#neurodivergent and proud

on TikTok Self-Diagnoses in COMPACT Magazine

Here’s my first piece for COMPACT Magazine, about the rise of young people using TikTok to diagnosing themselves as neurodiverse.

Over the last few months, followers of the “autism” hashtag on TikTok have been deluged with videos offering a variety of cures for the neurological condition, ranging from miraculous religious healing rituals to drinking raw cow’s milk. Such content is the latest iteration of viral do-it-yourself diagnoses and remedies for mental-health disorders. Though data on just how many teens are using TikTok to self-diagnose is inconclusive, videos with mental-health-related hashtags amassed more than 45 billion views last year, according to the platform.

Some celebrate this phenomenon as a triumph for personal agency and expanded access. Others lament that this is a sign of a rising culture of victimhood as well as withering institutional trust, with nearly half of Americans reporting that they have lost confidence in the health system since the pandemic. But a closer look at the history of self-diagnosis suggests that the latest trends on TikTok are simply a contemporary expression of America’s long-standing individualist tradition.

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With the advent of the internet, self-diagnosis began to change. As sites like WebMD grew, they faced criticism for exacerbating hypochondria and pushing their commercial sponsors’ medications. But the real transformation occurred with the rise of social media, when self-diagnosis as an expression of self-reliant individualism gave way to self-diagnosis as a form of expressive individualism. In short, diagnosing your own ailment went from being a way to operate independently of medical authorities to becoming a means for publicly proclaiming an identity.

Many #neurodiverse TikTokers claim their self-assigned label with pride. What they are engaged in may be better described as self-discovery than self-diagnosis; it is less a matter of recognizing one’s defects and more one of embracing one’s “true” identity. Young people may have once looked to their neighborhood, church, or family to inform their sense of self. But the decline of these institutions has led young Americans to seek new forms of recognition.

One problem is that these new identities can often serve to further alienate those who claim them from their prior communities. Doctors who disagree with TikTok diagnoses are accused of #medicalgaslighting. So are parents and family members. In one video posted last year, a teenage girl says her parents gaslit her by telling her that “getting out of bed in the morning and eating will cure [her] depression.”

The trends contributing to the rise of online self-diagnosis are only worsening. Recent studies show that attendance at houses of worship in the United States have reached a new low after Covid. This year, the share of Americans who attend weekly religious services hit a new low of 16 percent, down from 19 percent in 2019. Meanwhile, the share of those who never attend services jumped to 29 percent, up from 21 percent a decade ago. Neighborliness has likewise slumped, with only 29 percent of Americans regularly spending time with their neighbors, down from nearly half in 1974.

Read the rest of the piece here.

The most standard critiques of this phenomenon, as I mention in the piece, are that it weakens trust in medical professionals and authority figures, and it enables young people to feel justified in not attempting working through their social and neurological disorders.

If my abnormalities constitute an identity label, then I am absolved from having to take responsibility for my actions. The fact that I am diagnosing myself without referring to an external authority who can challenge me and help me to work through my issues makes it easier for me to take on a kind of determinist position toward my behavior, and to demand that society accept my quirks rather than me having to conform to society’s oppressive “neurotypical” norms. Surely Phillip Rieff and Christopher Lasch warned us long ago of such a rise of therapeuticism and pathological narcissism, respectively. 

But beyond its trivialization of personal responsibility, what is most worth our attention in the spread of mental health identitarianism is the light it sheds on the effects of mass atomization, cultural deracination, and spiritual disenchantment. 

There is a reason why identity crises are more explosive among young people living in bourgeois American suburbs than those living in urban or rural areas. “The urban child,” claims Camille Paglia (in a quote I quote way too much), “sees the harshness of the street; the rural child witnesses the frightening operations of nature. Both have contact with an eternal reality denied the suburban middle-class child, who is cushioned from risk and fear and who is expected to conform to a code of genteel good manners and repressed body language that has changed startlingly little since the Victorian era.” Or as philosopher Mary Townsend put it more bluntly in an essay on the surge of mental illness and suicide rates, suburbia is “a breeding ground for nihilism.” 

The suburban landscape–with its clear demarcation between residential and business zones, isolated dwelling spaces, and bent toward cultural assimilation and homogeneity–deprives youth of factors that used to play a key role in identity formation. In our age of rampant globalization, this atomizing suburban mentality has made its way beyond the confines of the suburbs and into urban and rural spaces.

When faced with the question “who am I?”, a young person living in earlier times might have been able to look to their kin and neighbors, whose proximity and social friction with whom could inform their sense of identity in a concrete manner. One could easily point to their neighborhood’s shared cultural traditions–their ethnic cuisine and celebrations, language or mode of communication, and religious convictions and rituals–and claim “this is who I am.”

On this last note, the fervor with which young people claim neurodivergent labels speaks to a broader cosmic void that surpasses those left behind by the loss of community and cultural legacies. Numerous scholars from Paglia and Lasch to Charles Taylor and Augusto Del Noce have highlighted the origins of the genteel and largely secularized bourgeois ideals of Enlightenment humanism and rationalism. 

Perhaps Michel Foucault’s most compelling work, Madness and Civilization documents the transformation of the conception and categorization of mental illness from the more “enchanted” Medieval period (which made space for a more “dazzled” or porous notion of rationality) to the more rigid and less imaginative Modern period. Whereas a person who was somewhat detached from the concrete details of reality and tended toward magical thinking might have been deemed mystical or creative in times past–and encouraged to take up a religious or artistic vocation–was written off as “mad” by the modern rationalist social imaginary, subjecting them to the scrutiny of medicalization or even relegating them to shadows of respectable society.

The combined effect of cultural deracination and spiritual disenchantment have informed the plots of a number of works of literature in the last century. Take Elizabeth Spencer’s 1960 novella The Light in the Piazza, which features a protagonist who suffered a cognitive impairment after a horse riding accident, leaving her, as a 26 year old, at the functional level of a six year old. Whereas she was treated as a pariah in her upper-middle class, predominantly Anglo suburb in the American South, she was treated like a “normal” human being when traveling in Florence, Italy. The change of environment–from its aesthetic richness, historical rootedness, and presence of religiosity on nearly every street corner–rendered her abnormalities mere quirks or even signs of a charismatic personality.

We might also consider J.D. Salinger’s 1961 novella Franny and Zooey. Franny Glass, a well to do college student, attempts to escape her ennui and general disillusion with the inauthenticity and drabness of her peers through Eastern Christian and Zen spirituality. Though her obsessive repetition of the “Jesus Prayer” certainly borders on the hysterical, Salinger’s depiction of Franny’s struggle forces the reader to question whether it is her or the stiflingly bourgeois society she finds herself trapped in that is truly “mad.”

Similar examples continue to abound in recent years, like Yaa Gyasi’s novel Transcendent Kingdom whose plot revolves around a devoutly Pentecostal Ghanaian-born immigrant to the US who struggles with mental illness, and her med student daughter who grapples with questions about faith, science, and cultural assimilation. Or the episodes of Netflix’s The Crown which feature Princesses Margaret and Alice’s respective gripes with the Royal Family over their spiritual and mental proclivities.

It’s fair to argue that young people self-diagnosing and giddily embracing neurodivergent labels is an inevitable and perhaps even a rational response to life in an atomized, uprooted, and disenchanted society. Young people whose proclivities make them more prone to recognizing and feeling the effects of our abysmal globalist moment–whether or not they have diagnosable mental instabilities–might find that in embracing their chosen label, they are validated in calling into question the status quo…that perhaps it is our senseless culture and its standards of normality that are more mad than they are themselves. 

Perhaps it is time to work to create viable opportunities for them to reestablish their roots in substantial realities like community, culture, and metaphysical truths.

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graphic by @revolvingstyle