I spent much of the last week finishing the continuing education units required for my biennial license renewal. I’m grateful for what I learned in a course called “Social Media Self-Diagnosis Culture,” as it was pertinent to the parent-child estrangement community.
In interviews with the New York Times and NPR program On Point, we discussed the lowering of diagnostic thresholds. This often occurs via social media personalities, some of whom are neither trained nor licensed mental health professionals. And professionals can be guilty of blurring the lines. For example, the other counselor in the On Point interview, Whitney Goodman, suggested that post-traumatic stress disorder has fluid and ever-changing diagnostic criteria. Looking back, I wish I had taken her to task on this: We have the diagnostic criteria in black and white, as determined by the American Psychiatric Association and published in the Diagnostic and Statistical Manual of Mental Disorders, Text Revision (DSM-5-TR).
What constitutes PTSD is in no way determined by the whims of unhappy social media users or unethical counselors.
Sound clinical judgment is crucial. Understandably, it is appealing to see oneself in social media content, and can fit nicely into the ongoing process of identity development. It lends to a sense of belonging, and a diagnostic label can make a person feel unique and special. In the event that someone has distress that is pathological in nature, bear in mind that the same symptoms can be part of multiple diagnoses.
There is less stigma around mental health than in eras past, and seeing a counselor is de rigueur among millennials. However, this has resulted in clinical language becoming more readily available to lay, untrained consumers. Given how algorithms function, simply searching for diagnostic information can contribute to confirmation bias.
The search for this information is also driven by wait lists, expense, and other impediments to psychological assessments being widely available. Without the guidance of a trained clinician, it’s easy for the consumer to conclude that distress within the normal range of human experience is actually symptomatic of a mental health disorder. Normal experiences get pathologized, and the resulting self-diagnosis does a disservice both to people who actually do have the disorders and to the misguided consumer. We parents and grandparents in the estranged community often experience distressful ripple effects.
All of this raises the question of what to do about self diagnosis. The instructor said that the onus should be on social media creators to refrain from using diagnostic language, and instead emphasize mental health habits that can benefit most anyone.
I believe that state licensing boards should be more vigilant, and publicly advocate for proper diagnostic assessment, as well as avoiding charlatans. As is so often the case, this is a multifaceted problem, and addressing it is likely to require a multifaceted strategy.
