For adolescents, Facebook and other social media have created an irresistible forum for online sharing and oversharing, so much so that endless mood-of-the-moment updates have inspired a snickering retort on T-shirts and posters: “Face your problems, don’t Facebook them.”
But specialists in adolescent medicine and mental health experts say that dark postings should not be hastily dismissed because they can serve as signs of depression and an early warning system for timely intervention. Whether therapists should engage with patients over Facebook, however, remains a matter of debate.
And parents have their own conundrum: how to distinguish a teenager’s typically melodramatic mutterings — like the “worst day of my life” rants about their “frenemies,” academics or even cafeteria food — from a true emerging crisis.
Last year, researchers examined Facebook profiles of 200 students at the University of Washington and the University of Wisconsin-Madison. Some 30 percent of posted updates met the American Psychiatric Association’s criteria for a symptom of depression, such as reporting feelings of worthlessness or hopelessness, insomnia or sleeping too much and difficulty concentrating.
Their findings echo research that suggests depression is increasingly common among college students. Some studies have concluded that 30 to 40 percent of college students suffer a debilitating depressive episode each year. Yet scarcely 10 percent seek counseling.
“You can identify adolescents and young adults on Facebook who are showing signs of being at risk, who would benefit from a clinical visit for screening,” said Megan Moreno, a principal investigator in the Facebook studies and an assistant professor of pediatrics at the University of Wisconsin-Madison.
Sometimes the warnings are seen in hindsight. Before 15-year-old Amanda Cummings committed suicide by jumping in front of a bus near her New York home Dec. 27, her Facebook updates may have revealed her anguish. On Dec. 1, she wrote: “then ill go kill myself, with these pills, this knife, this life has already done half the job.”
Facebook started working with the National Suicide Prevention Lifeline in 2007. A reader who spots a disturbing post can alert Facebook and report the content as “suicidal.” After Facebook verifies the comment, it sends a link for the prevention lifeline to both the person who may need help and the person who alerted Facebook. In December, Facebook also began sending the distressed person a link to an online counselor.
While Facebook’s reporting feature has been criticized by some technology experts as unwieldy, and by some suicide prevention experts as a blunt instrument to address a volatile situation, other therapists have praised it as a positive step.
At some universities, resident advisers are using Facebook to monitor their charges. Last year, when Lilly Cao, then a junior, was a house fellow at Wisconsin-Madison, she decided to accept Facebook “friend” requests from most of the 56 freshmen on her floor.
She spotted posts about homesickness, academic despair and a menacing ex-boyfriend.
“One student clearly had an alcohol problem,” Cao recalled. “I found her unconscious in front of the dorm and had to call the ambulance. I began paying more attention to her status updates.”
Cao said she would never reply on Facebook, preferring instead to talk to students in person. The students were grateful for the conversations, she said.