Are We Doomed To Become Parents Of Teens With Mental Disorders?

#Mental health now has over 68 billion views. #Tics has 4.2 billion, #borderline personality disorder 1.5 billion and #dissociative identity disorder has 1.3 billion. Tik Tok is taking over the world, its’ algorithms pruned by an army of psychologists to suck teens in and spend hours watching reel after reel. With teens now spending up to 9 hours of screen time a day, what could possibly go wrong?

Dissociative Identity Disorder (aka Multiple Personality Disorder), tic-disorders and Borderline Personality Disorder have never had prevalence rates above 2%. On all the different social media platforms, however, you find communities with aesthetically pleasing videos romanticizing symptoms and criteria for diagnosing. Influencers give the impression that having the disorder makes you “someone”.

Does it then come as a surprise that clinicians everywhere are reporting that teens are self-diagnosing using the exact terms from the Diagnostic Manual? One study suggests the prevalence rate of Dissociative Identity Disorder in college students are at almost 12%, which would make it as common as depression! Could this trend have something in common with what made the rate of autism over the last 20 years go up 241%? Mental health awareness campaigning and cultural shifts reducing stigma have clearly been successful. In the cities now therapists are a dime a dozen. If this enthusiastic mental health enlightenment is simply enabling discovery of the unidentified sufferers, then I must admit it makes me as a parent somewhat pessimistic. “Too much of a good thing” is an expression that comes to mind.

I think it’s worth re-examining our devotion to mental health publicity, because we are not factoring in the social contagion effect of mental disorders. There is a body of research showing how we mimic and transfer emotions unto one another subconsciously. If you have a neighbor who is happy, you are 25% more likely to be happy than if you don’t. Depression also seems to spread through social networks.

I witnessed this type of contagion in my first year of residency at a secured acute psychiatric ward. I was working the night shift and coincidentally there were 4 borderline patients in single rooms next to each other. One of them experienced an emotional crisis and broke the mirror in her room to cut herself. Shortly after, chaos had reigned and orderlies had rushed to the scene; the patient in the room next to her had done the same, and then the next. I spent that whole night suturing self-inflicted wounds, fantasizing about a residency in ophthalmology.

Time and time again we observe how portrayals of suicide in pop culture leads to real-life spikes in suicide rates.  A new study just confirmed how college roommates “infect” each other with their psychological distress. And another shows how teen girls watching hours of tic videos produce real-life facial tics because of the mimicking that happens subconsciously.

Dissociation is a very interesting tool the brain uses in response to an overload caused by severe childhood trauma. I saw it once where I worked in Norway, a young girl walked out onto the icy lake with suicidal intent in what is called dissociative fugue. The disorder in its real form is not a joke, it’s debilitating and isolating. It rarely takes the form portrayed in the movie “Split”, where it merely provides a colorful character, neither is it something that should be used by others as some sort of tribal tattoo.

That is in effect a big part of what is going on as well. Much of a teenager’s behavior is aimed at gaining a foothold in a social group, finding their tribe if you will. Untethering themselves, becoming a separate person from their parents while forming an identity- whatever that really is. We are at our most suggestible between 13-17 years old, and our hormonal machinery is firing full speed on all cylinders. Teens are high in neuroticism, which makes them volatile and quick to feel negative emotions. These changes alone would make them meet criteria of more than one mental disorder in the Diagnostic Manual. Which is the reason many psychiatrists hesitate to diagnose before adulthood. Add to the mix the rampant spread of social contagion, the wanting to identify- to be like- the influencers with the niche mental disorders that come with a community of guaranteed “lovebombs”, I’m surprised there are any healthy teens left at all.

Research is emerging demonstrating the link between digital media use and compromised mental health, clearly showing the substantial increases in adolescent depression and anxiety that began around 2012. The year everyone bought an iPhone and social media use went from “some have it”, to almost mandatory. 10 years later our teens are drowning in a never-ending addictive onslaught of bad trends.

I do wonder if the stigma around mental disorders still is such, that it warrants the risk of social contagion posed when kids see mental disorders all over Netflix, famous people being celebrated for “coming out” with mental disorders and suicide helpline advertisements at every bus stop.

We would be better served by merciless campaigning to raise awareness on this and of the war raging between us and social media, in which our teens are obliviously being slaughtered at the front. I worry that we are helplessly ill-equipped to win. One might even call it guerrilla warfare, seeing as we are never truly alone with our kids. Our social media adversaries are always hiding right in their hands ready to affirm any whim and impulse subjected to unwanted parental counseling. They can always seek refuge with the current tribe of their choosing, unvetted by us, because how can we possibly supervise the extensive networks available. Forming our kids into functioning, healthy adults is a parents’ ultimate mission and in society’s best interest. The parents are the soldiers we must mobilize, but they need to be armed with better information and confidence to act on it.

While we might be powerless against many factors contributing to illness, we could find ways to exert influence over the environment surrounding teens. That’s only possible if we are made aware by appropriate campaigning, of the degree of harm that environment has the potential of inflicting. To counter guerrilla warfare, we are dependent on accurate intel by experts and given the means to drive a wedge between the locals and the guerrilla soldiers. Parents could band together in insisting on parental controls, phone-free mandatory family time, extra-curricular phone-free activities with actual face-to-face interaction with peers and maybe altogether disallowing the worst social media offenders. It would help not to hear “but all of my friends are doing it” quite so often. That, and the de-romanticization of mental disorders on all channels would really increase our chances of success.