Sharing Mental Health Memes Is Making Things Worse, Not Better

Richard Dawkins was the first person to float the term 'meme'. In his 1976 book The Selfish Gene, the controversial evolutionary biologist wrote that a meme was "a unit of cultural transmission – the cultural equivalent of a gene". In Dawkins’ mind, memes referred to "tunes, ideas, catchphrases, clothes fashions, ways of making pots or building arches". The word has evolved considerably since the 1970s but the gene analogy holds for our modern online lives: "Just as genes propagate themselves in the gene pool by leaping from body to body via sperms or eggs, so memes propagate themselves in the meme pool by leaping from brain to brain." 
Millions of memes leap from brain to brain every day through social media. They have been circulated since the 1990s (the dancing baby first appeared in 1996) but are now an entire lexicon, each image moving in waves of appropriation and reappropriation at a scale unimaginable to us when we’re scrolling and chuckling alone. The shelf-life or ‘success’ of a meme can vary but the primary function – getting a laugh, hopefully thousands – remains the same.
This is also true for the recent explosion of mental health-related memes on Instagram in particular. There, all manifestations of human emotion are rendered into droll, irresistibly shareable squares. There are memes for everything that could fall into the bracket of 'mental health': depression, anxiety, eating problems, addiction, neurodiversity, bad therapy experiences, medication withdrawal, inpatient care and beyond. Terms like ‘triggering’, 'dissociating’, ‘trauma’, ‘intrusive thoughts’ and ‘attachment theory’ have eclipsed clinical settings and become common parlance as our collective awareness of mental health issues has expanded, informed by the powerful (but challenged with increasing fervour), diagnosis-based medical model. Memes have continued to reflect this. 
There are hundreds of meme-aggregating accounts with six-figure follower counts. These carefully curated galleries of bleakly funny or surreal pictures often place the individual at the centre; a pathologised punchline. In a world that can feel oppressive and lonely beyond the edges of our devices, making and sharing these memes makes sense as a way of connecting, coping and finding validation. "I often find comfort in autism-related memes that I can share with friends in the community," says Sarah, 31, from Essex, who was diagnosed with autism last year. "The shared, knowing lol is nice. But I’m aware that I afford consistent therapy and that the internet is probably saturated with mental health memes because people have been failed by the system and are looking to find themselves elsewhere." 
Last year, The New York Times ran a piece on how the dark humour of memes on addiction recovery accounts like @dankrecovery and @brutalrecovery can provide a good laugh to those navigating sobriety. A bleak, knowing laugh (as someone with a propensity for anxiety, I’ve snorted at every anxiety-related meme that utilises the Suez Canal-blocking ship and the tiny crane trying to move it) can be important in all kinds of settings. Laughing releases endorphins, which make us feel relaxed and calm. A significant study in 2017 also showed that laughter can relieve pain. But not everyone will perceive these images in the same way. 
One research study showed that so-called ‘depression memes’ are rated as more relatable and funny by those who consider themselves to be depressed than by those who don’t. Some people may find the memes disturbing. This difference in perception could speak to the idea that those well-versed in navigating difficult emotional states have a darker sense of humour. Whether or not this is true, the connection found in these memes – a like, a share, a retweet – can be fleeting. It is facilitated by social media platforms: omnipotent capitalist structures that are designed to engineer and exploit our emotional responses. To my mind, this warrants interrogation. If we do see shades of our own painful experiences in a silly image, what comes after the laugh we’ve had in bed, alone, in the dark? Does the growing popularity of mental health memes, and their content, reflect a deep well of unmet needs?
Mental health-related memes are shared by all generations but are particularly popular among young people. "My Instagram discovery tab is full of depression memes because, like so many of my friends, I have been looking at them for years. But I find them a little dangerous now," says George, 27, from Manchester. "There is sometimes a sense of powerlessness to them, which makes me pity myself a bit." Many young people make their own memes on accounts that chronicle their emotional distress. While researching this piece, I discovered many accounts run by young people that contained meme-heavy content relating to self-harm and eating problems which I found upsetting. When I contacted Facebook (which owns Instagram) to provide some information on the scale of such content and how it was shared, they were unable to provide specific data. They asked me to flag the accounts that concerned me and said they’d removed some – but not all – of the content. 
The Facebook recommendation guidelines do state that people can share their experiences, with some caveats. "Mental health and eating disorders are extremely complex issues, and no one at Instagram takes them lightly," a Facebook company spokesperson said to me over email. "We’ve never allowed people to promote or glorify self-harm or eating disorders on our platforms, and have updated this policy to ban even more content, including fictional depictions, like drawings or memes. We work with safety experts, including Beat in the UK, to develop our policies and we aim to strike the delicate balance between giving people the space to talk about their experiences and seek support, while protecting others from harmful content." 
The balance is, indeed, delicate. "I tend to advise not making sweeping generalisations about social media, because there are lots of positives," says Dr Jen Wills Lamacq, a child and educational psychologist who lectures psychology students on social media at University College London. "I can sense a liberation in young people feeling able to voice something that, in a different life, would have been something they would feel ashamed of. There is a kind of hedonism in saying, ‘This is me, and it’s fine!’ It is encouraging that there is a generation who are happy to embrace their quirks. But as a clinician, I question whether it is a wholly positive thing to be sharing these elements of ourselves online." 
Jen, who works across the age spectrum of 0-25, says she has noticed a "definite shift" in the way young people talk about their emotional experiences. "There is a sophistication to the language that leans heavily on clinical terms that they may well be picking up from social media, particularly in relation to neurodiversity and terms like ADHD," she explains. "I have to do quite a lot of work with young people to think about what having a normal range of emotions means. For example, what is the appropriate response to having an exam or falling out with your best friend? These are stressful to someone at an early stage of their development but I think some young people are becoming afraid of feeling difficult things." Jen is also keen to stress that while helping to de-pathologise emotion is important, "there may be someone with very real distress who needs a skilled professional to support them." The problem is who might be there to provide such support. "Waiting lists and referral thresholds are so high, which means young people and their parents are turning to the internet. There is an absence of other places to get information or have those conversations. It can be hard to get support unless you’re in crisis," she explains. In the meantime, what role are memes serving?

Does the growing popularity of mental health memes, and their content, reflect a deep well of unmet needs?

Dr James Davies is a reader in medical anthropology and mental health at the University of Roehampton. He is a trained psychotherapist and the author of Cracked: Why Psychiatry is Doing More Harm Than Good, a powerful and divisive inquiry into the murky science at the heart of psychiatry. His new book, Sedated: How Modern Capitalism Created Our Mental Health Crisis, asks why, despite the ever-increasing diagnosis of mental ‘disorders’ and more people taking psychiatric drugs than ever before, so many of us are not feeling better. The short and long answer being capitalism. James feels there is "deep discontent and cynicism" in this online space, which reflects how the mental health sector is responding to people’s distress. "There is some affirmation, which can be helpful, but the true value of these memes is revealed through analysing their social function, which is to communicate deep discontent. That discontent is legitimate, because for so many people, the sector isn’t working." 
In the last decade, the NHS radically overhauled the structure of psychological therapy services. Since the Improving Access to Psychological Therapies (IAPT) plan was launched, we have been told over and over again how more people than ever before (those with "mild to moderate mental health problems") would be able to access therapy, which is commendable. But aiming to treat as many people as possible also means that the system serves the state more than the individual. The priority is to get people experiencing distress back to work as quickly as possible. "It is not about living a more meaningful, rich existence with a sense of purpose; it is about getting off benefits and not being absent from the workplace," says James. 
Wholesale condemnation of IAPT is unfair. Some people may find the very act of talking to someone helpful, as well as being educated on the particular features of anxiety or depression. Others will find that the goal-orientated, symptom-management model means there isn’t the time or space to explore the deeper causes of their distress: experiences of trauma, oppression, political policy, the difficulty of modern living. There are therapists in IAPT services doing admirable work under ceaseless pressure from clinical commissioners to see people faster and more cheaply. NHS England states that 95% of people should be able to start treatment within 18 weeks of a referral. But so many people wait far longer for regular support. The outcome of talking therapy depends so much on the relationship and sense of trust developed between a client and a therapist. Within this framework, the scope for finding and holding that relationship, or a deeper understanding of the self, is limited. As experienced psychologists have pointed out, it was not always this way.  
The limitations of the mental health system and the powerful connective tool of social media have together created a huge market for individuals to step up and offer clear-sounding answers. The proliferation of life coaches and ‘practitioners’ selling their own brand of healing has been fascinating to observe in recent years. People entering this space will do so with the best intention – to help people – but we cannot ignore that this is a market. Money is exchanged, often lots of it. I recently looked at what a popular ‘practitioner’ in the female wellness sector was charging for coaching and nutritional advice and it worked out at £120 per session. I don’t know a single psychologist who charges this much for private work. The point is, where potentially vulnerable people are concerned, the power dynamic of client-and-practitioner must be open to criticism, along with the training and regulation – if any – which informs it. 
"The Instagram accounts of life coaches I’ve seen are incredibly seductive. There is an immense confidence in these people and confidence is reassuring," says James. "But the sector is not regulated. If you are not held to account, there is no accountability. You don’t have to demonstrate capability beyond putting cherry-picked testimonials on your website. I’m a psychotherapist so I would say this, but there is a stark difference to having gone through five years of hard training, working on the front lines of the NHS, having no money, constantly under supervision and constantly having to be accountable." 
So what is the perceived capability of someone offering to be your guide to ‘manifesting' via packages called ‘expansion accelerators’ or offering to be your unofficial guide to sobriety a consequence of? "Marketing," James says. "If you sell yourself as the answer, you begin to believe you are. While this is happening, there is a massive mental health crisis. We are not going to solve the crisis by way of affluent middle-class life coaches helping affluent middle-class people." 
The way coaches market themselves on social media feeds into the wider memeification of emotion. Many make memes of their own quotes on Instagram. If this isn’t a clear emblem of capitalism and individualism, I’m not sure what is. It would be unkind to assume conceit but what is the aim? For the image to be shared, touch someone and generate business? Whether we’re selling something, looking for something or just scrolling, we are all being incentivised to absorb information in this compulsively bitesize way. It is a market of aphorisms. Increasingly, when a meme from someone selling a service touches on emotional distress or need, some scepticism about the world in which it exists seems healthy. This is also true for qualified therapists who have pivoted to Instagram
The hugely popular psychologist Dr Nicole LePera, better known as The Holistic Psychologist, has met understandable criticism for generating a guru-like position on Instagram. Her content is very binary, with neat, highly shareable graphics that pit 'healthy' behaviours against 'unhealthy' behaviours. I used to think LePera was providing something quietly revolutionary. Sometimes I find her analysis of interpersonal relationship dynamics interesting. But I am deeply sceptical of any approach that implies a dogma to emotional healing, particularly if money is being exchanged without being accountable to anyone. I am worried, too, about LePera’s generalising of the word 'trauma' to mean 'childhood wounds'. Trauma is subjective but LePera (and others) have created swathes of content that does not really touch on what 'trauma' can mean in a clinical sense. Those experiencing very distressing manifestations of trauma may find the content reductive. Other psychological professionals I have spoken to have shared concern over the blinkered focus on self-responsibility. 
It is true that in order to heal, we have to learn to be responsible for our actions and make the conscious choice to be accountable, while also learning to accept ourselves. This is the focus of many therapeutic models. But in rooting pain – and the capacity to heal it – firmly within the individual, we risk ignoring what isn’t ‘ours’. Where powerful systemic oppression like poverty or racism is concerned, this isn’t good enough. As individuals in the Black community have rightly put to LePera, the emotional damage of racism is not a Black person’s fault. Nor is it their responsibility to teach white people what to do about it. LePera’s response to individuals challenging her on such matters has not reflected well. Of LePera’s nearly 4 million followers, you wonder how many would pause to think about this.
Whether or not individual healing – or whatever term we want to use – can be helped in some way by slick, shareable content on social media is precisely that: individual. Maybe little bits here or there can spark meaningful conversations or bring a laugh in the dark, which is hard to argue with. A fleeting connection is still a connection. But beneath the interface of a distracted boyfriend meme saying something pithy about a troubled mind is a much deeper problem. How much self-awareness is really generated when we scroll away? If we tag someone in an ADHD-related meme that tells us to tag ourselves if we relate to whatever is in the image, giving away our data in the process, who are we actually helping? The commodification of distress is a big, uncomfortable conversation but it needs to start happening.
Eleanor Morgan is an assistant psychologist and author of Hormonal: A Conversation About Women's Bodies, Mental Health and Why We Need to Be Heard

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