Rules of engagement, mental health and the internet

When you experience a mental illness, it can feel strange and even embarrassing to talk about it face to face. Many of us use the internet as a way of venting feelings anonymously, but can we always assume that this is a good thing? What kinds of rules might be helpful for us to follow when dealing with sensitive subjects like mental health in an online environment?

So many of us are using the web to talk about psychological distress these days. Hundreds of mental health blogs function like openly accessible online diaries. Posts like this one from Purple Persuasion can offer compelling insights into the experiences of individuals negotiating the mental health care system.

Charities like Mind provide online peer support groups, such as The Elephant in the Room, in order to try and combat common isolation among sufferers of mental illness.

I started my own blog Group Therapy in April 2010, after suffering intermittent bouts of depression across a period of years. Although I had reached a point where I was ready to start externalising some of my experiences, telling close family and friends how I was really feeling was still too daunting. So I told the internet instead.

Two years after starting my blog, I am completing a research qualification where I am considering the value of using online writing to help with mental health issues. During my studies, I have found plenty of evidence to suggest that confiding in a computer can be just as intimate as talking to a therapist.

For example, in the introduction to a special edition of The Journal of Clinical Psychology, Michelle G.Newman suggests that: "When questioned about sensitive areas such as criminal history, alcohol blackouts, sexual disorders and suicidality, clients will disclose more substantive information to a computer than to a clinician."

Yet the anonymity provided by the Internet can also have negative consequences. Internet 'trolling' is a common practice that involves a person posting abusive comments under a pseudonym. This can be intimidating and irritating for other web users.

In her recent book Alone Together, social psychologist Sherry Turkle has suggested that online personas are a means of avoiding the intensity and intimacy of so called 'real life' relationships. She says: "Digital connections may offer the illusion of companionship without the demands of friendship."    

Whatever your beliefs about the internet, it's likely that you will come across someone expressing feelings of intense psychological distress in a blog, forum or social networking site at some time. Or that you may even feel tempted to share those feelings yourself.

Knowing exactly how to engage and respond can be difficult.  Here are three simple rules of engagement that I think can help make online interaction a mentally healthy experience.

1.    Communicate

As well as sharing your own experiences, don't miss out on the opportunity to respond to others. Try to listen and encourage. A conversation about mental illness should not be a competition to prove which one of us has the worst symptoms! Amanda wrote well about this topic in her blog post We're all different, lets not compare our illnesses.

2.    Remember it's public

It can be cathartic to unload intense feelings in public forums, but many people still find subjects like suicide and self-harm deeply distressing.  Before you make very personal posts, consider the reaction of work colleagues and family who may see through your anonymity.

3.    Connect to offline support

If you come across someone who is extremely distressed, encourage him or her to seek other forms of offline support. If they've been unwell for a long time, they might have access to a crisis team or other medical professionals. While online support can be valuable, your influence is limited. Don't put pressure on yourself by being the only source of support.