What goes too far on social media?

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Is there a limit to what’s ok to post on social media? I’m not thinking about trolling and other such nastiness, but rather about widely broadcasting messages about being suicidal.

I’m not a huge social media user, but I do spend some time on Twitter. I follow around 2500 accounts, pretty much all of which are mental health-related. And it’s not all that unusual to see a tweet from someone who is actively suicidal, and the post conveys a sense of imminent risk to act.

I have such mixed feelings about this. Yes, I think it’s important for people to talk about their mental health, including thoughts of suicide. I know of one particular instance when a social media post by someone who had made an attempt led to first responders getting to the person’s home in time to save them. So absolutely there can be value, and I don’t want to detract from that at all.

Still, it concerns me when posting on social media (and I’m referring to broadcast posts rather than direct messages) is chosen as the way to reach out for help when someone is feeling immediately suicidal. I say immediately suicidal because I think there’s a big difference between someone posting that someone has been struggling with suicidal and someone posting that they won’t be alive tomorrow. There’s probably also a difference between a blog post where a broader context is given and a short social media post that’s not long enough to place the suicidal statement in a proper context.

I think it’s a good idea for all of us who experience thoughts of suicide at one time or another to formulate some sort of crisis plan. That can be something more formalized and written out in the form of a Wellness Recovery Action Plan (WRAP) or something along those lines, or it can be something more informal in the back of our minds. I don’t think broadcasting on social media should not be on the list of options when things reach crisis stage. Crisis support needs to happen on a one-to-one basis, not on a one to several thousand basis.

If crisis messages do get put out there for the world to see on social media, that can have unintended negative consequences. If the post gets lost in the massive shuffle of social media and no one responds, the poster may think no one cares and end up feeling even more alone. But the biggest issue is the potential to trigger others. If the poster is well connected in the online mental health community, there is an even greater potential to trigger others.

Also, what are readers of the social media post to do? Perhaps some readers will know enough about the poster to inform emergency services, but most will not, leaving them powerless to do anything concrete to help. I’ve seen suicidal posts and thought that I just didn’t have the capacity to take that on, but it’s hard not to feel a sense of guilt just scrolling on by a post like that.

At the same time, during periods of high suicidality, rational thinking is not operating at its best. That’s where a crisis plan can really be helpful, since it’s thought out ahead of time when rational thinking is accessible.

It made the news not too long ago when comedian Pete Davidson posted a message on Instagram implying that he was suicidal. “I really don’t want to be on this earth anymore,” he wrote. “I’m doing my best to stay here for you but I actually don’t know how much longer I can last. All I’ve ever tried to do was help people. Just remember I told you so.” In this case, he was well known and when readers contacted police they were able to do a wellness check, and he performed on Saturday night Live a few hours later.

Pete Davidson has a diagnosis of borderline personality disorder (BPD). I’ve noticed on my Twitter feed that many of the people posting about suicidality with imminent intent have BPD. I think there are a few factors of the illness that likely play into this. The combination of recurring suicidal ideation, rapid shifts in mood, and impulsivity can produce intense spikes in suicidal thinking. As a very broad generalization, in mood disorders the suicidal thinking is often more sustained than having abrupt spikes. I suspect that it’s these kind of spikes that are most likely to result in these kinds of social media posts.

To take a brief detour from suicidality, I also believe very strongly that graphic images of self-harm do not belong on social media. That can be profoundly triggering to so many people, and that’s not ok. There was a post on Twitter not too long ago with a very graphic image, which caused quite a stir among other members of the mental health community who were very triggered. There are many ways to reach out for help, but no matter how desperate someone is, a blood-filled picture on for thousands to see on Twitter is not the right way to get help.

Desperate times call for effective pre-planned measures. When things get to crisis stage, it’s time to reach for crisis-appropriate resources that can provide concrete, meaningful assistance in a timely manner. As a mental health community we should be supporting each other in opening up and accessing effective help earlier rather than later, and if at all possible we should try to avoid doing things that will end up multiplying our pain by triggering others.

Originally published at mentalhealthathome.org on March 7, 2019.