trend. So, next time someone says they've been diagnosed, just remember that it might be as rock-solid as getting a weather forecast from your local meteorologist. Psychiatric diagnosis: part science, part art, and a whole lot of head-scratching. A really good look again at ADHD Let's give ADHD another look. What do psychologists look for when diagnosing ADHD? They must be super objective and exist totally independently of social norms. Luckily, they carry copies of the DSM-5 like a Bible, so let's open it up. DSM-5 I quote, Fuck. What does it mean to have a deficit in attention and focus with ADHD? And what about an abnormal level of hyperactivity or impulsiveness? Do we have an anchor to evaluate? Rather than our biases. The thing with neurodivergence is that we know too little about them but are too eager to pretend that we know all about them. Well, um, we kind of don't know what ADHD is. The same is applied to autism. There isn't one thing that all autistic people have in common. There isn't any one brain marker, any one gene, or one experience. ADHD is a collection of behaviors and experiences that institutions have decided to label as disordered. Can you find ADHD symptoms written on the brain? I sure wish so. And no, creating a TikTok account won't magically give you ADHD. It's not something you can astrology your way into either. How we define ADHD is, well, socio-cultural. But surely, ADHD isn't just a collection of traits. Surely, there's something in the ADHD brain that unites every person with a diagnosis. Surely there's some fundamental difference, right? Or else, how can we consider ADHD to be a neurodevelopmental disorder if order isn't tied to the brain but to social context? When you start to investigate other mental conditions, you'll start to notice similar things. A lot of what connects neurodivergence isn't actually a firm material neuroscientific boundary but a socially determined and politically contested list. However, in contrast with many other disorders of the brain—for example, neurodegenerative diseases such as Parkinson's or Alzheimer's diseases—ADHD lacks any clear unifying pathology at the molecular, cellular, or system levels. And you can sure as hell bet that there are critical scholars who reject this idea that ADHD is a natural kind or an existing thing that is waiting to be found. There are people who have tried to theorize that depression has one unifying trait. These psychiatrists will cling to theories that uphold psychiatric legitimacy, even if these theories blatantly demonstrate the ways the system will maintain its own unreason in the name of declaring others unreasonable. It's time to stop pretending like we have a firm scientific understanding of neurodivergent identities and, therefore, the right to self-righteously gatekeep their meaning. These identities, like all identities, are shaped by society. The label holds a lot of power, uniting neurodivergent communities and enabling people to receive institutional support. The concept of social construction doesn’t deny this power; it just points out that these categories aren’t discovered in nature like hidden treasures. The reality of ADHD isn’t some universal truth waiting to be uncovered because ADHD, neurodivergence, and mental conditions are intertwined with social life, culture, ideology, and power. What we call ADHD is dependent on the time and era, constantly evolving like the latest fashion trends. That mix of neurological traits has always been around in one form or another, but society keeps changing which ones are considered impairments or maladjustments based on the context, which is often as invisible to us as water is to fish. Even though it’s been proven repeatedly that social context shapes all these categories, part of me still believes that well-practiced institutions, including psychiatry, are the best tools we have, at least at this period. I mean, shouldn’t we strive for a democratically effective truth? Yet, I can’t shake the knowledge that as long as humans use language to describe and categorize things, reality will always be socially constructed and limited, like trying to define the world through a never-ending game of Telephone. Our best bet on our own sanity My intention in highlighting these ideas is not to suggest that one random person's word is as reliable as any institution or that your TikTok feed is better than the DSM for identifying helpful mental health resources. However, before we criticize TikTok by blindly upholding the authority of psychiatric knowledge as the ultimate arbiter of reality, we need to recognize that both a stupid TikTok and psychiatric knowledge come with their own cultural baggage. I don't think these two cultural products are on a level playing field, but that's not because I believe mental illness is a real, biological, natural object waiting for some self-important psychiatrist to discover. If there's any reason I might be inclined to uphold the legitimacy of a psychiatric diagnosis, it's because I've personally seen people benefit from the labels and resources provided by psychiatrists and therapists. These professionals have helped individuals understand their struggles and find paths to improvement that they might not have discovered on their own. At this point, any critical person might say, "Sure, a lot of people feel better after psychiatric help, but is that just because it was the only legitimate option presented to them? And what about the countless individuals who have felt alienated, misunderstood, or even harmed by psychiatric institutions?" It's crucial to acknowledge that while psychiatric care has its successes, it also has significant shortcomings and has not been a one-size-fits-all solution. Many people have felt invalidated or stigmatized by the system, raising questions about the inclusivity and effectiveness of traditional psychiatric approaches. It makes sense why people have negative reactions to self-diagnosis. If these institutions give the legitimacy of our experience and form the foundation of how we see ourselves, it's natural to defend them instinctively. But philosophers and sociologists keep revealing that these identities aren’t ingrained in the universe or encoded in our DNA. These labels are just society's way of making sense of our personal stories in the broader context of history. Think about it like this: if our sense of self is shaped by power dynamics, then the battle to define our identity is a political one. The way we see mental illness or neurodivergence, is politically defined. ADHD or depression isn’t a concrete, biological structure; it’s a label created and influenced by society. So, when people push back against self-diagnosis, it’s not just about the accuracy of the diagnosis; it’s about who gets to control the narrative of our identities. And if you resonate with the ADHD way of interacting with the world, you'll probably know pretty early on if you're neurodivergent. Psychiatry often takes this experience, labels it as a disorder, and then tries to 'correct' it, which can feel dehumanizing. But if you're like me and want society to be inclusive so that everyone has the opportunity to live a good life, is this really the best way to understand neurodivergence? Should we really see it as an innocent abnormality that only psychiatric institutions can understand and fix? How useful is it to pathologize and control something that's essentially a political struggle? Shouldn't everyone have the right to access different tools for self-expression if they need them? Pathologizing that need just continues to perpetuate the control and power of psychiatric institutions. Sure, institutions—no matter how flawed—often use their power to help people get the resources they need. And yes, labels can help identify who needs resources. I'm not trying to discredit those who've been helped by psychiatry or who find comfort in the labels society gives them. But we should also reflect on the histories and assumptions that sustain these institutions. When people dismiss self-diagnosis, is it out of genuine concern for neurodivergent people and mental health? Or is it because of an uncritical belief in the ultimate authority of non-neurodivergent individuals to define the truth about neurodivergence? Sometimes, it seems like some neurodivergent people react negatively to self-diagnosis because of a "they haven't suffered like I have" mentality. But let's consider two things: first, we don't have to view our experiences purely through a negative lens. ADHD, for instance, offers a unique perspective on the world that isn't solely about challenges. Sure, maybe people have developed eye strain from neglecting basic bodily functions while hyperfocused on a project, but they also kind of thrived in that environment. Second, social alienation and suffering often drive self-diagnosed individuals to seek a label. Most self-diagnosed people aren't looking for a trendy identity, and if they are, maybe they're 10 years old. Why argue with a 10-year-old? We all have unique narratives of existence. Our individual ways of being and personal histories develop over time. Society categorizes, defines, and gives these experiences a history and social meaning. Knowing your identity has a history can be empowering; it's something we long for. But we end up understanding ourselves and our stories in ways defined by those in power. So let’s not do that.
