Privacy about depression on Facebook: Even to online "friends"

Alex is one of the young people whose experiences with psychiatric medication Kaitlin Bell Barnett chronicles in her recent book, Dosed: The Medication Generation Grows Up.

Alex, who began taking antidepressants for anxiety, depression and obsessive-compulsive disorder at age 10, had been a loner since childhood: He kept to himself and was happy about it. But as he grew older, he had periods of extreme anxiety and depression during which he felt an uncharacteristic need to reach out to others.

While in his early 20s, Alex quit his medications, frustrated that he had tried a series of different drugs without seeing his symptoms disappear. A few weeks after stopping the drugs, he fell into a deep depression. Alex had previously experienced depressive episodes during which he was seriously suicidal, but this time he didn't actually want to kill himself - he was merely having thoughts of hopelessness. Unfortunately for him, he decided to obliquely share these thoughts of hopelessness on his Facebook wall, leading to a harrowing experience:

  

Someone he'd met through one of the social network's groups interpreted the post as a suicide threat and somehow notified the public safety department at Alex's college, which in turn sent the police to Alex's house.  The police took him to the emergency room, where, although Alex insisted vehemently he wasn't suicidal, staff judged him a threat to himself and had him involuntarily committed to a psychiatric ward for two days.  He considered the experience ironic, given his attempt to be hospitalized at the same unit four years earlier, when they told him they wouldn't admit him unless he had a plan to kill himself. The take-home lesson is:  he is far, far more careful about what he discloses, even to online "friends."  

Had Alex actually been suicidal, his Facebook friend's actions might have saved his life. But as it was, it caused Alex a great deal of unnecessary trouble and anguish.

The episode highlights the complications of sharing dark thoughts and musings over social networks - and raises the difficult question of what the networks and the people on them should do to help or intervene. 

Kaitlin's Advice:  If you're feeling like you really need support and want to reach out to people over social networks, you might want to consider contacting people individually through a chat or a message, so there's an opportunity for back-and-forth communication and your words don't get misconstrued. Facebook users should know that if they post an update with suicidal content, anyone who can view their updates can report it to the social network's administrators. If someone does report suicidal content, the user who posted it will receive an email with a link to begin a confidential chat with a suicide prevention hotline worker. Facebook also has a resource center giving advice about how to help someone who has posted a suicidal comment. 

Mental health blogger Natasha Tracy has a great post with advice about how to respond if someone posts a suicide threat on Facebook. 

Read another anti-depressant medication adherence story.  Thanks to Kaitlin for this excerpt from her book, Dosed:  The Medication Generation Grows Up, and to Bethany Sales of Newman Communications for connecting us.