Last month, before an audience of millions, Gabbie Hanna unraveled in her living room, convinced she was the second coming of Jesus Christ. Hanna, a popular influencer who made her name on Vine in the early 2010s, had ignited controversy before, usually for her public feuds with rival influencers or dismissive comments about mental health. But this time, Hanna’s actions felt different, as she went from posting a couple TikToks a day to her 7.8 million followers, to uploading 150 videos over the next 48 hours.

Many viewers assumed Hanna was engaging in some kind of unhinged publicity stunt, and began flooding her comment section with cruel remarks. Their comments indicated to TikTok’s engagement-attuned algorithm that Hanna’s videos were indeed highly watchable, worthy of pushing out to millions more people. But within the torrent of ridicule and disdain were eddies of empathy and alarm, with dozens of commenters noticing that Hanna’s behavior was painfully familiar. “She was doing pretty much exactly what I was doing [when I was manic],” said Audrey Waugh, a TikTok creator in Ann Arbor, Mich., who suffers from bipolar disorder.

Indeed, a week later, Hanna posted a since-deleted series of TikTok videos in which she talked about her bipolar diagnosis, attributing her behavior the previous week to an intense manic episode. Such episodes are a common symptom of bipolar disorder, characterized by an excess of energy and a lack of judgment, sometimes leading to socially and financially disastrous actions.

“Pre–social media, pre-internet, your manic episode might be limited to a town square in your local town,” said Mark Matthews, a professor of computer science at University College Dublin who researches the intersection of technology and mental health. “Now the amplification of social media means that you’ve gone from your town square to the whole world.”