Online Depression Information Is Misleading: Analysis of Popular Health Websites
Depression is listed in the DSM-V as a purely descriptive diagnosis, but most health websites inaccurately describe it as causing symptoms, according to this study. Doing so may impair treatment outcomes and public trust.
July 30, 2024
Information about depression found online is commonly misleading. Many popular health websites mislabel depression as a cause of symptoms rather than a description of those symptoms, according to a study published in Psychopathology.1
Thirty organizations, including top institutions such as the American Psychiatric Association (APA) and the World Health Organization (WHO), were included in the study. Descriptions of depression from each website were classified into one of three groups: causally explanatory, descriptive, or unspecified.
More than half (53%) of websites presented depression as explicitly causing symptoms or used language that was both descriptive and causal. The remainder (46%) used language that was not clearly defined. Examples of each category include:
- Causally explanatory: A website states that “depression causes feelings of low mood, loss of pleasure, fatigue…”
- Descriptive: A website states that “depression describes a pattern of psychiatric symptoms including low mood, loss of pleasure…”
- Unspecified: A website states that “people with depression experience a low mood, loss of pleasure…”
Psychiatric diagnoses are purely descriptive; yet, none of the organizations directly referred to depression in this way. “The American Psychiatric Association, in the DSM-5, makes explicitly clear that the diagnostic criteria of mental disorders are descriptive in nature because the underlying pathologies are not known,” wrote authors Jani Kajanojaa and Jussi Valtonenb.
Rather, the authors noted that many leading health authorities used circular reasoning — a logical fallacy — when referencing depression. Circular reasoning occurs when a condition (or claim) and its cause (or evidence) are made synonymous. Circular reasoning is also commonly associated with ADHD 2 — a disorder that is highly comorbid with depression. People with ADHD are three times more likely to experience depression compared to those without ADHD.
“While it would be entirely correct to say that the human experiences that the diagnostic criteria describe can feel like an illness, it is different from claiming that an identified external biomedical pathological entity is really causing the symptoms.”
What Is Depression?
Depression is one of the most prevalent mental disorders impacting 6.7% of U.S. adults. There is no single proven cause; its onset is nuanced and its presentation can vary. To say otherwise is scientifically inaccurate.
Per the results, however, descriptions of depression are not clear and can easily misguide readers and patients. This can, in turn, impede public trust in medical authorities during a time when online information about mental health is already poor, according to the authors. 34
Social media further compounds this issue. A 2022 study published by The Canadian Journal of Psychiatry and reported on by ADDitude found that at least half of trending videos about ADHD on TikTok — a platform that attracts more than 1 billion active monthly users — are misleading. Although none of the videos were uploaded by major health organizations, they exemplify the need for reliable information on the Internet.
Understanding mental illness and its potential causes has been shown to help patients and readers regulate negative emotions, according to a recent study in Psychological Science cited by the authors. 5 Education complements treatment plans, which typically incorporate psychotherapy and medication ― although this combination can vary, says Karen Swartz, M.D.
“For some individuals, it’s psychotherapy alone,” she said in an ADDitude webinar on depression in teens. “For others, it’s primarily medication. That’s very individualized. But almost every study that’s looked at this has found that the combination is far superior to either one alone.”
“Part of it is that you need to learn about yourself and how to manage your symptoms, recognize them, and understand what it means to have a serious medical problem… In addition to these treatments, it’s important to include education and support so people understand what they have and how they’re going to manage it.”
By contrast, misleading causal claims can impede a patient’s ability to regulate their emotions. The authors note that viewing depression as having a known pathological disease process can impair treatment outcomes by discouraging patients and “effectively obscuring the links between mental distress, personal history, meaning, and cultural context.”
One approach to avoid circular reasoning is to frame depression within the context of stressful life experiences. Traumatic events have been associated with an increased risk of depression; thus, depression may be described as an “adaptive response,” “functional signal,” or “meaningful reaction” to adversity.
Similarly, ADHD has been associated with adverse life events, or “ACEs,” said Cheryl Chase, Ph.D., in the following clip from her ADDitude webinar about brain development under stress.
Still, it’s essential for professionals to be clear about what a descriptive diagnosis is. Accurate depictions include: 6
- “Depression is not a word that describes just one state of mind, but refers to a whole array of different feelings and thoughts…”
- “The experience we call depression is a form of distress…”
Doing so “provides more room, not less, to explore the various potential ways in which individuals can seek to understand the meaning of their lived experiences,” the authors wrote.
Limitations & Future Research
The analysis included 30 organizations: 13 governmental institutions, 9 non-governmental organizations, 3 professional psychiatric associations, 3 universities, and 2 intergovernmental bodies. Google was used to identify the top websites most likely to appear when users search “depression.”
Future research should include a systematic review of leading health websites. The process of searching for and analyzing popular health organizations in the present study was not exhaustive, thus limiting the scope of the results. Additional studies should further explore the impact of misleading information about mental health diagnoses, including the use of circular reasoning, on readers’ beliefs and treatment outcomes.
View Article Sources
1 Kajanojaa, J., & Valtonen, J. (2024). A descriptive diagnosis or a causal explanation? Accuracy of depictions of depression on authoritative health organization websites. Psychopathology. DOI: 10.1159/000538458
2 Meerman S. T., Freedman, J. E., & Batstra, L. (2022). ADHD and reification: Four ways a psychiatric construct is portrayed as a disease. Frontiers in Psychiatry, 13. DOI: 10.3389/fpsyt.2022.1055328
3 Reavley, N.J., & Jorm, A.F. (2011). The quality of mental disorder information websites: a review. Patient Educ Couns, 85(2):e16–25. https://doi.org/10.1016/j.pec.2010.10.015
4 Demasi, M, & Gøtzsche, P.C. (2020). Presentation of benefits and harms of antidepressants on websites: a cross-sectional study. Int J Risk Saf Med, 31(2):53–65. https://doi.org/10.3233/JRS-191023
5 Millgram, Y., Nock, M. K., Bailey, D. D., & Goldenberg, A. (2023). Knowledge about the source of emotion predicts emotion-regulation attempts, strategies, and perceived emotion-regulation success. Psychological Science, 34(11), 1244-1255. https://doi.org/10.1177/09567976231199440
6 Bowden, G,, Holttum, S., & Shankar, R. (2020). Understanding depression: why adults experience depression and what can help. British Psychological Society. https://cms.bps.org.uk/sites/default/files/2022-07/Understanding%20depression.pdf
