“Tell Me You Have ADHD Without Telling Me You Have ADHD”: Neurodivergent Identity Performance on TikTok

Abstract

User-generated content about attention-deficit/hyperactivity disorder (ADHD) is one of the most popular health topics on TikTok. Because most creators are lay people, yet they attract a wide audience, concerns have been raised about the accuracy of the information shared. Through critical discourse analysis of #actuallyADHD and #ADHDprobs videos, this study examines the content of these videos as they relate to creators’ ADHD self-disclosure. Analysis showed that platform affordances and performance practices of videos focused on humor and personal experiences rather than educational medical content. I argue that in user-generated ADHD TikTok videos the performance strategies of creators and platform affordances of TikTok indicate these videos function as identity work rather than health information.

Introduction

This project examines how TikTok creators with self-disclosed attention-deficit hyperactive disorder (ADHD) contribute to the formation of individual and collective ADHD identity through performances utilizing humor and relatability, as well as embracing the unique affordances of interaction and virality provided by the platform. #adhd is the seventh most popular health-related hashtag on TikTok, and yet medical researchers have found approximately half of the videos analyzed were misleading, and an overwhelming proportion (49 of the 52) of these misleading videos were from non-health care providers (Yeung et al., 2022). While the potential misinformation about a mental health disorder is concerning, the affordances and styles of interaction on TikTok vary widely from individuals actively seeking medical information from search engines, online support groups, or physicians. The algorithmic curation of TikTok’s “For You Page” (FYP) prioritizes content for individuals based on its own internal logics, rather than the validity of medical information. Since TikTok advertises itself as a platform to “Inspire Creativity and Bring Joy,” it follows that playfulness and humor are encouraged on the social network and prioritized over concerns of information accuracy on the platform (TikTok, 2022).

In alignment with the practices of other TikTok researchers (Schellewald, 2021), this project views these performances as meaning-making practices of TikTok users, more specifically self-disclosed ADHD creators. Self-making in social media contexts depends largely on the social practices and capabilities of the platform in which identity construction and self-concepts are being made, and TikTok is unique from other social networking sites in many ways (Bhandari & Bimo, 2022). The algorithmic curation of the For You Feed is unique from other social media platforms, and collaborative self-making based on algorithm identity takes place on the platform (Bhandari & Bimo, 2022). Other research on neurodivergence online has focused on microblogs (Egner, 2022) or message boards (Comstock, 2015), and has only recently turned to diagnosis and understandings of self on TikTok (Alper et al., 2023). This project examines how TikTok creators with self-disclosed ADHD contribute to the formation of individual and collective ADHD identity through performances utilizing humor and relatability. Through critical discourse analysis of #actuallyADHD and #ADHDprobs videos, this study examines the content and context of these videos as they relate to creators’ ADHD self-disclosure. I argue that user-generated ADHD TikTok videos performance strategies, aimed to increase visibility on the platform, indicate these videos function as identity work for creators rather than health information.

This research is relevant to contemporary directions in communication for several reasons. As a concealable stigmatized identity, individuals with mental health diagnoses such as ADHD have few opportunities to meet others with the same diagnosis face to face. As the disorder does not have any external markers, it is impossible to identify ADHD individuals without the vulnerability and inherent risk of “outing” themselves to each other. Using hashtags and profile disclosures on social media, individuals with ADHD have the capacity to build networks of connection to construct collective identity signifiers. Social media provides opportunities for individuals to publicly display and manage collaborative identities through various performance methods such as humor. TikTok’s features of visibility and the platform’s focus on connection and interactivity enable new forms of identity management on the app. In addition, the recent trends and popularity of ADHD content has made #adhd the seventh most popular health-related hashtag on TikTok (Yeung et al., 2022). This popularity provides new publicly available conversations about the understanding and conceptualization of individual and collective identity in ADHD adults.

Identity Performance and Exhibition Online

Identity expression is performative and highlights the dynamic and constant negotiation of identity, particularly in digital environments like TikTok. Externalizing these private experiences through performance provides a lens for those with ADHD to be recognized by viewers. Individuals portray aspects of their identity and can display signals through performance in a variety of ways (Goffman, 1959). However, online artifacts such as TikTok videos lack the real-time response and adjustments seen during in-person performances. These identity exhibitions serve as “digital traces designed to signify the individual” (Hogan, 2010, p. 380). These online exhibitions are still forms of self-presentation but are mediated by a third-party curator, in this case TikTok, to distribute the exhibition to others in an asynchronous manner (Hogan, 2010). Features available to online exhibitions on social networking sites like TikTok provide individuals with greater command over the signals and signs embedded in their identity exhibitions, which enables certain forms of performances to convey meaning to larger audiences (Khazraee & Novak, 2018). The performance of identity has been described for online influencers and microcelebrities as an aspect of authenticity and a means of curating and gaining a following online. Some influencers, especially those in minority spaces, produce identity-based content (Kim, 2023), which highlights the content creator’s identity first, rather than using an established persona to appeal to audiences. While persona-based accounts (Abidin, 2020) focus on building intimacy and coherency in their content, identity-based content forefronts the unique identity as the prominent aspect of their content (Kim, 2023). To signify their identity as ADHD, these content creators must perform their diagnosis in ways that are understandable to others, such as using “ADHD” in the account names, post titles or captions. These methods signal to others that they are part of an existing community through hailing (Fiske, 2004). Hailing methods are dependent on the social norms and changing ideologies of the social context in which they are deployed (Fiske, 2004).

Individuals seek connection with others through relatable narratives and signals displayed in their videos. Relatability is important for TikTok creators, as well as for user-generated health content creators, as it increases viewer engagement (Avella, 2023). This recognizability ties closely with relatability, a crucial indicator of success for user-generated health content generally, and as will be discussed shortly, is crucial for success within the TikTok platform. While health care providers have recognized the communicative potential available on TikTok, a large proportion of ADHD-related content on the app is from regular users rather than medical professionals, in the top 100 #adhd videos in June of 2021 only 11 were from health care providers (Yeung et al., 2022). While often similar to information shared by health care providers, user-generated health content has been shown to be very effective at increasing user identification with the subject of the video, which contributes to increased acceptance or adoption of recommended actions, such as seeking formal medical care (Mou & Shen, 2018). Narratives and personal experiences of individuals living with long-term conditions, as often is the case of user content, are useful in helping individuals make medical decisions (Mou & Shen, 2018). One contributing factor in the increased effectiveness seen in user-generated content is the increase in identification between the user and the material, and identification has been positively linked to desired outcomes (Quintero Johnson et al., 2017). These videos, in addition to creating isolated moments of identification, have broad reaching effects on collective meaning of disorders. Not only do online users trust user-generated health content and see “people like me” as very credible information sources but personal experiences have been proven helpful for people making medical decisions as well as support seeking (Mou & Shen, 2018). While the content of the video is important, the platform itself plays an additional role in how individuals perceive and understand user-generated health content on TikTok. The interpretation of user-generated content is embedded within the culture and connotations of the platform in which users interact with the content, as messaging is affected by perceptions of the function of the social networking site (Marwick & boyd, 2011).

Humor on TikTok

Affordance theory, originally developed within the ecological psychology (Gibson, 1979) has been used as a framework in discussion of the reciprocal relational status between an object and organism. This relational perspective has been furthered to incorporate technological design as an argument to encourage intuitive design (Norman, 2009). Norman asserted that the usefulness of an object was connected to the affordances, if individuals could not perceive the affordance of a technology, “it was worthless, at least in the moment” (Norman, 2009, p. 68). The affordances are materially and socially mediated and are co-created by technologies themselves and how people use them in practice. Affordances are “how objects shape action for socially situated subjects” (Davis, 2020, p. 6). Rather than features of a specific platform or software, affordances, in this case, are social artifacts that are shaped by social, political, and economic relations and are constructed both by the technology itself and how users interpret its uses. The “multifaceted relational structure” (Faraj & Azad, 2012, p. 254) of the possibilities for action between an individual and object/technology is a dynamic view which incorporates the contexts of technology, the abilities of users and the social relationships between users to be changed and make changes to how a technology, in this case, a social networking site, is used in practice. The affordances available in digital environments provide opportunities at the intersection of user practices and technology, which enable certain forms of performances to convey meaning to larger audiences (Khazraee & Novak, 2018).

The playfulness and focus on humor and relatable content on TikTok contributes to the users assumptions and types of videos that become popular on the platform. Platform features of virality and the platform’s focus on personalization through the “For You Page” video feed illustrates how the platform has become well known for videos focusing on humor and play as primary communicative patterns. Play in social media has been used as a boundary management mechanism, as well as a technique for individuals to cope with the fixity of norms (Papacharissi, 2012). It follows that a collaborative identity would integrate varying strategies for breaking existing norms and expectations of that group. Playfulness has been used in trending Twitter content to shape what information is considered publicly or privately appropriate (Papacharissi, 2012). As TikTok itself markets its platform as a place to “Inspire Creativity and Bring Joy” it follows that playfulness and humor are encouraged on the social network (TikTok, 2022). Although content is more favorably received when humor dominates a message, (Barry & Graça, 2018) humor has additional functions of creating relatability and virality in collaborative settings (Ask & Abidin, 2018). In addition to providing engaging content, humor provides alternative avenues for in-group members to push the boundaries of what conversations are considered appropriate for the form. While humor and relatability are linked, humor alone does not establish relatability in videos. Through explicit instructions and cultural norms, content creators provide instructions allowing users to identify with the situation and in the process show that such experiences are rather common, while encouraging commiseration and sharing those feelings and experiences (Ask & Abidin, 2018). Humor is often employed to enhance relationships, release tension, and maintain a positive outlook on life (Martin et al., 2003). Humor plays a role in identity construction and performance online, notably playfulness as a negotiation of norms in online discourse. TikTok’s encouragement of humor not only contributes to engaging content but also fosters relatability and viral trends, providing users with alternative avenues to navigate established norms and strengthen community bonds.

The prevalence of humor and mimesis on TikTok is a result of the platforms features which encourage users to publish interactive videos responding to or copying trends seen in other videos on their FYP feeds. The reproducibility affordances of the repost, tag, duet, and use sound features demonstrate how the structure and function of the TikTok platform is important to fully understand the context in which the content is being crafted and distributed on the platform. Scholars have described TikTok as a memetic platform, focused on the imitation and replication of content (Zulli & Zulli, 2022). The expectations and understandings of the platform have led to the emergence of a distinctive style of network on TikTok. Zulli and Zulli (2022), note that the TikTok platform actively fosters and endorses the practices of imitation and replication, both digitally and socially. This encouragement establishes mimesis as the foundational element of sociality on TikTok (Zulli & Zulli, 2022, p. 1873). The acknowledgment of mimesis as a prevalent and encouraged behavior underscores the platform’s unique role in shaping user interactions and content creation, fostering a culture where users actively engage in the imitation of others’ content, contributing to the formation of a distinctive type of networked public on TikTok. The examination of the self on TikTok differs from self-management strategies on other social networking platforms such as Facebook or Instagram, as the central importance of the FYP algorithm offers new strategies for user’s self-making practices, “The prominence of the FYP leads naturally to the prominence of the For You algorithm in the psyche of users, as they are quickly made aware that their experience on TikTok is almost entirely shaped by this algorithm” (Bhandari & Bimo, 2022, p. 5). This cultural or, in the case of ADHD-related content, medical knowledge is often introduced to users on the platform through the FYP algorithm but continues to affect users outside of the platform itself. In addition to the central nature of the FYP for individual’s activities on TikTok, individuals are aware that the FYP algorithm plays a huge part in the videos delivered to them on the platform. However, this functionality and conscious awareness is crucial to understanding how the delivery of content differs from individuals seeking medical information through Google or existing illness forums. Rather than seeking out information on ADHD on Google, individuals encountering ADHD content on TikTok are delivered the information without consciously seeking it out. The prominence of the FYP in the psyche of TikTok users (Bhandari & Bimo, 2022) demonstrates the centrality of the platform’s algorithmic curation process to an understanding of how individuals may understand their own identities when interacting with the platform as a whole. Because the curation algorithm delivers content to viewers based on a collection of data-driven assumptions of identity categories based on anonymous data points, an individual’s algorithmic identity (Cheney-Lippold, 2011) can have a large effect on the videos delivered by TikTok’s curation algorithm. However, scholars have demonstrated that TikTok users change their behaviors on the platform to ensure their own self-identities are reflected in the content they see on their FYP (Karizat et al., 2021). Since identity categories are not fixed, but dynamic, fluid, and contextual, and the collaborative process of identity is constructed by the user and the platform simultaneously (Karizat et al., 2021).

The platform’s cultural context plays a vital role in shaping the interpretation of user-generated health content, as it influences how users perceive and engage with the material, underscoring the interplay between user practices and technological affordances in the digital landscape. The practices of TikTok play a pivotal role in determining the visibility of videos on an individual’s FYP and the prominence of videos under specific hashtags such as #ADHDprobs and #actuallyADHD. The algorithmic nature of TikTok is crucial in understanding how these videos rise to popularity and become seen on individual’s FYP. A majority of users find videos through the algorithmic curation of the FYP rather than specifically seeking ADHD content out by their own desire, such as seeking them out via the search feature (Bhandari & Bimo, 2022). Because of this, the videos that rise to the top of searches and hashtags are heavily influenced by initial distribution controlled by the platform.

The wide range of content throughout TikTok is difficult to define, but through an ethnographic exploration of the app Schellewald has argued that several distinct “communicative forms” have emerged as memes, trends, and aesthetic styles specific to the platform, representing unique cultural expressions and meaning-making practices among its users (Schellewald, 2021, p. 1439). The brevity of the videos as well as the ephemeral nature of encountering them within the FYP stream reduces creators’ ability to center themselves as a distinct personality, focusing instead on their relatability. There is no time in the videos to communicate subtle differences and unique personality traits of each creator, instead focusing on locating the self in relation to common settings and circumstances such as school, work, and home (Schellewald, 2021). The brevity and ephemeral nature of the short-form videos provides further emphasis relatability as a key indicator of success in content on the platform.

Neurodivergence Online

Neurodivergent is an umbrella term, used by activists and individuals who have been labeled by the medical or psychological community with conditions such as autism, ADHD, dyslexia, or Tourette’s (Stenning & Bertilsdotter Rosqvist, 2021). The term neurodivergent is used as an indicator of many types of cognitive differences in contrast to the neurotypical cognition of many individuals, while removing some of the negative connotations of the deficit lens of diagnosis and emphasizing the diversity and spectrum of experience for those who identify as neurodivergent. Importantly, because neurodivergent is not a clinical term, the identity incorporates individuals who self-identify as well as those who have been diagnosed through the existing medical channels of diagnosis. This collective concept of neurodivergence strives toward self-representation, challenging the conventional categories imposed by medical authorities (Stenning & Bertilsdotter Rosqvist, 2021). Rather than viewing ADHD solely through a deficit lens, there is a call to recognize it as clusters of cognitive differences which opens up avenues for knowledge production about ADHD by individuals with ADHD themselves and collaborative groups (Bertilsdotter Rosqvist et al., 2023). One area of knowledge production where neurodiverse individuals are able to share their own experiences of neurodiversity and ADHD is social media, and as a popular health-related topic on the app (Yeung et al., 2022), these conversations and shared understandings are likely happening in videos and comments.

Individual identity construction, such as neurodivergence can be seen in a variety of media, including medical advertisements on social networking sites, which serve as theoretical diagnostic information for the ad’s targets, which also connects diagnostics with deficiency, as well as reconnecting it to capitalism (Gaeta, 2023). Targeted ads can serve to influence “the experience and status of disability on an embodied and social level.” (Gaeta, 2023, p. 2). The algorithm can serve as a mediator for the delivery of diagnostic information, and the viewing of medical information on TikTok may influence users to be more able to accept and incorporate new diagnostic information they encounter in future interactions (Avella, 2023). User-generated health information, such as TikTok videos from individual users with ADHD, have broad reaching effects on collective meaning of disorders. Not only do online users trust user-generated health content and see “people like me” as very credible information sources but personal experiences have been proven helpful for people making medical decisions as well as support seeking (Mou & Shen, 2018). These individual narratives contribute to the inherent meaning and experience of illness as a socially constructed entity (Barker, 2010). Through this public sharing of personal narratives, individual patients can reclaim some agency in the conceptions of their illnesses by the medical community as well as the larger public. “Medicalization can also grant the institution of medicine undue authority over our bodies, minds and lives, thereby limiting individual autonomy and functioning as a form of social control” (Barker, 2010, p. 152). Emerging work discusses the TikTok algorithm’s influence in self-making for autistic individuals (Alper et al., 2023), highlighting how algorithmic identity can play an active role in users finding a neurodiverse community on the platform.

Collective identity work can function to shift common narratives away from medicalized understanding of neurodivergence. In a study on autistic individuals on Twitter, Egner (2022) asserted that autistic individuals (who identify as Neurodivergent, as do individuals with ADHD), constructed identities in online spaces in part due to lacking access to positive representations and identity communities. Through Twitter, “users shared and asked others to share how they understand, perceive and make sense of a variety of different experiences related to their identity” (Egner, 2022, p. 358). Through this self-directed discussion, they were able to reframe traits which are often labeled problems in medicalized forums and reframe them as skills, or advantages. On Twitter, these autistic individuals used their platform to explore, in their own words, “what it is really like to be autistic” (Egner, 2022). ADHD message boards have demonstrated similar shifts in discourse away from the early history of institutionalized deviance to perceiving behaviors associated with the disorder to a construction of self relative to the capitalist assertion that the brain is naturally productive (Comstock, 2015). Some individuals experience medicating their ADHD not as a way to reduce deviant behavior, which is the common tale in medicalized narrative, but rather to produce self-disciplined and productive behavior (Comstock, 2015).

The functionality of TikTok is crucial to understanding how the delivery of content differs from individuals seeking medical information through Google or existing forums for illnesses. Rather than seeking out information on ADHD on Google, individuals encountering ADHD content on TikTok are delivered the information without consciously seeking it out (Avella, 2023). Users are delivered content on their FYP based on their algorithmically curated identity. Often consistent with an individual’s self-concept, an algorithmic identity is a collection of data-driven assumptions of identity categories based on anonymous data points (Cheney-Lippold, 2011). These data points, consisting of clicks, likes, location data, and user-entered demographics, are demonstrated to individual users through personalization algorithms such as the FYP. These self-identity categories are not fixed, but dynamic, fluid, and contextual, and the collaborative process of identity is constructed by the user and the platform simultaneously (Karizat et al., 2021). Research focusing on algorithmic folk theories suggests that TikTok users change their behaviors on the platform to ensure their own self-identities are reflected in the content they see on their FYP (Karizat et al., 2021). An individual’s algorithmic identity may play a large part in anecdotal evidence that TikTok diagnosed their ADHD, as well as fears from the medical community that social media is playing a part in increased diagnoses of psychiatric disorders (Yeung et al., 2022).

Methods and Analysis

To address the research questions, I used critical discourse analysis to study videos that made up the ongoing conversations occurring within user-generated ADHD content. Critical discourse analysis enables examination of both the structure and agency of social practices as it focuses on both the ideological and social functions of language (Fairclough, 1995). The TikTok Videos are viewed in this light as cultural texts with specific meanings and complex structures and hierarchies of interaction that play specific functions due to context, society, and culture (van Dijk, 1993). In selecting which videos to examine, I selected specific hashtags to increase the prevalence of content produced by ADHD creators about their experience rather than medical professionals or corporate entities. Initial exploration of several ADHD-related hashtags as part of a “long preliminary soak” (Hall, 1976) to find representative examples to be further analyzed. Several popular ADHD-related hashtags (including #ADHD, #ADHD awareness) were explored alongside individual creators highlighted in popular press articles (Williams, 2022) were viewed over the course of several weeks to identify hashtags with a large presence of personal experiences rather than medical professional videos. This initial examination provided context essential to engage in purposive sampling (Elo et al., 2014) of public TikTok videos. The videos lasted 43 seconds on average (ranging from 9 seconds to nearly 3 minutes), were coded in their entirety by the author.

The final exemplar sample included 40 TikTok videos from the top 20 publicly available videos within the hashtags #actuallyADHD and #ADHDprobs in the spring of 2022. All videos were available publicly on the TikTok platform and had at least 1,000 likes, indicating the video was widely distributed and viewed by users of the platform. Exclusion criteria were developed to eliminate irrelevant videos found on the hashtags, as several videos focused on Autism or ADHD/Autism combined diagnoses, which were removed from data analysis as the Autistic community may demonstrate different communicative patterns and performance identity strategies (Egner, 2022). These exclusion criteria reduced the sample to 29 videos for detailed coding, which demonstrated emerging saturation, as no new emergent themes appeared, and recurring examples of each theme began occurring.

Informed by grounded theory analysis (Bryant & Charmaz, 2007), I identified emerging themes and performative practices in the top 20 videos of each hashtag using initial descriptive coding (Saldaña, 2014) to gain more specific insights on performance practices of ADHD content creators. Discussions of both personal and workplace symptoms and experiences were noted in an overwhelming portion of the videos, incorporating discussions of personal care tasks, home management, as well as misinterpretations of time, focus, and memory. These nonmedicalized experiences were often discussed both directly and indirectly as jokes, recreations of everyday experiences or as educational examples of unknown ADHD experiences. To operationalize the differences between everyday experiences focused videos and educationally driven videos, communicative forms of TikTok (Schellewald, 2021) were used to specify differences between videos focused on individual lived experience or education videos. This framework, built as a result of ethnographic work on TikTok’s “For You Page,” provides a lens to view these short-form videos through the “platform-specific languages or memes, trends, and aesthetic styles that are specific to TikTok and the meaning-making practices of its users.” (Schellewald, 2021, p. 1439). While Schellewald’s communicative forms often coexist on the TikTok platform, the primary focus of each video was coded as either Lived Experience (18 videos) or Educational (11 videos). ADHD lived experience videos adapt a documentary communicative form to “express the self, talk about one’s life circumstances, or document a current event” (Schellewald, 2021, p. 1445), while the educational videos embrace explanatory tools which “focus on sharing knowledge from one’s own professional experience, hobbies, or general ways of going about life” (Schellewald, 2021, p. 1448). Extending Schellewald’s framework to incorporate the interactive communicative form, each video of the data set used hashtags as one form of interactivity, additional attempts at networked relationships were coded at platform level, demonstrated through the use of popular soundtrack (10 videos), creator level via requests to follow or indication of multipart video series (1 video), both (7 videos), or neither (11 videos). The various interactive and networked attempts of the videos encourage interactive activation of relationships required for collective identity construction (Khazraee & Novak, 2018).

Understanding how ADHD content creators embrace or reject medicalized versions of the disorder through discussion of medication, clinical diagnostic procedures, and criteria as well as the information disseminated by medical professionals can be perceived as embracing medicalized narratives of illness. Because the understanding of all illnesses is inherently social, personal expression of symptoms and experiences outside the medical sphere can recontextualize the illness for both the user and the audience (Barker, 2010). Medicalization was coded through video’s overt discussion of medications, clinical diagnosis processes, and doctor visits (6 videos), the creator themselves announcing their position as a medical professional either verbally in the video or by the inclusion of iterations of doctor, such as “doc” or “dr” in their username (3 videos). One video incorporated both overt medicalization and indications of the creator as a medical professional and a large number (19 videos) showed neither indication of medicalization.

To account for one aspect of performance used in user-generated ADHD content, subsequent waves of coding focused on the presence and themes of humor in the videos. Using the operationalization provided by van der Wal et al. (2020) in an examination of humor styles, who coded for humor as based on the intention of the actions, characters, or video creators to appear funny rather than if researchers personally perceived it as funny, which recognizes the intent of the creator of humor rather than coder preferences (van der Wal et al., 2020). If humor was present, additional codes were prescribed for the 10 possible types, of which only 7 emerged from the ADHD sample; self-defeating (poking fun at one’s own faults) and coping (humor about misfortune, sickness, or death, employed as a coping mechanism to deal with the difficulties of life) were the most prevalent, but aggressive, slapstick, self-defeating, irreverent, parody, and incongruity humor styles also appeared in the videos. Each video could contain multiple types of humor, and all but one video which demonstrated humor demonstrated more than one subtype. Several themes emerged in the close examination of videos, methods of collective identity construction through relatability focused performance, the prevalence and use of humor as a method of identity performance as well as the influence of the algorithmic practices of the platform to promote similar videos to the top of the examined hashtags.

Relatability as a Tool for Visibility

Many TikTok videos in the sample focus on users with ADHD sharing their lived experiences, presenting their daily challenges and quirks in a relatable manner. Unlike adhering to clinical criteria, creators playfully attribute their personalities and behaviors to ADHD. These videos push boundaries of public understandings of ADHD, emphasizing hidden struggles and fostering a sense of connection among viewers who share similar experiences. Many videos found in this sample demonstrated the primary purpose of sharing the creator’s lived experience with other TikTok users. In a video titled “Stuff I Struggle With That I Didn’t Know Was ADHD-Related” a user displays clips of her home, with overflowing boxes of seemingly random items on the floor while a voice over identifies them as “piles of random shit in the hallway,” later pointing to an overflowing garbage can “because you’re out of trash bags.” This video, filled with rapid talking and fast edits of debris around the woman’s home is one example of ADHD TikTok users sharing their lived experience with their viewers. The videos on ADHD TikTok often employ this frame, pointing to their ADHD diagnosis as the reasoning behind their behavior, such as “Things I did to help my ADHD before I knew I had ADHD,” or “Things I thought everyone experienced before I found out about Adult ADHD.” These titles, superimposed on the first frames of a video, demonstrate the creator’s lived experience with ADHD in a playful way, explaining that the behaviors, while often not fitting into clinical diagnostic criteria, are understood as part of living with ADHD. Rather than embracing medicalized versions of ADHD, these users have found ways to share what it is like for them to live with the disorder, rather than accept the existing social framework, similar to Autistic individuals on Twitter (Egner, 2022). This focus on individual experience highlights each individuals’ understanding of what ADHD is, which can conflict with existing diagnostic criteria. By framing their ADHD as an identity, creators make space to adjust and change existing understandings of ADHD through time as a shared malleable identity, which reframes this as information from diagnostically misleading to collectively powerful.

Unfortunately, large relatability of ADHD content can have negative side effects. During 2020 and 2021 numerous popular press articles claimed that TikTok diagnosed their ADHD (Boseley, 2021; Sullivan, 2021). Everyone thinks they have ADHD from TikTok because ADHD creators must make themselves relatable through generalizing their experiences to gain audiences and success on the social media platform. The influencer practice of using relatability as a tool for visibility and a way to gain larger audiences (Reade, 2021) may lead, however, to large-scale self-diagnosis, effectively diluting the importance of an ADHD diagnosis for those who have undergone the existing medical processes (which are time consuming and expensive for those who reside in the United States). The overwhelming hurdles to formal diagnosis illuminate a silver lining for ADHD content creators however: those who have previously been unable to gain insight or knowledge about their own neurodivergences are allowed access to a community where personal accommodations and new coping skills are readily shared among its members, without the hurdles inherent in the existing medical system.

In their attempts to connect with other adults with ADHD, creators demedicalized their experiences: by framing their ADHD as personality traits, or quirky habits these videos place importance on the individual’s daily experience rather than medical management of the disorder. Several videos couched their experiences as “things I thought were my personality but were actually ADHD” or discussed silent struggles, shame or things they “thought everyone did until I learned about Adult ADHD.” The presence of these videos implies that their ADHD is hidden or secret, as it is a nonvisually discernible disability for outsiders. However, by creating videos highlighting these secret traits, creators may find people who have experienced the same things. By highlighting traits and behaviors not listed in existing diagnostic criteria, creators shift conversations away from existing medical power and reassert their agency in collectively describing what their diagnosis means to them personally, rather than reaffirming existing medical knowledge. The relatability of these videos is highly salient, which is often the case on TikTok (Schellewald, 2021).

Understanding these videos as individuals sharing pieces of themselves rather than educationally motivated videos reframes this information as identity construction and performance rather than medical information. Research in disability studies has multiple models of understanding disability identity and medical models. This identity work, and construction of a diagnosis outside of the medical field, points to underlying reasons why many videos did not discuss medicalized functions of ADHD such as medication, treatment, and clinical diagnosis processes. The appearance of only 4 videos from individuals who advertise themselves as medical professionals, either explicitly stating it or including “dr” in their usernames, is unsurprising since the sample was purposely gathered to include largely user-generated content but demonstrates that some online conversations are happening between users rather than between existing systems of power. This finding underscores the power of social media platforms like TikTok in shaping and sharing diverse narratives about health conditions, allowing individuals to reclaim their experiences, connect with others, and contribute to broader conversations around mental health and neurodivergence.

Humor as Identity Work

Several videos took advantage of the unique audiovisual features of TikTok to embrace viral trends to increase their audience, one video, entitled “Meet the lesser known symptoms of ADHD . . .” used the theme song from Full House as an underscore to parody each symptom as if it were a character on the 1990s sitcom: Perfectionism waves at the screen, followed by impulse buying, rejection sensitivity and clumsiness, each wearing different outfits and gesturing with relevant props while smiling and nodding knowingly at the camera. The use of this sound, as well as the recognizable sequence displays an act of platform interactivity common in ADHD content. The mimicry of the Full House title sequence was trending at the time of data collection, and the sound has been used in over 23,000 videos, and the familiar video form demonstrates the memetic capabilities of TikTok (Zulli & Zulli, 2022).

Similarly, the use of coping and self-defeating humor closely mirrors the style of discourse seen by Ask and Abidin (2018) in college student memes, which incorporated similar humor styles to promote collective identity and relatability between struggling undergraduates. Considering TikTok advertises itself as a platform to “inspire creativity and bring joy” (TikTok, 2022) it is surprising that only 17 of the 29 videos incorporated humor as a performative tool. Of the 17 videos, 14 were Lived Experience, and three Educational focused, while videos without humor included more educationally focused (eight videos) and a much smaller contingency of lived experience videos (four videos). The high percentage of lived experience videos using humor aligns with identity management discussions (Ask and Abidin, 2018) as personal experience narratives have been shown as effective medical content (Quintero Johnson et al., 2017). Coping and self-defeating humor were present in 14 of the 17 videos which incorporated humor in the sample. Self-defeating humor has been employed as a tool to create and sustain friendships (Martin et al., 2003) which aligns with the fact that these videos are used to connect with fellow ADHD TikTokers. Many videos explicitly share experiences individuals had before their diagnosis (whether that diagnosis was formally procured or self-diagnosed is not disclosed in many cases) share self-defeating humor or making jokes at their own expense. Pointing out things that they consider to be symptoms of their ADHD that they were unaware of before diagnosis. Self-defeating humor is explained through the superiority or disparagement theory of humor, which sees aggression as the fundamental component to humor (van der Wal et al., 2020). Coping humor, on the contrary emerges from the relief theory, which posits that humor is a mechanism to release tension. Coping humor specifically is used to deal with stress and adversaries (Martin et al., 2003). This humor type can be used by those with anxiety and discomfort such as being left out or embarrassed, which is likely the case of some ADHD individuals, because of existing stigmas against the disorder itself as well as mental health disorders in general.

Conclusion

This study examined performances of an ADHD identity as they occurred in user-generated TikTok videos. Many examples from the data used humor as part of their performance, more specifically self-defeating and coping humor styles. These styles of humor align with individuals seeking connection with individuals who share their experience of ADHD as an identity rather than simply a medical diagnosis (Barker, 2010). These performances and understandings of ADHD demonstrate resistance against medicalized narratives of the disorder and introduce neurodivergence as an identity signifier with emerging group understandings. While this research focuses on videos pertaining to a specific identity and collection of hashtags, future research could expand on this sample to incorporate additional ADHD and other neurodivergent hashtag videos and comments. Additional research incorporating interviews with content creators or consumers would provide valuable insights on the individual intentions or perceptions of these identity practices. This project has highlighted the use of humor in ADHD-related hashtags which may serve as a tool to promote relatability and gather larger audiences to videos. Unfortunately, overgeneralizations or misunderstandings of user-generated content may paint an unreliable portrait of ADHD symptoms to medical professionals (Yeung et al., 2022), but these discussions of individual ADHD experiences align with collective identity management and exhibition of neurodivergent identities.