mental health

Twitter needs to step up: One Direction, Zayn Malik and #cut4zayn

/ marisalancione / 3 Comments

Trigger Warning: This post contains conversation about self-harm, including graphic descriptions of images.

One Direction

One Direction or 1D as the kids say. See what I mean about the crazy hair?

I’m almost thirty, but I still have a vague knowledge of the band One Direction. In case you don’t know who they are, they’re a British boy band and have crazy hair. I think they may have been formed by Simon Cowell during X-Factor UK. Also, I’m pretty sure Taylor Swift dated one of them, except I know that more because I love TSwift.

But this week was the first time I had ever heard the name Zayn Malik.

Zayn is one of the five guys that makes up 1D (that’s how the cool kids refer to One Direction). For those of you who don’t know, last week Zayn left the band on the Asian leg of their tour citing stress related health issues as the cause. Then this week, Zayn admitted he was leaving the band – forever.

Cue wailing tweens who henceforth went into complete hysterical breakdowns.

Now as a child of the nineties, I can appreciate the love of a good boy band. My teenage-self loved the Backstreet Boys, *NSYNC, and 98 Degrees. Think back — weren’t you devastated when AJ left the band to go into rehab? Or what about when Justin Timberlake left *NSYNC? Yes, nothing was ever the same again. (Until BSB got back together and toured with NKOTB — The New Kids on the Block — my first boy band love. This was epic.)

Backstreet Boys

Yeah, I want it that way.

So, you’re probably saying to yourself — Marisa, this is a mental health blog NOT an entertainment blog. Why are you going on about some stupid band that I have barely heard of? Because the departure of this wacky kid named Zayn from 1D led to the hashtag #cut4Zayn to start trending worldwide on twitter.

Yes, a hashtag promoting self-harm was TRENDING GLOBALLY on twitter, and it wasn’t the first time.

Back in January 2013, the same trend erupted after a photo of Justin Bieber emerged of the singer allegedly smoking pot. The #cut4Bieber hashtag was started by anonymous 4Chan users. An article in the Daily Mail quoted a 4Chan user as saying, “Let’s start a cut yourself for bieber campaign. Tweet a bunch of pics of people cutting themselves and claim we did it because bieber was smoking weed [sic].” The hashtag quickly became the top U.S. trend on Twitter and was mentioned more than 350,000 times.

Zayn Malik

Zayn Malik of One Direction

Flash forward to Wednesday, March 25th and the #cut4zayn hashtag topped out at 96,250 unique tweets according to Topsy and having a potential reach of 607K per hour. The Independent reported that the brain trust over at 4Chan are allegedly responsible for starting the #cut4zayn hashtag.

Many of the tweets included gory images with blood and I even saw a Vine of a girl slitting her throat. To be honest, as someone who used to self-harm, I couldn’t really look at the hashtag in detail because it was triggering.

My question in all of this was — where was Twitter in both the #cut4bieber and #cut4zayn phenomenon? Shouldn’t they have intervened and blocked any user who used the #cut4zayn hashtag? Couldn’t they have removed the images — that are still there by the way — that were uploaded using the hashtag?

Twitter was silent and let the trend erupt.

But then I looked at Twitter’s Terms of Service and their Rules & Policies. Nowhere do they talk about images that promote suicide, self-harm, or eating disorders. The closest thing is that “you may not publish or post direct, specific threats of violence against others.” Moreover, Twitter allows users the freedom to:

“post content, including potentially inflammatory content, provided they do not violate the Twitter Rules and Terms of Service. Twitter does not screen content and does not remove potentially offensive content unless such content is in violation of the Twitter Rules and Terms of Service.”

Cutting

This was one of the images that was shared under the #cut4zayn hashtag

So Twitter doesn’t “screen content” and won’t “remove potentially offensive content” unless they violate their rules. I’m pretty horrified that the violent images that I saw don’t violate their rules or terms of service. The #cut4zayn tweets weren’t direct threats. No one was telling a specific person to slit their wrists or commit suicide (that I saw). But they were PROMOTING self-harm. At least ONE of the tweets demonstrated how to cut yourself “properly” to commit suicide by cutting. To make matters worse there were many tweets that were making fun of self-harm.

But no, none of this went against the Twitter Rules or Terms of Service.

It’s not like there isn’t precedent for social media intervening with content that promotes self-harm and suicide. Facebook started a new suicide alert system that allows users to report their friends, which can also be used to report users who may be engaging in self-harm. Both Instagram and Pinterest prohibit images of self-harm from being uploaded to its sites.

What I find the most horrifying is that our largest population of individuals that are most likely to self-harm are on Twitter. According to a survey about teens and their social media use, 59% of American teens are on Twitter. Now, if you combine that with the fact that 90% of people who engage in self harm begin in their teen or pre adolescent years and that rates of self-harm among teens range from 14% to 39% — doesn’t that make a hashtag like #cut4zayn a direct threat on the lives of our youth? Especially when self-harm related hospitalizations in Canada increased 110% for girls and saw a 35% increase for boys. Do none of these facts make Twitter feel like they have a social obligation to intervene when a dangerous hashtag starts trending globally?

There is a self-harm epidemic among today’s youth and hashtags like #cut4zayn or #cut4bieber, even if they are a hoax or prank by idiot 4Chan users, only add fuel to the fire. I haven’t self-harmed in over four years, but I was still triggered by the images that I saw on Twitter. Imagine a twelve or thirteen year-old kid who is feeling lost and alone and it’s not hard to see how these images and tweets could incite them to continue to self-harm or worse, start self-harming.

Twitter needs to make a move to change its policies now before someone gets hurt; or worse, dies.

In case you missed it, I had a great conversation with Courtney Keese, she blogs over at Courtney’s Voice and is also the content manager Stigma Fighters Teen, about this dangerous new trend. Check out the video.

Bipolar Mixed State: Into the breach

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This week has been extremely difficult. I have been in the throes of a bipolar mixed state. This means that I am simultaneously experiencing a depressive and hypomanic episode. This means that I have been dealing with rage and agitation while simultaneously being too exhausted to move. It is like being at war with yourself. Like hypomania, there is no sleep, but unlike hypomania there is no excess of energy. There is no elation. There is no abundance of life. Instead you are morose, sad, and teary.

Battle

Photo courtesy of New Old Stock

I have spent the week trying to tamper the rage and muddle through my responsibilities with the exhaustion. The anger comes in waves. No, a wave is too gentle for what happens. The rage is more like a tsunami. The sheer force and violence picks me up like I am nothing more than a shred of paper. It thrashes me about until I am bruised and battered. My skin raw and bleeding. Anger, like water, fills my nose, mouth, and lungs; it threatens to drown me. I try and scream, but all that comes out is a sigh. I try and fight it, swimming hard against its current, but it’s useless.

The anger suffocates me until, like the natural ebb of the ocean, it leaves my body. I am left exhausted and defeated. Going through the routine of my life after the sheer violence of the rage is like swimming through mud with limbs made of lead. But just as I feel that I have a handle on things, just as land is in sight, the water swells and pulls me back again into its watery violence.

In addition to bouts of uncontrollable rage, I have been battling intrusive thoughts that can be downright terrifying. Please know that these are different than suicidal thoughts. Although I do think things like — that’s a big bus, it wouldn’t be terrible if it hit me by accident and I died. I mean, everyone is plotting against me and would rather that I was dead. They all hate me. They all think I’m a drama queen with this bipolar disorder thing.

But of course no one is actually thinking these things. My brain deforms acts of kindness, acts of indifference, acts of the everyday into something twisted and ugly. The actions of other people are gnarled until they are unrecognizable and I question my sense of reality.

It is hard to focus on work and responsibilities when your life is a battleground and land mines are everywhere. But I persevered, because that is what I do. I survive, despite the way that I feel. I push myself into work, smile, socialize, do what is asked of me. I try even harder to appear normal. All the while I am fighting the rage, paranoia, and exhaustion. I really just want to crawl into bed, pull the covers over my head, and cry.

Drawn and quartered

I thought a Lego man was less grisly depiction of being drawn and quartered.

Perhaps I am so tenacious in this state because I have spent the last 29 years of my life being drawn and quartered. I imagine horses tied to each of my limbs and a mysterious voice yelling for the horses to pull. My limbs rip from my torso as I try and fulfill all of the demands of everyone else, rather than what I need and want.  The voice that commands the horses is constantly criticizing what I am doing and telling me what I should be doing instead, regardless of how I am feeling.

I am sitting on the couch and it asks, “Why aren’t you at the gym?”

“Because I’m tired from fighting my fucking life.” I always start out tougher than I feel. I always feel like I can argue with the voice.

“That’s no excuse,” it snaps. “You could at least be working on your novel or your blog. Isn’t that what you really want to do with your life? Write?”

“Yes, but I’m really fucking tired because this week has been really hard.”

“Hard, you don’t know what hard is. You’re a pampered princess. Do you know what’s hard? Those kids in Africa who have to walk 10 kilometers each way just to get water for their villages. That’s fucking hard.”

“I know, but -”

“You’re just lazy. You’re a useless excuse of a human. You are pathetic. You are worthless.”

And that voice usually convinces me to do something – whether it’s hit the gym, clean the house, work on my blog – even when all I really want to do is curl up and sleep because I have been battling the ghosts that paranoia brings and tampering the rage the swirls inside of me. Even though I have been doing all of these things that take incredible amounts of energy, it pushes me to deplete myself further and further.

But it wasn’t until Friday that I finally told that voice to shut the fuck up. I will write my blog post when I get to it – if I get to it. I will go to the gym next week when I have slept a solid eight hours. I will socialize when I no longer feel like everyone is against me. For now, I will sit on the couch and watch TV. And that’s okay. That’s enough. I’m enough. And surprisingly, the mood lifted just a little. If only for a little while.

Medicating Women’s Moods

/ marisalancione / 4 Comments

[Note: I know in my last post I said that I was going to write about my time in the psychiatric ward, but then I read an article and my reaction was so strong that I had to write a rebuttal. So, I promise to continue my Dispatches from the Psych Ward series next week.]

Last week, The New York Times published an op-ed by psychiatrist Julie Holland called “Medicating Women’s Feelings.” I read it because I was hoping it was going to be a critique of how society has historically used psychiatry and pharmaceuticals to control women’s bodies and behaviours. Unfortunately, it ended up being a bad lesson in biological determinism, stereotypes, and oversimplification.

There are sweeping generalizations and stereotypes made throughout Holland’s op-ed. But my favourite one comes in her first sentence: “Women are moody.” There are roughly 3 billion women in the world and, according to Holland, we are all moody. In an article for The Frisky, Katrin Higher, argues that:

What she [Holland] fails to mention is that our particular biological expressions of fears and desires…are not any more moody than men’s particular manifestations of moodiness. Just because we may cry after something troubling, doesn’t mean a man won’t punch a wall (and maybe a woman will punch a wall, actually that sounds fun and I may try it) for a similar feeling.

Mood SwingKatrin is right. Some women may cry after something bad happens, but that doesn’t mean a man won’t react in some other way. Or, heaven forbid, they might actually cry! My point is, not all women are moody. It’s just ridiculous to think that all 3 billion of us react in the same way to situations. Some women are moody, but I also know a hell of a lot of men who are a lot more fucking moody than I am (and I have a disease that makes me pretty fucking moody).

Another issue with Holland’s op-ed is the overarching message that suggests that women’s “emotionality” is a source of untapped power and by medicating ourselves, we are losing this power. As someone who is both a woman and takes medication for a mental illness, does this make me less of a woman? Moreover, what about the trans community? Are trans women less of a woman because they don’t have the biology to make them emotional? Of course not! These sweeping generalizations about gender and emotions serve no one.

ValiumMoving beyond the oversimplification of women’s moodiness Holland argues that the pharmaceutical industry is “targeting women in a barrage of advertising on daytime talk shows and in magazines.” And she isn’t wrong. Since the advent of Valium being marketed as “Mother’s Little Helper,” psychotropic medications have been disproportionately marketed towards women. In a 2003 study Jonathan M. Metzl provided a visual history of how “psychotropic treatments became imbricated with the same gendered assumptions at play in an American popular culture intimately concerned with connecting ‘normal’ and ‘heteronormal’.”

If a woman was a lesbian, perceived as sexually promiscuous or frigid, or didn’t want to be a wife or mother, she was labelled as sick and often given medication until she agreed to the path set out for her by patriarchal society (check out Women and Madness by Phyllis Chesler for more about this). However, this was also true for gay men or other people who didn’t fit into heteronormative society. Keep in mind, homosexuality was only removed from The Diagnostic and Statistical Manual of Mental Disorders (the psychiatric bible of diagnosis) in 1986.

Medicated Holland is also not wrong in saying that women are overmedicated. She contends that “one in four women in America now takes a psychiatric medication, compared with one in seven men.” However, I would suggest that the disproportionate use of medication between men and women may be skewed by the fact that men are less likely to seek help for their mental health and are therefore less likely to be given medication. Men have been taught that they cannot show their emotions whereas women have been told it’s okay to be emotional (unless they’re too emotional, in which case they’re crazy or on their period). This ties back into the dangers of Holland’s assumptions about emotions and gender. If we believe that women are allowed to be emotional because it’s more “natural” to them and teach boys that they are not – how are the expected to then seek help when they are struggling with their mental health?

I would also argue that society as a whole, and not just women, are overmedicated. We want a quick fix for our mental health and therapy takes time. The global pharmaceutical industry is valued at approximately $300 billion and they spend roughly one third of all sales revenue on marketing rather than research. And it’s not just Big Pharma making profits on us popping pills. Doctors are profiting big-time by shilling certain medications over others. This has become such a major issue that one of Canada’s largest medical regulators, the Ontario College of Physicians and Surgeons, is barring doctors from receiving any gifts from pharmaceutical industries. And the same is happening in the U.S.

However, this isn’t to say that medication doesn’t have a role in treating mental illness. A lot of people, myself included, benefit from taking medication to manage our moods. It’s just that when your doctor and Big Pharma can team up to push a certain medication, you have to start questioning whether or not we really need that antidepressant or not.

It’s not that Holland’s op-ed is entirely wrong, it’s just that she lacks nuance and contextualization for a lot of her assertions. Both women and men are emotional beings who have the capability to suffer from mental illness. And whether you choose medication, therapy or both it’s important that you seek help for your mental health and choose the treatment that’s right for you.

In case you want to read more in response to Holland’s op-ed, The New York Times published a series of letters.

Working with a mental illness

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High stress workplaces and overworked employees aren’t anything new when it comes to North America. However, recently The Atlantic reported on a working paper from Harvard and Stanford Business Schools that investigated the impact that job stress had on the health and mortality of American workers.

“The paper found that health problems stemming from job stress, like hypertension, cardiovascular disease, and decreased mental health, can lead to fatal conditions that wind up killing about 120,000 people each year – making work-related stressors and the maladies they cause, more deadly than diabetes, Alzheimer’s, or influenza.”

It’s incredible that 120,000 Americans are dying each year because of workplace stress. It’s not particularly surprising when we think of our climate of work and our glorification of busy. If you’re not busy, you’re worthless! We base our value on how many things we are able to achieve in a day. If we’re not exhausted and exasperated at the end of the day, then our day wasn’t worth anything. If we can’t complain about how tired and busy we are, our lives don’t matter.

Hamster wheelI have been on sick-leave for the past 5 months and have stepped off of that hamster wheel of stress, Only now have I been able to look critically at my work self. I already knew I was a perfectionist workaholic (I take after my dad in that regard). But, I hadn’t realized that I had been conditioned to say yes to everything and respond to additional work with a smile and can-do attitude because I was told that’s what team players do. That’s what hard workers do. That’s what people who get promoted do.

But it’s not.

That’s what doormats do.

That’s what people who cannot establish boundaries do.

Now that I have established distance from work, I recognize that it wasn’t just unmanageable workloads and difficult colleagues that caused my latest relapse (although they were major players). It was my inability to ask for help and not establishing boundaries with colleagues that really made me sick. If I had the strength to tell my boss sooner that I was floundering under the weight of my workload instead of trying to do it all, maybe I wouldn’t have relapsed. Now I can see that the workplace may create stress, but only I have the power to stop these situations from impacting my mental health.

WorkingThis week I will be returning to work. It will be a gradual return that will take about 8 weeks until I return full-time. To say that I’m nervous is an understatement. I am terrified that being thrust back into the pressure cooker will completely destroy me this time around. All of these realizations that I have had about my role in my own sickness are great, but will I actually be able to say no? Will it be possible for me to do my job without making myself sick? I run through hypothetical scenarios with my therapist and in those moments I can say: “No, I have too much to do. If you want me to complete that task then you will need to take something off my plate.” But when it comes down to it, will I actually do it?

I hope so and I’m going to try my hardest.

Whether you have a mental illness or not, boundaries are critical in maintaining good mental health as the Harvard and Stanford paper illustrates. However, as someone with a mental illness, I must recognize my limitations and work around them. I have to understand that asking for help isn’t a sign of weakness, but a sign of strength. My ability to say no will not only benefit my health and future, but it will also benefit my employer.

Wish me luck!