Destigmatization or Romanticization? Let’s Talk About How We’re Talking About Mental Health

In the seventeenth and eighteenth centuries, mental conditions were considered “evidence of moral and cognitive failure to regulate oneself” (Grinker, 2020). Stigmatization of mental illness and disability has a long history of drawing moral lines between “normal” and “flawed” individuals, isolating the latter from society. In the past decade, however, there has been a noticeable shift in how our society talks about mental health. In what anthropologist Richard Grinker calls “a stunning reversal of a shameful and stigmatized history,” modern culture is increasingly pushing to normalize the experiences of mental illness and disability. This is perhaps an optimistic indication that we are finally progressing toward a world in which those with mental conditions are treated with the respect and empathy that they deserve. But as we collectively barrel towards a radically new relationship with mental health, it is essential to remain aware of the impact of these societal attitudes and to consider how this historical moment can be handled responsibly. 

Short-form video platforms like TikTok, Instagram, and YouTube are at the epicenter of this cultural movement toward normalizing mental conditions. Platforms like TikTok that allow participants to consume and create unfiltered, original content have proven to be immensely effective in the spread of information and sharing of personal experiences online. The firehose of algorithm-curated, raw content delivered through short-form video to consumers makes these platforms uniquely effective in immersing users in specific interest areas, flooding their video feed with a high concentration of content that may focus on specific diagnoses or identities (Milton et al., 2023). 

Young adults are the primary consumers of short-form video content and are therefore the main demographic experiencing this movement toward normalization. For many young people in the process of identity formation, online mental health spaces have become an integral part of their personal exploration and search for community (McVay, 2023). This new wave of mental health information on social media has fueled a sub-culture of self-diagnosis of psychiatric conditions, with 74% of youth psychologists surveyed in a Psychiatric Times poll claiming that they frequently see patients presenting self-diagnoses based on online information (Weigle, 2023). The sudden widespread embrace of these diagnoses has raised concerns among professionals about the normalization of mental illness morphing into an adoption of psychiatric labels as “consumer identities” — particularly among adolescents — that may diminish the perceived seriousness of certain diagnoses (Haltigan et al., 2022). 

Adjacent to this mental health movement has been the rise of the online “Neurodiversity Movement,” a push for accommodation and acceptance of the “neurodivergent” community — often defined to include individuals with autism spectrum disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD). This movement has also been associated with progressive efforts to make the world a better place for individuals with differently functioning brains. However, concerns about aestheticization are similarly prominent within this movement, with tension around the validity of self-diagnosis of more abstract, “neurodiverse” identities. 

Throughout my argument, I broadly categorize mental illness and neurodiversity as “mental conditions” or “mental differences.” There is significant overlap in the trends within these movements, and many aspects of my argument apply to both communities. I do, however, want to establish outright that I am not referring to neurodivergent conditions as mental “illnesses.” Importantly, my discussion of neurodivergence is largely limited to ASD and ADHD. Additionally, I want to acknowledge that the movement to normalize mental illness being discussed is primarily focused on the de-stigmatization of anxiety and mood disorders. Many serious mental conditions such as personality disorders, substance use disorders, and schizophrenia are still incredibly stigmatized in today’s society, and excluding them from this discussion of mental illness is a reflection of the priorities of the modern discussion around mental health rather than a reflection of these conditions’ validity or importance.

This paper explores the impact of modern online culture on the perception of mental illness and neurodiversity. I first discuss how the normalization of psychiatric terminology has influenced our society’s perception of mental illness, addressing the dangers of trivializing such language. I then consider how social media use as a tool for self-help has impacted our culture’s perspective on mental illness and analyze the benefits and risks of using social media as a tool for mental health communication. I go on to analyze the intersection of mental conditions and identity, addressing how the treatment of psychiatric labels as consumer identity traits threatens to commodify and trivialize these conditions. Addressing the further complications of this issue within neurodivergent communities, I ultimately emphasize the importance of balancing the weight of assuming a disabled identity within a sensationalist culture. Overall, I aim to illustrate that the benefits of our society’s movement to normalize mental conditions are only attainable if we assume a collective responsibility to prevent this process of de-stigmatization from becoming a process of commodification and aestheticization. 

The newfound prevalence of psychiatric terminology in online discourse marks a promising step toward de-stigmatizing mental differences, but the adoption of this language necessitates a collective responsibility to use these terms correctly. In February of 2022, #anxiety, #ADHD, #BPD, and #depressed had over 28 billion views on TikTok combined, illustrating how psychiatric language has become an integral part of recent online discourse (Chochol et al., 2023). As our society discusses mental health and uses this terminology more openly, there emerges a new potential to de-stigmatize and understand mental conditions. In demystifying psychiatric challenges, we begin to deconstruct the ‘us and them’ polarization that has historically stigmatized mental conditions, breaking down barriers to empathy and allowing for a more open conversation about how we can effectively address mental health.

Increased usage of this psychiatric terminology, however, does not inherently correspond with decreased stigma. As discussed by Marissa Alejandra Gutiérrez Pizarro in her thesis Use of psy discourse on the public vernacular, the normalization of terms like “anxiety,” “bipolar,” “OCD,” and “depression” can very easily lead to their “trivialization” when these terms are misused, used humorously, or “recontextualized” to take on different meanings in everyday speech (Alejandra Gutierrez Pizarro, 2022). While treating mental illness as a taboo subject is damaging, it is similarly dangerous to discuss it openly in a way that minimizes its impact – a person with obsessive compulsive disorder, for example, is not going to benefit any more from their obsessive-compulsive behaviors being viewed as trivial quirks than as personal failings. Though some might insist that the discussion of mental illness is, in itself, a step in the right direction, I propose that it is only helpful when discussed with accuracy and responsibility. The way that we discuss mental illness directly impacts how our society treats this issue. If the goal is for people’s experiences to be taken seriously and treated with empathy, then our society must make a collective effort to use psychiatric terminology with the weight of its intention.  

The abundance of self-help content now circulating social media platforms is providing useful resources for those experiencing mental health challenges, but the unfiltered nature of these platforms makes it very easy for this well-intentioned movement toward mental health awareness to cultivate a further isolating culture for those experiencing severe mental illness. In a world where many people face financial, geographical, and social barriers to proper mental healthcare, social media can serve as a “lifeline” for those struggling with severe conditions (Martin, 2023). According to cognitive behavioral therapist Marie Chellingsworth, “‘peer support can be hugely beneficial’” for those experiencing mental health challenges, and many people who lack support at home can find it in these growing online communities (Martin, 2023). Additionally, social media has been identified by scholars and psychiatric professionals as a promising public health tool — one 2023 study notes that the “accessibility” of online mental health information “allows the public to seek information about… symptoms…facilitating the early detection of mental health disorders” (Gobel et al., 2023). Considering the importance of these resources, the cultivation of online communities for mental health help is clearly a step forward in making the world more easily navigable for those struggling with mental illness or disability. As these online sub-cultures grow, however, we find ourselves faced with complicated questions of trust and validity. 

According to Milton et al. (2023), the relatable and vulnerable nature of user-generated self-help content on social media is what makes it such a great resource for people – listening to someone talk about their experience is simply “less cold” than the clinical alternative. This relatability, however, has opened the door for a wave of “over-pathologization” of everyday mental health challenges, causing many average users to believe that they, too, are mentally ill (McVay, 2023). This issue of inaccurate self-diagnosis is compounded by the sheer amount of misinformation that exists on unfiltered social media platforms; a 2022 study reviewing 500 mental health TikToks, for instance, found 84% of the videos to contain misleading information (Weigle, 2023). When coupled with the echo-chamber reinforcement effect of modern social media algorithms, it is easy to see how the self-diagnosis of mental conditions is gaining traction. 

While some might argue that the self-identification of mental illness only carries repercussions on a personal level, this fails to acknowledge how our societal perception of mental health challenges is influenced by our discussion of the topic. The process of over-pathologization, explains Dr. Jennifer Katzenstein of Johns Hopkins University, is a blurring of the line between a mental health “experience” — something that everyone encounters in their life — and mental health disorder “warranting intervention” (McVay, 2023). As our society embraces topics like mental health and self-care with great enthusiasm on social media, this distinction between “experience” and “illness” threatens to be lost in what seems to be a trendification of mental health struggles. When  people use psychiatric labels inaccurately to describe their everyday experiences, we begin to trivialize the legitimate and often debilitating challenges faced by those living with these diagnoses. Though it may seem that embracing the narrative that ‘everyone struggles with mental health’ would make the experience of mental illness less isolating, this method of normalizing these experiences threatens to create a culture in which mental illness is not treated with the seriousness that it warrants. If typical mental health fluctuations become synonymous with mental illness, then those experiencing severe mental illness would still become isolated — instead of their experiences being stigmatized, their experiences would be in danger of becoming dismissed as normal, “flattened” by the trendification of mental health discourse (Camp, 2023). 

The best way to curb this issue of over-pathologization and over-generalization of mental health issues is by promoting factual information on social media and fostering a conscientious discussion of the differences between mental health experiences and disorders. According to Chellingsworth, “the presence of qualified mental health professionals” and fact-checking safeguards for content on social media helps “foster a safer environment” for the online discussion of mental conditions (Martin, 2023). Though the current format of short-form social media would make any true regulation of this content difficult to maintain, voices of reason promoting an increased awareness of the weight of the issues being discussed would help steer conversation in the correct direction. The presence of mental health self-help content on social media can act as a tremendously helpful tool for those experiencing severe or isolating mental health challenges, and it is essential that, as a society, we do not pollute this blossoming productive conversation with a trivialization of serious conditions. 

As these online communities grow around shared experiences of mental illness and disability, mental conditions are increasingly being treated as quirky or honorable identity traits on social media — a trend that could easily commodify these labels and further trivialize the public’s perception of serious conditions if handled recklessly. In their study “Social media as an incubator of personality and behavioral psychopathology: Symptom and disorder authenticity or psychosomatic social contagion?” Haltigan et al. (2022)  raise concerns that the “positive social and emotional reinforcement and resonance” that social media users receive when sharing their experiences online may be cultivating an environment in which “various… ‘neurodivergent’ or sick role identities or personas can be claimed at will – with no… tether to empirical reality.” This trend is occurring particularly among adolescents, for many of whom the adoption of a disability label is a facet of their developing identities – treated as a personality trait rather than a serious health issue (Caron, 2022). Labels of psychiatric conditions are also being exploited by many online content creators to boost the “authenticity” of their content, with social media influencers sharing intimate details of mental health struggles in an effort to forge stronger relationships with their viewer base. This vulnerability has been shown to be an effective method in increasing social media influencers’ value as paid collaborators, boosting the advertising revenue of vlog-style content (Lind & Wickström 2023). As diagnoses of mental conditions become treated as “consumer identities” that are glorified by social media trends, we stray further from the goal of de-stigmatizing these conditions, instead diluting their meaning and commodifying the experience of mental illness and disability (Haltigan et al., 2022). 

The irresponsible use of these labels for clout can also negatively impact those who genuinely require support. As claims of disadvantaged labels become synonymous with attention-seeking behavior, we collectively become more skeptical of everyone who claims to be struggling – including those who truly need help. As discussed by YouTuber Alexander Avila (2023) in his video essay “TikTok Gave Me Autism,” the trendification of certain diagnoses is leading many therapists to dismiss patients’ concerns because having a certain diagnosis “is trendy now.” Both the widespread adoption of these labels and the resulting skepticism perpetuate the harmful ideas that mental conditions are matters of personal choice and that their symptoms are personality traits. This is a haunting echo of the idea of “moral failure” that has historically stigmatized mental health diagnoses (Grinker, 2020). 
 

One proposed solution to this aestheticization of mental conditions is simply to disconnect them from the idea of identity altogether. A societal shift toward a clear delineation between diagnosis and identity, like that which exists for many physical health conditions, could reinforce the clinical legitimacy of mental conditions while making the haphazard adoption of these labels less likely. While a diagnosis of a mental illness might benefit from being treated strictly as a chronic health issue, a diagnosis of neurodivergence, such as ADHD or ASD, is often more complex in its relationship with identity. The neurodiversity movement is founded upon a “neurodivergent” versus “neurotypical” dichotomy, with an abstract and somewhat “dubious” spectrum separating the two (Russel, 2019). As noted by Ginny Russel of the University of Exeter, “many neuroscientific studies of ADHD, Tourettes, autism, and other neurodevelopmental conditions have mixed results that are not well replicated,” leaving much of the diagnostic criteria for neurodivergent conditions dependent on qualitative adherence to social norms and personal experiences with sensory sensitivities (Russel, 2019). The apparent subjectivity of these diagnoses has led to a popular embrace of a looser definition of neurodivergence as an identity, a way of defining one’s unique relationship with the world. For many neurodivergent people, like speech pathologist Dr. Sara Verdon, this renders a diagnosis irrelevant – “that’s just who you are” (Verdon, 2023). This experience of neurodivergence has led to significant debate within neurodivergent communities as to the validity of redefining neurodivergence as an identity, rather than a condition requiring a diagnosis (Overton et al., 2023). 

While we must acknowledge how neurodivergence impacts one’s identity and relationship with society, defining neurodivergence in a strictly personal sense presents a serious risk of trivializing the diagnostic term, potentially diminishing the usefulness of this label in the clinical sense. Though some argue for the expansion of autism’s definition to encapsulate a more holistic identity, scholars like Sam Fellowes (2024) cite concerns that broadening the scope of the diagnosis might make it “less suitable for making effective, reasonable accommodations” for those who need them (Fellowes, 2024). De-pathologizing neurodiversity ultimately fails to address the profound neurological challenges that many higher-needs members of these communities face, reducing the experience of a diagnosis of autism or ADHD down to a reflection of “high-functioning” individuals (Russel, 2019). This bias toward the reflection of a narrow selection of experiences ultimately contributes to the potential for diagnoses to become aestheticized on social media, and the absence of diverse representation might ultimately further stigmatize the experiences of individuals with less publicized experiences. 

Neurodiversity inherently encompasses a complex spectrum of experiences, suggesting that it is not appropriate to treat the neurodivergent experience as purely a medical condition or purely a facet of one’s identity. As psychiatry advances, it is likely that we will gain a better understanding of this spectrum and how we can best articulate the distinction between neurodivergent and neurotypical brains. Until then, however, it is essential that we remain conscientious of how our discussion of neurodivergence impacts the social spheres we live in, as our perception of conditions directly affects how we address them societally. 
The current online discourse surrounding mental conditions indicates that our society is making great strides toward a more open, less stigmatized conversation about mental health and neurodivergence. However, true progress can only be made when we intentionally push to recognize the nuances within these conversations and actively fight against the aestheticization and trendification of mental conditions. The goal of destigmatizing mental conditions is to cultivate a world in which we can look beyond a diagnosis to recognize the humanity of the individual. As this movement has been swept up by modern culture, however, we have begun to lose sight of this goal, normalizing and celebrating the condition rather than the person. It is difficult for humans to collectively recognize and reflect nuance — this is the reason why mental conditions have been stigmatized in the first place. To move forward on a path toward collective empathy and respect for those living with mental differences, disabilities or illnesses, we must each individually attempt to recognize the importance of imagining one another complexly.