TikTok has a therapy problem.
Creators who purport to reduce the stigma around mental health issues may be unintentionally spreading misinformation on the app, where people who post about mental health are easily confused with real professionals making similar content.
In one video, a woman lists lesser-known symptoms of anxiety, including being susceptible to emotional outbursts, feeling restless, and being irritable. The woman makes direct eye contact with the camera and is framed so her face fills the screen, as if she’s video chatting directly with the viewer.
In another video, which was posted two months earlier, a different woman lists four traits of what she calls “high functioning anxiety,” juxtaposing being outwardly “calm and put together” with “needing reassurance,” and claiming that having a cheery demeanor stems from “lacking boundaries.” Her video looks nearly identical to the first woman’s, from the bright lighting to the framing to the eye contact with the camera.
The difference? The first woman is therapist Micheline Maalouf, a licensed mental health counselor who’s certified by the National Board for Certified Counselors. She has 1 million followers, and when she’s not creating content, she’s treating clients at her private practice in Orlando. The second is former television host-turned-content creator Raquel Olsson, who has been criticized by professionals on TikTok for posting misleading videos about mental health. She has 1.6 million followers.
Differentiating between the two videos, and both creators’ authority on these subjects, can be a challenge, especially when their content looks virtually the same.
Olsson does not refer to herself as a mental health professional, and told Mashable that she considers herself a “mentor-reporter” who makes content on “human behavior and personality.” In an email, Olsson clarified that she seeks to “approach topics from either a philosophical perspective to promote self-reflection, or a journalistic perspective to shed light on more novel phenomenons that we all may deal with but are not classified in the DSM.”
“I deliberately never discuss clinical issues like depression or any other type of psychiatric disorder,” Olsson said.
Her video about anxiety, she said, was about a “non-medical term” since “high functioning anxiety” is not a clinical diagnosis. Since she has faced backlash from her high functioning anxiety video, though, she’s made less content about diagnosable disorders and more about phenomena like imposter syndrome or revenge bedtime procrastination.
Not all creators are clear about their limits, though. Like many other professions, hobbies, and interests, the mental health niche on TikTok ballooned last year when . Spotting an outlet where they could provide education and normalize seeking treatment for mental health issues, en masse. Many make videos like Maalouf’s, promoting therapy and listing potential symptoms of mental illnesses viewers may not recognize. In a country where healthcare, let alone mental healthcare, remains inaccessible to many, these videos can serve an important purpose: They alert viewers to treatable issues they may not know are affecting their day-to-day lives. But some creators are leveraging that interest in mental health content for views without being qualified to speak on these complex, often very personal issues.
How mental health creators go viral
Open discussions of mental health are slowly becoming more normalized, but the effort to destigmatize the conversation may also have opened the door for misinformation to spread more easily. Olsson is far from the first, and certainly won’t be the last, creator to post content about mental health. Videos about mental health appear on For You Pages every day, pathologizing common traits and making claims as “fact” without providing the evidence to support them. Maalouf doesn’t see a problem with creators discussing their own mental health experiences to push viewers to seek treatment on their own, but she is concerned with the influx of creators speaking about mental health with authority they don’t have.
“I think the issue is with non-professionals giving that [advice], because they don’t necessarily have the correct information,” Maalouf told Mashable. “And maybe they do have the information from lived experience…[but] it’s not necessarily factual information. There’s a lot of people talking about mental health, and they’re not really qualified to do so.”
Clickbait flourished on the internet long before TikTok became a mainstream platform, and will likely continue to do so after the zeitgeist moves to a new one. TikTok, though, is uniquely poised to unintentionally spread misinformation because of its format: Videos are limited to 60 seconds, captions can’t be longer than 100 characters, and the app doesn’t allow click-through links except in creator bios. More complex videos longer than 30 seconds, Maalouf noted, don’t tend to do as well as shorter ones. Videos like Olsson’s, on the other hand, which make general statements that can apply to a wider audience, are more likely to go viral.
Dr. Inna Kanevsky, a psychology professor at San Diego Mesa College, started calling out TikTok creators for making misleading and false claims about psychology late last year. She’s gained a reputation, and roughly 780,000 followers, for debunking pseudoscience and feuding with creators who broadly cite “psychology” without providing the evidence to back their claims.
In an interview with Mashable, Kanevsky pointed out that these videos tend to employ similar formulas: The creator draws the viewer in with some commonly felt experience, refers to “recent studies” or “science,” and then states an unproven but easily repeatable claim about psychology.
Creator Max Klymenko was a recent thorn in Kanevsky’s side. In a sponsored video from late February, he cited “the latest science” to claim that wearing black can “have a negative impact on your mood and well-being,” and that wearing orange or red too often can “increase your anxiety.” In a response video debunking Klymenko’s, Kanevsky pointed out that the “latest science” Klymenko may have been referring to — a 2018 published in Color Research and Application — concluded that participants may have had cultural and personal associations with certain colors, but those associations don’t impact mood. Klymenko did not respond to request for comment from Mashable.
“Once they find a formula…they just keep doing that because it’s rewarded,” Kanevsky said, referring to creators like Klymenko who employ similar video formats. “They basically propagate their point of view that is not empirically backed, that is essentially pseudoscience…It’s not necessarily the best treatment or the best people to listen to. But they are popular and positive and attractive. And that may prevent people from seeking actual help.”
Kanevsky has made it clear in her videos that she is not a therapist, but an academic, and tries to teach her viewers how to read and interpret peer-reviewed studies rather than blindly trust viral videos. To combat misinformation, her bio links to a she cites when debunking another creator’s video, and she does not provide information on clinical details of mental health disorders, preferring to refer curious viewers to licensed therapists and psychiatrists.
Derrick Javan Hoard, a licensed marriage and family therapist in Seattle, noted that many therapists have struggled to adapt to an increasingly online practice. He’s carved out a niche on TikTok, with an audience of roughly 247,000 followers, debunking misleading videos posted by “life coaches.”
Like motivational speakers and other creators making mental health content, life coaches are not licensed mental health professionals, but tend to be more digitally savvy than most therapists. Meanwhile therapists, Hoard said, are lagging in their tech skills.
“Most therapists are still stuck in the ’90s.”
“I don’t deny that they have good information, that they might even be presenting that information in a way that’s better than most therapists do on the TikTok page,” Hoard said, referring to self-proclaimed life coaches. “Especially because most therapists are still stuck in the ’90s.”
But that viral appeal that non-licensed creators have is precisely what makes their content problematic.
Viral creators aren’t equipped to talk about mental health
The guidance life coaches offer can seem like therapy, but life coaches aren’t held accountable by licensing boards and codes of conduct the way mental health professionals are. That allure alarms Hoard, who works with children and families, because so many minors don’t have access to help with their mental health and can easily be manipulated by self-proclaimed life coaches. There are instances of therapists taking advantage of their clients or interacting inappropriately, but those therapists can at least be disciplined and stripped of their license.
“They can build a relationship with people. What is to stop them from abusing that relationship?”
“They can build a relationship with people. What is to stop them from abusing that relationship?” Hoard said, referring to the popularity of life coaches on TikTok. “There is nothing that anyone can do to a life coach…to stop them from harming someone else at all. There’s nothing in place.”
The discussion around mental health on TikTok walks the fine line between alerting viewers to seek treatment and encouraging them to self-diagnose based on videos that often mislabel widely felt emotions. Healthcare to many Americans, particularly in Black communities and other communities of color, and people seeking psychological help often have to be their own advocates. Information and awareness about mental health can be crucial in empowering people to seek treatment.
At the same time, diagnosing yourself incorrectly based on a video you’ve seen can trivialize very real conditions that do actually greatly affect someone’s life. The spike in TikTok content about and , for example, has raised awareness about these common neurodiversities. Both are chronically undiagnosed in women, so educating people about lesser known symptoms can be beneficial. But creators also run the risk of minimizing the very serious and nuanced developmental challenges that can come with being neurodivergent when they water it down into a 30-second video.
Worse, a self-diagnosis based on a viral video can lead to someone trivializing their own very real mental health issues by not acknowledging the more serious symptoms they’re experiencing.
Kanevsky is concerned that the rise in mental health content from untrained and unlicensed creators may further stigmatize getting actual help because dipping into pop psychology is more palatable than seeing a therapist over a long period. In one of her , which received more than 4 million views, Kanevsky admonished Olsson for “exploiting mental health for clout” and blocking people who asked for evidence to back up her videos. She took issue with Olsson’s use of the phrase “high functioning,” Kanevsky told Mashable, because it implies that anxiety symptoms aren’t an impairment. The phrase “high functioning anxiety” isn’t a clinical diagnosis, but separating these widely felt experiences from just “anxiety” may normalize negative patterns instead of destigmatizing treating them.
“You still need therapy to help you cope with your stress.”
“The reality is, if you actually have those symptoms to the point where they are interfering with your life, you’re not really high functioning,” she said, noting that these videos don’t always provide viewers with resources for treatment. “You still need therapy to help you cope with your stress.”
Olsson told Mashable that her video was inspired by her own experience with anxiety, and that it wasn’t meant to be used as a means for self-diagnosing. In an email, she added that “high-functioning anxiety” may not be a clinical diagnosis, but that she posted the video “purely to help other people recognize a possible hidden issue that wasn’t widely talked about yet.” She denounced the “toxic cancel culture” that she claims Kanevsky employs by challenging creators to provide evidence, and said as a content creator, she does not “feel obligated to act like some dehumanized resource.”
“I’m an actual person, and I have the right to create my content the way I want,” Olsson said, noting her need to establish her own boundaries as a creator. “I’ve decided to post sources when I think is necessary, and have let go of the expectation some people have attempted to dictate. If people want to find out more about what I talk about, they are free to fact-check themselves and take up that responsibility.”
Olsson has started backing some videos with sources linked in her bio, but maintains that expecting her to provide more nuance on a platform that “thrives off of 15-second dance videos” is “presumptuous.”
While many creators do have good intentions in spreading awareness of mood disorders and developmental differences, Kanevsky worries that the rise in misguided mental health content can diminish the need for accommodations by creating unrealistic expectations for people with those conditions. She’s particularly irked when creators who do not have a background in psychology offer tips for managing those conditions instead of suggesting people seek professional help or ask for accommodations.
TikTok is seeing an influx of ADHD-related content, for example, but the videos life coaches post about making lifestyle changes to manage it don’t always acknowledge more serious symptoms that may need medical treatment. There should be more of an emphasis on normalizing asking for accommodations for invisible disabilities, Kanevsky said, rather than expecting people with those disabilities to operate the same way as everyone else, and that isn’t communicated in many creators’ TikToks.
Shani Tran, a licensed therapist near Minneapolis, who posts videos about therapy on TikTok, is careful to limit her content to avoid perpetuating stereotypes about mental health issues. As a Black therapist, she recognizes that her followers — many of whom are Black, Indigenous, people of color, or low-income — don’t always have access to a mental health professional. Still, she’s hesitant to make any of her videos discussing possible mental health issues seem like a checklist of symptoms.
“It’s important that I do put information out there, but I also stray away from giving…too much information. I don’t pull it right out of the DSM,” Tran said. “I try to use words like ‘may look like this’ or ‘could look like this,’ not definitive words.”
People experience depression, for example, in different ways and with varying severity. Tran added that some people may be confined to their beds during depressive episodes, and others may still be able to go to work and appear to function normally while experiencing depression. Both cases are deserving of treatment. Creators who talk about mental health, though, don’t always discuss the complexity of depression symptoms that licensed therapists like Tran are equipped to spot.
Applying one treatment method to a broad swath of viewers is ineffective at best and dangerous at worst.
Diagnosis aside, content about mental health issues should focus on pushing the viewer to seek treatment if their symptoms impact their day-to-day lives. Licensed therapists tend to tread more carefully than non-professional creators do when discussing mental health, and make it clear that their content may offer advice but is not a replacement for therapy. Treating mental illness is highly personalized and tailored to each patient, and applying one treatment method to a broad swath of viewers is ineffective at best and dangerous at worst.
The limits of discussing mental health on TikTok
Even Tran, as a licensed therapist, has to establish that boundary with her followers. She doesn’t answer DMs from people seeking mental health treatment, instead including links to find other therapists in her bio. She also created a directory of therapists of color for TikTok users looking for help from someone who better understands them. Engaging in a conversation with someone looking for help can be an ethical violation of her license because she isn’t their therapist and can’t come up with a treatment plan based on a few messages. In addition to the ethical quandary, therapy takes up a significant amount of energy that Tran can’t expend on TikTok.
“We say, ‘Let me put my therapy hat on.’ When I slip into therapy mode I’m working.”
“There’s a lot of thought that goes into it. We say, ‘Let me put my therapy hat on.’ When I slip into therapy mode I’m working,” Tran said, and added that it isn’t fair to her, as a therapist off the clock, or to the person seeking help. “There’s so many other things that go into therapy, such as being able to judge someone’s body language, being able to judge whether the client has you taking them down a road that they might not be able to handle.”
Creators who don’t have backgrounds or certifications in psychology aren’t trained to establish that boundary, let alone handle crisis situations that actual therapists are equipped for. When they speak with the same authority as licensed counselors, a person going through a mental health crisis may not be able to tell the difference.
Hoard turned off his DMs entirely for his own health because he couldn’t ethically help all of the minors reaching out to him. A life coach or untrained creator could easily leverage those children’s desperation for help he said, and that should raise red flags.
“If I were a bad person, I would have unlimited — unlimited — access to children,” Hoard said. “They’re a life coach, and people think that should actually fucking mean something, so they trust them. That’s what I’m concerned about. That’s what scares me, how many life coaches we have out here life coaching children.”
Directly confronting creators who post misleading content has its limits, however. Hoard, like Kanevsky, challenges creators on TikTok by duetting misleading videos. He takes a more therapeutic approach than Kanevsky’s academic one, explaining the delicate nuances of trauma and relationships that purported life coaches don’t. In one video duet with TikTok user successlifecoach, for example, Hoard debunked the myth that men are predisposed to “pulling away” in relationships by explaining the pursuer-distancer dynamic that can be present regardless of gender.
Some creators don’t acknowledge the criticism, but others do engage in discussions that Hoard finds ultimately unproductive. Hoard has shut down debates with people too entrenched in pseudoscience to have a constructive conversation — like a self-proclaimed “retired psychic medium” — and with racist users who question his integrity and qualifications. The microaggressive comments aren’t worth his energy.
“Do you ask doctors to sit down with naturopaths? Do you ask astrophysicists to sit down with flat earth[ers] like this?”
“I worked way too damn hard as a Black man to get this license…And so it’s so frustrating from a racial standpoint. I have people asking me to fucking debate, like, bitch, I am a therapist!” Hoard said. “Do you ask doctors to sit down with naturopaths? Do you ask astrophysicists to sit down with flat earth[ers] like this? Bitch, we are not on the same level!”
Improving mental health TikTok
Hoard describes life coaches as “symptoms” of a larger problem: a “completely and totally fucking broken” healthcare system. Many of the TikTok’s issues in mental health content are systemic; therapists can’t treat clients from outside of their states, which limits access to seeing affordable therapists and therapists of color. Hoard is petitioning the American Association for Marriage and Family Therapy, the American Psychological Association, and the American Counseling Association to allow therapists to see clients from out of state through a Change.org petition, but in the meantime concedes that controversial tele-therapy services like Better Help are “better than nothing.”
TikTok, though, can at least make an effort to curb the rampant spread of misleading content on its platform.
There are ways for viewers to determine whether TikTok videos are posted by actual therapists — Tran noted that anyone can look up someone’s license in each state. Maalouf also recommended making sure a therapist is certified by their state’s licensing board before following them, but added that doing so is an extra step that many TikTok users, who are scrolling through videos quickly, probably won’t take. The onus should be on TikTok to take more responsibility for combating misinformation.
Maalouf wishes TikTok had a badge like its verified checkmark, but exclusively for mental health professionals. For one, it would make the difference between mental health creators and actual mental health professionals more clear. It would also further discourage people from pretending to be experts. Maalouf is part of a private Facebook group for therapists who are also TikTok creators, and they’ve ousted creators who claim to be therapists without actually having licenses. Hoard added that having some sort of verification process for licensed therapists would limit the influence that self-described life coaches have on vulnerable minors.
TikTok did roll out late last year and employed a new flagging system for potentially harmful videos, but can still step up on moderating its own content rather than relying on Maalouf and the rest of the therapists in that Facebook group.
A verification system, Maalouf added, would also allow licensed professionals to discuss more delicate topics that would usually be flagged by TikTok, such as eating disorders and suicide ideation. Although TikTok will take down videos with certain keywords — more recently, the platform started to ensure they want to watch potentially triggering content — users still sneak by TikTok’s flagging system by coming up with euphemisms for “banned” words. “Suicide” is referred to as “sewer slide,” for example, or self-harm is described in a string of emojis. Maalouf said she’d be totally fine sending sensitive videos to TikTok for review before getting the thumbs-up to post, but that not being allowed to speak about the subject at all without dancing around it is reductive.
“If we have to make up words for something, we’re further stigmatizing the topic.”
“If we have to make up words for something, we’re further stigmatizing the topic,” Maalouf said.
Until then, users need to be more discerning when it comes to taking advice from internet strangers.
If you want to talk to someone or are experiencing suicidal thoughts, Crisis Text Line provides free, confidential support 24/7. Text CRISIS to 741741 to be connected to a crisis counselor. Contact the NAMI HelpLine at 1-800-950-NAMI, Monday through Friday from 10:00 a.m. – 8:00 p.m. ET, or email . You can also call the National Suicide Prevention Lifeline at 1-800-273-8255. Here is a list of international resources.