What is the most common mental health misinformation on TikTok?

The Guardian

3 days ago

Thousands of influencers peddle mental health misinformation on social media platforms – some out of a naive belief that their personal experience will help people, others because they want to boost their following or sell products.
As part of a Guardian investigation, experts established clear themes to the misinformation contained in videos posted with a #mentalhealthtips hashtag on TikTok.
Several videos about borderline personality disorder suggest symptoms that are everyday experiences – such as feeling anxiety when people change plans, experiencing mood swings, a fear of abandonment and mirroring people's behaviour to be liked.
Another video purports to show how depression manifests in the workplace as a lack of concentration, feeling tired, having low energy levels, a loss of appetite and irritability.
'While some of the 'symptoms' overlap with depression, these can be attributed to a range of afflictions and struggles,' said Liam Modlin, a therapist and psychology researcher at King's College London.
One video said that people with bipolar disorder experience mood swings because their emotional pendulum swings more widely and rapidly than most. However this is a misunderstanding, since people experience extended mood changes over periods of weeks rather than rapid 'mood swings'.
'This is an example of misappropriating a mental health diagnosis to wrongly explain or justify behaviour,' said Dan Poulter, a former health minister and NHS psychiatrist. 'A person with bipolar disorder may find this trivialising of their experience of living with a debilitating and serious mental illness.'
Another popular video suggests that when someone is about to die by suicide they become 'almost bipolar' – 'language [that] can further stigmatise mental health', said Prof Rina Dutta, a consultant psychiatrist and psychiatry professor at King's College London.
Another video claims signs of abuse are constantly apologising; breaking down during small disagreements; needing reassurance; struggling to be open; being hypersensitive to criticism, and hiding feelings.
'The behaviours it describes, while potentially present in abusive dynamics, are not exclusive to abuse and may occur in a variety of other contexts,' said Modlin. 'By presenting these signs without sufficient context or diagnostic nuance, the video risks encouraging viewers to self-diagnose or mislabel complex relational struggles as abuse.'
This was the most common form of misinformation contained in the videos.
One video promotes a method it said was cheaper than therapy and had fewer side effects than antidepressants that could enable people 'to heal from trauma in an hour' and involved writing about the traumatic experiences for 15 minutes non-stop.
'No research suggests this is sufficient for cure, definitely not in an hour, and there is risk of independently forcing oneself back into this traumatic mindset without the support of an experienced therapist,' said Amber Johnston, an accredited psychotherapist.
Another clip suggests that crying is self-soothing and good for processing emotions, including by stimulating the release of cortisol. 'Cortisol changes related to crying are complex and cannot be distilled down in this way,' said Amy Durden, a psychotherapist. 'Crying can bring relief but not always. It can be self-soothing but if the person crying judges their crying negatively, they do not experience this benefit and may feel acute shame.'
Several videos featured glib quotations that the experts viewed as unhelpful such as: 'If you're not changing, you're choosing', while another popular quotation said: 'When you feel like everyone hates you, sleep. When you feel like you hate everyone, eat. When you feel like you hate yourself, shower. And when you feel like everyone hates everyone, go outside.'
'This is a huge oversimplification of how to address complex emotional states,' said Durden. 'It seems to be pulling from behavioural activation in CBT, but without any context or individualisation.'
A specific breathing technique for treating anxiety was promoted in another video. 'There is no single, universally effective breathing technique that is helpful in all cases,' said David Okai, a consultant neuropsychiatrist. 'If performed incorrectly, the exercises can be the equivalent of hyperventilation, which can be extremely unpleasant and exacerbate anxiety.'
Another video suggests depression is caused by alcohol, tobacco, MSG, caffeine, sugar and hydrolysed wheat. Modlin said that although lifestyle factors can contribute, 'this framing is overly simplistic and potentially misleading', since there are complex interwoven factors, including genetics and neurobiology, psychosocial stressors, childhood adversity, medical conditions and personality styles.
Other clips promote supplements including saffron, magnesium glycinate and holy basil extract to ease anxiety. Although the psychiatrist Famia Askari said there are some studies showing benefits to some of these, there is not sufficient consensus for these to have become part of clinical practice – they are also manufactured supplements, in contrast to the 'natural' claims that featured.
Two videos recommend admission to psychiatric units based on personal experience, including one suggesting someone had considerably improved after six days, and another offering a template for children to ask their parents to have them admitted.
Poulter said this was 'misleading' and can 'create misconceptions' about the benefits of inpatient admission. 'Inpatient admission can in fact create and reinforce maladaptive coping mechanisms,' he said. 'It is also very rare that someone would be driving themselves into mental health hospital in the way depicted by the video.'
Another video depicts someone in a hospital gown in what appears to be a psychiatric ward stating: 'I was too honest with my psychiatrist.' This could be harmful as it is 'potentially encouraging people to not be honest and open with healthcare professionals about their mental health', said Poulter.
In another clip, a woman gives her strategies for managing anxiety, including eating an orange in the shower. 'There is no evidence-base for eating citrus in the shower as a means to reducing anxiety, and I would worry that this would lead on to an ever-increasing spiral of unusual behaviours,' said Okai.