If you scroll through TikTok or Instagram and you might encounter a creator introducing their "system," listing out alters with names, ages, and personality traits. Some wear different clothes to represent different parts. Others use filters or voice changes to depict internal switches. Hashtags include #DID, #MultiplePersonalities, or #PluralGang, reaching billions of views.
As a trauma psychologist, I’ve spent years treating individuals with complex dissociative disorders. I’ve also spent enough time online to recognize the impact that digital culture is having on how people conceptualize their inner lives. There are powerful possibilities here: social media can demystify mental health and create access for those who feel isolated. But what happens when information drowns out expertise? Or when entertainment and education get conflated? And to complicate it further, what happens when youth with very real struggles begin modeling their symptoms on algorithms rather than on their own experience?
The COVID-19 pandemic changed how we relate to ourselves and our mental health. With clinical services strained during the pandemic, many turned to online spaces for answers. According to Salter et al. (2025), self-diagnosis of psychiatric conditions, especially among adolescents and young adults, has exploded across platforms like TikTok and YouTube over the years. Conditions like ADHD, borderline personality disorder, Tourette's, autism, and DID have found massive digital audiences. In fact, videos tagged with #DID have been viewed more than 2.7 billion times (Salter et al., 2025).
What’s behind this? A mix of isolation, curiousity, algorithmic amplification, and real mental health need. For many, online content provides language and validation that's missing in their offline lives. But this boom in visibility hasn’t come without costs.
One of the most concerning trends in recent years is the gap between clinically accurate information about DID and how it is portrayed online. DID is a complex trauma-based disorder involving identity disruption, amnesia, and significant functional impairment. It typically arises in the context of repeated, early-life interpersonal trauma. Most people with DID don’t talk openly about their symptoms, and they don’t present with fully fleshed-out alters dressed in cosplay.
The reality is often quieter and difficult to narrate: blackouts, memory gaps, flashbacks, suicidal thoughts, and relational struggles. In fact, shame is highly correlated with dissociation (Rudy et al., 2022), and many people with DID resist or even reject the diagnosis. Online portrayals, in contrast, often depict DID as quirky, theatrical, and at times, desirable.
This is what Salter and colleagues (2025) refer to as imitative DID: a presentation that may involve real psychological distress but lacks the phenomenology, etiology, and internal conflict characteristic of genuine DID. These individuals often develop complex self-state systems influenced by online communities and fandoms, but without the amnesia, distress, and comorbidity typical of clinical DID (Boon & Draijer, 1993).
There is a feedback loop happening between social media and clinical settings. People consume online content, identify with symptoms, label themselves, and at times present to therapy requesting affirmation of those self-diagnoses. Clinicians who hesitate may be accused of gatekeeping or invalidation. In some cases, there’s outright hostility toward any clinical skepticism.
As Chevalier (2024) argues, this looping effect can reshape how psychiatric diagnoses are understood not only by the public but also by professionals. And when this happens, the distinction between subjective identity and clinical syndrome becomes blurred.
To be clear, there is nothing inherently wrong with self-reflection or identity exploration. In fact, many people experimenting with self-state language online may be grappling with trauma, neurodivergence, or unmet relational needs. The problem is misinformation, not exploration.
DID is not an aesthetic. It’s a significant, often debilitating disorder with high rates of suicidality, hospitalization, and functional impairment. People with DID have extremely high rates of PTSD, substance use, eating disorders, and medical issues linked to chronic trauma (Felitti & Anda, 2010; Webermann et al., 2021). Many remain vulnerable to ongoing abuse into adulthood (McMaugh et al., 2024).
This is why accurate diagnosis matters. When clinicians use validated tools like the SCID-D (Steinberg, 2023) and MID (Dell, 2006), they can differentiate DID from conditions with overlapping symptoms like borderline personality disorder, psychosis, or an underlying dissociative disorder. But if we collapse everything under the umbrella of multiplicity, we risk mislabeling distress and missing opportunities for targeted care.
We need to stop reacting with moral panic. Dismissing all online self-diagnosis as fake or attention-seeking is clinically reckless. Many people exploring DID language are suffering. But we also cannot afford to treat self-diagnosis as synonymous with clinical diagnosis.
Here’s what we can do:
1. Show up online with credibility and compassion. Mental health professionals need to occupy more digital real estate. That doesn’t mean dancing on TikTok, but it does mean providing grounded, research-informed content that can be accessed by the public. It means writing, speaking, commenting, and showing up with nuance.
2. Validate distress. We can honor the pain behind someone’s self-diagnosis without automatically endorsing the label. That means asking better clinical questions and using validated tools. It also means being honest when symptoms don’t align with a diagnosis.
3. Teach about dissociation. Dissociation reaches beyond alters. It includes amnesia, depersonalization, derealization, and sensory numbing. Educating the public (and professionals) about these less sensational features can help create more accurate narratives about trauma and its effects.
4. Respect the intelligence of the public while upholding clinical rigor. People want information. They want language. They want to be understood. If clinicians and researchers aren’t providing that in accessible ways, someone else will. And they might be wrong.
Social media is not going away, nor should it. The democratization of mental health language has empowered countless people to seek care and find community. Clinicians need to recognize that the problem is not the internet. The problem is not having enough qualified, trauma-informed voices in digital spaces.
We need more psychologists, social workers, educators, and survivors to contribute to the conversation online. We need digital literacy campaigns that teach people how to discern credible sources. We need to train clinicians to understand online cultures rather than fear them so that they can better serve the clients who live in them.
Most of all, we need to stay curious. When a client walks in with a list of alters or uses language they learned online, we shouldn’t roll our eyes. We should ask: what are they trying to express? What pain is underneath this identity? And how can we support their exploration of memory, of emotion, and of the self?
References
Boon, S., & Draijer, N. (1993). The differentiation of patients with MPD or DDNOS from patients with a cluster B personality disorder. Dissociation, 6(3), 126–135.
Chevalier, O. (2024). "It starts on TikTok": Looping effects and the impact of social media on psychiatric terms. Philosophy, Psychiatry, & Psychology, 31, 163–174.
Dell, P. F. (2006). The Multidimensional Inventory of Dissociation (MID): A comprehensive measure of pathological dissociation. Journal of Trauma & Dissociation, 7(2), 77–106.
Felitti, V. J., & Anda, R. F. (2010). The relationship of adverse childhood experiences to adult medical disease, psychiatric disorders and sexual behavior. In R. A. Lanius, E. Vermetten, & C. Pain (Eds.), The hidden epidemic: The impact of early life trauma on health and disease (pp. 77–87). Cambridge University Press.
McMaugh, K., Roufeil, L., Salter, M., & Middleton, W. (2024). Incestuous abuse continuing into adulthood: Clinical features and therapists’ conceptualisations. Journal of Trauma & Dissociation, 1–16.
Rudy, J. A., McKernan, S., Kouri, N., & D'Andrea, W. (2022). A meta-analysis of the association between shame and dissociation. Journal of Traumatic Stress, 35(5), 1318–1333. https://doi.org/10.1002/jts.22894
Salter, M., Brand, B. L., Robinson, M., Loewenstein, R., Silberg, J., & Korzekwa, M. (2025). Self-diagnosed cases of dissociative identity disorder on social media: Conceptualization, assessment, and treatment. Harvard Review of Psychiatry, 33(1), 41–48. https://doi.org/10.1097/HRP.0000000000000416
Steinberg, M. (2023). The SCID-D Interview: Dissociation assessment in therapy, forensics, and research. American Psychiatric Association Books.
Webermann, A. R., Brand, B. L., & Kumar, S. A. (2021). Intimate partner violence among patients with dissociative disorders. Journal of Interpersonal Violence, 36(3–4), 1441–1462.
