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Guest Essay

By Emma Camp

Ms. Camp is an assistant editor at Reason, a libertarian magazine.

Few, if any, psychologists would say that a preference for natural lighting, doodling in class or even identifying as L.G.B.T.Q. is a sign of A.D.H.D. or autism.

And yet, everywhere I look online, someone is trying to diagnose me with something, using “symptoms” unrelated to clinical diagnostic criteria. Videos with titles like “6 Signs You May Have A.D.H.D.” and “Signs That You Might Have O.C.D.” can rack up millions of views. In them, “neurodiversity advocates” encourage me to consider which of my personality quirks is instead a sign of mental illness or neurodiversity.

In many online circles — particularly those frequented by young, white, middle-class women like me — certain diagnoses are treated like zodiac signs or Myers-Briggs types. Once they were primarily serious medical conditions, perhaps ones of which to be ashamed. Now, absent social stigma, mental health status functions as yet another category in our ever-expanding identity politics, transforming what it means to have a psychological or neurological disorder for a generation of young people, though not entirely for the better.

I was first diagnosed with autism at age 20, shortly after my sophomore year of college. After my costly evaluation, I was relieved. Knowing I had autism gave me the permission I needed to accept my quirks and insecurities.

The condition quickly became a core part of my identity. I joined a sensory-friendly theater group at my college, proudly announced that I was #ActuallyAutistic on social media, and set up a recurring donation to an autism rights organization. The social approval that followed was addicting. The more I talked about autism, it seemed, the more opportunities I got, whether it was grad school essay material or a side gig serving as a consultant on a study. The diagnosis had crystallized into a central part of my self-concept. I didn’t just have autism. I was autistic.

And I wasn’t alone. Loudly identifying with a diagnosis is common, especially online, where disclosures to family and friends have become public declarations about our personal brands.

On platforms like TikTok and Instagram, content from mental health influencers who offer advice and relatable anecdotes have accelerated the integration of medical labels into identity. These influencers show off the most attractive elements of their conditions, epitomizing an aesthetic view of everything from neurodiversity to mental illness. An aestheticized label comes with merch to match (flags, fidget toys, coloring books). There are “happy stimming” autism influencers and pages devoted to twee cartoons about O.C.D. Such aestheticization flattens the difficult reality of living with a psychological or neurological disorder to little more than cutesy products and personality traits.

The attraction of a flattened label is the way it provides meaning to common insecurities. Disorganization can be A.D.H.D.; social ineptitude can be autism. This approach provides quick relief from many of the anxieties central to teenage and young adult life. Am I weird? Is something wrong with me? Is this normal?­ When labeled, what makes you wince isn’t your fault, and it’s not something to be ashamed of. It’s what makes you unique.

But flattening mental health labels into little more than personality test results risks the chance that our culture will take these conditions — and the people who claim to have them — less seriously.

One visible consequence is a more common embrace of self-diagnosis over clinical evaluation. When mental health labels are framed primarily as tools for increasing self-knowledge, anyone is as qualified to diagnose mental illness as a therapist or doctor. The mental health influencers most frequently promoting this perspective post videos detailing often-questionable symptoms that appear to rack up particularly high view counts.

Given the mental health crisis among American youth, some of the attraction of self-diagnosis is that it’s often difficult for young adults who seek a clinical evaluation to get one. In the United States, adult evaluations for conditions like autism and A.D.H.D. are often not covered by insurance. When they are covered, they can still be expensive — mine was over $500. Waiting times for testing in places like Canada and Britain can be years long.

But obtaining appropriate mental health care is ultimately dependent on securing a clinical diagnosis. For conditions where psychiatric medication is often helpful, like A.D.H.D. or O.C.D., being clinically diagnosed is a prerequisite for getting critical drugs. But even in cases where medication is not routinely prescribed, a formal evaluation provides a more objective analysis of someone’s symptoms and behaviors, making it easier to provide tailored mental health services.

While it could be easy to cast mental health aestheticization as a turn toward pop psychology in the face of inaccessible mental health care, the reality is more complex. It’s worth considering what new social pressures might draw some people to labels that ultimately mean they’re mentally ill.

White women have long been vulnerable to aesthetically acceptable mental illness, from 19th-century teenage “hysteria” to the “pro-anorexia” web forums of the early aughts. Mental health aestheticization is yet another version of this predilection, now rooted in 2020s intersectional identity politics.

Under the kind of identity politics most frequently found on left-wing internet circles, immutable identity characteristics like race, gender and sexual orientation are a person’s most important features, giving those in certain historically disfavored groups special authority to comment on issues affecting their community. There’s a constant throat-clearing among many left-leaning young people — “as a queer person,” “as a woman of color”— phrases used to assert epistemic authority or dodge accusations of wrongthink. I myself have started many a sentence with “as an autistic person” to pre-empt criticism.

This brand of identity politics creates a perverse incentive to collect as many “disadvantaged” boxes as possible. For those who might otherwise have little cachet under this politics, an identity-defining mental health label offers a claim to oppression. What was once a dry medical label is now what makes one worthy.

But mental health diagnoses, along with most other categories up for examination under our identity politics, are accidents of birth. To make them central features of our identities is to focus on the things we can’t control ourselves — an approach that is ultimately disempowering.

Our culture needs to discard the restrictive form of identity politics that turns individuals into totems for much larger groups, and creates a bizarre impetus for otherwise privileged young adults to yearn to be disadvantaged. The problems that many forms of identity politics seek to fix — racism, sexism, homophobia, among others — are real, pressing problems. However, making intersectional identity box-checking the foremost way that individuals perceive themselves will not solve them.

Almost three years after my diagnosis, I’m increasingly ambivalent about the label. It’s not a core, or even relevant, part of my self-concept. I still have many of the same idiosyncrasies as I did three years ago, but I don’t need to fixate on my autism to accept them. At a certain point, making my identity revolve around a neurological condition began to feel limiting.

While our immutable identity characteristics surely shape us and shouldn’t be erased, they’re hardly everything. What makes us interesting and worthwhile people isn’t the circumstances of our birth — or our disordered psyches — but the choices we make, and the ideas and people that we care about.

Emma Camp (@emmma_camp_) is an assistant editor at Reason, a libertarian magazine.

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