Here's What All Those Words on #TherapyTok Actually Mean
Welcome to Overshare, Highsnobiety's deep dive into the role social media plays in our mental health. From a close look at how Gen Z does therapy to a personal essay from the viral comedian Jake Shane to a glossary of words, phrases, and diagnoses that get thrown around on #TherapyTok.
Mental health. We’re all talking about it. Words like ADHD, narcissism, anxiety, and depression get tossed out like confetti. By making information about symptoms, diagnoses, and treatments widely available, social media has helped destigmatize mental health care. But where there’s information, there’s misinformation. And though increased exposure to conversations around mental health can be empowering, it can also cause harm. Because it can be hard to tell when to seek a diagnosis. For example, is your lack of focus ADHD or are you just bored? Is your roommate actually a narcissist or do you just not like that they always eat your Trader Joe’s soup dumplings?
A good place to start is with the definitions of the words we’re seeing everywhere. If you’re going to use them, you might as well know what they actually mean.
On a quest to be better informed ourselves, we spoke with psychologist Dr. Hannah Wertz, psychiatrist Dr. Laura Kimeldorf, therapist Ariella Beyzer, and psychologist Dr. Miriam Rizk about some of the most popular terms that get thrown around and how they’re used by healthcare professionals. And while those we spoke with see value in becoming better acquainted with these terms, they also encourage each of us to seek out professional advice whenever possible. It's a healthy reminder: Mental health is a journey that you don’t have to take alone. Use what you find online to start conversations about mental health with friends, counselors, and doctors.
Diagnoses and Mental Illness, with Dr. Hannah Wertz
Trauma: The word “trauma” has become nearly synonymous with any strong negative experience. But trauma has a real clinical definition, explains Dr. Wertz, and is defined in the The Diagnostic and Statistical Manual of Mental Disorders (DSM) as the experience of being “exposed to threatened or actual death, serious injury, or sexual violence.” Wertz notes that although a negative experience may not be a trauma, it “doesn’t mean that it’s not significant,” or that what a person is going through isn’t valid. “It’s just about knowing what the correct diagnosis is to get on the right treatment plan.”
PTSD (Post-traumatic stress disorder): PTSD is often used to mean any past negative emotional experience that still affects someone in the present, like memories of an emotionally draining work environment or an upsetting breakup. But “PTSD has to involve four different subsets of symptoms: re-experiencing symptoms (nightmares, intrusive thoughts, etc), avoidant symptoms, negative alterations in cognition and mood (negative beliefs about self), and hyperarousal. It also has to last longer than a month and impair your functioning,” says Wertz. Only about 10-20% of people who have experienced trauma develop PTSD.
Major Depressive Disorder (MDD): People say they feel depressed after a bad or disappointing day. It’s common to hear this word used as a synonym for sadness. However, MDD involves symptoms like “persistently low or depressed mood, decreased interest in pleasurable activities, and feelings of guilt or worthlessness for two weeks or longer,” according to the National Institute of Mental Health. Although a day or two spent lying in bed all day may feel like a depressive episode, MDD is defined as experiencing these symptoms to the point where they interfere with someone’s everyday functioning for two weeks or longer – “getting out of bed, showering, engaging in social relationships, taking care of themself” says Wertz. “Major Depressive Disorder really impacts your functioning.”
Dysthymia: Sometimes people use terms online like “high-functioning” depression, but dysthymia might be a better term to describe symptoms of depression. “Dysthymia more accurately captures a sort of chronic low-level mood, or a low-grade depression that is chronic but doesn’t impact your functioning significantly,” says Wertz.
Obsessive Compulsive Disorder: In internet shorthand, OCD gets used to mean a very neat, clean, or detail-oriented person. But color-coding your calendar doesn’t mean you have OCD. “People can be clean and organized without having anything be wrong about it, but also, people who may really have OCD sometimes miss that they have OCD because there has been this culturally accepted definition [of OCD as being clean],” explains Wertz. “OCD can present so many different ways. Someone with OCD may have recurrent intrusive thoughts about something like pushing someone in front of a train, having sex with a family member, becoming convinced that they have run over someone with their car even if they haven't.” These kinds of recurrent thoughts can cause significant anxiety.
Narcissism: Selfish, rude, or unreasonable? Not exactly. Narcissism is a very specific issue, explains Wertz. “It’s a rigid pattern of behavior, not just something that happens in arguments. It involves loss of empathy, treating others as objects and a means to an end, and grandiosity, and it involves these symptoms to a point that it really negatively affects someone’s relationships.”
ADHD: Because pretty much everyone can relate to some of its symptoms, ADHD gets used as shorthand for: “I can’t focus” or “I’m easily distracted.” We’ve come to understand ADHD to mean being disorganized, having excessive energy, or as a tendency to daydream and procrastinate. And while those are aspects of ADHD, and attention problems are prevalent in many people, according to Wertz, ADHD is also a “specific diagnosis,” whose symptoms are significant, and impacts daily functions.
Eating Disorders: Whether it’s used to describe someone who’s very thin or to explain why someone follows a certain diet, “eating disorder” gets tossed around constantly. But eating disorders like bulimia, anorexia, and binge eating disorder involve severe and persistent pathological behaviors around eating and food that impair functioning. That said, while someone may not meet criteria for an eating disorder, they may still have disordered eating, which can still negatively impact their well being.
Disordered Eating: Wertz notes that there’s a lot of talk about pathological behaviors around food on TikTok that may not meet the criteria for bulimia or anorexia or binge eating disorder, for example, but could still be considered restrictive eating patterns or binge eating patterns that fall into the “disordered eating” category.
Bipolar Disorders: You may have heard this term used to describe someone who’s moody. It also gets tossed out when someone has an angry outburst. But bipolar disorders “affect a person's mood, energy, and ability to function.” Those with bipolar disorders have mood episodes, which are periods of intense emotional feeling that last days or weeks. This disorder involves debilitating symptoms and extreme changes in sleep, energy, and activity level.
Anxiety Disorders: Everyone experiences anxiety sometimes. It’s easy enough to think that experiencing anxious emotions or fear means you have an anxiety disorder, or, conversely, that there’s no such thing as an anxiety disorder because everyone feels anxious from time to time. But anxiety disorders often involve excessive fear that can make everyday functioning difficult or impossible. Some of the more well-known anxiety disorders include PTSD and GAD (General Anxiety Disorder).
Medications, with New York-based psychiatrist Dr. Laura Kimeldorf
“The brain is an organ, and like any organ, it can sometimes require help to perform its functions,” says Dr. Laura Kimeldorf, a New York-based psychiatrist. And, “there is no one size fits all medication plan for a given diagnosis. It requires careful consideration of a variety of factors. It requires patience, sometimes a bit of trial-and-error, and it requires trust in your doctor.” That’s why using medication to treat a mental health-related issue is a choice that should be made with your care provider. For reference, below are a few of the most common medications and what they’re typically used to treat.
Adderall: Adderall is a stimulant that can increase feelings of alertness, focus, and attention. It’s one of a few common drugs used in treating ADHD. “Adderall is a brand name for a specific medication. It is not a generic term. It is a combination of mixed amphetamine salts,” explains Dr. Kimeldorf. “For somebody diagnosed with and having clinical symptoms of ADHD, Adderall can sometimes be helpful in controlling symptoms (such as avoiding tasks, physically fidgeting). People get nervous about Adderall because it has the potential to be misused. It is a
highly controlled substance, and it should be,” she says. “When taken as prescribed, problems like addiction to Adderall are less common.”
Ritalin: Ritalin is another commonly used treatment for ADHD. According to Kimeldorf, “It has a different mechanism of action [than Adderall and] it is not a mixture. Ritalin is methylphenidate. In any given patient, one or the other class of medications might have different effects. Although amphetamines and methylphenidate tend to work in a similar way, there are many varieties of both, and in any given person, the efficacy between drugs varies widely.”
Antidepressants/Anxiolytics (anti-anxiety/anti-depression meds): This group includes drugs like selective serotonin reuptake inhibitors (SSRIs) and selective serotonin and norepinephrine reuptake inhibitors (SNRIs). They are among the most commonly prescribed drugs for anxiety and depression, and they are also sometimes prescribed for disorders like OCD and PTSD. Kimeldorf explains that these medications can result in greatly diminished symptoms of anxiety and depression: “They tend to work well for both anxiety and depression, and many people have symptoms of both at the same time.”
Mood stabilizers/antipsychotics: These drugs are used to treat illnesses such as bipolar disorder and schizophrenia and mood disorders. They’re used to help ease mood swings or alleviate symptoms like hallucinations and delusions associated with certain disorders.
Therapy Modalities and Mental Health Professionals, with Los Angeles-based therapist Ariella Beyzer
“The biggest thing is finding someone you feel comfortable and safe with,” says Los Angeles-based therapist Ariella Beyzer. “Not every therapist is the right fit for every person. That’s okay.” In Beyzer’s opinion, everyone “and their grandma” needs therapy. “More than needs therapy – is entitled to therapy,” she says. “One of the misconceptions I often run into is that people go to therapy because there is something wrong with them or because they are broken. I think you don’t come into therapy because you are broken. I think you come into therapy because you realize you deserve something better.”
Social Worker: Typically, therapists and social workers have a master’s degree in social work and are licensed in clinical social work (LCSW). The difference is in the type of job, not the training (and not to be confused with psychologists who have PhDs, and psychiatrists who are MDs). Social workers can work in various settings, including hospitals, nursing homes, and the court system. They take care of vulnerable individuals of all ages, connecting people to resources and providing therapy.
Life coach: A life coach is not a therapist but someone who helps clients achieve specific goals. While mental health or wellness may factor into the coaching process, a life coach is not technically a mental-health professional, and the coaching industry is fairly unregulated.
Therapy/Psychotherapy: Therapy is a broad term. A mental health therapist or psychotherapist employs researched treatment methods to target obstacles in functioning. “There are many different versions of therapy,” says Beyzer. “The common theme is that we're trying to help people get to know themselves better, then identify and use coping skills in order to process things differently.”
Cognitive Behavioral Therapy (CBT): Commonly summarized as changing negative thoughts to positive ones, the idea behind CBT “is that your thoughts and behaviors are on a feedback loop. Your thoughts impact your behaviors, and your behaviors impact your thoughts,” says Beyzer. If the therapist can help you change your behaviors, they can help you change your thoughts. “It’s very hard for me to tell you to stop being anxious or catastrophizing. But if I can change your behaviors, like doom scrolling, then that behavior will help change your thoughts and mood.”
Meditation/Breathing Exercises: The results of a sustained meditation or breathing practice are measurable, particularly when it comes to reducing stress and anxiety. “Breathing exercises and meditation are pretty closely related,” says Beyzer. “In meditation you're using some sort of technique, like mindfulness, chanting, or sustained attention. The goal is to train your attention and awareness to achieve mental clarity and to achieve more emotional stability and calmness.”
Symptoms and Results, with California-based psychologist Dr. Miriam Rizk
“It’s important to recognize warning signs,” says Dr. Miriam Rizk. “To ask, ‘What are the things I should be aware of? When should I go seek help?” This is also why it’s so important to know what we mean when we use words and phrases related to actual symptoms. Because when we casually say things like “‘I feel so gaslit” and “Girl is manic,’” says Rizk, they can lose their meaning, which can make it harder to recognize real warning signs and know when to seek help.
Gaslighting: Sometimes it seems like everyone is talking about being “gaslit.” But gaslighting has a narrow definition and a few specific traits. First, a perpetrator of gaslighting has to deny that an event took place, causing the person being gaslighted to question their perception, despite hard evidence to the contrary. Gaslighting is associated with personality disorders such as narcissism, and is often accompanied by phrases from the perpetrator like “You’re making this up” or “You’re crazy.” It’s a psychological manipulation tactic, one that may not even be conscious, and causes those being gaslighted to lose their sense of identity, perception, and worth.
Triggers: “On social media people will say ‘I watched this and I'm so triggered.’ But contrary to popular belief, [being triggered] is very different from feeling uncomfortable,” says Rizk. “Essentially it's feeling and experiencing an intense and pretty negative emotional reaction in response to a current situation that reminds us of a past negative event or thing that we’ve experienced.” (Like the symptoms related to PTSD, which are “triggered.”)
“The term also refers to substance use,” says Rizk. “If people who are in recovery hang out with people they used to use with or go to a similar place where they used to use, they might feel triggered and remember those memories, or even feel cravings to use again.”
Panic attacks: A panic attack is an overwhelming physical experience. “Panic attacks can happen in response to a perceived threat (like a thought), or a life-threatening situation,” says Rizk. “There is a physiological reaction, like increased breathing, increased heart rate, higher blood pressure. A lot of people have characterized it as feeling like a heart attack.”
Suicidal: The adjective “suicidal” is sometimes used online to describe feeling livid or totally fed up. But this word, more than many others on the list, holds a particular gravity. “Suicidal” is “an all-encompassing term for desire to end one’s life,” says Rizk.
If you’re experiencing symptoms you think may require treatment, or if you or someone you know is struggling seriously with their mental health, there are so many ways to find help. Start by talking to your medical doctor or calling your local clinic. You can also get help online. Get specific with your search terms, and when you find a site that looks useful, always check to see if it has proper accreditations (scroll all the way down and look for badges that have words like “accredited” or “rated”). A good place to learn about the different types of therapists and therapy modalities available is Psychology Today. Most importantly: Talk to your friends and family, and ask for help.
