What role is technology playing in our experiences with depression?
Earlier this year, during a recurrence of the depressive and anxiety disorders I have experienced, episodically, since I was a teenager, I typed a tweet. It was about how sad I felt. Before hitting enter, I deleted it, deactivated my account and instead rang a telephone counselling service to speak to “someone”. After about 15 minutes of trying to articulate my problems, the counsellor put me on a three month long referral waiting list for proper clinical therapy. She then directed me to a website. There were podcasts and online forums there, I was told, and an app I could download. I lost my temper and threw my phone across the room.
It was a petulant thing to do but what the person at the other end of the phone could not have realised was how much I felt technology, particularly the noise of social media (much of my own making), had become an integral part of the problem. I knew my sadness was there: I didn’t need it to send me push notifications.
I’m not alone. Most young people now cannot or struggle to remember a time before social media and exist in a world in which mental health diagnosis rates are rising while funding for treatment is being cut.
Anxiety and depression, indeed all mental illnesses, are medical labels we apply to the breakdown in the system of relations we have come to recognise both within ourselves and with the world around us. In the throes of this breakdown I, for example, cannot logically distinguish between a crowded tube platform and the certainty of imminent death or I simply forget that I live inside a body which needs to be fed and washed regularly. Perhaps the biggest cruelty is that this breakdown occurs invisibly. Many concerning behaviours of people living with mental illness – self-harm, eating disorders, substance misuse – are also attempts to lend an exteriority to untraceable, intangible sadness or trauma.
It’s not surprising, then, that social media is at the centre of many current discussions about mental health: the internet, too, is all about exteriority. The opportunities for immediate, stylised disclosure it offers are not a mere pastime but now part of the fabric of young people’s daily experience, a regular site for the ongoing formation and reformations of their relationships with themselves and each other.
Depression makes me behave like a panda: frigid, reluctant to nourish myself and calmly indifferent to the possibility of my own extinction. But then, even pandas have learned to play things up for an audience.
A few months ago, I took a selfie whilst crying and posted it to Instagram with the hashtag #nofilter. It was attention-seeking, yes, but then everything I do on social media is attention-seeking. I looked uncharacteristically sad but my tears, the first I had shed in months, were in fact a moment of joyful release. I had wanted to document this strange juxtaposition in the same way I document a nice outfit or tell a bawdy joke on my Facebook page. I had even undercut the sincerity of the image with a wry, knowing hashtag – a brilliant post. A beguiling work of semi-fiction. Or not. Two hours later the “likes” had rolled in and I found myself wondering what they even signified. I had made my sadness a performance – were the notifications telling me I had done well in this regard? Were they expressions of empathy? Did I feel any better?
Rachel Sykes, an academic at the University of Nottingham who is currently researching “oversharing” in literature and contemporary culture points out that Facebook posts, Twitter and blogging platforms like Tumblr lend users “both the potential to assert control over what people see and a complete lack of agency as to how and where people view the content.” As such, she suggests, “there is a limit to how much confessing online translates into action and resolution.”
What counts as online “oversharing” is a value judgement, of course. And these judgements are often gendered. One rarely sees straight men accused of it. In one sense, this is a question of perception: the white male voice dominates culture and so is presumed to be always rational, objective and proportionate; it is the voice of the sane. As Sykes suggests, the subjectivity any other voice may be forced to inhabit when articulating opposition to this dominant discourse can be read as “a general sign of weakness, not as a viable mode of expression”. Criticism of online “oversharing” can be paternalistic, she suggests, and “a way of regulating information sharing practices: a way of highlighting that which is ‘outside the norm’”.
It’s unsurprising, then, that online oversharing and mental illness have a connection. Defining what constitutes “mental illness” is about regulation too and it’s not purely medical. A simple illustration: if you are rich and able to function economically you may be able to exist merely within the bounds of the “eccentric”. If you are homeless, poor, or must work to live you more quickly have to submit to the language of mental health, for doctors, social workers and employers.
Some parts of this subjectivity translate into the virtual world, too. As writer Wail Qasim points out, this is most apparent for users who have experienced psychosis: “social media can enable the sharing and perpetuation of 'delusions'. The moments where the uncontrollable sharing of what is untrue, because you're detached from reality, is perceived as indistinguishable from kooky online opinion to your audience.” At other times, he suggests, this can work the other way, “critical discourse is taken as delusion or psycho babble a) because you're identified online as having a 'MH problem', or b) your content falls outside of the ‘mainstream’ so you must be mad.”
In the 1961 Preface to his History Of Madness, in which he argues that madness is a way for society to confine ‘undesirables’ both conceptually and physically, Foucault said “modern man no longer communicates with the madman”. But then, Foucault’s Snapchat game would have been shit. In a much less highbrow sphere, the viral success of the Snapchat film Mudditchgirl91, a fictional creation of writer Alex Kazemi, played by actress Bella McFadden, is a more modern investigation of the relationship between social media and mental health. In the film, Mudditchgirl91 is a teen vlogging star documenting her eccentric and troubling behaviour. As art goes, the film has all the subtlety of the GCSE drama-devised piece the dossers in your class came up with the night before the exam. But its success amongst its target audience (teenagers) speaks for itself. Earlier this month, in a further video, Mudditchgirl91 committed “social media suicide” leaving a video sucide note before disappearing forever. Kazemi then released the following statement:
“You all loved her when she was alive and doing weird shit for you on camera, but now that she’s dead, does she still matter?” he probed. “Is she worth a headline? Is her suicide worth writing about? Is she just last week’s news? Is she a digital artefact? A statistic? A digital ghost? Does her truth now require a #TRIGGERWARNING?”
It’s crass, yes, but it makes a point about how easy it is to forget that online we’re part creator, part consumer and, when you’re living inside mental illness, constructing and then proffering your own pain for consumption may come at further cost to your wellbeing. Disclosure itself may not be a problem but that does not mean the how, who and why are irrelevant. You can livetweet your sadness to hundreds of followers but it’s still unlikely you will announce it to your colleagues or classmates the day you’re signed off sick. There is a power dynamic, a context to disclosure that can more easily be forgotten online.
This lack of context is a problem with some extremes of online mental health visibility activism and identity politics. Social justice blogging and North American academia have both rightly drawn attention to the issue of “triggering” (a term drawn from clinical treatment of conditions like post-traumatic stress disorder) i.e. the idea that content in blogs, articles or literature can trigger the physical symptoms of psychological disorders in readers and so should carry an appropriate disclaimer. To warn people about particular types of content like rape, violence and suicide is surely advisable and hardly that radical a concept (Eastenders has been doing it since the 90s). Though it’s worth remembering that people who actually live with PTSD report how irrational and unpredictable triggers are – often they bear no ostensible relationship to the nature of the trauma itself.
‘Depression makes me behave like a panda: frigid, reluctant to nourish myself and calmly indifferent to the possibility of my own extinction. But then, even pandas have learned to play things up for an audience’
Yet in some corners of the internet, the word “triggering” has mutated from this clinical use - sometimes being used where “distressing” or “upsetting” are perhaps closer to what’s being described. This shift in the deployment of the word is something to be a little suspicious of on platforms like Twitter, where interactive cues are sparse and words alone must suffice. In its worst form, this can contribute to an online culture where not only your mental health but your compassion and sensitivity must be curated and performed in line with authorised rubrics. If, for example, you do not confess your own history of mental illness, you have no right to speak, if you do not put ‘TW’ at the beginning of your own narrative, you are not being sufficiently mindful of others’. Any deviation from these rigid performance conventions – such as metaphor (is Beyoncé, for example, stigmatising mental health in "Crazy in Love"?) or humour – which I know from experience, can be healthy modes of expression, become anathema and everyone is forced into a position of coherence. But the true, “IRL” experience of mental illness is the very opposite of coherence.
Trying to crystallise one’s own mind into a consistent political identity online simply risks replacing one set of myths and misconceptions about mental health with another. Mental illness’s invisibility leaves it without the identifiable power structures of other political identities like class or race. There is no recognisable oppressor – merely aggravating factors like poverty or isolation, which exacerbate its devastating effects. None of us know who else may be living with mental illness at any time and the application of identity politics leads to a discussion where everyone must enumerate their scars and traumas for each other in order to justify their right to their chosen mode of self-expression. To be on the receiving end of demands for this kind of disclosure, to feel compelled to trade your pain online as a hallmark of sincerity is a distorted form of activism that does more harm than good.
When I had my first breakdown at 14, I funnelled my anxieties into my childhood Catholicism. The gaudy images of hundreds of saints and martyrs which festooned my bedroom wall and the sacraments I would sneak out of school to obsessively receive every lunchtime allowed me to displace my fears and sadness about daily life into a vast cosmos of heaven and hell. Now, in my 20s, the internet is no less vast and infinite a landscape for this projection. The experience of something like anxiety can make you acutely self-conscious whilst hindering your self-awareness. Social media amplifies this. The personal is political, sure, but mental illness is a direct attack on one’s sense of personhood. Like religion, the Internet is a largely amoral vehicle - its kindness or cruelty still coming from the flawed human beings who use it. Online identities can never be a true reflection of ourselves – at best they are a refraction, subtly bending and changing our direction as we pass through them. Sometimes this change can be for the better, but when already inside the distortions of mental illness, we still need to learn not to bend so much that we break.