Freddie deBoer on the phenomenon of mental health culture online and the two primary kinds of participants (my headline over-dramatizes the case he’s actually making):
I was not, at first glance, inspired with confidence by this Washington Post piece on online mental illness culture. The piece has a header image of a “mental illness influencer” lounging in bed, taking a selfie. I’m someone who’s committed to de-glamorizing mental illness, and I’ve been begging people to stop romanticizing pathology for a long time. I suppose there’s an implied critique in that photograph, but it’s not ideal.
On substance, Tatum Hunter’s piece fails the way so many others have failed in this milieu: it studiously avoids the possibility that some people who talk about their mental illnesses online don’t really have them. I’m not specifically talking about simple fraud and lies, which I suspect are rare, but rather the weird combination of hypochondria, Munchausen’s syndrome, and social contagion that we see all around us in these spaces. Spend any time at all in these communities on Tumblr or Tik Tok and you will find many people, most of them young, who are using mental illness as a means to self-define, to differentiate themselves from the hordes of other people they see online who are just like them. I’ve written again and again about why it’s a bad idea to want to be your mental illness, and it’s even worse to want to be mentally ill, period – not just bad for other people, but bad for you. But there are people who have become influencers and garnered hundreds of thousands of followers on their apps of choice by performing mental illness. People use their disorders to chase clout. That’s just reality.
Hunter considers the problems of misdiagnosis, of self-diagnosis, of people undertaking mental health care on the advice of internet randoms rather than under the care of a doctor, but nowhere does she seriously consider the possibility that the basic problem for many people is that they believe they have mental disorders they don’t in fact have. I think doing so is seen, at this point, as a kind of identity crime, and thus unlikely to be found in the Washington Post.
But hypochondria exists. Munchausen’s syndrome exists. Psychosomatic illness exists. I can get people to admit to those realities in the abstract, now, but they stay entirely in the abstract – to suggest that any group of people is suffering under those conditions, rather than under authentic mental illness, is treated as a sin. This was my biggest disappointment with Ross Douthat’s book on his chronic illness, which I quite liked overall; Douthat never stops his narrative to ask whether any of the people who believe themselves to be sick from chronic illness actually aren’t. (Surely he himself suffered, but because of the woo and mysticism found in that space, an accounting was necessary.) And I don’t know how we confront the spiraling number of people claiming to have illnesses for which there are no objective tests without being frank about the existence of hypochondria, Munchausen’s, and psychosomatic illness – particularly when people insist on deepening the social incentives by giving the sick more and more attention.
Even for the authentically ill, online culture is fraught. The meta-problem with pieces like that in WaPo, obviously, is that by giving certain members of this community the glamour shot treatment (literally in this case), they’re creating direct incentive for people to make illness their identity -and to not get better. Young people understand the allure of being seen; they don’t yet understand the horror of being frozen in other people’s gazes. They don’t understand the costs of being defined. There have been many opportunities for me to make myself the mental illness guy, certainly including financial opportunities. Perhaps I’ve already fallen into that trap, despite my efforts to remain a generalist. But I’ve fought to avoid that because I know just how painful and limiting self-definition can become. I’m sorry to pull wizened old guy here, but young people don’t understand. They don’t understand that pinning yourself down that way can produce a kind of horror.
