Monday, October 28, 2013

Health : The Atlantic: Social Media Is Redefining 'Depression'

Health : The Atlantic
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thumbnail Social Media Is Redefining 'Depression'
Oct 28th 2013, 12:30, by Anne-Sophie Bine

(Nikko Russano/flickr)

A few months ago, Laura U., a typical 16-year-old at an international school in Paris, sat at her computer wishing she looked just like the emaciated women on her Tumblr dashboard. She pined to be mysterious, haunted, fascinating, like the other people her age that she saw in black and white photos with scars along their wrists, from taking razor blades to their skin. She convinced herself that the melancholic quotes she was reading—"Can I just disappear?" or "People who die by suicide don't want to end their lives, they want to end their pain"—applied to her.

Among Tumblr's 140+ million blogs, social communities form around specific topics: music, fashion, photography, and also kinds of disorders. Months ago Laura was part of one such community, scrolling through hundreds of photographs on Tumblr that evoke negative emotions through art and call it depression. Black and white photographs of mystical emaciated women who stare off into the distance put psychological torment and beauty on the same page, and quotes like "So it's okay for you to hurt me, but I can't hurt myself?" and "I want to die a lovely death," try to justify self-harm. All this is at the tip of anyone's fingertips: anyone can search tags like "self-harm," "depression," or "sadness," and find thousands of blogs with a similarly distorted vision of what it means to be depressed.  

"Even those people who are 'wannabe depressed' still feel the same emotions. It's dangerous to talk about 'wannabe depressives' because we don't know for a fact that they are in fact wannabes," Laura says. "There are a lot of people that suffer."

Certainly those who are "wannabe depressed"—a term Laura used to describe those who seem to seek out and share imagery associated with torment, but are not clinically depressed—believe in their own pain, but they often blur the line between depression and commonplace negative emotions. This makes it difficult to tell what's "wannabe" and what's clinical depression.

This online cultivation of beautiful sadness is easy to join: anyone can take a picture, turn it black and white, pair it with a quote about misunderstood turmoil, and automatically be gratified with compassion and pity. And this readily accessible sea of dark poetry could easily drown out those whose suffering has reached the clinical level. During the vulnerable years during which adolescents seek out self-affirmation and recognition from others, this new, easy promise of being recognized as strong, beautiful, and mysterious by Tumblr "followers" can be very tempting, says Dr. Mark Reinecke, chief psychologist at Northwestern Memorial Hospital. Too often, it just leads to more teenagers believing and feeling they are depressed, self-pitying, self-harming.

"When you look at secular trends and epidemiological research completed over the last several decades, there seems to be a slow and fairly consistent increase in levels of depression for each succeeding generation of teenagers," says Reinecke.

(soundlessfall/Lee Forrest/Matthew Wild/Radikha Bhagwat/Flickr)

Tumblr isn't the only place this glorification of self-pity happens.

"Tumblr is a very easy place for people to feed off of this kind of frenzy because of their 'reblogging' system, [which makes] it very easy to [spread] pictures and gifs… particularly gifs, which can be quite graphic," Laura says. "But there are specific sites [for] specific conditions, like 'Prettythin', for pro-anorexics. It's grown like wildfire."

The short, soundless, looped video of gifs makes self-hatred into practical bite-sized packages. On Tumblr, Laura came across many of these, some of which show teenagers cutting themselves.

This sort of exhibitionism of self-harm, suicide, depression, or self-loathing under the pretext that it is beautiful, romantic, or deep is hardly unusual. Today the depression many teenagers, like those on Tumblr, say they have is one that's linked to a notion of "beautiful" suffering.

"Tumblr was, at the start, a photography and art website," Laura says. "If you link that together with depression blogs, you end up with a glorification of these conditions. There's definitely a growing community of people feeding off of each-other's strong emotions, and it's definitely visible online."

Searching the "depression" tag on Tumblr now brings up this disclaimer at the top of the page: "If you or someone you know is dealing with an eating disorder, self harm issues, or suicidal thoughts, please visit our Counseling & Prevention Resources page for a list of services that may be able to help."

"There is more interest in the topic and more self-identification," says Dr. Stan Kutcher, an adolescent psychiatry expert and the Sun Life Financial Chair in Adolescent Mental Health, who says he sees a trend of romanticized depression, of self-victimization. "I see that on lots of social media. Not just Tumblr," he says.

Kutcher says the problem is in misinformation. Adolescents are getting a lot of information from the media, on websites such as Tumblr, or from their friends, not from reputable sources.

"In this waterfall of information there is a lack of critical understanding," Kutcher says. "You see kids self-identifying as having that depression, but they don't have a depression. They're upset, or they're demoralized, or they're distressed by something." In other words, adolescents are confusing the clinical disorder called "depression" with normal, everyday challenges.

"People use the word 'depression' if they can't find their keys, or if they've had a fight with their mother or father, or if they've had an argument with their boyfriend or girlfriend, if they didn't make the school team or didn't do well on an exam," Kutcher says. "When we use the word 'depression' for every negative emotional state, the word loses its meaning." Kutcher says this over-diagnosis of normal human experience is indeed a social trend.

"The pendulum has swung from 'let's never talk about it and let's never educate ourselves about it' to 'let's everyone blab about it,'" Kutcher says. "It's a very interesting phenomenon. How you respond to an affective state depends on what that state is. If I've been demoralized, I don't need Prozac, for Christ's sake."

This phenomenon affects teenage girls disproportionately: between 2008 and 2010, 12 percent of teenage girls aged between 12 and 17 suffered from a major depressive episode, which is three times higher than the rate of their male counterparts (4 percent), according to a report by the Substance Abuse and Mental Health Services Administration in 2012

Reinecke proposes an explanation for this: girls and boys in modern society are socialized differently. Boys are socialized to take action. While not always helpful in managing their problems, it helps get their mind off of them for a time. Girls are pushed to dwell on their experience.

"What you can get sometimes is a reverberating "echo chamber" of girls who are sharing these experiences and these thoughts and it potentiates the negative feelings, the depression," Reinecke says.

Closed social media sites facilitate this grouping even more. Communities are set up all around affinities, designed around developing homogenous social groups rather than diverse ones. Eric Meyers, assistant professor of information science at the University of British Columbia, calls this the Silver Bubble Problem. When you search for things repeatedly, the system tends to retrieve similar things to present to you.

"Things don't challenge your world-view," Meyers says. "You don't get contact with other ideas, and as a general rule you tend to discount them anyway. There [are] both empowering and challenging aspects of [social media]. There have been a lot of really great civic engagement opportunities for young people that have come out of social media. At the same time, there is a lot of narcissism and stewing in their own juices."

The teenagers who group together and, in Laura's words, "feed off of each other's obsessions" contact other teenagers with the same ideas, the same attitudes. Reinecke says identifying with people with similar views, in this case others who claim to be depressed, just reinforces that feeling.

"Teenagers will say, 'My friends understand me. They get it,'" Reinecke says. "All right, good, but when you're with them, does it lead you to feel better? Do they give you a different perspective on the world, or different things that you could try to improve things? The answer is: 'Well, no, but they do understand me.'"

The Silver Bubble Problem makes it difficult for those inside the community to see the outside world in the first place. But they often don't want to get out because to leave the community would be to lose the people who understand them.

"It's important for suffering people to have these communities online so that they can talk," Laura says. "It helps people who feel isolated."

Laura describes how difficult it was to get out. She managed because of people in her non-virtual life who made her realize she had to stop doing these mildly masochistic things to herself. She decided to stop following self-harm blogs and hasn't been on "Prettythin" for at least eight months.

"I just wanted a sense of community, to find people who felt the same way I did without having to reach out on my own, because that was quite daunting," Laura says. "I felt different. The community is telling themselves that they're different." Today, Laura looks at her own case with more perspective, understanding that a sizeable part of what she felt then had to do with this culture. She now says she is well on the road to recovery and instead uses Tumblr as a provider of inspiring images.

This sense of being different, of understanding the world for what it truly is, is the gratification these teenagers seek. If they are part of this community, they are part of something dark and beautiful, something misunderstood by the rest of their peers. They have depth and secrets that no one else can understand.

For a fragile mind, these communities seem to provide the perfect solution: support, understanding, acceptance. To be accepted by this community, they have to advertise their suffering. Teenagers thus subconsciously choose to suffer to fit in and get acceptance, says Laura.

Despite the ongoing expansion of the virtual world and all its nooks and crannies, the problem is avoidable, according to Laura.

"If you don't go out of your way to find those things, you won't come into contact with them," she says. "A lot of [young people] don't really try to avoid it. It's the responsibility of the people that go online."

For Kutcher, the solution lies in recreating the distinction between normal emotional states and the clinical condition of depression and the way to go about this is through education, especially of professionals that work with young people at schools or other institutions.

"It's quite easy to differentiate," Kutcher says. "You just have to know what kind of questions to ask and understand what the answers mean. But we don't have the cadre of trained human health services providers that have those skillsets, frankly. That's another huge challenge that we have: to educate the people that the kids will go to if they need assistance." 


    






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