Our desire to understand ourselves.

I am going to take a chance with this newsletter and dip into a topic that carries, for many, strong emotional reactions. Given that, I want to be thoughtful…hopefully wise about how I address the topic. 

Over the past several years, I've watched a fascinating shift unfold. Increasingly, people are turning to online platforms (TikTok, Instagram, Reddit, etc) to answer one of the oldest human questions: Who am I? 

This might start with questions about how to understand our own behavior. Finding a label, finding a category, finding a place to fit in, helps to make sense of who we are and why we do what we do. There could be a number of ways this is approached, but it often starts with self-reflective questions: “What is wrong with me?” or “Why do I do what I do?” In a world filled with categories, labels, diagnoses, and symptoms used to define behavior, people want to know “Why am I like this?” 

Being able to categorize our experience feels useful. It can seem to connect us to something much deeper: What is my essence? What is my identity? Am I a continuous subject or a bundle of fleeting perceptions? (e.g., David Hume).

Why do we seek to find this kind of self-understanding? 

We seek these understandings for many reasons, but some might include feeling comforted by a label that describes our behavior; labels might decrease uncertainty, avoiding the discomfort it brings; labels can help us belong by connecting to communities with similar labels - belonging matters; knowing who you are might help guide decisions, figure out relationship patterns, and so on. I am sure there are other explanations, and I can see the benefit of this process. 

Humans have long had a hunger to know themselves. We have always been looking for answers about who we are, trying to understand our existence: astrology, personality tests, enneagrams, Myers-Briggs, attachment styles, love languages, trauma identities, generational identities, neurodivergence, and, as I am reflecting upon here: diagnostic labels and the problem of self-diagnosing.

I can comfortably make the claim that some self-diagnosis is problematic and there is research to support this (see Research Spotlight below), and I have talked previously about how the DSM has contributed to the medicalization of ordinary human suffering (contributing to protocol-driven narrowing of therapists' attention away from the function of behavior of the individual sitting in front of them). I guess in this newsletter, I want to orient to other harms that categorization can lead to when it becomes the primary lens through which we understand our suffering.

But first, let's look at how self-diagnosing through technology is at issue. Self-diagnosing labels are overwhelmingly driven by social media algorithms. These algorithms are interacting with predictable features of human cognition. Here is a simple way to think about algorithms…bear with me. Every time you open an app, the algorithm runs a rapid process to build your feed: (1) Inventory collection - the system gathers all recent posts from people you follow, plus public posts it thinks you might like; (2) Signal gathering: it looks at contextual signals like who made the post, its popularity, your current device, and the time of day; (3) Prediction modeling: the algorithm calculates the exact mathematical probability that you will like, comment, share, or spend time reading each post; and (4) Relevance scoring: each piece of content receives a final score, and the system ranks them to display the highest-scoring posts at the top of your feed. The key behavioral signals used in algorithms rely on your actions to determine what content makes it to your screen: watch time, active engagement, content attributes (e.g., visual themes), and relationship strength (e.g., how often you DM, tag, etc.). These behavioral signals then allow for “filter bubbles,” which continuously provide content that matches your existing beliefs. Algorithms shield you from differing viewpoints and hook you into “dopamine loops” that prioritize high-arousal emotions over calm content. Woof! 

What happens next? The information ecosystem shapes what we see. The algorithm mistakes curiosity for certainty. Imagine someone wonders, "Could I have ADHD?" They watch one TikTok video. The algorithm interprets this as a preference, so it delivers more ADHD videos, ADHD influencers, ADHD memes, ADHD symptom checklists, and so on. The algorithm has quietly transformed a question into an apparent answer. Confirmation bias blooms – our tendency to seek information that confirms our existing beliefs is amplified. Additionally, base rates for the ADHD diagnosis disappear. And, once someone adopts a label, they often find belonging, understanding, shared language, and validation in online communities (questioning the diagnosis can begin to feel like questioning the community itself – keeping people from asking broader questions). Imagine a content creator says, “If you lose your keys, interrupt people, procrastinate, and replay songs, you probably have ADHD.” Millions of people will recognize themselves in this description (it’s embarrassing to tell folks how many times I have replayed a song in a single hour because I love the beat). 

But, and this is a big BUT, these behaviors are extremely common. The algorithm doesn’t ask: How often? Since when? Across what settings? How impairing is it? What else could explain it? They don’t ask whether this is clinically valid. Instead, they flatten these everyday experiences into a diagnosis, and alternative explanations disappear. Increasingly, experiences that might once have been understood as grief, uncertainty, fear, loneliness, heartbreak, identity development, existential questioning, and other common experiences are now no longer normal human experience, but a condition, a diagnosis, an identity. 

Some of the most common self-diagnosis labels are anxiety, depression, ADHD, Autism Spectrum Disorder (ASD), Obsessive-Compulsive Disorder (OCD), and Borderline Personality Disorder (BPD). Everyday traits like procrastination, lack of focus, and forgetfulness are frequently mistaken for ADHD. Normal social awkwardness (just had one of these moments myself at our yearly block party, where I sat alone for a period of time talking to no one) or sensory preferences are ASD. Normal situational stress or nervousness becomes an Anxiety Disorder.  Universal feelings of low motivation and fatigue are Depression. High emotional intensity is BPD. This isn’t how diagnosis works.The problem is not curiosity about mental health.

The problem is that a 60-second video cannot distinguish between an anxiety disorder, burnout, sleep deprivation, momentary awkwardness, or clinical depression. Getting the wrong answer has real consequences.

Here is my biggest concern: human variation becomes pathology.

Everyone forgets things, gets distracted, feels socially awkward, worries, has repetitive thoughts, gets overwhelmed, has mood swings, struggles to focus. Instead of asking, "Could these experiences be part of who I am or describe part of my experience?" the question becomes: "Is this who I am?" The label shifts from description to identity. Behavior becomes divorced from context. 

Let me return to “Am I a continuous subject or a bundle of fleeting perceptions?” Perhaps we are both: a continuous being who experiences the ongoing flow of changing experience. 

A diagnosis potentially describes a pattern. It may point toward a particular type of treatment. It may even offer relief and a sense of belonging in some cases. But it should never become the final answer to the question, "Who am I?"

We are not categories. We are not clumps of behavior. We are not even the stories we tell ourselves about why we suffer. We are living beings whose thoughts, emotions, and behaviors emerge from an ever-changing interaction between biology, learning history, relationships, culture, and the present moment – we are beings. To understand ourselves requires more than a label. It requires curiosity, flexibility, and awareness."I am rooted, but I flow."— Virginia Woolf

To read more about this issue: 

https://www.ynhhs.org/articles/risks-of-diagnosing-with-ai

https://www.psychiatryadvisor.com/features/self-diagnosis-in-psychiatry/

Personal Reflection:  I am rooted, but I flow.

Click Here To Listen

Take a moment to settle into a comfortable position. If it feels right, close your eyes or soften your gaze. Allow yourself to notice your breathing. 

Now, bring to mind a label you have used to describe yourself. It might be a diagnosis, a personality trait, a role, or simply a word you have repeated over the years: anxious, introverted, successful, ADHD, caregiver, people pleaser, perfectionist. Hold that label gently in your awareness.

Ask yourself:

When did I first begin using this label?

Has there ever been a time when it felt more true? Less true?

Does this label describe all of me...or only part of my experience?

How could this label possibly account for all of me? Am I larger than this label?

Notice that while the label may come and go in your awareness, something remains constant.

Thoughts come.

Emotions come.

Memories come.

Labels come.

And yet there is also the part of you that notices them all. As you sit quietly for a moment, consider this: I am rooted, yet flow. I am being.  

Rest in this for a few moments and then return to the day. 

ACT Micro Practice

Set aside five quiet minutes and think of a situation that has been difficult recently. Before reaching for an explanation or a label, simply return to the experience itself. Ask yourself:

What am I actually noticing as I recall the situation right now?

What thoughts are here?

What emotions are here?

What sensations do I notice in my body?

What memories or images seem connected to this moment?

Allow yourself to observe without trying to organize the experience into a category.

Then ask: If I didn't have a label for this experience, what would I be curious about? Stay with whatever emerges.

Sometimes understanding begins not with finding the right category, but with becoming more deeply acquainted with the experience itself.

Research Spotlight: The Science of Remembering We Belong

The rapid growth of self-diagnosis through social media has become an emerging area of psychological research. Increasingly, individuals, especially adolescents and young adults, are turning to platforms such as TikTok, Instagram, and Reddit to understand their emotional experiences. While these platforms may reduce stigma, foster a sense of community, and encourage help-seeking, they also carry important risks. Foster and Ellis (2024) note that social media often presents simplified descriptions of complex psychiatric conditions, making it easy for viewers to identify with common experiences while overlooking the broader clinical picture. Another challenge is that social media algorithms are designed to maximize engagement rather than clinical accuracy. Once users begin viewing content related to a particular condition, algorithms tend to deliver increasingly similar material, reinforcing a single explanation for their experiences while reducing exposure to alternative perspectives. Hudon et al. (2025) found that psychiatric information on TikTok frequently contains misleading, incomplete, or clinically inaccurate content, highlighting the need for greater caution when using social media as a source of mental health information. Lastly, the consequences extend beyond simple misinformation. Armstrong et al. (2025) found that self-diagnosis can strengthen confirmation bias, increase self-pathologizing, and delay appropriate assessment and treatment. 

References  

Armstrong, S., Osuch, E., Wammes, M., Chevalier, O., Kieffer, S., Meddaoui, M., & Rice, L. (2025). Self-diagnosis in the age of social media: A pilot study of youth entering mental health treatment for mood and anxiety disorders. Acta Psychologica, 256, 105015. https://doi.org/10.1016/j.actpsy.2025.105015Foster, A., & Ellis, N. (2024). TikTok-inspired self-diagnosis and its implications for educational psychology practice. Educational Psychology in Practice, 40(4), 491–508. https://doi.org/10.1080/02667363.2024.2409451Hudon, A., Perry, K., Plate, A.-S., Doucet, A., Ducharme, L., Djona, O., Testart Aguirre, C., & Evoy, G. (2025). Navigating the maze of social media disinformation on psychiatric illness and charting paths to reliable information for mental health professionals: Observational study of TikTok videos. Journal of Medical Internet Research, 27, e64225. https://doi.org/10.2196/64225

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