More people are using online tools to self-diagnose mental health and psychiatric conditions, but experts urge caution as the risks associated with misdiagnosis are high.
The increased availability of screening tools online has allowed more people to seek professional help after receiving a positive result, particularly with the advent of artificial intelligence and virtual assistants such as ChatGPT.
Not seeking medical help after a self-diagnosis, however, can lead to misdiagnosis, increased anxiety, and the misuse of medication as people who self-diagnose purchase drugs online without a prescription, experts warn.
Dangers of self-medicating
“As the economic climate has shifted globally, accessing information this way has become the more affordable option for a lot of people,” Dr Hopolang Matee, a clinical psychologist at Lighthouse Arabia, told The National.
While information is more accessible than ever, particularly across social media platforms, there are many risks of self-diagnosis.
These include “an incorrect or dangerous diagnosis, increased patient anxiety about the diagnosis, obtaining unfiltered advice on social media, using the self-diagnosis to self-treat, including online purchase of medications without a prescription, and technical issues including the loss of privacy”, according to the report, Implications of Online Self-Diagnosis in Psychiatry, published in the journal Pharmacopsychiatry.
"Self-medication after self-diagnosis poses significant risks including choosing the wrong medications or dosages, overlooking harmful drug interactions, and opening a risk to addiction and dependency, which can exacerbate symptoms or cause adverse reactions," said Carla Khalil, a clinical neuropsychologist from The Valens Clinic Dubai.
An increase in conditions across the board
There are more than 200 types of mental health conditions, according to Cleveland Clinic. Each diagnosis can have a range of symptoms that overlap with each other and these vary widely from person to person in terms of severity and duration.
In recent years, there has been a noted increase in many of these conditions.
Globally, diagnosed anxiety and depression increased by 25 per cent, the World Health Organisation reported in 2022, a statistic believed to correlate with the Covid-19 pandemic.
Last year, a US poll found anxiety rates in Americans had decreased since the start of Covid-19, but were higher than pre-pandemic, with 28 per cent reporting symptoms, a statistic that is 3.5 times higher than before 2020.
The Priory Wellbeing Centre in Dubai also said last year that anxiety was the largest single driver behind 10 to 19-year-olds seeking treatment, with a quarter of patients experiencing the issue.
There has been an increase in the diagnosis of behavioural and neurodevelopmental conditions, such as attention deficit hyperactive disorder and autism spectrum disorder.
The number of those aged 23 to 49 receiving a formal ADHD diagnosis from 2020 to 2022 nearly doubled, according to the 2023 report by Epic Research.
The rise of self-diagnosis
One in four people have self-diagnosed based on social media information, according to a survey by American healthcare software company Tebra, but only 43 per cent of those followed up with a medical professional.
Self-diagnosis is increasingly common among teenagers.
In March, a poll by EdWeek Research Centre in the US found that 55 per cent of students use social media to self-diagnose, with 65 per cent of teachers reporting that they'd seen this behaviour within their classrooms.
Dr Khalil said the rise in self-diagnosis can be attributed to several factors.
“Firstly, increased access to information online has empowered individuals to research symptoms and potential conditions independently. This, coupled with a desire for autonomy in healthcare decisions, has led many to seek out information and attempt to diagnose themselves,” Dr Khalil said.
“A lack of trust in traditional healthcare systems may also drive individuals to take matters into their own hands.”
But it can be a double-edged sword, she said. “On one hand, it can empower individuals to take control of their health and become more proactive in seeking treatment. It can also help reduce the stigma associated with certain conditions, especially in mental health.
“However, self-diagnosis can be inaccurate and potentially harmful if it leads to unnecessary worry or inappropriate treatment. It's important for individuals to use self-diagnosis as a starting point for conversation with healthcare professionals rather than a definitive conclusion.”
The dangers of misdiagnosis
A danger of misdiagnosis is the risk of people misusing medication as a result of their misdiagnosis, but experts warn never to take medication of any kind without a formal diagnosis or consultation with a qualified medical professional.
“Speak to your GP to inquire whether there is an indication for any psychiatric consultation,” Dr Matee said.
ADHD is one condition that is often self-diagnosed but, without a thorough assessment, it can be easily misdiagnosed as symptoms often overlap with conditions such as anxiety and bipolar disorder.
“In the case of bipolar disorder, self-diagnosis may be particularly risky due to the complexity and variability of symptoms,” Dr Khalil said.
“Misinterpreting mood swings or other symptoms as typical fluctuations in mood can delay proper diagnosis and treatment. Additionally, untreated bipolar disorder can lead to severe mood episodes and potential consequences such as substance abuse or self-harm.”
There are also risks of self-diagnosing neurodevelopmental conditions such as autism spectrum disorder.
“ASD is complex and can present differently in each individual, making accurate self-diagnosis challenging,” Dr Khalil said.
“Misunderstanding or misinterpreting symptoms could lead to inappropriate interventions or self stigmatisation.”
The relationship between mental and physical health can also interfere with the diagnosis of many psychiatric conditions, such as vitamin deficiencies, thyroid problems and sleep disturbances.
Sleep disturbances, for example, can lead to brain fog and a lack of concentration, which are common in ADHD.
Vitamin D deficiency can be associated with fatigue and low mood, while insufficient B12 can cause irritability and nervousness, both often resembling depression or anxiety.
People also experience symptoms of depression and anxiety as a reaction to societal factors, although this does not mean they would meet formal criteria for diagnosis, said Dr Matee.
“The world has shifted in painful and frightening ways,” she said. “People are feeling less safe and secure. The political climate has shifted globally. Job security has decreased, thus performance pressure has increased.”
A matter of affordability and accessibility
For many people around the world, an official diagnosis isn't accessible.
In the UK, the waiting time for an adult to receive an ADHD assessment can be up to 10 years, according to the NGO ADHD UK. For autism, NHS data last year showed the average wait time for a diagnosis is 300 days.
In the UAE, while the process may be quicker within a private healthcare system, any psychiatric assessment and therapy can cost thousands of dirhams if it's not covered by insurance.
Heidi Frost, a stay-at-home mother in Dubai, diagnosed herself with ASD after her four-year-old daughter was formally diagnosed. This also came after years of research.
“I can think of 50 different things I could spend $5,000 on,” she told The National, referring to the cost of an official assessment.
“I like labels, I like having proof, I like having an authoritative thing that I can point you to, but it's more about [the price tag and] having to schedule a day where I have to answer questions I've answered before – and I've never met a questionnaire I can't argue with.”
Credibility is key
Without medical guidance, there is much room for confusion and misunderstanding, said Dr Matee, as diagnosis is complicated even among professionals.
“There is mistrust in mental health or medical professionals because there is conflicting information that they might have come across from an unreliable source, which creates mental interference or noise inside the person who is struggling,” said Dr Matee.
“While many sources such as blogs and online platforms can be helpful, engage in those that are backed up by research. Consult peer-reviewed and credible articles and resources published in academic platforms."
Dr Khalil said if someone can't afford a diagnosis or faces other barriers, they could explore community health centres, free clinics and other resources for support and guidance.
“It can also be helpful to seek out support groups or online forums where individuals share experiences and coping strategies,” she said.
“Most importantly, focusing on self-care techniques and seeking out resources for managing symptoms can be beneficial without necessarily having a diagnosis, specifically in mental health."
