Search for “high-functioning anxiety” on TikTok, and look what happens. “Three signs of high- functioning anxiety.” “With high-functioning anxiety —” “Five things you don’t realize you’re doing because of your high- functioning anxiety.” More than 10,000 videos with millions of young viewers. “No. 1, you tend to have extremely high standards for yourself and might even identify as being a perfectionist.” “You’re nice and easy to be around, but you people-please too much.” Many are made by professional clinicians, and they mean well. But here’s the thing. High-functioning anxiety isn’t a medical diagnosis. It’s a hashtag. “No one cares about me, so why should I care about myself?” “It’s OK to not understand what you’re feeling.” “And it’s easy to think that you’re all alone.” Over the last decade, there has been this massive cultural shift in how we talk about our psychology and our feelings. “I see a therapist.” “It’s OK.” “It’s OK.” “It’s OK.” “It’s OK.” “It’s OK.” “It’s OK.” “It’s OK.” Even Burger King cares about your mental health. [MUSIC PLAYING] Awareness is good. It teaches us to talk about our feelings. And it combats harmful stigma. But all this awareness is not reducing rates of mental health problems. What it is doing is convincing some teenagers that they have a mental illness when they don’t. Mental illness among teens is rising. Teenage anxiety rates increased 27 percent, and depression rose 24 percent. And that was in the three years before the pandemic. Teenagers today have lots of reasons to feel anxious and depressed. And some are actually unwell. This is a really difficult argument to make. I don’t want to unintentionally dismiss anyone who is suffering or having difficulty. But I’ve been researching this area for five years. And what I think is happening is a cycle that can be broken down into three stages. First, the increased awareness: It’s well-intentioned, but not always reliable. “Are you hurting? If the answer is yes, you have trauma.” “Procrastination is actually a short-term coping tool to avoid feeling anxiety or dread.” A popular type of video on TikTok is five things you might not realize were a mental disorder. And it’s really generic things, like biting your nails, or fidgeting, or being a people-pleaser. “I just need to take an anxiety nap. Can you wake me up in 30 minutes? I’m not well.” All this awareness oversimplifies and maybe even popularizes mental disorders. This leads to the second stage, a phenomenon I call overinterpretation. “Put a finger down if you find it impossible to control your thoughts or stop worrying. Put a finger down if it feels like you’re constantly in a state of stress or panic.” More young people are now self-diagnosing based on this flood of information and interpreting normal daily struggles as a mental illness. “Put a finger down if you constantly seek reassurance. Put a finger down if reassurance only makes you feel better for —” So it’s not surprising that the language that they’re now reaching for is the language of mental disorder because that’s the language that adults have encouraged them to use. Overinterpretation can then become a self-fulfilling prophecy, the third stage of the cycle. If you think you have anxiety, you avoid uncomfortable situations. Ironically, this makes you more anxious in the long term. If you think you have depression, every low mood becomes evidence that you have a mental disorder, so you become more depressed. It’s kind of like a reverse placebo. We call it the nocebo effect. And this then ends up feeding back into the loop of increased mental health awareness efforts. And that triggers the cycle to start all over again. What does all this mean? A lot of young people are left overly distressed. Meanwhile, legitimate mental disorders are ironically taken less seriously. If everyone is ill, no one is. I’m not saying we should stop talking about mental health. No one should suffer in silence. But we need to be smarter about how we talk about it and not label all our feelings with psychiatric terminology. [MUSIC PLAYING]