A Digital Drug

Since its appearance in 2017, TikTok has become one of the most popular social media platforms among pre-adolescent, adolescent, and young adults worldwide. Despite facing regulatory challenges in certain countries, TikTok continues to experience exponential growth, boasting over 1.5 billion active monthly users in 2024 (Statista, 2024a) and consolidating its position as the fastest-growing social media platform among children and young adults (McCashin & Murphy, 2023).

TikTok is particularly popular among individuals aged 18-24, comprising 18-19% of its user base (Statista, 2014b). This demographic holds relevance as it is known to be more susceptible to behavioral addictions than adults. Additionally, recent scientific research, such as the study conducted by Caner, Efe & Başdaş (2022), indicates that adolescents exhibit higher levels of addiction and anxiety on TikTok compared to other prominent social media platforms like Facebook, Instagram, or Snapchat.

As a video-based platform, TikTok allows its users to watch, create, edit and share videos between 15 seconds and 10 minutes length; using a simple, colorful, and intuitive interface to create various filters, music or lip-syncing templates. However, what makes TikTok a highly addictive platform is that the videos presented to a user are algorithm-driven, and highly tailored to their selected preferences, view history, rewatches, comments, likes or reshares (Anderson, 2020). 

TikToks’ Artificial Intelligence (AI) algorithms quickly learn individual preferences as they are not limited to capturing users’ likes. Therefore, the individual’s feed is adapted to their real preferences, which facilitates a continuous cycle that starts from the first use and becomes increasingly accurate with repeated engagement (Davis, 2019). The rate of high-intensity rewards in TikTok is unusually high, so the user keeps scrolling through the App to get more content. In this context, Forbes analyst John Koetsier (2020) deemed TikTok as a “digital crack cocaine for your brain”.

Providing scientific support for Koetsier's assertion, a recent functional Magnetic Resonance Imaging (fMRI) study conducted by Su et al. (2021) in China shed light on the neurobiological mechanisms underlying TikTok addiction. The study revealed that TikTok's personalized videos activate reward centers within the brain, including the Ventral Tegmental Area (VTA), anterior thalamus, cerebellum, and lateral prefrontal cortex. These findings suggest that TikTok's algorithm possesses a remarkable capacity to identify and deliver highly addictive content, thereby reinforcing users' engagement with video-watching behavior.

TikTok Brain

While TikTok has demonstrated its potential in facilitating supportive communities among diverse populations such as individuals undergoing psychiatric hospitalization (Schaadhardt et al., 2023) or members of the LGBTQIA+ community (Paciente et al., 2023), recent research highlights its negative effects on mental health, particularly in adolescents and young adults. In this context, the term 'TikTok brain' has emerged to describe the detrimental impact of excessive TikTok use on users' cognitive abilities and psychological well-being. Notably, recent studies have begun to reveal the adverse effects of abusive TikTok use on:

• Depression, stress, and anxiety: Recent studies by Chao et al. (2023), Gentlzler et al. 2023, Rogowska & Cinicio, 2024, Sha & Dong (2021) and Williams et al. (2024) have demonstrated an association between abusive use of short-video apps like TikTok and elevated levels of stress, anxiety, social anxiety, depression, and loneliness. Furthermore, Sha & Dong (2021) found that these emotional symptoms are associated with a decline in memory among TikTok users. Lambert et al. (2022) have also reported that taking a one-week break from social media, including TikTok, results in reduced depression and anxiety, and improved emotional well-being.

• Body image disturbances and eating disorders:  Highly-visual social media, as is the case of TikTok, have been consistently linked to body image concerns (Choukas-Bradley et al., 2002; Sagrera et al., 2022; Saiphoo & Vahedi, 2019). As suggested by Tiggemann and Zaccardo (2016), a continued exposure to thin, idealized bodies can impact one’s body image, so the overrepresentation of these body stereotypes can have severe negative effects. Interestingly, Pop et al. (2022) discovered a notable correlation between Body Mass Index (BMI) and TikTok usage among medical students, revealing that individuals with higher BMI tend to engage less with the platform.
    In 2021, a Wall Street Journal investigation revealed that TikTok floods child and adolescent users with videos of rapid weight loss methods, including guidance on consuming fewer than 300 calories per day and endorsing a "corpse bride diet," which depicts emaciated individuals with protruding bones. The journalistic investigation involved the creation of a dozen automated accounts registered as thirteen-year-olds, to ascertain the extent of TikTok's algorithmic content recommendations. The findings revealed a distressing pattern wherein adolescent accounts were exposed to tens of thousands of weight-loss-related videos within a remarkably short timeframe of joining the platform. These findings reveal the potential harm posed by TikTok's algorithmic content distribution system, particularly in the context of vulnerable user demographics such as children and adolescents.

• Sleep disorders: The study by Wang & Scherr (2021) sheds light on a significant concern regarding the impact of TikTok usage on sleep health. Their findings show the adverse effects of automatic engagement with TikTok, leading to pre-sleep cognitive arousal and subsequent daytime fatigue. Other researchers have also found that an overattachment to TikTok is associated to  sleep disturbances in adolescents (Chao et al., 2023; Wei et al., 2021).

• Mental health misinformation: Psychologists and psychiatrists have noticed that the visualization of TikTok videos related to mental health can bring with them a proliferation of misinformation. For example, Yeung et al. (2022) found that half of the TikTok videos about ADHD are misleading, contributing to the widespread dissemination of mental health misinformation. Olsson (2021) has also observed an increasing number of adolescents and young adults self-diagnosing psychological disorders like ADHD, OCD, dissociative identity disorder, autism or Tourette syndrome. In addition, a recent content analysis found that alcohol-related content on TikTok showed a propensity to promote rapid consumption of multiple drinks and to align alcohol consumption with positive associations, while rarely communicating the known negative outcomes (Russell et al., 2021).

• Radicalization: TikTok has also been analyzed for its dangerous algorithm, which can quickly radicalize the user. A recent research by Little & Richards (2021) has found that the engagement with transphobic content in TikTok, is related to an increase of videos in the user’s feed related to racism, misogyny, and homophobia.

Assessing TikTok Addiction

Evaluating your habits can be the first step towards healthier Tikok use. The following six questions, adapted from the Bergen Facebook Addiction Scale (Andreassen et al., 2012), can help you assess if your TikTok usage might be excessive. For each question, select one of the following responses: (1) Very rarely, (2) Rarely, (3) Sometimes, (4) Often, or (5) Very often.

A score of “Often” or “Very often” on at least four of six items may suggest the respondent has developed an addiction to TikTok.

Strategies for Promoting Healthier TikTok Use

If your TikTok usage is excessive, addictive, or if you simply want to adopt healthier habits with the platform, consider implementing strategies to promote healthier TikTok habits. The following are seven strategies to reduce or eliminate your time on TikTok:

Conclusion

In conclusion, emerging research is demonstrating the negative impact of excessive TikTok use on user's emotional well-being. While the platform offers opportunities for community building and support, particularly within marginalized groups, TikTok also poses risks to mental well-being, including exposure to harmful content, sleep disturbances, eating disorders, anxiety or depression, among others.  As TikTok continues to evolve, further research is warranted to better understand its nuanced effects on mental health and inform strategies for promoting safe and responsible use of the platform. Collaborative efforts among mental health professionals, researchers and policymakers are essential to address the challenges posed by TikTok while maximizing its potential as a platform for fostering positive mental health outcomes.

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‍References

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