The validity of self diagnosing mental health conditions

Just in case you aren’t chronically online like me, there tends to be a lot of mental health content on Tik Tok. Creators talk about symptoms of their ADHD, autism, borderline personality disorder, OCD, and more. Some of the creators talk about their professional diagnosis, while others mention that they diagnosed themselves with a certain condition for various reasons.

I’m on a part of Tik Tok that is focused around mental health, so I’m familiar with how nuanced the discussion can be. However, on a surface level, there seems to be a lot of videos that are like “do you have this habit or trait? You probably have ADHD!”, and then the examples they give are fairly common traits that most people, including neurotypicals, experience at times. On one hand, these discussions might create a spread of misinformation about mental health conditions. On the other hand, the discussion of mental health and neurodivergence in general can lead to normalizing it and reducing the stigma. In this article, I want to talk about both: self-diagnosis versus formal diagnosis by a qualified professional. Regardless of your opinion, I hope you will read this in its entirety to hear a nuanced perspective.

First, I just want to note that I am using neurodivergent and mental health/mental illness here somewhat interchangably. I am aware they are not the same, but since I experience both, it’s how this came out. I also want to note that I am not a licensed mental health professional. I have worked with clients in mental health settings, have a high interest in the topic, and I am professionally diagnosed with several conditions, with another one tentatively self-diagnosed. My goal is to probably eventually go back to school to actually become a therapist once I'm done having an existential crisis about what I want to do with the rest of my life. I take mental health very seriously. The point is, all of that means that I have mixed feelings about self diagnosing.

One of my biggest issues when it comes to self-diagnosing is that it could potentially lead to conditions being seen as less impactful than they actually are. Then, people who are actually affected by the condition could possibly be less likely to be accommodated or taken seriously when they seek help.

When it comes to a complex topic like mental health, misinformation is bound to arise and spread. As I briefly alluded to before, certain content and information being spread could lead to people who experience hints of behavioral or cognitive difficulties deciding that they have a certain condition. Then, if they clearly don’t struggle in their day-to-day life, others will get the impression that the condition isn’t that big of a deal. However, saying that begs the question: “what does struggling look like?” Even people with mental illness or neurodivergent conditions can appear “normal” at a glance, through a strategy called masking. In a way, we all have a form of masking when attempting to function at work, with others, or with daily tasks. It’s a strategy to appear “normal”, neurotypical, or functioning as expected in our current society. For those who have worked in food service or retail: masking can be compared to your “customer service” persona. But neurodivergent people have to mask more than others, and more intensely. They also experience more consequences from both masking and not masking. A neurodivergent person who does mask can experience burnout. Although burnout can look different for everyone, it typically means that someone is unable to function and can no longer carry out daily tasks of living, working, socializing, and more.

So then, what is the difference between people who have a condition and people who just have some of the symptoms, but it doesn’t affect them in a clinically significant way?

The symptoms of a lot of conditions are things that everyone experiences daily, especially in our current capitalist society that often functions against human nature. However, the main criteria for a diagnosis tends to be the severity of symptoms and how often it affects a person’s life. Someone might lose their keys on occasion, but can identify the problem and come up with a system to not lose them. On the other hand, someone with ADHD might lose their keys often enough that it makes them late for work, whether or not they have a system that’s supposed to be in place to help. And then, on top of severity and effect, the number of symptoms that go towards a diagnosis also plays a role. That’s what makes the difference between a quirk and a diagnosable condition. Again, this is complicated by masking.

People know themselves and their lives the best. That’s why I’m torn when it comes to self-diagnosing. Someone’s perception of what certain symptoms look like in themselves can play a huge role. What appears to not affect someone's life due to masking or their ability to function could actually be impacting them hugely internally. On one hand, someone could hear an experience of a condition, and decide they have it arbitrarily. But what feels equally possible is that someone could hear about a condition and finally have a name to put with what they have been experiencing. Finding a community with a diagnosis can be so healing and validating, and researching symptoms to cope and find ways to self-accommodate are all very beneficial. In this article from Northeastern University, a professor, Meryl Alper, says it best. She talks about how Tik Tok is reducing the stigma around autism, and expresses that she doesn’t know if diagnosing through Tik Tok is going to be a net positive, but that it’s important to discuss self-diagnosis without “the morality lens and panic-driven agenda”. I appreciated that she also pointed out that “Diagnosis isn’t just one single event. It’s a process, in the same way that understanding who you are is not one single thing. It’s continually in motion”.

I think that if I had to choose, the open-minded part of me wants to say that self diagnosing is harmless and can actually be helpful. But I admit that there is also a part of me that gets annoyed with people who self-diagose, especially when they don’t appear to be affected in certain ways. It gives me imposter syndrome or something; I feel like the struggles I go through aren’t actually all that serious if another person is able to function while claiming to have a disorder when I can’t in some ways. And, those of us who have mental health stuff already struggle to be taken seriously or understood without people who have it quite easy taking on a label that doesn’t clinically suit them.

One pet peeve is people on Tik Tok saying they’re having intrusive thoughts when what they’re just having is an impulsive thought. Intrusive thoughts are defined as unwanted and disturbing thoughts that can come on suddenly or because of external stimuli. Types of intrusive thoughts might be sexual, violent, or negative in some way. The OCD and Anxiety Center website states that the difference between intrusive thoughts that are a part of a clinical diagnosis such as anxiety or OCD and ones that aren’t is the way that those thoughts are perceived by the person having them. People with a mental health condition are more likely to see that thought as shameful and bad. Therefore, people who actually have intrusive thoughts caused by a mental health condition generally don’t joke about them due to feeling shame, although of course, some people use dark humor to cope. I’ve seen people admit their true intrusive thoughts on Tik Tok that aren’t cute or funny and get ripped apart due to people thinking they are weird. Meanwhile, it’s a trend to call certain thoughts "intrusive" (such as in this Tik Tok). Even though intrusive thoughts are a symptom, not a mental health condition in itself, I still feel like it’s a good example of how applying a mental health term to oneself when you don’t actually suffer from it can negatively impact those who do and make it seem silly and less serious.

I understand that someone labeling a silly thought as an “intrusive thought” when they don’t actually have a diagnosable disorder really isn’t that serious in the grand scheme of things, at least to many people. But I can’t help but take that kind of thing seriously. Mental health conditions have been joked about for a long time, and it just seems like more people taking on the label arbitrarily can get mixed in with jokes. I worry that this can create even more of a culture where people who ask for accommodations aren’t taken seriously because other people can deal with it fine. Of course, like I mentioned earlier, there isn’t really a way to determine how severe a condition is in someone, and if one person is better at masking than others, or likes to joke about their condition, it doesn’t mean that they’re doing anything wrong.

That being said, mental illness not being taken seriously can be a problem when people try to give advice for something they don’t actually experience in a clinically severe way. A classic example of this is the typical “if you have depression, take a walk and go outside”, or if you have ADHD, “buy a planner”. It seems like this advice is often given by people who don’t experience these struggles in a significant way. Maybe that’s an assumption on my part, but many of us know that it’s not so simple to fix your brain chemicals. While doing something like going for a walk can be helpful for your mood, the advice totally negates the fact that many people with depression struggle to even brush their teeth or take a shower. That sort of “advice” and mindset is also part of the stigma that leads to things like mental health days off from work or school not being taken as seriously, although that is luckily changing.

Speaking of taking mental health days off from work, the subject of capitalism and the healthcare system naturally has to be discussed. Even if it was 100% clear that an official diagnosis is the only “real” way to decide that someone has a condition, the fact is that, here in the US, it’s incredibly difficult to do so because of how expensive our healthcare system is. Also, it’s hard for many to get an appointment with a practitioner because there are too few available for those who need help. Even then, doctors have their own biases or not enough time to see each patient, leaving them to dismiss someone’s struggles without truly getting to know them, or not having enough knowledge in the subject area. Although doctors are highly educated and trained, they don’t know everything. I’m pretty sure that general practitioners are the most common doctors that people see, and due to the nature of their job, they don’t get an expansive education into mental health like a psychologist or psychiatrist might.

Taking all of that into consideration, if some people are self diagnosing, why does it matter? Even if someone does manage to get professionally diagnosed for their autism, ADHD, OCD, or whatever, there’s not many resources out there to help, especially for adults. There’s therapy for some, but that’s also expensive, and medication, but those options don’t necessarily work entirely for everyone. What many people need is resources and support in the long term, but there isn’t much available. I’ve worked for the kinds of organizations that attempt to provide this kind of support, but most were understaffed, underfunded, or had to limit who they could help to a very specific criteria. At this point, it kind of just seems like self-diagnosing is a way to cope and learn how to accommodate your own struggles, if nothing else will. Validating yourself and finding a community can be incredibly helpful for many.

But then, there are some people who roll their eyes at the mental health conversation in general. Some of them believe that it’s all a matter of mindset, as I mentioned previously. Others think that people are just lazy or want attention. Some don’t think mental health conditions exist at all (and they are usually the type to believe that you can just beat the ADHD symptoms out of someone or something). And to an extent, believe it or not, I can kind of, partially, see where they’re coming from. At least in the US and other capitalist societies, a lot of mental health conditions are a result of the lifestyle we are forced to live. Earlier in this article, I talked about how anyone might have symptoms of a mental health condition, but the difference between just an occasional experience and diagnosis is the frequency and severity of the symptoms. Well, on a similar note, a capitalist society is rigid in a way that brings to light people who can’t conform to the necessary functions in the way that the majority can adjust to.

Because I have ADHD, I want to use that as an example. ADHD used to not be an issue at all. In fact, there is a theory that it used to be evolutionarily advantageous. In our modern society, many people with ADHD struggle to keep their jobs whether they lose interest in it or are fired, lose objects, and have a difficult time focusing on tasks. The Ted Talk called “ADHD Sucks, but Not Really” discusses reasons how it was beneficial. It talks about how it’s less of a problem, and more of a “fish out of water” situation, due to our current society. ADHD can also be a superpower. If we are doing something we like, we can get it done quickly, and it will be high quality work. Or, while many of us struggle with consistency, we can even do a mass amount of boring things overnight due to hyperfocus. But it can often be a difficulty in our society, due to the expectations of focus, consistency, and memory that we are all required to have to survive.

Also, the ADHD example isn’t to say that all neurodivergent or mental health conditions are superpowers, because many of them are difficult. But even so, they are all still negatively impacted, or even caused by our capitalist society. Depression is a common one. Yes, depression is often caused by the reduction of serotonin synthesis, which means less of the happiness chemical being produced. There are other reasons someone might have depression too. Walks and self-care are overly simplistic ideas to treat it, and medication doesn’t work for everyone. There is one big cause that can’t be solved with therapy, medicine, or positive thinking, and that's how we have to exist: in many ways that are against our human nature. So, people’s depression that causes them to be unable to work or clean or whatever can be caused by brain chemicals misfiring, and made worse by our current societal expectations and things like low wages, lack of walkable cities and community. In short, many mental illnesses would not cause someone to not be able to function if we had another way of doing things that didn’t cause people to have to work nonstop without having enough time to pursue their passions.

Of course, there are more complex mental illnesses such as schizophrenia, OCD, and more, but those too could potentially be less disabling if someone had available options to accommodate themselves, or if mental health services were prioritized with more professionals to perform services and less expensive treatments. Similarly, this would also help homelessness caused by mental health struggles, but that’s another discussion.

In summary, in a capitalist society, mental health and neurodivergence is seen as a problem or made into one because those of us with it can’t properly conform to what is expected. But even with that knowledge, that is unfortunately what most of us have to deal with. For that and many other reasons, mental health diagnoses are valid. And due to the complexities behind getting a diagnosis, and the lack of help out there, self diagnosing might be too. I still feel a bit torn on it, but it’s good that people are feeling validated, finding a community of others like them, and finding ways to cope in what seems to be an increasingly stressful world.