Friday, December 18, 2015

The Mental Health Warriors of Instagram

Cassie, 21, is one of a number of MH Warriors supporting each other on Instagram

"Imagine your body is a car. Everyone in the car can drive but only one person can be in control at a time. If you are in the passenger seat, you can easily communicate with the driver, but those in the back seat sound a little distant and it is harder to communicate with them. Everyone can move seats in this car at any point, suddenly without warning. This car is my body. This is what it feels like to live with DID."

Cassie is 21, and in many respects she is just like any other alternative Scottish girl. She likes dying her hair in colors like purple and blue. She describes herself as an "ethical vegan." She likes to sing, and play guitar, and is in a long-term relationship with her girlfriend, Fi. But Cassie isn't your average 21-year-old. She lives in an in-patient ward, and has spent more of her life in the hospital than out of it, battling anorexia, DID (dissociative identity disorder) symptoms, OCD, and self harm. Her life is documented through her Instagram account, on which she has over 10,000 followers, the majority of whom are also dealing with various mental health conditions. The girls in this community refer to themselves often as "MH (mental health) warriors," and the community allows them, for the most part, to help and support each other through whatever problems it is that they are dealing with.

"That common understanding and sympathy toward each other's situations was probably the best thing about recovery communities for me," explains Daisy, a recovered sufferer of anorexia who became a part of the "recovery community" in October 2013. Often, sufferers of eating disorders will search the internet (on sites like Twitter, Tumblr, and the Instagram app) for things related to the illness; it isn't uncommon for anorexia sufferers to spend hours obsessing about food, or poring over recipe books. This is the same for people who are sick, but also in recovery, who frequently cite feeling "alone" or "misunderstood" in their struggle to recover from the illness. "I think I was aware of what was happening to me and so I was looking on the various #anorexia and #anorexiarecovery hashtags to see if anybody else was going through the same thing," explained Daisy, describing how she first came to join the community. After following a few Instagram accounts ("mostly girls") devoted to eating disorder recovery, Daisy made her own account and began to post photos of her meals throughout her journey to health.

Mental illnesses can be self perpetuating, as sufferers often lack insight into their own condition. Outside perspectives can therefore be incredibly beneficial in order to help people begin recovery effectively. It is for this reason that it has been found to be beneficial for patients in recovery to spend time with other people dealing with similar issues. This is why treatment for people with mental health problems often involves group therapy—someone who sees other people succeeding in tackling their illnesses can feel encouraged and incentivized to do the same thing for themselves. Daisy describes seeing others recovering as being a "big motivation" for her to start her own recovery, and told me that being able to support others also reinforced her own recovery. "Being a good role model gave me comfort in the process," she explained. She still receives messages from other people in the community, telling her she has helped them in their recoveries. "You do become very emotionally invested in other people's lives and recoveries," she admits, "and that can be seen as a good thing, or a bad thing."

Cassie says the MH community helps her deal with her DID (dissociative identity disorder) symptoms

For Cassie, her Instagram account acts not only as an aid to recovery for herself and others, but as a record of her own state of mind. DID is a relatively unexplored condition previously known as multiple personality syndrome. Cassie's condition presents itself as eight different personalities (the official term for which is 'alters'), varying from age four to age 26, and depending on which is in control of her body at the time, the content of her Insta account will vary. "Imagine someone hacking into one of your social media accounts and you find a post you never wrote," she explains. "That is what it feels like, except I know who made the post." She sometimes worries that one of her alters might post something inappropriate to share on social media, but at the same time she describes her profile as a "good way of keeping track of what we've all been up to." DID is thought to be caused by repeated childhood trauma, with the dissociative aspect being a coping mechanism the individual uses to protect the conscious self. Psychologists believe that if an adult experiences a very traumatic experience, it can result in them showing symptoms of PTSD. When children experience extreme trauma they are more likely to show symptoms of DID, both in childhood, and later on into adulthood, perhaps because of their use of imagination as a coping strategy. "I had blank spells, and chunks of my life seemed to be missing," Cassie says. "I often felt like I was out of my body, watching myself."

Within the general population, the rate of dissociative identity disorder is between 0.1 percent to one percent, and can be incredibly isolating for sufferers, who fear being unbelieved and alone. Within the community of "MH warriors," the condition is still relatively rare, but there are some people with the condition who can provide each other with the sort of companionship and understanding they would be hard pressed to find elsewhere. "DID is a very misunderstood illness so being able to connect with people who are going through the same thing has helped so much" Cassie says, when I asked her about her followers who have the same condition. "The support has been a godsend, because people 'in real life' don't always know how to respond to my alters, especially the younger ones." She worries that people might think some of the posts are written by her as herself, as her disorder is very complex to express. "As much as my alters and I share the same body, we are all different people."

Although the Instagram recovery community is nothing but helpful for some, there are others whom it does not benefit, and for those people it can potentially be detrimental and harmful. Following controversy surrounding 'pro anorexia' and 'thinspiration' accounts, Instagram has had an official policy for a while now, banning accounts and hashtags that promote self harm, including eating disorders. For a community of mental health sufferers, many of whom must still be 'ill,' in order to be in the progress of 'recovery,' there is a fine line between the healthy side of eating disorder recovery and the dangerous side of eating disorder promotion. Eating disorders are inherently competitive by nature, and when the focus of the community sometimes falls on 'body checking' and posting pictures of food to other people suffering with eating problems it becomes easy to see how recovery communities can sometimes contribute to a decline in the mental health of someone who is already sick.

After following a few Instagram accounts devoted to eating disorder recovery, Daisy made her own account and began to post photos of her meals throughout her journey to health.

"I spent an unhealthy amount of time on Instagram," Daisy says. "Every single thing that went in my mouth had to be arranged, photographed, and posted...it became quite obsessive." She remembers first joining the recovery community and noticing everybody putting their "highest weight, lowest weight, goal weight, and current weight" in their Instagram bios. There was also a phase of calling yourself the "king or queen of a certain food." Cassie echoed the same point of view, saying that you have to be "selfish" when it comes to your own recovery. She doesn't follow accounts that she thinks will trigger her, and unfollows people who she feels aren't taking their recovery seriously. "I am here to support others as they support me, but I will choose my battles," she adds.

For everyone in recovery communities, there must come a point when they have to leave. A part of being "recovered" would mean that the individual no longer feels the need to use the support of other people online. Daisy still has her original Instagram account, but she uses it for personal purposes now, rather than recovery. "I'm glad I left, as leaving has enabled me to recover to a level I wouldn't have if I were still posting all my food online," she remarked. "I reached a point where I felt it was holding me back."

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