TikToxic or TikDoc? A Thematic Analysis of Adolescents’ Use of Online Short Videos as a Mental Health Information and Support Source

We collected data from April 2024 to October 2024. We drafted an interview protocol based on the hypothesized motivations, barriers, and consequences (see introduction). Specifically, our interview protocol consisted of creating a timeline based on Rickwood et al.’s (2005) phases to understand adolescents’ mental health, help-seeking journey, and the role OSVs played throughout. For each phase, we inquired about their reasons for using OSVs and experienced barriers. We piloted this protocol with three university students (M_age = 19.33, SD = 1.15, range 18–20). Based on these pilot interviews, the protocol became a topic guide instead of set questions. We also added two timepoints to the timeline (when receiving professional help and when receiving a professional diagnosis) and the positive/negative consequences of using OSVs. The final protocol is available on https://doi.org/10.17605/OSF.IO/T5U9C. The preregistration can be found at https://doi.org/10.17605/OSF.IO/F9KVA. The study was approved by the Ethics Committee from the Faculty of Social and Behavioural Sciences at the University of Amsterdam (FMG-5279_2023).

Adolescents could participate if they met three inclusion criteria: 14 to 18 years old; having used or still using social media/OSVs to find information or support for their anxiety and/or depression concerns; and having sought offline help for their concerns. We recruited adolescents through schools, healthcare providers, Instagram, TikTok, and snowballing. We emailed schools and healthcare providers with information about the study and provided posters and flyers. Interested adolescents could contact the first author, who checked whether they met our inclusion criteria. The first author informed adolescents about the study design, as well as their guardians, when the adolescent was younger than 16. Adolescents and their guardians (if adolescents were younger than 16) had to provide online consent before the interview. After participation, adolescents received monetary compensation (€15).

In total, 24 adolescents from rural and urban areas in the Netherlands participated (M_age = 16.21, SD_age = 1.09). All other participant characteristics can be found in Table 1. Duration of concerns ranged from 1.5 to 13 years, with participants mentioning that the severity fluctuated over time. As we were interested in self-identified concerns, we relied on adolescents’ self-reported perceptions of their concerns and did not use standard assessment measures for anxiety or depression. The first author conducted 22 online and two in-person interviews, which took between 31 and 72 min (M = 46). After each interview, the first author recorded a voice note about the interview to encourage reflexivity. All interviews were audio recorded and transcribed verbatim.

We followed the six phases of reflexive thematic analysis, which is a more constructionist approach to coding and developing themes (Braun & Clarke, 2006, 2021). We combined both inductive and deductive coding techniques, recognizing that these are not mutually exclusive (Braun & Clarke, 2021, 2023). We chose this approach as the purpose of this research was to learn more about adolescents’ own experiences and thus allow the data to inform the analysis structure and sense-making, while also recognizing that we had some pre-determined ideas that inspired deductive codes.

We coded all data in Atlas.ti24 software. Throughout the analysis process, we used triangulation (bringing in different perspectives since all authors have diverse backgrounds), reflexive work, and negative case analysis to achieve and validate our themes. For example, the last author, who mostly studies externalizing behavior among adolescent boys, would point us to how boys may have different experiences than girls, while the second author, who mostly studies online health information seeking, recommended analyzing the platform characteristics in greater detail. In phase 1, the first author re-read the transcripts and examined the timelines, while noting down initial impressions and ideas for codes (e.g., “self-disclosure” and “neurodiversity content”). For example, during this phase, it became apparent that many adolescents mentioned how their use of OSVs changed in valence over time. In phase 2, the other authors joined to read, code, and discuss one transcript, using the preliminary codes from phase 1 and especially each author’s own interpretations to produce new codes. Based on our discussions of this transcript and the resulting codes, the first author then coded the other transcripts using the resulting codes while also producing new codes in an iterative process. Throughout the rest of the analysis, the first author had weekly discussions with the second author and bi-weekly discussions with all authors to discuss the analysis. In phase 3, the first author sorted the codes into four initial themes by analyzing co-occurrences between codes and the meaning participants gave to these co-occurrences. The first author then discussed these developed themes with the second author, which led to the addition of the fourth theme. The first author then discussed the themes with the other authors, who agreed with these themes and suggested dividing the themes into subthemes for clarity. In phase 4, the first author reviewed the themes by returning to the coded data extracts and the entire dataset. This led to merging codes (e.g., merging “relating to content creator” and “identification”) and coding previously missed data extracts. In phase 5, the first author refined and defined the themes and selected data segments to illustrate each theme. For example, during this phase, we limited the theme “Not everyone’s cup of T(ikTok)” to the features of OSVs that bothered adolescents, so that it would not overlap with the other themes. In phase 6, the first author wrote a story around the data.

In line with our constructionist approach, we believe that research projects are shaped by researchers’ characteristics. Therefore, it is appropriate to acknowledge our positions. The first author is a young adult and clinically trained psychologist who has experience with mental health issues and related social media content. These positions helped to connect and understand participants and to a certain extent be an “insider” (Labaree, 2002), while also being mindful of the unique experiences and context of each adolescent, which may differ from her own experiences. The first author kept a reflexive journal throughout the data collection and analysis to critically examine how these positions shaped her interactions with participants and how these might influence data interpretation. The first author also discussed these reflections with the other authors.

The second, third, and fourth authors have a background in communication sciences, while the last author has a background in developmental psychology. They have not encountered mental health content on social media. All authors believe social media has both positive and negative sides, which influenced our decision to design a study and develop themes in which both sides are explored.

Throughout the interviews, all adolescents discussed changing their use of OSVs over time. Most adolescents described an initial increase in watching mental health OSVs, which was often perceived as positive, as they liked getting information and support for their mental health. However, at some point, this information and support became overwhelming, repetitive, or triggering, leading adolescents to consciously decrease their use of OSVs for mental health. This resulted in seeing mental health content in moderation, which adolescents evaluated positively. As we noted these three clear, distinct phases, we divided this theme into three sub-themes: (1) Initial engagement, (2) Overexposure, and (3) Mindful use.

The first sub-theme relates to adolescents’ initial and positive experiences with OSVs as an information and support source. Some adolescents deliberately sought information and support on OSVs as they perceived great information availability on OSVs: “TikTok is just the platform where you can find anything” [Male, 16]. Most adolescents, however, were not actively looking for information or support, as they were not yet aware that their problems might be signs of mental health issues. They thus did not use OSVs with the specific purpose to find information or support, but the availability of the content, as well as the convenience (i.e., they already used the app), led them to mental health videos: “I didn’t go on TikTok with the thought: I want help. But TikTok just provided help” [Female, 16]. Adolescents related and interacted with these videos, which the algorithm picked up: “At some point I just got one and then I got more and then I watched the whole time (. . .) I found it hard to explain or say what was going on with me and those videos were relatable, they explained how I felt” [Male, 14]. Adolescents also found OSVs an attractive source due to the experience-focused format they deemed trustworthy: “I preferred seeing people who experienced this too rather than information based on science, because I knew the tips from people who experienced it would help, because they are still alive” [Female, 17]. Others felt OSVs provided them with autonomy they would not get when seeking help via other means: “I prefer TikTok over a psychologist. I can decide whether I want to hear it or not, I can just scroll past it if I want to” [Female, 17].

The second sub-theme relates to how these initial positive experiences turned into more negative ones over time. Adolescents mentioned that content became repetitive or triggering over time, as illustrated by the following quotes: “Now I already know what they are going to say, every video is the same” [Male, 16]; “I was just done with getting those TikToks the whole time. They help you, but at the same time you feel bad about it” [Female, 16]. Also, features that initially motivated adolescents to use OSVs turned into barriers. For example, one participant mentioned the drawbacks of the experience-focused format: “I felt like it was contagious, now I have all these problems too” [Female, 17]. Many participants mentioned how the algorithm changed to solely providing mental health content, resulting in feeling overloaded: “It took over my whole TikTok, I even deleted TikTok, I just didn’t know what to do. When it’s only about mental health, it has a bad influence on me” [Female, 16]. Importantly, some adolescents, especially the ones who did not see much triggering content, did not go through this phase but rather felt they got what they needed from OSVs and so decreased their use: “In the last months, I have barely used social media (. . .) I have already found out about so much on social media” [Trans male, 18].

The third sub-theme relates to how adolescents changed these previous negative experiences into positive experiences again. Many participants did this by tweaking their algorithm to see less mental health content, as expressed by this participant: “I didn’t want to see it anymore, so I swiped it away and searched fun TikToks, so my For You slowly became more fun” [Female, 17]. Other adolescents temporarily deleted the app or created separate accounts for mental health and non-mental health videos: “My main account was quite negative, so I made another account on which I watched positive stuff, so I wouldn’t drown in the negative stuff” [Male, 16]. This led to experiencing more autonomy in deciding when to see mental health content: “When I only had mental health videos, it made me feel bad. But now I also have fun stuff and when I see a mental health video, I can scroll past it if I don’t feel like seeing it” [Male, 14]. Their changed way of using OSVs also led to experiencing mostly positive consequences again, as expressed by multiple adolescents: “Now I just see that stuff occasionally and I can just relate and find comfort in it, it’s hard to describe, it just hits, you know” [Male, 16]; “It’s nice to see that others struggle with the same stuff, sometimes” [Female, 16]; “I only use TikTok for my mental health occasionally now. Sometimes I see something and I put it in a folder, mostly reassuring stuff, so I can watch the video when I need it” [Female, 16].

All adolescents described positive consequences of OSVs for their mental health, even if experiencing negative consequences at some point (Themes 1 and 3). As these positive consequences occurred in several ways, we subdivided this theme into two sub-themes: (1) A supportive environment and (2) A place to self-educate.

The first sub-theme describes the motivations and consequences on their mental health that adolescents experienced when using OSVs for support. More than half described the experience-focused format as a—though often unconscious—motivation to find support. They often were presented with content they related to, and knowing that others similarly struggled provided them with a sense of support and sometimes even hope as others got better. For instance, one girl expressed, “Although I already got professional help, it made me feel extra supported. Also knowing I wasn’t alone with these problems” [Female, 17]. Half of the girls, but less than a third of the boys, disclosed their own issues on OSVs, which led to experiencing support and a sense of catharsis: “When I was 15 it was a relief to get those feelings out, get it off my shoulders . . . I didn’t know the people who liked it yet I knew I was a person in a community who could relate to me” [Female, 16]. Disclosing issues on OSVs was sometimes, but not always, motivated by the anonymity of OSVs: “I can ask anything without them judging me, whereas in real life they know you and think you’re weird” [Female, 17]. Finally, an often-expressed sentiment was the lack of offline resources and hence turning to OSVs to find support: “I couldn’t talk to anyone offline about this, so I needed TikTok for that” [Female, 16]. Interestingly, as adolescents often encountered peers on OSVs who would encourage them to seek help offline (either by directly saying so or by showing their help-seeking experiences), adolescents reported an increased intention to seek help as a result of using OSVs and resultingly built an offline support network: “TikTok learned me it’s okay to talk about it, you’re not alone, just talk to the people around you. So I did” [Female, 15]. Some adolescents reported they would or did again use OSVs if they felt in need of support or information after their therapy had ended or when their offline resources could not provide adequate information or support: “In therapy, I learned a lot, now I needed to practice it. I wanted to know how others did and experienced this. I did not have a therapist I could ask anymore, so I went on TikTok” [Female, 16].

The second sub-theme describes the motivations and consequences adolescents experienced when using OSVs for information. Notably, adolescents encountered much less information than support, and if they did, they often did not actively search for it nor had any pre-existing questions they aimed to answer. Similar to the first sub-theme, adolescents often encountered peer experiences they could relate to, and, next to providing support, this often informed them about their mental health as they could recognize symptoms, learn how to verbalize them, and understand them in terms of a specific disorder. For example, one participant said: “I was looking on TikTok like could I get a diagnosis and what could be symptoms and how do people experience that? And specific situations too” [Female, 16]. Adolescents reported that OSVs increased their help-seeking intentions or their ability to verbalize their problems during therapy sessions: “It helped the process of getting a diagnosis, because I could verbalize what was going on in me” [Male, 16]. Moreover, adolescents appreciated the experience-focused nature as they could observe how others coped with issues and extract useful tips: “Doctors did not experience it themselves. People who just tell their story and how they cope with it . . . I would try that too” [Female, 18]. This use of tips was also related to adolescents’ lack of offline resources, as they thought they could not find these tips elsewhere: “I don’t want to bother others with my struggles, because what if they don’t know or what if I waste their time?” [Female, 15]. Finally, the format drew adolescents to self-educate on mental health issues. The majority expressed that the format made it easier to understand information and could provide them with tips when they needed these most due to the 24/7 availability: “It’s a video and also an explanation, like on internet you only have text, but on TikTok you have visuals alongside the text. It helps you to understand it and sometimes you got more information or something that really helped” [Female, 16]. Note, however, that adolescents were wary of the information quality, as described in the following theme.

Many adolescents—interestingly, nearly all girls but less than half of the boys—expressed that they had seen a “darker” side of OSVs where self-harm and suicide content was common. Adolescents with varying symptom levels and durations felt attracted to this content, but those who encountered this when symptoms were still mild indicated it often led to a rapid decline in their mental health. Most adolescents eventually noticed how this content negatively affected their mental health and actively avoided it over time. A few adolescents, however, mentioned they would watch this content, especially when feeling down, as they found comfort in feeling sad. In line with the previous theme, we divided this theme into two sub-themes: (1) Peer experiences can be triggering, and (2) Information is not always helpful.

The first sub-theme encompasses adolescents’ perceived negative consequences of being (constantly) exposed to peer experiences. Adolescents almost unanimously agreed that peer experiences could trigger their mental health issues: “You see a lot of people who are putting ideas in your head. How they feel impacts you, it triggers me’ [Female, 17]. Moreover, adolescents mentioned that peer experiences sometimes decreased their hope in recovery, led to finding or sharing harmful tips on self-destructive behaviors, comparing symptoms and consequent worrying, or even competing with others to be the “worst off.” This is illustrated by the following quotes: “Sometimes you see people for whom therapy did not work, which made me feel less hopeful” [Female, 17]; “TikTok basically gave me a tutorial on how to self-harm (. . .) or how to faint, because if you do that often you kill yourself” [Non-binary, 14]; “I really started to focus on how I could get worse. How do I make my problems worse, how do I get taken more seriously? Then I started seeing things like self-harm and I started searching for it too” [Male, 16]. Unsurprisingly, many adolescents mentioned this worsened their symptoms: “I was constantly being triggered, and I think that’s why I fell so deep” [Female, 16].

The second sub-theme includes how information, while not per se misinformation, could harm adolescents. Fewer adolescents mentioned this topic, as most adolescents seemed to use OSVs more for support than information, and hence were more drawn to peer experiences on OSVs. However, when exposed to information on OSVs, adolescents reported this could lead to confusion about the information or to worrying about their mental health, as described by this adolescent: “I would often doubt myself like I have experienced half of this but not the rest. Then I didn’t know how to feel and I would start feeling insecure” [Female, 15]. Finally, a few participants mentioned that OSVs negatively affected their therapy as OSVs would lead them to believe they had certain mental disorders, while their therapist was not open to discussing these self-diagnoses: “On TikTok I found similar experiences and I thought: I have this too. But my psychologist just told me I was exaggerating (. . .) I really don’t like her, she didn’t help me at all” [Female, 16].

The fourth and final theme describes why some adolescents refrain from or are hindered in using OSVs as an information and support source. Although participants also described decreasing their OSV use as a result of drowning in mental health content (Theme 1), positive consequences on their mental health and consequent offline help-seeking (Theme 2), and/or negative consequences (Theme 3), this theme encompasses more specifically the features of OSVs that pose barriers to OSVs as an information and support source. This theme is divided into the sub-themes (1) Format and (2) Offline sources available.

The first sub-theme describes features of the format that hinder adolescents when using OSVs. Interestingly, adolescents always described this in relation to mental health information rather than support. This seemed mostly due to the experience-focused format. Many adolescents perceived this as a barrier for information-seeking, as everyone has different experiences and opinions, while adolescents sometimes experienced a need for more “objective” information or going into therapy open-minded. For example, one participant said, “Everyone has a different situation. Someone can do this type of therapy, another can do that type of therapy. I didn’t want to get tunnel vision like this is going to work for me and then it’s not going to work for me” [Male, 16]. Moreover, this plethora of different experiences and information led to distrust in the information: “I don’t believe much of it because self-diagnosis is bullshit. It’s mostly people who think they have something and then they say things that are probably not true” [Male, 16]. Besides the experience-focused nature, not everyone appreciated the limited time of OSVs and the video format, due to limited time for a proper explanation or to fully understand the video: “On TikTok most people experience it themselves and I would rather look up on the internet to see what really entails a specific disorder. On internet everything is written and TikTok is mostly videos. I find that harder to oversee than a written text, it’s over so fast that I have to watch it more than once” [Female, 16]. Finally, participants disliked the unpredictability of OSVs, as they don’t have titles and are presented on the For You Page, which is in contrast to other platforms (e.g., YouTube, Google), where you often more actively search content and see from the title what you will get: “On TikTok, you don’t always get what you want. On YouTube you know because they have titles, TikTok hasn’t” [Female, 16].

The second sub-theme relates to adolescents having offline resources available, which they preferred over OSVs. This was also related to the above-mentioned distrust. Due to the possibility of misinformation, adolescents did not fully trust information and believed it always needed to be checked: ‘I would check with my therapist, because some people say things while never having spoken about it with a professional” [Female, 16]. Moreover, the therapist had the advantage of knowing the adolescent personally and therefore could provide more suitable information and support than OSVs ever could: “I stopped using TikTok once I had a therapist. She knows me personally and I tell her everything, so she can exactly say what is going on with me” [Female, 18]. As a result, many participants mentioned using OSVs less once they received (professional) help. For example, one participant mentioned: “I talked to her rather than looking things up (. . .) I could ask her everything so you also learn more” [Male, 16].

Our first research question concerned why adolescents use OSVs for mental health information and support. Most adolescents could initially not recall why they started using OSVs for mental health information and support. They never made the conscious decision to search for mental health information and support, which contrasts with earlier findings showing that adolescents consciously look for mental health information (Pohl et al., 2024). Oftentimes, adolescents’ mental health journey started with watching mental health OSVs, as OSVs informed them that their experiences might be signs of mental health problems. They thus might not yet have been aware enough of their symptoms to consciously look up information on OSVs. Moreover, they might not have consciously used OSVs to learn about their mental health, as they might not have seen OSVs as a learning opportunity, but rather as entertainment or distraction (Schluchter, 2024; Turuba et al., 2024). However, while they may not have been aware of why they used OSVs, the convenience, availability of information, and algorithm seemed to play a role. Adolescents are avid users of OSV platforms, and OSVs about mental health are immensely popular and widespread (Basch et al., 2022; Samuel et al., 2024; Zheluk et al., 2022), making it likely that an adolescent will encounter a mental health-related OSVs at some point. Adolescents who relate and interact with this content (e.g., liking, fully watching the video) will be shown more mental health OSVs by the algorithm (Klug et al., 2021), providing adolescents with information and support even when they might not yet be aware of their symptoms and need for information or support.

Adolescents who were aware of their concerns and actively searched mental health content did so because of the availability of information and support, the short video and experience-focused format, and perceived autonomy. This is in line with the importance of peers and autonomy during adolescence (Brown & Larson, 2009; Dahl et al., 2018). OSVs allow adolescents to connect with peers and find support, which they might find difficult in offline relationships or with other online resources (e.g., websites) that are less peer- and experience-focused. While some OSVs are made by professionals, adolescents mentioned not seeing this content as often (similar to Milton et al., 2023) and generally preferring information from people with lived experiences, which adolescents deem as more relevant than factual knowledge provided by professionals (Rasmussen-Pennington et al., 2013). Furthermore, OSVs provide autonomy as adolescents can get information or support without needing to consult their parents or mental health services, thereby gaining control over their mental health journey and overcoming barriers to offline help-seeking, such as stigma or difficulty accessing offline sources (Gulliver et al., 2012; Pretorius et al., 2019; Radez et al., 2021).

Adolescents more often used OSVs for support than information, which is in line with a large body of research showing that adolescents use social media and OSVs to connect and find support from others (Moreno & Jolliff, 2022; Odgers & Jensen, 2020; Radovic et al., 2017; Turuba et al., 2024). Most participants did not actively contribute (e.g., posting) to OSVs themselves, but experienced support by simply watching others with similar problems, which has already been found true for adolescents struggling with NSSI (Lewis & Seko, 2016). For some adolescents in our sample, this support was especially important as they felt or feared stigmatization or alienation offline, which aligns with earlier research showing difficulties in offline relationships for adolescents with anxiety and depression (Gorrese, 2016; Kaushik et al., 2016). Interestingly, adolescents expressed needing less online support over time as they increasingly sought support offline as a result of positive peer experiences on OSVs and being encouraged by OSVs to ask for support from friends or family. Moreover, over time, adolescents reported being less able to find support through OSVs, as OSVs felt impersonal or could not provide them with tangible help, whereas offline sources could. OSVs seemed to provide an environment where adolescents with anxiety and depression concerns could initiate their first supportive peer relationships. Encouraged by the support they received and the skills they learned while building these online relationships, they subsequently built offline relationships and support networks that could help them above and beyond the support they found on OSVs.

While the algorithm was part of the reason why adolescents used OSVs, the algorithm also appeared to be the greatest barrier when using OSVs. While previous research into adolescents’ online health information-seeking behavior showed that adolescents mostly purposefully engage in searching mental health information (Pohl et al., 2024), the algorithm of OSVs does not allow adolescents to engage in these purposeful searches. Rather, it provides content continuously, even when an adolescent might not desire this. As a result, their autonomy was hindered, and many adolescents felt “overloaded” by OSVs. Over time, these adolescents realized how this overload negatively affected them and tried to restore their autonomy by decreasing their use or trying to change the content they were provided, similar to previous research showing that adolescents change their use of social media from more negative to positive as they mature (Radovic et al., 2017). A second barrier was the information quality. These concerns are not surprising, as content analyses have shown that mental health information in OSVs is indeed of debatable quality (Basch et al., 2022; Samuel et al., 2024; Zheluk et al., 2022). This is especially worrisome as OSVs generally lack clear signs to show that information is correct (e.g., a verification mark; Schluchter, 2024; Turuba et al., 2024), whereas it is known that adolescents verify online sources based on such visible cues (Park & Kwon, 2018; Rasmussen-Pennington et al., 2013). Despite adolescents’ concerns, only a few mentioned double-checking information with offline or online resources. Finally, the experience-focused and time-limited format hindered some adolescents, which is in line with earlier findings that this format does not allow for nuanced and in-depth information or tailored advice (Pfender & Bleakley, 2024; Schluchter, 2024; Turuba et al., 2024).

Our final research question concerned the perceived positive and negative consequences on mental health. Our results echo three of the most prominent concerns with OSVs, namely that content might be triggering, misleading, and, to a lesser extent, that using OSVs is addictive (Zenone et al., 2021). First, adolescents mentioned several ways in which triggering content impacted their mental health. In line with previous research, adolescents reported normalization of harmful behaviors (e.g., self-harm), pessimism about symptom development or recovery, encountering and enacting on detrimental tips, and ultimately worsening their symptoms (e.g., Lewis & Seko, 2016; O’Reilly et al., 2018; Schluchter, 2024; Sjöström et al., 2024; Turuba et al., 2024; Underhill & Foulkes, 2025). Previous studies highlighted how triggering content may be especially concerning when it is shown unexpectedly and frequently (Radovic et al., 2017; Turuba et al., 2024), and similar to the findings by Davis, Landesman, Yoon, et al. (2025), we show that adolescents perceive the algorithm as an exacerbating force in the impact of viewing triggering content as triggers show up at unexpected times and almost always (leading to feeling overloaded). As mentioned above, however, adolescents fortunately realized after some time that this content negatively impacted them and actively tried to diminish exposure to triggering content. Second, misinformation left some adolescents worried or confused, and in more severe but rare cases, it negatively affected their therapy as their therapist was not open to discussing information they found on OSVs. However, these negative consequences were much less prevalent than the negative impact of triggering content, as adolescents were aware of the risk of misinformation. Third, a small subset of our sample noted that their use of mental health OSVs became excessive and addictive, but similar to earlier research, our participants also engaged in strategies to limit their use (e.g., deleting the app) once they realized their use became excessive and harmful instead of helpful (Turuba et al., 2024).

Despite these negative consequences, most adolescents ultimately felt that positive consequences outweighed the negative consequences, although we must note that we believe that some negative consequences (e.g., sharing tips on self-harm or suicide) are extremely harmful and cannot be outweighed by positive consequences. For most adolescents, the balance between positive and negative consequences shifted over time: adolescents initially experienced mostly positive consequences, followed by a period in which they mostly experienced negative consequences, and finally a period in which they experienced more positive consequences again, due to learning what worked (and what did not) for their mental health. Similar to previous research (Milton et al., 2023; Radovic et al., 2017; Turuba et al., 2024), the most often mentioned benefit was receiving network support and feeling less alone. Moreover, similar to previous research (e.g., Russell et al., 2021; Salzmann-Erikson & Hiçdurmaz, 2017; Sjöström et al., 2024), seeing other people’s recovery journeys and, paradoxically, sometimes seeing others being worse off than them, could instill hope and reassure them they were okay (downward social comparison; Festinger, 1954). Moreover, adolescents reported that OSVs increased their awareness of their mental health issues, which is in contrast with earlier findings showing that OSVs may lead to lower knowledge (Wolenski & Pettit, 2024). However, we did not examine whether adolescents obtained accurate knowledge, but rather whether adolescents felt more informed. Adolescents reported that they felt more informed and were better able to communicate their issues, which aided their help-seeking and therapy as they could be more active clients. Especially promising was adolescents’ increased intention to seek help as a result of OSVs, with only a few adolescents mentioning no increased intention and none reporting a decreased intention to seek help, despite earlier concerns that social media might prevent offline help-seeking (Pretorius et al., 2019; Scott et al., 2022; Underhill & Foulkes, 2025). Increased help-seeking was not only attributed to increased self-awareness but also resulted from the modelling and destigmatization of therapy on OSVs. Finally, OSVs could also directly improve adolescents’ mood as OSVs provided an outlet for their emotions and helped them to find tips for alleviating symptoms. Although participants expressed concerns about information and tips being too general or just a reflection of someone else’s experience that might not necessarily work for them (Milton et al., 2023; Schluchter, 2024; Turuba et al., 2024), they did appreciate the ability to find useful tips right when they needed them and did not have offline resources available.

Our study has several strengths. First and foremost, our qualitative and semi-structured interview design allowed adolescents to make their voices heard. Rather than the researchers deciding on what outcomes and relations are important and should be studied, adolescents led us to the relationships and outcomes studied in this paper. This yielded interesting insights and implications for research and practice that we would not have discovered otherwise. For example, in a quantitative design, we would not have thought to study the learning curve adolescents went through (experiencing positive consequences at first, but then realizing it also negatively affects them, and ultimately changing their use to limit these negative consequences). Second, our study consists of a diverse sample in terms of educational level and gender. As it is known that information and support needs and social media use differ across gender and educational level (Helsper & Eynon, 2010; Pan et al., 2021; Svensson et al., 2022), our sample allowed us to capture how adolescents across genders and educational levels used OSVs as an information and support source—which turned out to not be so different at all.

Despite these strengths, we also note several limitations. First, participants may have suffered from recall bias. It is known that adolescents have trouble recalling their social media activity (Boyle et al., 2022). Although our use of a timeline likely limited recall bias (van der Vaart & Glasner, 2007), we cannot rule out that adolescents may have over- or underestimated their reasons for using OSVs, barriers, and consequences on their mental health. For example, adolescents might have attributed changes in their mental health to OSVs, whilst they were consequences of a third factor, such as changes in their offline lives. Second, adolescents with anxiety are relatively underrepresented in our study compared to adolescents with depressive symptoms. Although we offered options for online instead of in-person interviews and allowed adolescents to turn off their camera, adolescents with anxiety symptoms only wanted to participate if communication was asynchronous (e.g., interviews via text messages) and so lost interest in our study once informed about the design. We thus may not have fully captured how adolescents with comorbid or predominant anxiety symptoms experience OSVs as a potential source of information and support, while they may have different experiences (Seabrook et al., 2016). For example, they might be more motivated to use OSVs due to the asynchronous nature, which allows them to consider their interactions more carefully (Nesi et al., 2018). This remains a topic for future research.

Society often views OSVs as a potential danger to adolescent mental health. We show that OSVs could also serve as a potential source of information and support for adolescents with mental health concerns. We highlight several implications of our research to increase this potential. First, adolescents mentioned OSVs were a helpful source of information and support, but only if their feed would not be overflooded by videos on mental health, and as long as videos were not triggering. They often came to this realization themselves, but only after some harm was done. It is important to help adolescents recognize when content becomes triggering and overwhelming, so that negative consequences can be mitigated earlier. For example, adolescents could use a traffic light tool where they explicate their mental state, OSVs use, and plan of action for each color (e.g., “red”: feeling depressed, seeing content about suicide, plan of action could include searching for fun content, limiting OSV use, and seeking offline support). Moreover, policy should force platforms to provide options (or defaults) to turn off features such as the infinite scroll and algorithmically curated feeds, to prevent adolescents from being provided with and feeling overwhelmed or triggered by continuous (negative) mental health content. For example, the Digital Services Act (European Union, 2022) already forces platforms to be transparent about their algorithms and to allow users to turn off the recommendation-based algorithm. Our findings may also compel platforms themselves to change their policies, as we show that users tend to turn away from OSVs due to negative experiences with algorithms or harmful content. Thus, our study shows that adapting these algorithms and regulating content may also be directly in the interest of these platforms. Second, along with other researchers (Basch et al., 2022; Chochol et al., 2023; Lim et al., 2022), we believe informational and supportive content made by professionals could increase the potential of OSVs. By following trends or challenges, stitching or replying to popular videos, and co-creating videos with adolescents with lived experience, these videos may be more engaging and reach adolescents who now report not seeing professional content. Third, the potential of OSVs for information rather than only support could be realized by combating misinformation. Active monitoring and control of misinformation on OSVs would be the ideal solution, but similar previous calls by scholars have so far been largely ignored by OSV platforms such as TikTok. Legislative efforts and partnerships with renowned mental health organizations, such as the recent collaboration between the World Health Organization (WHO) and TikTok, may help in combating misinformation and spreading evidence-based information (World Health Organization, 2024). Moreover, our findings imply another way of combating misinformation, namely addressing adolescents’ desire but often inability to check information with offline sources such as their therapist. While some adolescents already did so and found this extremely helpful, many of our adolescents expressed not being taken seriously by their therapist or refrained from doing so, as they believed their therapists had negative views on social media and would not be open to it. As a result, these adolescents became more prone to misinformation and less open to information from their therapist. Multiple scholars have already argued that conversations about social media use should be incorporated into clinical assessment and therapy (Chochol et al., 2023; Kruzan et al., 2025; Twenge et al., 2025). Based on our results, we wholeheartedly agree and believe that during these conversations, it is important for professionals to be non-judgmental towards adolescents’ OSV use in order to facilitate helpful conversations that help build healthy OSV behaviors and foster therapeutic alliance. Importantly, these implications are of interest to professionals from different health disciplines, as OSVs are used for information and support for all types of health issues (Song et al., 2021)

Our findings also provide avenues for future research. First, longitudinal research is needed to provide insights into how individual differences, consumption of mental health OSVs, and anxiety and depression may develop and interact over time. This eliminates potential recall bias and could inform a more person-specific approach in which we discover which adolescents are most inclined to use OSVs and who are most susceptible to positive and/or negative effects. A longitudinal design could also address the often-expressed concern of whether adolescents who initially experience no to mild concerns develop concerns to form a sick-role identity in order to belong to a community (Corzine & Roy, 2024; Underhill & Foulkes, 2025). Second, it would be informative to examine the effects of mental health OSVs in real-time. While adolescents in our interviews mentioned what consequences they perceived on their mental health, they may have suffered from the third person effect (Davison, 1983). They often described how they became aware of the negative consequences or risks (e.g., misinformation) over time and how they could now adequately manage this, whereas their younger self (“the third person”) was not able to do so. While this may be true, it may also be that adolescents underestimate the consequences OSVs still have on them. Moreover, we had no access or experimental control over the OSVs they saw, and so cannot clearly distinguish what type of content has which effects. By employing experimental research in which adolescents are differentially exposed to mental health content (e.g., different density or types of content on their feed) or by combining data donation methods with experience sampling methods, the effects of mental health content could be elucidated. Third, we recommend examining the larger societal context and including adolescents from diverse backgrounds and countries in future research. Most research, including ours, is focused on adolescents from a white and Western background, while it is plausible that OSVs are used and experienced differently by adolescents from diverse backgrounds. For example, it is known that people from different backgrounds have different experiences accessing and getting mental health care (Snowden, 2003), which may ultimately affect how they use OSVs (e.g., using OSVs as a replacement for mental health care or as a means to self-diagnose; Chochol et al., 2023). Moreover, digital media use by adolescents in the Global South is poorly understood, and interventions are also mostly based on Western therapy models (Davis, Anderson, Yang, et al., 2025). To fully grasp adolescents’ use of OSVs for mental health information and support and to ultimately create interventions that are beneficial to all adolescents, it is thus important to do more cross-cultural research and to take larger societal themes into account.