One of the fundamental changes in the way we talk about mental health in recent years has been the use of social media. Ten years ago, having a conversation about depression, anxiety or a phobia online – or anywhere else – would have been comparatively awkward and uncommon.
But, in 2018, there is now a fundamentally different attitude to talking about mental health as celebrities and the population in general open up about their struggles with anxiety, depression and related issues – the #TimeToTalk campaign is a great example of this. This is obviously a very good thing – awareness, lessening of stigma and a more open approach to mental health means lots more people will seek help.
However, there is an unhelpful aspect to this trend, and one that we’ve seen become increasingly common. Before I explain what this is, two concepts need to be understood.
The first is the concept of secondary gains. A secondary gain occurs when there is an unintended benefit related to being unwell or suffering from a something like a mental health issue. For example, a secondary gain from suffering from depression might be related to having some time off work, which gives you a chance to do some life admin, avoid a dislikeable boss or catch up on your favourite box set.
Maybe your friend or relative will come round and spend a few hours being kind and helping you or, if your mental health story is interesting, the local press might want to interview you. There are several very popular magazines with lots of true life stories featuring people still suffering from mental health issues, many of which pay for stories.
These are secondary gains and, in general, there is nothing wrong with this. Hardly anybody would consciously pretend to be ill just to gain attention or (although, obviously, this does happen and it’s called Munchausen’s syndrome) and it’s nearly always an unintended by-product of the illness.
The second concept is that lots of people suffering from a mental health issue feel helpless and let down by many of the treatment pathways currently available. The NHS are working their socks off to treat people but they’re poorly equipped to deal with lots of mental health issues.
The go-to combination of CBT and medication advocated by most GPs and NHS practitioners has a remarkably low rate of success. And when this intervention doesn’t work – despite supposedly being effective for lots of people – the patient inevitably feels more broken, helpless and ill than before. Alcoholics Anonymous are another example of a treatment pathway for a mental health-related issue that has a very low rate of success. This treatment failure adds to the feeling of helplessness and often marks the start of many years of poor mental health – it’s a story we see, sadly, on a regular basis.
Back to social media: combine the above two concepts and you’ll understand why the idea that being stuck with a permanent illness, or disorder, can work for some people as a modus operandi, even though, in many cases there is something that can be done to address the issue.
But they believe there is nothing that can be done to help them, given their past experiences of seeking treatment, and connecting with a community of like-minded sufferers via social media is their way of processing this problem in their life.
They gain comfort from conversing with others in the same situation, creating an echo chamber that confirms their belief that they’re stuck with this illness and this is what defines them. This is their secondary gain from being ill and, for some people, it forms the basis of their social media presence and who they are in general: I’m ill, so I and everyone around with me just has to deal with it.
There are a lot of good conversations about mental health happening on social media and it’s undoubtedly helping many people seek out treatment that puts them in control of their mental health, but for some it’s one of the main factors keeping them from really believing they can get better or cope with their issues and live a normal life.
After all, if everyone they converse with in relation to their mental health feels the same way – broken, helpless and stuck with it for life – why should they believe their plight to be any different?
From the perspective of an organisation that helps people overcome mental health challenges, we would strongly recommend anyone suffering with an issue to take an honest look at how they use social media and ask themselves: is this really helping me overcome my issues? Or is it just re-enforcing my unhelpful beliefs about my illness?
Instead of posting about your mental health struggles, why not have a chat with us about what help is available so you can change the conversation from about being unwell to how great you’re doing. Wouldn’t that be an amazing thing?