Rise of the Instagram Therapist: Should You Follow?

Mental health content is in high demand, with some pros’ followings in the millions. When finances and access make it hard to get an in-person visit, the social media doc will see you now—but there can be a dark side.

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If I ever lost my phone, I wouldn’t fear a stranger thumbing through my camera roll (kids, dogs, random cocktail, repeat) or reading my texts (“what’s for dinner?” is about as salacious as it gets). No, I have bigger worries: my saved posts on Instagram. Under that little bookmark icon lies enough wisdom, education, and advice from therapists, relationship counselors, and the like that it must violate some HIPAA law if someone were to see it.

It started with a couple of therapists during the pandemic. Then the clever Instagram algorithm started giving me more of what I wanted. And now, I’m concerned about my inner child, my attachment style, and my clear lack of boundaries.

I’m clearly not the only one—the sheer number of followers certain Instagram therapists have amassed is proof. Sara Kuburic, a psychologist behind the handle @milliennial.therapist, has 1.4 million; Nicole LePera of @the.holistic.psychologist, 5.4 mil. And while research typically points to the ways social media contributes to depression, psychologists are attempting to use their platforms to promote better mental health and break the stigma around therapy.

“I think it’s what people need,” says psychologist Rachel Goldman, Ph.D., a clinical assistant professor in the department of psychiatry at NYU Grossman School of Medicine, who goes by @drrachelnyc to her nearly 22k IG followers. “They’re looking for support, answers, and to feel connected.”

But do mental health posts provide that? That, friends, is the question.

Therapy Is Trending

Before we can understand the therapist-as-influencer explosion, we need to understand the context. In 2020, as the pandemic reared, e-visits with mental health pros skyrocketed. In an American Psychological Association (APA) poll of 1,800 psychologists that same year, 74 percent said they saw more patients with anxiety disorders than pre-pandemic, and 60 percent saw more patients with depression. “I’ve had a waitlist since March 2020,” says Dr. Goldman.

And as waitlists expanded, so did the popularity of mental health pros on Instagram. For people who couldn’t get an appointment or afford care, apps, free online communities, and social media content became a holdover. “In 2020, we were disconnected, feeling isolated, and in need of support, so many people turned to social media,” says Dr. Goldman. And lest we forget the convenience factor, it’s far easier to swipe, scroll, and screenshot than to read an entire book or do the sometimes arduous legwork of finding a professional near you.

The plus side of this shift to social media? “People have more of an awareness of mental health now than ever, and that’s a good thing,” says Ann-Louise Lockhart, PsyD, of @dr.annlouise.lockhart, who has nearly 83,000 followers. “The more people you reach, the more information and education you can give to people who may not normally have access to it.”

To wit, a 2022 study published in Psychiatric Quarterly found that online support positively affected mental health. So much so that 81 percent of survey respondents expressed interest in accessing mental health services via an online peer support community. And yet, a whopping 60 percent of American adults with mental illness didn’t receive mental health services the previous year, according to the National Alliance on Mental Illness (NAMI).

Of course, there are a plethora of reasons for this, including lack of access and financial burdens, but the stigma surrounding mental health is often a major barrier, too. Posts from mental health advocates or therapists can destigmatize people’s struggles, thoughts, or behaviors, says Jennifer Mills, Ph.D., a professor of psychology at York University in Toronto, Canada, who has researched the effects of social media.

Occasionally, social media can worsen the stigma,” she says, but for the most part, helping people learn to understand and express their feelings is a good thing. “Research shows that understanding what you are feeling helps you to feel better,” says Dr. Mills. And so, the theory goes, mental health pros with a strong online presence could help normalize the idea of therapy.

Instagram vs. Reality

Support, community, education, and stigma-busting? Check x 4. But if only it were so simple. “I have mixed feelings about mental health content on social media, especially with so much misinformation out there,” says Jess Sprengle, LPC, who has nearly 82,000 IG followers at @thecrankytherapist. “I think that MH content can be, and sometimes is, very useful for folks—e.g., basic information about self-care, different mental health conditions—but it’s absolutely something people need to be vigilant about.” There are, as Dr. Goldman puts it, “a lot of potential negatives.” Here’s what to watch for as you scroll.

Influencers are not necessarily experts. A blue check mark behind a name may give you social cred, but it doesn’t denote mental health prowess. The person you’re following may not have the credentials to provide mental health advice, says Dr. Lockhart. “It may be a person who experienced depression, and now they have this big platform to talk about depression,” she says. “They may be an expert on their depression, but they’re not an expert in mental health.”

But many people don’t look at the credentials in a bio. Why does it matter? Licensed mental health professionals have an added layer of responsibility, says Dr. Goldman. “I have to think twice about how every post I share will be perceived, how it will affect somebody, will it put my license on the line,” she says. Instagram doesn’t have set rules around expertise, but a pro with a license must adhere to a code of ethics and a higher standard than someone without one. “This has come up a lot lately with one particular IG therapist, as she is not licensed and has a huge following,” says Dr. Goldman.

In 2021, the APA issued guidelines for providers using social media. These include such statements as: “Psychologists are mindful of ethical and legal obligations to maintain client privacy and confidentiality at all times,” and “psychologists consider the need to avoid contact with their current or past clients on social media, recognizing that it may blur boundaries of the professional relationship.”

Social media isn’t a substitute for counseling. Just as IG images of perfect homes and wardrobes don’t portray the full picture of someone’s real life, reading an IG post isn’t actual therapy. “We should remind people of this as much as we can,” says Dr. Goldman. “People are giving very specific and detailed information, but what works for one person may not work for somebody else.” Therapy with a professional skips the platitudes for an individualized plan based on your diagnosis.

Dr. Mills believe social can be helpful for more “normative” mental health concerns that we all experience from time to time (feeling blue or overwhelmed), but recommends talking to a licensed therapist for bigger issues. “For example, it can be difficult for people to know whether the feelings they are experiencing are due to anxiety, depression, or something else altogether,” she says. This is when you need to speak with a therapist.

During in-person therapy, a mental health provider will do an intake and assessment, ask for background information, and get to know you as a person to provide a personalized treatment plan. “In social media content, you miss all those nuances; you can’t capture it all in a short caption, a picture, or a video,” says Dr. Lockhart.

Not everyone is a narcissist. As mental health content floods our feeds, we’re throwing around terms that weren’t even part of our collective vocab a few years ago, such as trauma, attachment styles, and narcissism. Who hasn’t watched a Reel or TikTok thinking, Whoa, that’s my ex? (For the record, only 6.2 percent of the population has a narcissistic personality disorder, or NPD.)

First, know that it’s normal to self-diagnose (or diagnose others). Even budding psychologists do it, says Dr. Lockhart. “In doctoral school, every time we learned about a new diagnosis, we all thought we had it,” she says. “But that’s why it’s so important for mental health professionals to make sure they’re putting forth the right information and presenting things based on real evidence and not because it’s popular clickbait.”

No, you can’t get a diagnosis, not even via DM. The information pros share on social media is meant to be general and not intended to serve as a diagnostic tool. Still, many therapists regularly get DMs and comments asking for help.

Some therapists don’t accept DMs for this reason. “I have a strict rule about not providing therapeutic support to strangers (or anyone, really) sliding into my DMs,” says Sprengle. “I’m always happy to help people find referrals, but I’d prefer to do that via email vs through IG.”

Dr. Goldman also allows DMs but, similarly, won’t offer specific mental health advice. “Instead, I’ll be as supportive as I can, strongly encourage them to seek therapy, or send them a relevant post,” she says.

Scroll Smarter

Despite the potential pitfalls, you can benefit from mental health content if you understand its intent and limitations. Safety, baby! Consume with caution this way.

Do your research. There is a difference between an advocate, a psychologist, a psychiatrist, and all the other types of people who post mental health content. “Go beyond the number of followers and the verified check mark,” says Dr. Lockhardt. Visit the expert’s bio and website to see if they’re licensed and credentialed. “If someone wants legitimate sources of information, they need to do the extra step,” she says.

At the very least, use our mental health alphabet decoder (all require clinical training to be licensed):

  • M.D.: Medical Doctor. Psychiatrists graduated from medical school and are able to prescribe medication.
  • Ph.D.: Doctor of Philosophy. Psychologists have a Ph.D., which involves a rigorous, research-based program that can take four to seven years.
  • Psy.D: Doctor of Psychology. Also a psychologist, this newer degree is similar to a Ph.D., but programs tend to emphasize clinical training over research methods and statistics.
  • LMFT: Licensed Marriage and Family Therapist. Has a master’s degree with a focus on family dynamics sand couples.
  • LCSW: Licensed Clinical Social Worker. Has a master’s degree in social work, often helping individuals and communities find government and legal resources.
  • LPC: Licensed Professional Counselor. Has a master’s degree in mental health counseling.

Another thing to consider: the term “therapist.” We tend to use it interchangeably with “psychologist” in the U.S., where it requires a doctoral degree. But “in other parts of the world, you could have a bachelor’s degree,” says Dr. Goldman, which means less extensive training.

Check their research. When you’re reading content on social media, you want to know where the information is coming from, who the source is, and if it’s science-backed. “Are they citing evidence?” says Dr. Lockhart. “Look at the consistency of what they present and if they are verifying their information through quoted sources or credible evidence.”

Of course, it’s ok if a therapist shares info from their POV, as long as it’s not presented as data. In that case, look for statements such as “in my experience.”

Take what you need. Some Instagram therapists only post content about narcissism or trauma because that’s their specialty, says Dr. Goldman. If that doesn’t pertain to you, it’s not for you. Be mindful of the information you’re consuming and ask yourself whether it’s relevant to you. “If it’s making you question yourself or your family members, maybe it’s not the best account for you to follow,” Dr. Goldman says. Which brings us to this point…

Beware mental health content on social media that makes you feel bad about yourself. Sprengle, who has a private practice in Austin with a focus on eating disorders (ED) and body image issues, shares this warning: “Eating disorder content is tricky, and the nuance that’s often necessary is difficult to capture in a brief social media post. There’s a lot that isn’t helpful about ED on social media, and a lot of ED behavior—like body checking—veiled as ‘body acceptance/positivity.’” This is one reason she keeps her content to “the more basic side or more social justice-oriented side vs talking explicitly about behaviors and numbers.”

Her advice when you see something that’s triggering (no matter the topic) or just sounds… wrong? “Know who you’re following and don’t always accept that someone knows the ‘right’ answer just because they have some letters after their name,” she says. “Lots of therapists/letter-havers cause harm. A good rule of thumb: Who is being centered in this content? Am I seeing only people with privilege? Is there representation of folks who need to be represented?”

Look for authenticity—and a pro you jive with. If you’re not vibing with someone’s style, unfollow them—no hard feelings. Just like in life, you’ll get furthest when you keep the company of people whose values you share. “Surround yourself with accounts that make you feel inspired or encouraged,” says Dr. Goldman.

As for me, your writer, I’m working on being more discerning about who I follow and the type of information I take to heart. But I’ll still be saving mental health posts I find helpful, comforting, and validating. As I turn in this piece, as if on cue (sneaky algorithms!), Spotify starts playing “Narcissist” by Lauren Spencer Smith. Maybe someone should tell her just how uncommon NPD actually is.

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Pandemic and Mental Health: “Patients with Depression  and Anxiety Surge as Psychologists Respond to Coronavirus Pandemic.” American Psychological Association. November 2020. 

Stigma Statistics: “Mental Health Facts in America.” National Alliance on Mental Illness

Online Support and Community: “Opportunities to Expand Access to Mental Health Services: A case for the role of online peer support communities.” Psychiatric Quarterly. January 2022. 

Narcissistic Personality Disorder Prevalence: Frederick S. Stinson, Ph.D., Deborah A. Dawson, Ph.D., et al. “Prevalence, Correlates, Disability, and Comorbidity of DSM-IV Narcissistic Personality Disorder: Results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions.” Journal of Clinical Psychiatry. July 2008. 

Guidelines for Psychologists on Social Media: “APA Guidelines for Optimal Use of Social Media in Professional Psychological Practice.” American Psychological Association. October 2021. 

 

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