Not surprised at all. It's often either a cry out for help, or it's people trying to engage in self-manipulation to further their goal of me vs the world, everyone hates me, and I can produce evidence to prove that. The later is still a form of a cry out for help, but it's a particularly twisted version because some end getting lured down a path of non-stop lying/self-deception.
It should still be treated like self-harm, such as cutting/burning/physical pain. The problem with the internet is it's just such an addictive drug for self-delusion, self-hurt, lying, manipulating, exaggerating and so on due to partial anonymity and ease of access/use. From a pragmatic stance, I'd rather people were abusing themselves online, than physically self-harming, but abusing yourself mentally is still incredibly serious. Just because there is no scars, loss of body function or physical pain doesn't diminish the mental affliction. It's easier for people to do as well, as many can't cope with physical pain/marks/evidence, so may think about physical self-harm but not actually do it. Making up fake accounts online, or lying or exaggerating has little instant downside, and it often has great rewards. If you're part of a community, or on a public social media profile, you'll potentially have lots of people rush to say positive things/support you/make you feel good. Well-intentioned, yes, but if you're lying/exaggerating/harassing yourself, all you're doing is deceiving others and manipulating them/yourself for personal gain or attention (some people potentially even do it for money/fame). None of that is actually going to help sort any of your true underlying concerns/issues, it will just lead you to seek ever greater hits of internet delusion, whilst never actually addressing your problems. You know you're lying to yourself, no matter how much false attention comes your way.
For anyone in the medical fields, trying to tackle some modern day self-harm and calls out for help will be slowly taking on new forms of people abusing/hurting themselves. The internet is far more involved in psychology education these days, from the notable large problem of trolling/abuse, but also like what I said above, the ways in which some can use the internet as a tool to self-harm/deceive themselves. People involved in any of the above need help, guidance and possibly counselling, but me speaking frank about what some do is also required because being factual plays a small part in public education/awareness. It's important not to be accusatory of people and go right to you're lying (unless there is serious evidence), but to talk about the above behaviours in a generic way, so those who know they are self-deluding can be educated by proxy on how it's only abusing themselves, manipulating others and not really tackling their true problems nestled deep in their minds/hearts.