Like, Comment, Prescribe: The Vloggers ‘Diagnosing’ Their Followers

Editor’s note: Short videos by self-proclaimed experts offering psychological analysis of reality TV stars or explaining the behaviors associated with various personality disorders grew hugely popular across Chinese social media platforms in 2024. While the trend has helped raise awareness of mental issues among young people, including children, health professionals have countered that much of the content is misleading and warned of the dangers of self-diagnosis.

As a 20-something brand media consultant, Li Miao regularly browses Chinese social media and short-video platforms to keep track of the latest trends. Recently, she took a deep dive into one hot topic about guests on a reality TV show who netizens had “diagnosed” with having narcissistic personality disorder (NPD). Yet, the more content she consumed, the more she began to compare her own behavior and wonder, “Do I also have that?”

After watching one particular video — which characterized someone with NPD as being self-centered, controlling, lacking in empathy, and unable to reflect on or admit mistakes — Li was convinced. “It’s over. It seems that I really have it,” she recalls thinking as she sat alone and upset in her home in Hangzhou, capital of the eastern Zhejiang province.

Likewise, Yao Xin’an, a social media user in Beijing, now believes she could have a variety of psychological problems, ranging from post-traumatic stress disorder (PTSD) to some dissociative disorders, which refers to a group of conditions that cause an individual to disconnect from their thoughts, feelings, memories, or sense of identity.

Li and Yao have not actually spoken to a mental health professional about their concerns; their entire knowledge of these disorders has been gleaned from social media.

It’s not hard to see where the confusion comes from. In many short videos, common behaviors such as feeling “spaced out,” suddenly calm, or senseless in a crisis are depicted as abnormal, or even as a sure sign of a mental health issue.

Perhaps more worryingly, content creators have a habit of using stigmatizing language. For example, several have referred to NPD as an incurable “personality cancer,” and urged people to avoid friends, relatives, and colleagues who display characteristic behaviors. The comments sections are often dominated by anxious and distressed netizens expressing concern for themselves or a loved one they feel could be affected.

The reality, of course, is that mental health is a complicated business, not something that can be summed up in a short video. For NPD alone, while self-proclaimed experts on social media are happy to pinpoint a handful of key behaviors, the American Psychiatric Association’s description of the condition highlights its variability, citing that affected individuals “may be grandiose or self-loathing, extraverted or socially isolated, captains of industry or unable to maintain steady employment, model citizens or prone to antisocial activities.”

While some grownup users take these short videos to heart, most take them with a pinch of salt. However, younger viewers can be less discerning.

Zhang Jiayi, a high school student in Zhejiang, has seen several videos in which vloggers have described behaviors that she feels she exhibits as characteristics of a disorder. “If only one or two traits match, there may be a small chance of something being wrong,” she says. “But if more traits match, then it must mean there’s some psychological problem.”

Short on science

Ding Ruyi, an associate professor in Sun Yat-sen University’s Department of Psychology, says the popularity of these “diagnostic” videos stems from humans’ innate tendency toward self-exploration, which social media tends to feed into.

“Modern society is complex and volatile,” she says. “Individuals face increased pressures and challenges. Everyone hopes to better understand themselves and the motivations of those around them to cope with the complexity of the outside world and improve their adaptability.”

However, Ding highlights there are major problems with this latest pop science trend. One is that the content in these psychological analysis videos is usually misleading and lacking any scientific basis, and therefore likely to cause misunderstanding. Describing the occasional low mood as evidence of depression or an anxiety disorder “ignores individual complexities and lacks rigor.”

Plus, when relied on in place of a consultation with a qualified health professional, these videos could increase the emotional strain on a person already struggling with a condition. “Someone may even give up or delay seeking professional help, thinking that they have actually been diagnosed with some personality disorder, which could affect their mental health even further,” Ding warns.

While vloggers may present themselves as experts in the field, only registered psychiatrists have the training and legal right to make diagnoses in China. “Even a psychological counselor or therapist couldn’t easily define some mental disorders,” Ding says.

As with physical ailments, mental health requires professional assessment and intervention. While online sources can serve as a basic source of information, or to spread awareness, Ding says they should only be the starting point. “If we’re physically sick, we need a doctor to diagnose us and treat us. We don’t just rely on the internet or short videos to judge and fix the problem on our own.”

(Due to privacy concerns, Yao Xin’an and Zhang Jiayi are pseudonyms.)

Reported by Jiang Jixuan and Guo Shaoming.

A version of this article originally appeared in China Youth Daily. It has been translated and edited for brevity and clarity, and is republished here with permission.

Translator: Eunice Ouyang; editors: Wang Juyi and Hao Qibao.

(Header image: Visuals from Shijue/VCG, reedited by Sixth Tone)