TikTok As a Public Health Tool in the Diagnosis of ADHD.

By: Sophia Huynh, Human Biology, Health, and Society ‘25 

The COVID-19 lockdowns caused the use of social media usage to skyrocket. TikTok, a social media platform that is centered around short-form content, saw a 180% increase in 15 to 25-year-old users [2]. Many adolescents and young adults have used the app to learn more about neurodevelopmental conditions and mental health disorders such as autism, attention deficit hyperactivity disorder (ADHD), borderline personality disorder, dissociative identity disorder, and others. Due to the short-form content format of TikTok, information about these disorders is often oversimplified and misrepresented as creators attempt to simultaneously maximize view count, watch time, and information. However, one positive outcome of this is an increase in awareness for these disorders. 

ADHD is a disorder that can be quite polarizing. Some understand it as overdiagnosed while others believe that it is underdiagnosed. The root of this perspective is an inadequate understanding of the different presentations of ADHD across genders and ethnicities, confounded with financial barriers to diagnosis and treatment. For example, white children are more likely to be diagnosed with ADHD compared to Asian, Black, and Hispanic children [9]. These barriers in diagnosis can be due to cultural factors such as Black communities being more likely to be skeptical about the accuracy of ADHD diagnosis and treatment [5], or socioeconomic factors. Furthermore, girls with ADHD are more frequently diagnosed as the inattentive type than boys, who predominantly display the hyperactive or combined type. An individual with the inattentive type of ADHD is more inattentive and easily distracted, while individuals with the hyperactive type of ADHD are more likely to be impulsive and hyperactive; the combined type of ADHD may have a mixed presentation of symptoms. The hyperactive presentation has been adopted as the “typical,” leading to biases in parents, teachers, and physicians, resulting in a referral bias in which females with ADHD have less referrals than males with ADHD [7]. 

These statistics demonstrate that further research and policies are required to improve diagnostic rates of ADHD, such as implementing improved data systems, increasing regulatory vigilance, and appropriately training teachers and medical professionals on the different presentations of ADHD across races and genders. While these initiatives are necessary, their development, funding, and implementation are lengthy processes. One unlikely emerging public health tool that is proving itself to be effective is TikTok, a social media platform centered around short-form content. 

Dr. Sasha Hamdani is one of many psychiatrists who uploaded her first TikTok video in December of 2020 with hopes of creating an educational space for ADHD. In six months, she gained over 100,000 followers and began livestreaming to answer her audience’s nonclinical questions about ADHD and direct them towards sources where they could get more personalized help [3]. Through Tiktok, she expanded her creative outlet while educating her audience on signs and symptoms of ADHD and empowering them to advocate for themselves. 

Internet accessibility  has boomed in the last decade, and more than 80% of adults search for health information online [4]. The internet and specific social media outlets have proven themselves to be increasingly important in public health studies, as studies are now incorporating search engine data to examine the impact of online information-seeking behaviors on health outcomes [11]. As a testament to TikTok’s role in promoting mental health awareness, ADHD diagnosis rates in adult women have doubled from 2020 to 2022 [8]. It is plausible that increased screen times during the pandemic allowed many individuals to understand their struggles.

However, one caveat of TikTok is that anyone can upload a video. The next video that appears on your For You Page can come from a board-certified clinician or an uncredited source. This can lead to inaccurate medical advice and illness portrayal or the spread of dis/misinformation. Public health agencies and TikTok staff must recognize and acknowledge the influential role that TikTok has garnered in our society and understand that it is a double-edged sword bearing the ability to mislead and inform. Thus, research into app engagement and perceptions of health data is necessary to understand its effects on our digital society, especially impressionable young children and adolescents that make up the majority of TikTok’s user base. Policies must be put in place to prevent the prevalence of misinformation to ensure that users responsibly source health information from the app [10].

Children with ADHD are at increased risk of later experiencing adverse health outcomes and engaging in detrimental behaviors such as substance abuse, self-harm, and suicidal behavior, among other behaviors [6]. It is imperative that we understand and address the disparities in medical diagnoses of ADHD to better serve those with ADHD. TikTok has become closely intertwined with individuals’, especially childrens’, understanding of ADHD and diagnosis, and it is high time that we acknowledge its potential to be a powerful public health tool. When used responsibly, accurate medical information on social media platforms like TikTok can raise awareness for individuals, especially those who are underrepresented, to advocate for themselves and get the help that they need for ADHD and other conditions with diagnostic disparities. 

References

1. Attention-Deficit / hyperactivity disorder (ADHD) in children. (n.d.). Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/adhdadd

2. Bahorsky, R. (n.d.). Calling Dr. TiKTOK: Experts weigh in on an alarming Social-Media trend | Giving. https://give.as.virginia.edu/news/story/calling-dr-tiktok-experts-weigh-alarming-social-media-trend

3. Hamdani, S. (2023, October 4). TikTok is a tool for mental health, not a threat to it. Harvard Public Health Magazine. https://harvardpublichealth.org/human-behavior/tiktok-mental-health-videos-do-they-actually-help/

4. ​​Jacobs W, Amuta AO, Jeon KC. Health information seeking in the digital age: An analysis of health information seeking behavior among US adults. Cogent Social Sciences. 2017;3(1):1302785. doi: 10.1080/23311886.2017.1302785.

5. Koons, S. (n.d.). Study finds white children more likely to be overdiagnosed for ADHD. Penn State University. https://www.psu.edu/news/education/story/study-finds-white-children-more-likely-be-overdiagnosed-adhd/#:~:text=According%20to%20the%20researchers%2C%20social,treatment%20than%20families%20of%20color.

6. Morgan, P. L., & Hu, E. H. (2023). Sociodemographic disparities in ADHD diagnosis and treatment among U.S. elementary schoolchildren. Psychiatry Research, 327, 115393. https://doi.org/10.1016/j.psychres.2023.115393

7. Rucklidge, J. J. (2010). Gender Differences in Attention-Deficit/Hyperactivity Disorder. Psychiatric Clinics of North America, 33(2), 357–373. https://doi.org/10.1016/j.psc.2010.01.006

8. Russell, J., RPh. (n.d.). Number of ADHD patients rising, especially among women. Epic Research. https://epicresearch.org/articles/number-of-adhd-patients-rising-especially-among-women

9. Shi, Y., Guevara, L. R. H., Dykhoff, H. J., Sangaralingham, L. R., Phelan, S., Zaccariello, M. J., & Warner, D. O. (2021). Racial disparities in diagnosis of Attention-Deficit/Hyperactivity Disorder in a US national birth cohort. JAMA Network Open, 4(3), e210321. https://doi.org/10.1001/jamanetworkopen.2021.0321

10. Zenone, M., Ow, N., & Barbic, S. (2021). TikTok and public health: a proposed research agenda. BMJ Global Health, 6(11), e007648. https://doi.org/10.1136/bmjgh-2021-007648

11. Zhao, X., Hayes, T., Timmons, A. C., Wu, W., & Frazier, S. L. (2023). Unpacking Inequities in ADHD diagnosis: Examining Individual-Level Race/Ethnicity and State-Level online Information-Seeking patterns. Administration and Policy in Mental Health and Mental Health Services Research, 50(4), 576–590. https://doi.org/10.1007/s10488-023-01259-w