TikTok Is Not Your Doctor

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S1: Welcome back to another episode of Is that ADHD or am I just for you?

S2: Hi, I’m Rachel Hampton

S3: and I’m Madison Malone Kircher. You’re listening to I.S.. Why am I

S2: in case you missed it?

S3: Slate’s podcast about internet culture

S2: and it’s Madison’s favorite time of the year Olympic season. You get it back to back, baby, dirty, dirty, dirty trickster.

S3: I love the Olympics so much

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S2: I thought, You’re about to sing the giant Jovian national anthem.

S3: Do you know we all call my home? The thing is, I don’t know any of the words after that, so I usually just switch to the Canadian anthem.

S2: It’s just no.

S3: The last few words in the middle, and I usually just substitute in the Canadian national anthem.

S2: The reason we’re talking about nationalism is because if the Olympics isn’t, and that’s basically all it is, is nationalism. Madison, you having a good time?

S3: Nationalism and athletic prowess? Yes, I’m having a great time. I love watching hot, ripped people do hot people things, though I do have one one gripe, one request.

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S2: What what is it to stop the human rights abuses?

S3: OK, I have two requests.

S2: What’s the second one?

S3: No, I was I was angling for, you know, like a feasible requests. This, I think, is implementable immediately.

S2: OK, tell me about your incremental change.

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S3: I think NBC should be required on the Kyren underneath the ice dancing pairs as they’re skating to tell us if they’re fuckin’ or not

S2: or half cocked. Oh my God. I mean, it would be a service to us all, just real journalism right there to know which one of these couples are actually couples.

S3: The other thing I keep waiting for is there hasn’t really been a breakout Tik Tok star of these games. I’ve been thinking a lot about Ilhan Omar, who is a U.S. women’s rugby player from the Summer Games. We definitely talked about her on the show back in the day, and though the U.S. women’s rugby team didn’t do so hot, she had a hell of a games.

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S2: I mean, she got what she came for, which is a series of sponsorships, whether that comes from winning the game or winning TikTok, does it really matter?

S3: It does not. The only thing that gives me comfort is the knowledge that TikTok’s algorithm certainly knows me well enough. That should a winter Beijing 2022 Games star arise, they will be on my for you page. Absolutely without fail to tweet. It’s actually not a bad intro to what we’re talking about on the show today. You know TikTok’s algorithmic assumption that it knows you better than, you know you. You know how the app is, if it’s maybe, say, showing you nothing but content from queer women, you might be, well, a hot queer woman yourself, hypothetically.

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S2: I mean, you’re not wrong. Am I getting content from hot queer women? Yes. Am I now questioning everything about myself? Also, yes. Does Tok know something I don’t know? Maybe TikTok definitely thinks they know something that I don’t know,

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S3: and that’s great. Except what we’re talking about today is that it isn’t always, you know, healthy revelations or light bulb aha moments. These assumptions can actually be really dangerous.

S2: Tik Tok, the app and the app’s community of users, cannot possibly correctly know everything about you. It is not psychic, according to Madison. It is not listening to you.

S3: Later in the episode, we’ll be talking about how those assumptions went horribly awry in the true crime community this month, after some people refused to accept the very real and very tragic death of a former Miss USA as reality.

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S2: But to fully understand why that happened, first, we’ve got to rewind and get into TikTok’s culture of self-diagnosis. One of my favorite topics

S3: our official diagnosis. It’s both helpful and hurtful.

S2: More on that after the break. And we’re back with Dr. Ticktock, who might be more fraudulent. Dr. Oz, we’re going to find that out today.

S3: Truly, the number of times tick tock has tried to diagnose me with things is it’s getting too high to count.

S2: You got to tell me, what are your tick tock diagnoses?

S3: I mean, the app is like sentient web M.D., right? It’s I’ve been diagnosed with depression, anxiety, ADHD, being a woman who has to exist in this world like having to pay taxes. Did you know that was the condition one could suffer from? Just the list goes on and on. Any time I open the app, it’s somebody talking straight to camera being like, Do you need oxygen to breathe? That’s a symptom of insert thing here.

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S2: I got to say of the list that you listed, at least three of those I know are accurate, so

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S3: stressed about paying my taxes. Yeah, OK, drag me. Well, I

S2: have also been diagnosed. I will drag myself minor. In fact, more specific than the general plight of being alive in America, I’ve gotten well, yes, anxiety and depression. Those are those are just true. I’ve gotten autism, I’ve gotten ADHD, I’ve gotten a Ehlers-Danlos syndrome, I’ve gotten hyper flexibility. But what’s funny is that TikTok has been correct on more than just the anxiety and depression. It helped me realize that your girl is hot. She’s a hot girl because she has stomach issues, specifically IBS.

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S3: I’m not going to make you get into the details here, but so TikTok helped you figure that out.

S2: Yeah, I mean, I had had symptoms actually first started suspecting after I read Luster by Raven Leilani. Great book. But she said, I cannot predict the overreactions of my stomach. And I was like, Oh, relatable content. And then after I read that tick tock knew that I was reading that because after that, I started getting more IBS content. And it was just so relatable. I hate that word, but it was. It takes this thing that you kind of accept as just part of your life, as in like you can’t do. You can’t go to a party after you have milk or you have to prepare for trips or you’re a little constipated after you fly. And all these things that I was just like, This is just who I am. This is my life. And then it’s like, Hey, maybe, maybe there’s something you can do about that, or at least a name for it.

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S3: So this this was an instance where the Tic TAC diagnostic portion ultimately had a positive outcome.

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S2: Yeah, it did. And the thing is, I wouldn’t have known to ask my doctors about IBS had I not been on TikTok as a woman. It’s particularly helpful to see other women articulate a variety of symptoms because really often the medical establishment has only studied things from a white male perspective, and a lot of conditions just don’t present exactly the same way for women or people of color as they do for white men.

S3: Here’s where me and Rachel and also our lawyer have to just state on the record that we’re not recommending diagnosing yourself with anything because tick tock tells you to. But this is certainly a good argument for the fact that you can equip yourself with the tools to discuss your symptoms with your doctor and figure out what, if anything, is happening in your body based on what tick tock thinks is happening in your body.

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S2: Yeah, it gives you a kind of language for things that you might otherwise not have had, but there is some danger to that specificity, especially when it comes to mental health. Because what mental health diagnosis tick tock does is take everything you do, all your little quirks and behaviors and make them a symptom. So rather than starting from Point A, which is a symptom and recognizing it, it takes it the opposite way, which is this thing is now a symptom and it’s just normal behavior.

S1: Let’s talk symptoms of ADHD in women. Women with ADHD tend to have lower self-esteem. They’re more likely to be dreamers. They tend to fidget in their chair a lot. They might deal with odd eating habits or binge eating. They’re more likely to be labeled as moody or too sensitive. They tend to have difficulty with time management and organization. They tend to be more sensitive to rejection and criticism, and they’re more likely to be anxious and have a serious case of imposter syndrome.

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S2: I don’t know about you, but that just sounds like being alive in the world.

S3: The Venn diagram of like things I have experienced and what this woman is claiming is ADHD is a freaking circle.

S2: The thing about this woman is that she’s not just somebody, she’s a doctor like she is a licensed professional saying that these. Extremely common behaviors or quirks or whatever are symptoms of ADHD. And that’s just really discomforting for me to see because it’s there are so many kids on this app who are now thinking I have low self-esteem and eating issues because we live in a patriarchal society. I must have ADHD kids.

S3: I’m a 30 year old woman and I’m nodding along like, Uh-Huh. Uh-Huh. Okay. Uh-Huh. The thing, though, that really freaks me out is it’s not just truckers who are flooding the app with this kind of stuff. The company, especially in recent weeks. I don’t know if this has been happening to your for you page, but it seems like tick tock is like actively courting advertisers who capitalize precisely on this kind of thing. I have just gotten so many ads for people looking to medicate me for various mental health conditions of late.

S2: Oh yes, I have actually just last night in scrolling at one am after the little man told me to go to sleep, I got an ad for ADHD medication.

S3: Earlier this week, Media Matters published an article called Tick Tock is enabling predatory ADHD advertisers to target young users. It was written by a journalist named Olivia Little. And I the minute I saw this headline, I just thought, Oh, it’s not just me. And of course, it’s not just me. Like, for lack of a wiser thing to say here, duh. But it does really excellently detail how insidious TikTok’s ads can be, especially when it comes to health care.

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S2: In January, NBC reported that the health startup Cerebro, which is the company I’ve gotten ads from promoted ADHD ads focusing on quote negative body images and contained a misleading health claims. Specifically, these ads linked obesity and ADHD. The ad featured a person that was just surrounded by junk food, and once again, it takes this Tik Tok phenomenon of connecting like disparate symptoms to ADHD, a diagnosis that requires a lot to get to.

S3: So NBC reported that Tik Tok removed those particular ads, but this Media Matters piece did a little more digging and found that cerebral and other advertisers like Done, which is another company advertising ADHD meds, continued to run plenty of ads about their products in a very similar spirit.

S2: The I think, really uncomfortable aspect of this there’s a lot is that the ads that I have gotten almost always feature young women, which really capitalizes on the fact that if you Google ADHD, these symptoms and if you were screened for it as a child, very often the most common symptoms that people look for are common because they present that way in men. Women who have ADHD report very different symptoms, and you can find a lot of people on Tik Tok, on Twitter, on Tumblr and almost any social media platform describing the process of getting a diagnosis with quote unquote non normative symptoms. And that’s really helpful sharing of information. But it has led some observers who have self-diagnose themselves as having ADHD, but haven’t actually gotten that confirmed by a medical professional. Then making everything in their personality a symptom.

S3: Good old-fashioned confirmation bias

S2: with medical diagnoses labeling everything as a symptom is just so bad. In the comments of these videos, you’ll see people being like, Do I have a personality or is it just all symptoms? Or realizing that all my quirks are just symptoms? That’s not how diagnoses work. It is not. Turn every single part of your personality into an avatar of whatever, like mental or physical illness you think you have. It is a very specific set of things. It’s not everything.

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S3: By the same token, though, that group of people in the comments. It can be really exciting to find a community of people dealing with the same struggles as you. You know, having people to talk about similar difficulties with is really, really beneficial. And one of the reasons this has become such a phenomenon is likely because we are or culturally have been so hesitant to discuss mental and physical health publicly for so, so long.

S2: And it’s also important to note that getting a diagnosis of the marginalised person requires a lot of self advocacy because symptoms are usually described the way they present in white men, and it requires a lot of research and connecting symptoms. It wasn’t until after I mention that I thought I had IBS, that I was diagnosed as having it, and it’s because I brought it up and I had started connecting the symptoms. So I really want to say that it self-diagnosis internet is not a net negative. It’s also important to note that things like therapy are often really inaccessible if you don’t have. Have a lot of money. I want to plug Open Path Collective for that. They have low cost therapy for 30 to 60 dollars or therapy for black girls, which offers a sliding scale and has all black women. Those have been really great resources for me.

S3: So it’s really hard to say that we shouldn’t just take all these medical shortcuts because in some cases they are life changing, if not life saving. But I think where we’re landing here, Rachel, is that, you know, direct to consumer goods. Being marketed to us on TikTok should include, you know, mattresses and clothes. And if I get one more ad for like green powder that will make my stomach feel better, I’ll scream. Perhaps those ads should not also include medical treatments.

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S2: Yeah, that’s that’s pretty much where we’ve landed.

S3: So we’ve got one side of TikTok convincing themselves that everything one of their traits is an indication of some mental or physical condition. Now we’re going to talk about another side of tech talk, which is a group convincing themselves that they’re uncovering something that just absolutely isn’t there.

S2: Two sides of the same coin. That’s why we are right back on true crime.

S3: TikTok After the break, we’ll be back to discuss the way true crime talk has taken the recent tragedy of former Miss USA Cheslie Kryst death by suicide and really warped it into their newest, just invasive investigation into what they think really happened.

S2: Just a heads up after the break. We’re going to be discussing suicide if you need it and turn it off. Feel free. Hi, new listeners, thanks so much for tuning in to our show, we are so glad you all are here. In case you missed it, yes, we will make that joke every week when you come out twice a week on Wednesdays and Saturdays. So make sure to subscribe wherever you get your podcasts so you don’t miss out on anything like our episode from Wednesday, where we talk to Vulture’s Rachel Handler, Rachel told us about the bizarre beliefs of celebrity couple Shailene Woodley and Aaron Rodgers. There’s aliens, there’s there’s dick jokes, there’s there’s Miles Teller. Don’t miss it. And we’re back

S3: earlier this month, Cheslie Kryst died by suicide after jumping from a building in Manhattan.

S2: The attorney and 2019 Miss USA winner turned extra correspondent also had a really active TikTok account with hundreds of thousands of followers.

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S3: I didn’t actually follow her account and had never seen any of her videos before. But the very day after she died, TikTok showed me the last video she posted on the app, and it’s a video of her holding up this like cute little box of Eminem’s there pink and white, and they have her face printed on them. Real, tiny.

S2: I also had followed her until after the news of her death started taking over the app. But Madison, you wrote a piece about this, right?

S3: Yeah, I did, and Will will link it in the show notes. I found myself watching that final video and many of her other videos over and over again, sort of just almost instinctively scanning, watching, you know, looking for answers, right? I think that’s a really natural human response to to an unanswerable situation. You know, the question of why. Which of course, there is no answer in those videos. There’s only popular TikTok audios and smiles and makeup routines. That answer was never going to be there,

S2: but you’re not the only person going to these videos for an answer.

S3: Yeah, that’s right. I, as one does watching TikToks right, I headed straight to the comment section and first I found a lot of people who were also feeling those same feelings. And I saw a lot of total strangers leaving morning notes of support for her family. And that felt right to me. But I also found an alarming number of comments from people who just wouldn’t let go of that unanswerable question. I was also posing to myself, you know, strangers were coming to these videos and writing about how they were looking for clues like, like, this was some kind of true crime drama and not just an abject tragedy.

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S2: Yeah, you mentioned this in your piece. Some of the comments that things like, are they sure she wasn’t pushed? And there needs to be a full investigation on what really happened because something isn’t adding up. She seemed truly happy and full of life.

S3: I mean, those are horrifying to me, and I think they connect really interestingly to what we were just talking about with mental health diagnoses on tick tock, right? All of those comments seem to willfully ignore what we know very, very clinically about depression and the way that it manifests. There’s no one way for a depressed person to look right.

S2: There isn’t if those comments kind of fly in the face of almost everything we know about depression, which is that it is very easy to have a high functioning depression to look as if you are not dealing with this really terrible thing while feeling the complete opposite and seeing observers taking what is a manufactured social media feed as gospel rather than what I’m assuming her family is saying is is just

S3: really shitty, and it feels to me like the dark side of a very positive or healthy human experience, right? Grieving collectively. That’s a good thing. And the internet provides a place for communities to be together who might not otherwise have been able to. And it’s it is comforting, you know, even I’m a complete stranger. I am very sad about this woman’s death in the way that I think any human who feels for any other human is. And it was it was nice to see comments from other people, especially, you know, I found myself thinking about any other person who might be struggling with depression or suicidal ideation, who also might be watching these videos and looking in the comments and the idea that somebody might see a note from a stranger offering support, you know, imploring them to stay here on this Earth. Life’s better with you here. Like, that kind of stuff really warms my heart, and I think is what keeps me coming back, frankly, to an app like TikTok as we talk about all of these sort of toxic elements.

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S2: Mm hmm. I mean, this isn’t the same, but I remember in 2020 after George Floyd died and there was it was the height of the pandemic. Gathering inside wasn’t safe. No one was vaccinated, and the only option it felt like was to grieve online. And that was one of the only places I could process how angry and upset I was and know that other people were feeling the exact same thing.

S3: The thing that does become a little tricky, though, right, is this this same feeling of hyper familiarity also creates a very toxic idea that this and we are speaking now specifically about Cheslie Kryst that this community knows better or knows more knows something that the people who actually knew this woman do not, Kryst mother, April Simpkins, said in a statement that quote in her private life, she was struggling with high functioning depression, which she hid from everyone, including me, her closest confidante, until very shortly before her death. So that means. Kryst family who are right now experiencing the worst thing that could happen to a person, they’re willing to accept how their loved one died. Ticktock Malone but they do,

S2: and here is where TikTok’s algorithm comes in. Because instead of quashing these conspiracies, the conjecture and positing and hypothesizing that goes on in these common sections only makes these videos float up to the surface, only make it come across people’s F-Type’s like Madison.

S3: It’s totally drama fueled and the really most obvious and recent comparison. It is, of course, Gabby Potato.

S2: If you have another episode from September about that, I I mean, we did it, but I cannot highly recommend it enough. In the weeks immediately after potato’s disappearance, theorizing on TikTok about potato became an entire genre,

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S3: one that was like a very good growth hack if you were starting up a TikTok account about true crime, which is a gross way to think about it, but also not a terribly new idea. I was thinking was trying to think of like the biggest or earliest example of this happening online and and 911 springs immediately to mind, right? We toss around the phrase jet fuel can’t melt steel beams as a dark, jokey meme on the internet, right? But the thing is that started out as a way of manipulating tragedy for internet attention

S2: and these kinds of conspiratorial, attention grabbing pieces of content. They use tragedy for clicks are never really about getting answers or justice or peace for those who are suffering again, because the people using this for clicks have no way of knowing what the immediate survivors are defining as justice or peace. They’re just using this tragedy for clicks,

S3: and this happens in really serious situations like the ones we’ve been talking about today. And also it happens on a really aggressive level, even in more mundane situations. Thinking about Couch Guy, you know, at the time, the internet tried to ruin a man’s life over the fact that he didn’t get off the couch quick enough when his girlfriend came to visit. Or more recently, when we talked about West Elm Caleb on the show, a guy who was a kind of crappy dater in New York City and suddenly had to use the word witch hunt. But that’s kind of how I describe it.

S2: The internet has really given people the power to find answers, and I think people now expect that they can find answers on the internet if they just try hard enough. But that’s not true. And sometimes there are no answers, or sometimes the answer just isn’t the one that you want.

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S3: I’m still somewhat hopeful about the ways in which digital spaces are becoming more and more important how we process grief. It’s so powerful to be able to grieve in a community, to mourn with other people, and I really do think that the more people who have access to that, all the better.

S2: I said it before, but in the aftermath of George Floyd’s death. Digital spaces were the only spaces that I had really to grieve. And the thing that gives me hope about those spaces is that they were moderated in some way. There was a common understanding of what was acceptable in those moments and what wasn’t

S3: exactly and what we’re talking about. Figuring out going forward here is decorum or internet etiquette, if you must, you know, look, it was right there. You’re never going to bust in on a shiva or a funeral and start screaming at a bereft family in all caps about clues and suspects and piles of laundry. I mean, I guess you could

S2: if you want to get bounced out the door,

S3: tick tock the app itself and tick tock us, the community of people using it. We’re just going to have to get better at being. That’s a perfect word, Rachel. We’re going to have to get better at being those bouncers. All right, thank you for listening, that is our show for today. We will be back in your feeds on Wednesday. Please subscribe wherever you get your podcasts, it’s the best way to make sure that you never miss an episode. We love hearing from. I see. Why am I guys so feel free to shoot a damn where I see my my underscore pod or an email? I see. Why am I at Slate.com? I promise you, we do read all of them, and you guys just have the best ideas, so please

S4: keep them coming.

S2: I see. Why am I is produced by Daniel Schroeder, we are edited by Forrest Wickman and Allegra Frank. Amber Smith is senior manager of podcast Audience Development and Alicia Montgomery is executive producer of Slate podcast See Online

S3: or at a Real Live Doctor’s Office.