The controversial community’s free, instant, anonymous care is replacing IRL counseling. Will it do more harm than good?
By Arielle Pardes, Health.GOOD.is
Two years ago, Max Stolfe was in a dark place. He had just transferred to a new college in New York, and he was struggling to keep up with the workload. He had, by his own account, one friend. After years in and out of therapy, he didn’t have much to show for it, and no one to turn to with his hopelessness. So he did the only thing he could think to do: He posted on Reddit.
“I'm not sure if this is a rant or a cry for help,” he wrote, explaining that he felt like “no one really cares about me,” and “I don't know what to do.”
Over 2,000 miles away, in Canada, Ryan Stroeder logged onto Reddit. Stroeder barely knew how to use the site—he had, until that point, only used Reddit a few times to comment on threads about motorcycle repairs—but when he saw Stolfe’s post on his home page, he knew he couldn’t ignore it.
“It had been sitting there for like 12 hours, which is an eternity in internet time,” Stroeder says. “No one had given this guy any advice.” And so, he wrote back, as if simply to say, ‘I’m here for you’:
“Ouch. Sounds like you're having a tough time max. That sucks. I've been there, so I kinda know what you're talking about. I've been in the ever circling vortex of self doubt, frustration, and loathing. It's no bueno. I know.
Rule numero uno - There are no more zero days. What's a zero day? A zero day is when you don't do a single fucking thing towards whatever dream or goal or want or whatever that you got going on. No more zeros. I'm not saying you gotta bust an essay out everyday, that's not the point. The point I'm trying to make is that you have to make yourself, promise yourself, that the new SYSTEM you live in is a NON-ZERO system. Didn’t do anything all fucking day and it's 11:58 PM? Write one sentence. One pushup. Read one page of that chapter. One. Because one is non zero.”
The internet has long been a place to unload our problems and confess our darkest secrets—and those admissions haven’t always been positive. Reddit, in particular, has earned a controversial reputation as the birthplace of threads like r/thefappening, devoted to 2014’s infamous leaked celebrity nudes, and r/thedonald, which spawned the now-closed subreddit that recently drove an armed conspiracy theorist to investigate the so-called Pizzagate rumors. But increasingly, online communities are taking the place of IRL therapists for people to divulge and deal with their mental health. Even the darkest places, like Reddit, can surprise you with its displays of humanity.
On Reddit, groups like r/mentalhealth provide spaces to share garden-variety psychological problems; r/anxiety responds in real time to anxiety attacks; r/gettingoverit offers support for trauma, depression, and doubt. There are groups for eating disorders, for suicidal thoughts, and for people who are simply feeling stuck—made up of thousands of regular users who respond to queries in real time, with real support.
“Peer support can be very effective,” said Dr. John Torous, the co-director of the Beth Israel Deaconess Medical Center Digital Psychiatry Program, which researches the intersection of technology and mental health solutions. Torous says the most effective mental health apps all have some kind of human element. In other words, technology can make mental health care more accessible, but it isn’t perfect. “I think the trick is that, sometimes, it doesn’t have the structure or the certainty of professional help.”
Still, the DIY approach has its benefits: Research has shown that young people, in particular, are reluctant to seek professional help. Reddit therapy, on the other hand, is free, mostly anonymous, and always at one’s fingertips.
“We know that right now, less than 50 percent of individuals with mental illness are receiving treatment for their mental illness,” said Adam Haim, the technology lead at the National Institute of Mental Health. “If you look at online communities, there’s definitely an opportunity to identify signals of concern”—changes in language that may indicate a manic episode or a suicide threat, for example—“and then triage very quickly.”
Reddit, in particular, seems promising. Last year, when the site turned 10 years old, there were close to 73 million posts and 82 billion page views, along with millions of users who are there to act as a safety net when someone posts a cry for help. One study, presented at the Association for the Advancement of Artificial Intelligence’s annual conference on blogs and social media, found that comments in subreddits, like r/depression and r/mentalhealth, were “surprisingly high quality” and provided more emotional support and prescriptive advice than both Twitter and Facebook. The researchers, from Georgia Institute of Technology's School of Interactive Computing and Arizona State University's Department of Computer Science, concluded that Reddit can “(fulfill) unique information and social needs of a cohort challenged with a stigmatic health concern.”
Like others I spoke with, Stolfe says he turned to Reddit because he didn’t want to burden his friends or family. Plus, he wasn’t sure if he was just going through a rough patch or if he was struggling with something more serious, like depression. “Looking back at it,” he says, “writing that post was the first indication that I couldn’t handle (my problems) by myself anymore.”
Subreddits like r/suicidewatch are full of posts like this: “I really think I should tell someone I want to kill myself, but I have no one to talk to … This post would actually be the first time I've told anyone I want to kill myself.” Because people are more likely to divulge sensitive information in online support groups than in IRL ones, spaces like Reddit can actually be the first step in getting someone help.
Erin, who asked that we not use her last name, started posting on r/suicidewatch after struggling with depression and suicidal feelings. “When I came here, I wasn’t looking for help or someone to tell me how to fix things,” she told me. “Instead I needed to be heard. I needed to be able to say that I wasn’t ok and that I didn’t know any way to be okay. Someone read my post and they didn’t try to fix me.”
“Reddit is a terrible place to be doing any kind of crisis intervention,” said Erin, who is now a moderator for r/SuicideWatch, r/depression, and several other mental health-related subreddits. Since most redditors aren’t psychologists, replies on desperate posts can be a grab bag of consolation, trolling, and prescriptive advice. Sometimes, she told me, people will post well-intentioned replies—writing things like, “It gets better,” or “You should try X”—that can end up doing more harm than good.
Moderators have tried to mitigate these replies with guidelines. On r/suicidewatch, for example, there’s a sidebar that states the rules: no judgment, no abuse, no trolling, and most importantly, no diagnoses:
“It's fine to share what worked for you, but DO NOT advocate for or against any specific type of therapy, self-help strategy, or medication, especially street drugs or alcohol, and DO NOT diagnose people.”
Stroeder, whose reply to Stolfe’s post has spawned an entirely new subreddit, Non-Zero Days, for people who are feeling stuck in a rut, says he still receives messages every day from people who read his original exchange with Stolfe. But he doesn’t see himself as some kind of messiah or as someone who is particularly qualified to give advice.
“It’s not about me telling you how to live,” he said. “It’s just, ‘Hey, here’s something that works for me and if you want, (you can) interpret it in your own personal way and use it as a tool to improve your own life.’”
Since posting on Reddit two years ago, Stolfe started going to therapy. He’s also been opening up more to his friends and family IRL. Now, when something is bothering him and he tells someone close to him, he doesn’t feel as if he’s burdening that person. He says he owes some of that to that singular Reddit post, which reassured him that he wasn’t alone or overreacting to his feelings.
“There’s something incredible about the internet being able to help people, but I guess to me, it still seems uncharted,” he says. “I really appreciate what that post did for me and what the site's community said to me. People reach out to me even now about it, but (now) I want to turn to someone with professional expertise.”