What can the internet teach us about mental health? – Sam Voss, MSW

*(the examples provided below are composite cases, synthesizing disguised information and not any patient in particular)

Social media has emerged as an interesting platform in the fight to reduce the stigma surrounding mental health. The World Health Organization reports that one in four adults suffers from a diagnosable mental disorder within a given year, yet mental health is a concept that is often misunderstood and misrepresented. Because social media is an ongoing conversation, the taboos that accompany mental illness have diminished, many people feel free to discuss their personal journeys.  Clients have often said, “I was reading this Twitter feed, and it said….” The content of many Twitter feeds provides a model for describing their own symptoms.

When the abstract concepts of anxiety and depression have a real-life example, the client is better able understand his/her own diagnosed experience. This model can also serve as a point of connection to his therapist and family. It allows the client to express to his family: “This is what is happening when I feel ‘crazy’.” Using these real-life examples leads to the discovery that the experience is more common than has been realized.

This can also be a double-edged sword. In graduate school, I took a class about the diagnosis of mental health disorders and I found myself sorting everyone in my life (including myself!) into categories. Was this behavior indicative of a depressive disorder? MAYBE my friend’s difficulty in the dating world was due to a personality disorder! Is he manic? Should I suggest therapy!? I had to work to regulate my judgments.  With some self-reflection, I was able to understand my need to diagnose: I was excited about this new skill and wanted to apply it to my life.

Occasionally, I notice that my clients have the same experience. In an effort to understand themselves and the dysfunction they observe in their lives, they turn to the Internet and other resources for answers. This has led to many fruitful conversations about the ways symptoms manifest themselves, and how the client understands themselves. It also allows us the opportunity to examine whether a certain label fits— or doesn’t— and what it means to the person to have a specific diagnosis.

For example, 37-year-old Kesha, who was diagnosed with depression during her intake session, said that she felt attached to a diagnosis of post-traumatic stress disorder (PTSD). Kesha and I had worked together for several months when she introduced the subject of PTSD. Our work prior to that time focused on the way her mood impacted her personal relationships. As we explored, Kesha reported that PTSD felt more serious than depression.  If she had a more “serious” diagnosis, other people would understand her helplessness in controlling her emotions and her behavior. The conversation helped me understand the hopelessness that Kesha felt about her ability to relate to others. This realization provided us new ways of thinking together about her situation.

For therapists, an initial diagnosis provides the understanding of a client’s symptoms and an informed consideration of the modality of treatment. For clients, a diagnosis often means the beginning of a successful investigation. Exploring the intersection of these points of view is an important part of the therapeutic work.

As therapists, we welcome the client’s curiosity about themselves and help them learn more about their symptoms and how to improve them.

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