In June 2019, Kirsten Muller-Vahl, a psychiatrist at Hannover Medical School and head of its Tourette’s outpatient department, noticed unusual symptoms in her new set of patients. To begin with, all of them were teenagers, and they were suffering from sudden and uncontrollable tics. Even though none of them had any history of the condition, they were all shouting different kinds of obscenities.
Muller-Vahl consulted her tight-knit group of global Tourette researchers and soon found out that her newest patients were not unique. It seemed that a shift in patients and symptoms was happening all over the world, and what was even more surprising was that it was happening at the same time. But what really puzzled Muller-Vahl was that most were repeatedly shouting the same phrase: “You are ugly.” As it turned out, this phrase was the key to understanding this strange spike in cases.
Four months before the mysterious global outbreak, a 20-year-old German suffering from Tourette’s named Jan Zimmermann launched a YouTube channel and TikTok page detailing what it’s like to live with his condition. He immediately became a social media sensation, gathering more than two million subscribers on YouTube and millions of views on TikTok where he shows his viewers how his condition can force him to blurt obscene words, or experience uncontrollable tics and convulsions.
Zimmerman had the tendency to blurt the phrase “you are ugly”, one that he shared with all new-style patients suddenly appearing all over the world. After making this connection, researchers found that all patients who suddenly claimed to have tics were also fans of Zimmermann. When Muller-Vahl confronted her distressed patients and told them that none of them really had Tourette’s, most of them recovered immediately.
But despite their recoveries, this case presented researchers with an unprecedented psychological mystery showing how imagined symptoms can spread purely from TikTok videos. While these teenagers did not suffer from Zimmerman’s condition, something triggered their minds to believe that they did, and all of the sudden, all of them simultaneously and independently developed these TikTok tics.
With TikTok becoming one of the most used social media apps today, it’s becoming even more important to consider, could TikTok be causing a mass psychosis? Mass psychogenic illness (MPI), also known as mass sociogenic illness (MSI), is a real occurrence where a group of people starts feeling real physical symptoms at the same time, even though there is no physical or environmental reason for them to be sick.
The dancing plagues of the Middle Ages were probably the most bizarre form of MPI. In July 1518, residents of the city of Strasbourg were struck by an uncontrollable urge to dance. It started with one woman stepping into the street and dancing for nearly a week before she was joined by three dozen others who also seemed to have the same uncontrollable urge. The town then hired musicians to provide backing music, which only worsened the situation as more people joined in.
It wasn’t long before the marathon started to take its toll. By August, the dancing plague had 400 people in its clutches, with 100 of them dancing themselves to death. More recent but less dramatic cases include a boarding school in Mexico where a student developed leg pain and paralysis. Soon after, hundreds of their schoolmates began experiencing the same symptoms. In East Africa, three girls who started laughing uncontrollably managed to infect over 100 other students, forcing their school to close down.
The triggers for mass psychogenic illnesses cannot be entirely isolated, but they can easily spread among people who share the same anxieties, fears and sense of community. This is what makes the TikTok tics an even more intriguing study. TikTok rapidly gained popularity during the pandemic as a trendy dance video and crazy challenge app. But since then, it has established itself as the world’s most popular app, with nearly three times as many users as Twitter.
A recent study even found that it has dethroned Google as the most popular domain in 2021, with most of its visitors using the app as a primary search and discovery platform. With over one billion active monthly users who spend an average of 95 minutes a day using the app, it has become more important than ever to understand what kind of effects TikTok has on our brains. While the effects of social media on our mental state have been a topic of debate for the past decade, the emergence of TikTok is different.
It allows users to watch an unlimited stream of new content, observe trends rise and fall daily, and find something new with each swipe. Because the videos are often extremely short, the user can quickly decide whether to continue watching or move on to something more interesting. This constant stream of information can narrow and exhaust our attention span over time, limit our concentration and affect our short-term memory. TikTok places a constant focus for content to be delivered in 60 seconds or less, making anything longer feel like it’s a waste of our time.
Some users have reported that they don’t have the patience to watch 10-minute videos on YouTube anymore, even when the topic interests them. This reduction in our attention spans can come with a variety of risk factors, such as poor academic performance, communication struggles, social isolation, relationship difficulties, stress and anxiety. A recent study conducted by Curtin University in Australia has shown that heavy use of social media can lead to problematic mental health consequences, especially for people with lower attention spans,
Which brings us back to the TikTok tics. This curious Tourettes case was the first form of social media-induced sociogenic illness. In addition to the teenagers in Germany, about 50 patients across the globe presented the same symptoms, which demonstrates the domino effect of our social media landscape. Constant exposure can lead to low attention spans in those that never had the issue before, which can lead to psychological illnesses which in turn can spread imagined conditions around the world, in a way that we never even dreamt of before the age of the internet.
According to TikTok, videos tagged with the hashtag “Tourrettes” have been viewed more than five billion times. The unexpected appeal of these videos among teenagers can be attributed to a need to stand out or be different. but, the truth is, videos like these also provide a sense of community, acceptance, sympathy and validation, which all seem to be present in patients suffering from MPI.
Even though Zimmerman’s intentions were to show his followers what it’s like living with Tourette’s, it also validated violating social conventions and gave proof to young impressionable viewers that the more disruptive you are, the more viral you’ll go. This is the basic concept behind TikTok. The whole idea is to promote videos that can go viral in an instant and push young content creators to produce similar content. That’s why the first thing you see when you open the app is the “for you” page where short videos that are carefully selected to grab your attention are displayed.
It’s why the videos are on auto-play and shown in an endless scroll, and there is no signalization of progress or duration of the experience. All these features are intentionally designed to grab and keep the attention of young users for as long as possible and urge them to create similar content if they want to get that attention for themselves. In a recent interview, comedian Andrew Schulz talked about how TikTok’s algorithm promotes useless content in the West, but shows entirely different content centered around innovation, architecture and science in China.
Like Schulz, many argue that TikTok is intentionally making people dumb by manipulating user behavior and pushing mindless content on its impressionable young viewers. To that point, TikTok trends have included things like the blackout challenge where children were tasked with holding their breath until they fainted. The penny challenge, encouraging kids to push pennies behind partially plugged phone chargers, which could have dangerous results. And the tooth file challenge, where young users were causing permanent damage to their teeth just for some of that desired attention.
The more these videos went viral, the more content creators saw it as an opportunity to gain traction on the platform. This in itself feeds the vicious cycle of harmful content that leads to illnesses similar to the TikTok tics and other mental disorders. Today, TikTok is being looked at in a number of U.S. states to determine its influence on its young users’ mental health. According to Dr. David Barnhart, clinical mental health counselor at Behavioral Sciences of Alabama, all social media platforms impact how a person views themselves.
But because of TikTok’s rapid-fire influx of content, users are exposed to dozens of videos within minutes, which makes the effect much more devastating than other platforms. Users can easily become addicted to the app and may seek constant stimulation as a result. This constant stimulation increases stress and anxiety levels, especially with numerous videos that fuel body dissatisfaction, appearance-related anxiety and much more.
Mental health professionals have reported seeing a number of younger patients who spend considerable time on TikTok, claiming to have severe mental health conditions such as schizophrenia and bipolar disorder. And the main issue with such claims is that more exposure to targeted content can influence teenagers to misdiagnose themselves with a mental illness without consulting a professional, only because they can relate to some of the symptoms of a TikTok influencer they follow.
Just like the TikTok tics case, young adults who self-diagnose can also do so from a desire to feel like they are a part of a community, or to rebel against social constructs, and in the process, they can genuinely believe that they suffer from a specific illness, even when they don’t. The flipside to all this is there are several positives that come from highlighting mental health issues online. The sense of community which can be harmful in some cases can also be helpful in normalizing these conditions and sending the message that people are not alone.
Young people suffering from their own issues can come together and support each other with helpful tips on how to deal with depression, anxiety and other hurdles in their daily life. Videos discussing mental health get millions of views on TikTok every day and draw attention to symptoms that some people may not have realized were an issue. This can spur people into action and encourage them to seek help.
As with all things, there are positives and negatives, which is why experts don’t believe that deleting TikTok is the answer. Instead, regulating and monitoring the time spent on the app is key. Otherwise, the social media-fueled mental health crisis is only going to get worse. The age of the internet has definitely brought a whole new dimension of concerns that we should worry about, but TikTok itself has changed the online world. It’s a cultural phenomenon with a superior algorithm that is unmatched by its social media rivals.
It’s built to ruthlessly and aggressively collect your data, and constantly feed you content that’s for you. Content that could change the direction of your life, warp your perceptions of the world around you and even cause mass psychogenic illnesses worldwide. MPIs have existed for hundreds of years, and yet a lot of the reasons why they happen remain a mystery. But what we can learn from the TikTok tics case is that we are now entering a new era of “social media-induced sociogenic psychosis”, and apps like TikTok have more control and power over our youth than we thought.
The best predictor of future behavior is previous behavior, and based on what we already know, we’ve most likely not seen the last of social media-induced psychological illnesses. For now, at least you had the patience to watch this entire video. Thanks for not swiping to check out the latest escalator dance clips or watch a guy deep cleaning a horse's hoof.