The thought of joining TikTok last year made clinical psychologist Julie Smith apprehensive.
As the video-sharing app’s popularity was surging in late 2019, it was better known for viral dancing clips than as a place to find a therapist.
“I think I was the first therapist on there,” Smith, who is based in England, told CNN. “I thought I was going to be trolled or ignored.”
Initially, it took Smith some time to get used to the app — the thought of being seen on social media was “a discomfort” she had to sit with.
Filming her first video on therapy concepts in November 2019, she was surprised by an unwelcome guest.
“In those early days, I found it easier to talk to the camera as I walked along, so I filmed as I walked through the forest,” Smith said. “The horse started following me around and decided to steal the show,” going to the bathroom during the video.
She likes to include the bloopers, though. “They are a great chance to make people laugh and remind us all that mistakes are a part of the process.”
Within a month, those mistakes became less significant to Smith. The excitement and interest in her content grew, and she was gaining 100,000 followers a month by Christmas.
And when the United Kingdom went into lockdown in March due to the coronavirus pandemic, she attracted even more followers as people spent more time at home.
Fast-forward a year, and she’s posting videos on mental health several times a week and has amassed more than 2.2 million followers.
A bite-size education in mental health
The impact of Smith’s work on TikTok goes far beyond the numbers. Although she doesn’t offer therapy directly via the app, she offers regular bite-size educational videos focusing on mental health.
She has covered topics such as self-sabotage, anxiety and narcissism. A video she did for World Mental Health Day, using grains of rice in a clever analogy, received 100,000 likes and almost 500,000 views. A comment left on this video said, “I’m trying to come out of a very dark place and it helps not to feel alone.”
Other TikTok users frequently say her videos have inspired them to consider pursuing a career in psychology.
“I am quite naturally introverted, but I felt quite passionate about making information accessible to people — and TikTok allows you to access so many people,” Smith said. “I help teach people about how their mind works, how their emotions work.”
That information could help people “understand what’s happening in our bodies when we feel anxious, and effective ways you can bring that anxiety down.”
In a year of lockdowns and social distancing, aside from messages of gratitude, she has been told that her videos have helped save lives.
“You can’t imagine the isolation some people are dealing with and if people can access something that says ‘keep going, there is light at the end of the tunnel,'” she said, that message “makes it all worth it.”
Some of TikTok’s trends aren’t good for kids
Smith is aware she is only one voice in a vast arena of noise. TikTok has 100 million active users across Europe and more than 100 million across the United States.
Inevitably, there are TikTok posts and trends that encourage people — often kids — to do things that aren’t good for them. One trend earlier this year involved young people portraying themselves as Holocaust victims, while another reportedly saw teenagers take part in the “Benadryl Challenge,” and resulted in teenagers overdosing.
Popular YouTube and Twitch streamer PaymoneyWubby lambasted the platform as “TikToxic” in a video that now has over 1 million views.
The potential dangers associated with using social media are becoming increasingly well-documented — particularly for young people.
For every additional hour young people spend on social media or watch television, the severity of depressive symptoms they experience goes up, according to a 2019 study published in the journal JAMA Pediatrics.
Social media may also disrupt activities that have a positive impact on mental health such as exercising and sleeping, while increasing exposure to online bullying, according to 2019 research published in Lancet.
But Common Sense Media — a nonprofit that provides education on safe technology usage — urges caution on connecting happiness outcomes with social media too readily.
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Micheal Robb, Common Sense Media’s senior director of research, suggested it was far too complex to simply say social media alone impacts mental health negatively.
“Mental health disorders emerge from a complex set of social, genetic, and experiential factors, which have varying influence across adolescents’ development and situations,” Robb told CNN.
“Several large studies of young people have found correlations between heavy technology use and unhappiness. But: correlation is not causation. It’s possible that the effect goes in the other direction. It could be that unhappy people spend more time on social media or use social media in more problematic ways. And the correlations that are found are weak,” Robb said.
Robb said TikTok can be a great source of creativity for people. But he said it comes with a caveat.
“Make sure that use of TikTok, or any social media, doesn’t overwhelm the other things we know are good for kids: getting enough sleep, eating healthy foods, being social with friends and family (offline and online), doing their schoolwork, reading, etc.,” Robb said.
The overall evidence into the impacts of social media on young minds is emerging but is still “in its early stages, and not definitive,” said Bernadka Dubicka, chair of the child and adolescent faculty at the Royal College of Psychiatrists in the UK.
“We have never had a generation before that has had to depend on self-acceptance through algorithms and notifications around likes. We don’t know what kind of impact that might have on a mass scale for these generations of kids.”
Putting something positive out there
Cutting through the noise and encouragement to do harmful things for users can often be a challenge. And for Smith, the dangers found on TikTok are similar to the dangers people can find anywhere on social media.
She doesn’t deny that the negative and toxic content exists on TikTok. She said she wants to use her videos to help counteract it.
“I can’t make the negative stuff disappear, but I can put something positive out there. That’s my goal with these videos – with each one I want to educate, inspire and motivate someone and leave them feeling a little bit better from when they started.”
Robb encourages parents to have open dialogue with kids and to steer them toward “positive, healthy online interactions.”
“Discuss what they should do when they encounter negative stuff such as kids acting inappropriately or other users spouting hate speech. Tell them they can always come to you when something upsets them — even if they went somewhere they weren’t supposed to,” he said.
TikTok has parental controls
The safety and well-being of its users is TikTok’s top priority, and the platform has been using a number of measures to try and combat toxic and potentially harmful online material, a TikTok spokesperon said.
“Users can make their account private, which restricts their uploaded content and incoming messages to followers only, ” the spokesperson said. “We also have protections like restricted viewing mode, filters, in-app reporting, and we use a combination of people and technologies to detect and remove inappropriate content and accounts that violate our policies.
TikTok also said it has introduced greater parental controls, encouraged a localized approach to content policy and even proposed establishing a coalition with other social media platforms to root out harmful content.
Regardless of what TikTok officials do, Smith plans to stay online to educate people about their mental health.
“If it wasn’t for TikTok there is no way I would have reached this number of people with my messages. There is a lot of negativity about social media being this really awful place and there are those awful corners of social media, but there are also these wonderful corners,” she said.
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Rather than complain about how terrible social media can be, Smith wants to influence it.
“If you can come off the app feeling a bit better than when you started, that’s a good thing,” she added.
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