Introduction
Shrouded in stigma, mental illness is primarily an intrapersonal and private experience that is difficult to be sure about. For sufferers, it can be difficult to confide in others or seek help. Surfing the internet can be a private activity; it is readily accessible and contains a wealth of perspectives from purportedly authentic sufferers. Hence, it is unsurprising that individuals who suspect they are experiencing mental illness would first search the internet for information (Fergie, Hunt, & Stilton, 2016). Indeed, there is an online bounty of self-help information drawn from professional medical guidelines such as the Diagnostic and Statistical Manual V or interventions like cognitive behavioural therapy (Illouz, 2008). This has inadvertently led to a conflation of normal fearfulness or low mood with anxiety (Horowitz & Wakefield, 2012) or depression (Horowitz and Wakefield, 2007) and a subsequent backlash against self-diagnosed mentally ill as mere attention-seekers (Teng, Crabb, Winefield, & Venning, 2017).
The role of mental illness stigma in preventing help-seeking behaviour is well-documented (Parcesepe & Cabassa, 2013). Hence, Perpetuating the notion of faking mental illness for sympathy therefore creates another layer of stigma that discourages disclosure and help-seeking. This confusion can cause sufferers to wait until symptoms become extremely severe before seeking professional help. Thus, sufferers could go untreated for longer instead of being quickly equipped with skills or medication to help themselves.
Mental illness creates non-verbal experiences that can be difficult to express using text alone. Video testimony has become a popular way to communicate mental illness experiences as it offers both visual and aural expressions. YouTube is one example of a public video sharing platform that is incredibly popular. In 2017, the platform had 1.5 billion monthly active users (Constine, 2017) and contains a rich array of professional and user-generated content (e.g., cooking tutorials, building furniture, documentaries). Given the stigmatised, intrapersonal, and private nature of the mental illness experience, watching educational and commentary videos describing this is an easy way to start discerning whether one has mental illness. For example, recent studies found that people with psychosis actively sought out first-person accounts of mental illness to understand their own (Aref-Adib, 2016). Top YouTube videos discussing Generalized Anxiety Disorder were also user-generated rather than of professional origin (MacLean, Basch, Reeves & Basch, 2017).
In the last decade, mental illness stigma has been reduced by increasing mental health literacy (Corrigan, 2016). However, ambiguity surrounding when to definitively call a negative experience a mental illness has contributed to labelling open disclosures of mental illness experience as mere pretence (Teng, 2017). As discussing mental illness is now less taboo, some may perceive having the label of being mentally ill to mean access to social support, giving rise to the phenomenon of some individuals romanticizing mental illness. Romanticizing mental illness means to idealize mental illness as a positive and attractive quality. People who romanticize mental illness may therefore be perceived as unlikely to be mentally ill despite what they portray.
For those in emotional distress, using the internet to search for others with similar experiences to understand their own experiences is often a part of discerning whether they are mentally ill (Fergie, Hunt, & Stilton, 2016). Therefore, encountering videos that discuss mental illness experiences or question its validity can be expected. Audience-content interaction can also be used as information about how acceptable or valid an emotional experience is. This could feed into decisions about confiding, help-seeking, or offering help. This study explores public discourse surrounding romanticizing mental illness in the YouTube comments section of two videos discussing this phenomenon to understand this angle of mental illness stigma. The following sections give an overview of the characteristics of experiencing mental illness and build towards why the phenomenon of romanticizing mental illness can be unhelpful for sufferers.
Literature Review
Mental Illness
Commonplace and Hidden
Mental illness is a common and oftentimes private affair. The World Health Organization (2017) estimates that some 322 million and 264 million people globally suffer from depressive and anxiety disorders, respectively. Though vast improvements to cost effectiveness and treatment for mental illness have been made, prevailing misperceptions and stigma prevent many sufferers from seeking help until it becomes debilitating (Insel, Collins, & Hyman, 2015). Sufferers often carry the same misperceptions as the public and self-stigmatise, which further reduces their self-esteem. This causes them to stay silent and not seek mental health resources like counselling or psychiatric services to avoid being associated with mental illness (Clement et al., 2015; Vanheusden et al., 2008; Wuthrich & Frei, 2015). In the US, only about one-third of people living with mental illness sought any form of help (Bathje & Pryor, 2011). According to a cross-national study by the WHO, only 24.6% of college students stated they would definitely seek help for future emotional problems (Ebert et al., 2019). Mental illness stigma has thus contributed to underutilisation of mental health resources.
Disclosure is a Gamble
Mental illness experiences are difficult to communicate to others because of anticipated discrimination (Corrigan & Rao, 2012). Sufferers often cited great difficulty in confiding to close others about their mental illness despite knowing the benefits of doing so (Corrigan & Rao, 2012). Social support is instrumental in recovering from mental illness (Eriksen, Arman, Davidson, Sundfør, & Karlsson, 2014), but this is not possible without disclosure. Even so, sufferers perceive this as a double-edged sword - where stress about maintaining secrecy lessens, stress about potential discrimination from others increases (Corrigan & Rao, 2012). Interestingly, YouTube has emerged as an unstructured medium within which mental illness support, information sharing, and companionship can be found (Naslund, Grande, Aschbrenner, & Elwyn, 2014). These YouTubers participate in an economy of negative affect that connects them with audiences and presents their struggles as a narrative of positive transformation (Berryman, & Kavka, 2018). They also feel that online interactions create a sense of community and shift their energies into productive activities that help them feel better (Sangeorzan, Andriopoulou, & Livanou, 2019). However, YouTubers represent a minority of mental illness sufferers and it is likely that disclosure remains a daunting choice to make for most others.
Media Trends and Romanticizing Mental Illness
Media portrayal continues to shape ideas of mental illness and can perpetuate negative stereotypes (Ma, 2017). For example, the movie “Split” in 2016 featured a main character with Dissociative Identity Disorder (i.e., the person has multiple personas that emerge spontaneously and do not share memory). This character kidnaps someone and becomes a villain because of his Dissociative Identity Disorder. Unfortunately, this implies that being mentally ill makes you a villain. Such portrayals propagate stigma in the general population globally (Pescosolido, Medina, Martin, & Long, 2013). Studies have also noted behavioural effects of mental illness ideas in the media. For example, portrayals of suicide in media reporting tend to temporarily increase suicide rates of vulnerable others, and negative portrayals such as those listed above could lead to lowered support seeking behaviours (Hoffner, Fujioka, Cohen, & Atwell Seate, 2017; Niederkrotenthaler, et al., 2019).
Modern caricatures like “Suicide Squad”, “Crazy Ex-girlfriend”, or songs like “Sweet but Psycho” portray mentally ill characters as quirky daredevils that make for fun fiction. However, because the alluring confidence portrayed by these characters is woven with traits of mental illness, they can be associated and idealized together. In “Suicide Squad”, Harley Quinn is portrayed as one half of a dramatic and dysfunctional relationship with the Joker. Most fans enjoy this portrayal while recognizing that it is fantasy. However, some fandom discussions border on endorsing Harley’s instability and Joker’s abusive tendencies as desirable in a relationship (Salter, 2019) and could encourage actual abusive relationships.
Social media influencers have become a prominent source of mental illness disclosures (Naslund et al., 2014). Some have commodified mental illness, promoting merchandise with quirky texts such as “I hate being bi-polar, it’s awesome!” (Ziege, 2017). Some also claim mental illness for personal gain in the form of attention (Teng et al., 2017). These were heavily criticized online for trivializing what mental illness sufferers experience and making it seem ‘cool’ to have a mental illness - in other words, romanticizing it (Picton-James, 2018; Prentice, 2018).
A Quandary of Proof
The idea of romanticizing mental illness presented in the online environment could cause sufferers even more uncertainty by framing help-seeking as attention-seeking behaviour. These ideas could make non-sufferers dismissive of mental illness disclosures because attention-seekers are perceived as undeserving of support. This attention-seeking stigma means that disclosures implicitly demand some proof of illness - a license to discuss. Oftentimes, the only proof possible is a diagnosis. So, it is likely that this is what sufferers will proffer in defence of their claim. While online disclosure can be facilitative in help-seeking and recovery offline (Naslund, Aschbrenner, Marsch, & Bartels, 2016), it is possible that the attention-seeking stigma could also undermine the perceived veracity and therefore benefits of such diagnosis disclosures if there is social backlash in real life.
The Study
There is a paucity of research on how romanticizing mental illnesses could impact stigmatization and offers of social support. We need to understand what kinds of people the online community thinks mental illness romantics are and what they think motivates people to romanticize mental illness. This will offer some insights into the kinds of character judgements made against this group. We need to understand why the online community might target certain individuals so that we know how people might apply the prescribed definition of a mental illness romantic to real life. Following that, it is also important to know what kinds of consequences the online community describes as attributable to romanticizing mental illness. Finally, it will also be interesting to gather information on what ideas and implications of romanticizing mental illness are being strongly debated on within the community as this could highlight important ethical discourse about the portrayal of mental illness. The answers to these questions will help provide important insights into how romanticizing mental illness could contribute to stigmatizing mental illness disclosures and perpetuating unhelpful behaviours that discourage help-seeking by the mentally ill. This way, it may be possible to identify misconceptions or misrepresentations of mental illness that can be addressed with anti-stigma campaigns or media policies in the future. Therefore, we put forward the following research questions:
RQ1: How do YouTube commenters stereotype those who romanticize mental illness?
RQ2: What do YouTube commenters believe are the motivations and notions behind romanticizing mental illness?
RQ3: How do YouTube commenters characterize the behaviour of a typical mental illness romantic versus a typical mentally ill person?
RQ4: What consequences of romanticizing mental illness have YouTube commenters described?
RQ5: What are the contentious ideas or practices surrounding romanticizing mental illness?
Method
Sample
YouTube is the most popular video sharing platform with 1.5 billion monthly active users (Constine, 2017). Its popularity and broad base of users make it an ideal platform to sample from. This is especially since videos uploaded there can reach very high levels of exposures and elicit lively viewer interactions in the comment section. Sampling for this study took the following steps. First, we searched YouTube for the following keywords: “romanticizing mental illness.” This yielded more than 100 search results (the total number is not available as YouTube does not provide that data). Next, to ensure the videos were of interest to the online community, we sorted the videos based on their recency (posted in 2019), their reach (minimum of 200 000 views), and discursive value (at least 1000 comments). Based on these, we selected the two videos with the highest engagement based on both number of views and number of comments, while also ensuring that both videos explicitly discussed romanticizing and/or commodifying mental illness and its harmful effects. A summary of the characteristics for each video and YouTuber are provided in Table 1.
In brief, the videos defined romanticizing mental illness and discussed in greater detail examples of romanticizing mental illness in popular culture (e.g., movies, Netflix series), individuals (e.g., social media influencers), and personal experience. The videos also explained how romanticizing mental illness added to the challenges faced by those who were mentally ill and emphasized to viewers the importance of seeking professional help. For analysis, we extracted all comments from the video page via a comment scraper website and downloaded them into a Microsoft Excel file. We analysed all the comments and their direct replies from Clementine Productions (2321 lines) and all comments from Luke Alexander (6311 lines). This totalled 8632 lines of excel data, where every line was a comment or a reply to a comment.
Analysis
We first browsed the entire dataset to get a sensing of the data. For analysis, we used primary-cycle coding and secondary-cycle coding framed by a constant comparative approach as recommended by Tracy (2013). For primary-cycle analysis, we began with a line-by-line examination of each comment and assigned descriptive codes and corresponding abbreviations. Then, we compiled them into a codebook. These codes/abbreviations were amended for better fit to the data throughout coding and referred to frequently for consistency. For secondary-cycle coding, we identified patterns, processes, or rules among primary-cycle codes. Then we categorized them and assigned secondary analytic codes and abbreviations. From there, we conducted thematic analysis of the codes and organized them to answer our research questions.
Results
Luke Alexander and Clementine Productions discussed a range of topics that commenters reacted to. A summary of these themes is provided in Table 2 below. A more detailed summary of discussion points in each video is available in the Annex.
In the comments, two separate issues were discussed together. First, mental illness was often portrayed and perpetuated as a romantic concept. Second, there was a subset of mental illness romantics who portrayed themselves as mentally ill or reacted in unhelpful ways towards others’ mental illness. Both issues were presented as leading to unfavourable outcomes for those with mental illnesses.
RQ1: How do YouTube commenters stereotype those who romanticize mental illness?
Luke Alexander cited another YouTuber as an example of someone who was romanticizing mental illness. Commenters agreed that some YouTubers romanticize mental illness but did not provide other specific examples. They also agreed that some social media influencers dramatized normal emotional experiences and mislabelled these experiences as mental illness. For example:
YouTuber: *gets sad for half an hour*
YouTuber: i HaVe SeVeRe DePrEsSiOn
Teenagers were repeatedly mentioned as vulnerable to such behaviour because they were “impressionable.” Girls were also said to be prone to such dramatizations. These girls would often do drastic things such as “skip lunch,” wear “normal people scare me” type of merchandise, or be “constantly complaining about something they don’t even have,” and “that they have it worse than anyone else.”
The term “Neurotypicals” was used to describe people who never experienced mental illness and cannot understand what it means to be mentally ill - a naive and ignorant out-group susceptible to misperceptions. One commenter said, “We all have feelings, but you can't abbreviate your problems with illnesses.” Commenters claiming mental illness accused neurotypicals of giving self-disclosures “a bad name” by using this label on themselves to go “seeking attention.”
Clementine Productions mentioned that he felt guilty of romanticizing his depression as it was a state that he “grows attached to” and “feels meaningful” after some time. This was supported by a number of commenters. One commenter said: “It also gives people who struggle with mental illness the sense that it's okay to stay in a bad place and continue on suffering instead of … working toward recovery.” However, we note the distinct lack of likes and replies to these comments compared to rants about people pretending or profiteering off mental illness which could mean that these are not very popular viewpoints.
RQ2: What do YouTube commenters believe are the motivations and notions behind romanticizing mental illness?
Both videos highlighted that some people treat mental illness as a social asset, a matter of “aesthetics”, or uniqueness. Luke Alexander blamed Tumblr memes for giving vulnerable individuals the wrong idea about mental illness while Clementine Productions raised “Creepypasta” as a genre of horror stories that used trauma and mental illness to justify characters’ actions. They proposed that consuming such media led to some using mental illness as a social shield. Commenters contributed their ideas about why people did that.
#coping. One commenter mentioned some sufferers rationalize that “it hurts so much so it has to be worth something, it has to be meaningful.” Sometimes the rationalization could be so ingrained that they might think, “This is who I really am… Every other state of mind is a lie. This pain is actually good.” Expressing these romantic ideas about their mental illness was stated as “an easy way to receive negative/nurturing attention,” and perhaps trigger supportive reactions from their social network to help them cope.
#relatable. Relatability evolved from meaning whether something can be communicated to another, to whether something can be understood and empathised with by another (Zimmer, 2010). Commenters described self-labelling with mental illnesses “as a topic that you can post about for easy relatable teen points” to garner supportive responses from others in their network. “Girls will fake anxiety attacks and depressive episodes so people will pity them,” and influencers on various social media platforms treat mental illness as “a piece of revenue to get more relatable fans” and sell merchandise.
#special. Mental illness seems to carry the notion of making someone “feel special.” This is possibly because mental illness seems to be associated with “special treatment and attention” and is therefore “the ideal thing to be.” Simplistic and sometimes positive misconceptions about well-known mental illnesses have also led to them being regarded as mere “quirky personality trait[s],” “cool,” “aesthetic,” and “trendy.” Table 3 lists these misconceptions.
#socialabsolution. Commenters presented accounts of romanticizing mental illness that appeared to have less innocent motivations. Mental illness was used as an “excuse from normal social roles” such as going to school. Claiming mental illness was also used as a reason “to be untouchable” by presenting oneself as a victim, or a “damsel in distress.” This socially obligated others to “be at your orders” and continue supporting you, essentially blackmailing them “to trap someone in a relationship”. Another commenter highlighted that suicide was sometimes “portrayed as an act of courage and a weapon for revenge.” This perpetuates the notion that people who commit suicide are “just misunderstood” heroes who “were able to give justice … while still being pretty and powerful”.
Notions of the victim and hero seem to be presented as the essence of why mental illness is romanticized. They are attractive concepts about mental illness that seem to be wielded to enhance one’s self-esteem, compel social support, and gain social absolution from personal responsibility. This status is subsequently used to demand social support from others (See Figure 1). The simplification of mental illnesses into shallow descriptors could promote romanticizing by making them seem more relatable and easily put on for show.
RQ3: How do YouTube commenters characterize the behaviour of a typical mental illness romantic versus a typical mentally ill person?
Both videos claimed that attention-seeking use of mental illness can be observed from 1) frequent, open, self-labelling with a mental illness, with 2) lack of solution-focused behaviour. Luke Alexander was harsher and more definitive about the attention-seeking motive of people he identified as fitting this description. However, Clementine Productions said that these people could also be seeking help for a genuine problem that is equally valid even if it is not mental illness. Instead, he discouraged accusing people of attention-seeking because there is no way to tell for sure.
Many commenters thought a mental illness romantic was someone who would “proudly proclaim that they have [insert mental illness],” and engaged in behaviours such as “sad-posting,” or wearing “normal people scare me” shirts. Yet, they would also “refuse to ever see a psychologist or therapist” because “they're afraid of being outed as a ‘poser’.” A mental illness romantic might also express that “addiction to self-harm [is] so cool and panic attacks [are] so deep” or compare “horrible experiences to Melanie Martinez songs.” One commenter related that their friend reacted to them sharing about their panic attacks by calling them a “smol bean,” which means something that is cute, fragile, and precious - a disempowering response reflective of their romanticized understanding of mental illness.
Commenters expected that typical mentally ill persons “don’t want [their mental illness] slapped on their shirt as a quirky personality trait,” because “wearing a shirt that displays my anxiety to everyone gives me anxiety.” Other commenters countered that they would not mind wearing merchandise with their mental illness on it because “it feels like owning it, and not letting it control me.” The merchandise became a statement of victory and openness to conversation rather than special treatment. Similarly, some commenters criticised that “plenty of people who love being the centre of attention also have anxiety.” Some commenters shared that mental illness is “not always all bad all the time” and those with mental illness “are allowed to have personality traits outside of their disorder.”
Identifying someone who was faking mental illness seemed clear-cut given the high consensus on the abovementioned criteria. However, commenters claiming mental illness also revealed that they engaged in some behaviours labelled as faking for completely different motivations. For example, some do not seek professional help because they “don’t have the resources”, or because of stigma. Another explained that they spoke freely about their mental illness to “people I trust about my anxiety” and not for attention. This highlights the highly ambiguous nature of discerning coping and support seeking behaviours from attention-seeking behaviours.
RQ4: What are the consequences of romanticizing mental illness as described by YouTube commenters?
In both videos, the trivialization of self-disclosures and support seeking behaviours was cited as the main negative impact of romanticizing mental illness. Both YouTubers mentioned that increasingly casual use of mental illness terminology contributed to minimizing the impression of the true level of dysfunction that they imply. Commenters furnished supporting testimonies and expressed their frustration at this situation. First, they detailed experiences resulting from the perception that those who disclosed their mental illnesses tended to be “faking it for attention”. Second, they shared experiences resulting from the casual use of terms typically associated with mental illnesses.
#faker. The belief that those open about their mental illness are mental illness romantics faking it sometimes led to reactions of disbelief by those who were being confided to. Commenters shared that when “Suicide Squad” was released, it could have higlighted the possibility of copycats and “many of my friends believed I was faking and trying to get attention.” One commenter shared that when they see “people proudly proclaim that they have it I automatically don’t believe them anymore.” Another shared that this happened even with close family where “my mother, she said I was lying.” As a result, the commenter who was 12 years old at the time did not attempt to seek treatment again until 21 years old. People with mental illness grappled with “the need to prove it due to fakes” because they were “scared to be lumped with attention seekers.” These reactions made seeking both social support and professional help more difficult.
#lolmetoo. Frequent use of mental illness terms to describe non-disordered everyday experiences seems to have robbed sufferers of the vocabulary to describe what they were going through. Terms like ‘depressed’ and ‘anxious’ were used so often to describe ordinary feelings of sadness and fear that they lost the implication of pathological significance in the layman’s understanding. Commenters claiming mental illness reported receiving trivializing responses like “gurl me too I cry every night you are not special,” “lmao [laughing my ass off] me too bruh [brother].” These responses can cause those with mental illness to “feel guilty identifying as [the mental illness] and searching for help because it feels like maybe I'm ‘faking it’.” Hence, they doubted the validity of their experiences. One commenter sums this up, “those people romanticizing mental illnesses make it harder for someone with an actual mental illness to make someone believe that they are actually suffering”.
RQ5: What are the contentious ideas or practices surrounding romanticizing mental illness?
Both Luke Alexander and Clementine Productions affirmed that romanticized mental illness art, memes, and productions still had creative value. However, they believed that creators have more responsibility to be aware of the potential harm that their works can bring to vulnerable others. Commenters weighed in on both sides.
#creativefreedom. Memes have become a unique form of online digital communication that is highly symbolic, entertaining, and importantly, conveys nonverbal information (Aguilar, Campbell, Stanley, & Taylor, 2017). These characteristics seem to have made them a common vehicle for expressing difficult experiences in mental illness to others in a way that is less morbid and more relatable for those who never had mental illness. Commenters claiming mental illness cited that they often needed to explain to people who have never had mental illness “what is going on in my head through memes” to make it an easier conversation topic and represent their intangible experiences more completely with visual metaphors. They argued that memes should not be targeted as romanticizing mental illness because they are often used to share about mental illness with others “without making it become something extremely sad” and difficult to discuss. Memes also helped people to “cope with what they are feeling” so that they feel there are others who understand.
Commenters suggested that making memes for the purpose of relating experience and coping was acceptable but using it for profit was not. In one commenter’s words “merch bad, memes good(usually), let art be art.” Some commenters slammed productions like “13 Reasons Why” for perpetuating romantic ideals of mental illnesses. However, another commenter asserted that these creatives had “every right to romanticize or falsely portray these issues.” This commenter reasoned that if we were not careful we would “have to ban pretty much everything someone claimed was an inspiration for tragic behaviour,” and that creators have no obligation to create a realistic character” or “shelter its audiences with reassuring rhetoric”. The commenter did concede that “the fact that the show claims to be realistic is problematic”. Another also stated that “if some people are dumb enough to believe that, well, they deserve whatever consequences they get from it.” These commenters proposed that the responsibility of distinguishing between what is an accurate representation of mental illness and what is not lies with the audience.
Luke Alexander was adamant that a proper diagnosis was the best way to get help. Clementine Productions, while supportive of professional help, withheld judgement because it was impossible for non-professionals to be certain if someone was truly suffering. Both cited that people claiming to have mental illnesses publicly with no apparent effort to improve were confusing audiences about what experiences were pathological.
#self-diagnosed. Self-diagnosis refers to instances where an individual decided that they suffered from a mental illness without consulting a professional. Self-diagnosis of mental illnesses was seen as “wrong” and associated with attention-seeking. These negative reactions could be a misplaced frustration with a subset of mental illness romantics who wielded mental illness in a way perceived as self-serving and unnecessary. Presented this way, the negative commentary on self-diagnosis could make some fearful of discerning their experiences when it is a necessary step towards getting help. As one commenter put it, “a self-diagnosis …is nothing more than a place to start.”
#attention. Despite firm negative reactions to mental illness romantics, some commenters balanced this view with compassion. One commenter stated that mental illness romantics are “probably doing [it] for a reason, and it is often a cry for help” that hints at another reason for attention. Others shared that some of these purported romantics are suffering from mental illness - just not the one they claim to have. For example, in the case of Dissociative Identity Disorder, “most people who fake the illness don't mean to fake it, they tend to have other mental illnesses or trauma that causes a sort of pseudo-DID.” As these motives are difficult to discern, another commenter expresses “hope for a culture of understanding - even for those who appear to be unsympathetic in their ‘faking’” because they may still need help.
Discussion and Implications
This study sought to understand online discourse on the issue of romanticizing mental illness. By analysing two videos on YouTube that discussed this issue as well as the comments they generated, this study found a wide range of perspectives. Commenters expressed anger, frustration, and disappointment with how mental illness was romanticized through the media and perpetuated in everyday interactions. Blame was placed on careless usage of terms meant to describe the pathological experience of mental illness, and simplistic understandings of what entailed mental illness. Commenters also shared thoughts on why mental illnesses were romantic and desirable labels. Collectively, the results alluded to the possibility of an implicit thought process where the desire to apply romantic notions of a hero or victim ideal to oneself, and the desire to receive social attentions consistent with those ideas could lead to people adopting the label of mental illness. These motivations appeared consistent with self-enhancement theory (Shrauger, 1975) where people desire to embrace positive evaluations of the self to satisfy their need for communion with others. A more recent review on self-enhancement theory suggests that the tendency to seek self-enhancement increases when a high risk of rejection is perceived (Kwang & Swann, 2010). This lends some weight to commenters’ speculation that mental illness romantics claiming to have mental illness could be driven by a deeper need for communion with others. It also seems to support the consensus that teenagers are most vulnerable to such behaviour as they are more highly attuned to others’ evaluations of them and are likely to have increased sensitivity to rejection (London, Downey, Bonica, & Paltin, 2007; Chango, McElhaney, Allen, Schad & Marston, 2012).
Romanticizing mental illness is a relatively new phenomenon for which little research exists. Studies that mentioned this phenomenon addressed it from the perspective of media portrayals of romantic ideas about mental illness (Carter, 2015) and no one to our knowledge has examined any public discourse regarding romanticizing mental illness. Our analysis of these sets of comments offers but a tentative snapshot of the phenomenon as understood by interested members of the community on YouTube and a description of some of the perspectives that someone seeking information about mental illness might come across on this platform. The following paragraphs propose possible implications of these perspectives and opportunities for future research.
Portrayals of Mental Illness
Several commenters’ statements highlighted a possible perceived tension and ambiguity in defining the extent of creators’ versus audience’s responsibility in the accuracy of interpreting presentations of mental illness. Guidelines such as the Responsible Reporting on Mental Health, Mental Illness, & Death by Suicide by the National Union of Journalists and supported by the Scottish government exist to instruct journalists on appropriate ways to report on mental illnesses that avoid sensationalism or misinformation.
Educating the Public on Mental Illness (National Union of Journalists, n.d.), and guidelines for theatre and screen such as those developed by Mindframe in Australia (Mindframe, 2007) were created to regulate the portrayal of mental illness in the media. These guidelines urge professionals to carefully consider how vulnerable populations might interpret portrayals of mental illness and to avoid the pitfalls of misinformation in favour of sensationalism. Creative expression is something that is respected and in today’s prolific use of social media or content hosting sites - well-engaged with and shared by many denizens of the internet. No educative recommendations are yet available that specifically target the lay producers and consumers of such content. Here, research can be conducted to test preventative measures such as pre-viewing notices which explicitly warn viewers about the artistic nature of mental illness portrayals in the work and encourage them to seek professional guidance.
Education
Discerning accurate versus inaccurate portrayals. The accounts provided by many commenters hint at the presence of many simplistic misconceptions about common mental illnesses. Teenagers were mentioned as being most susceptible to harbouring these misconceptions. Adolescence is a period of development when many mental illnesses first appear (Seroczynski, Jacquez, & Cole, 2003). Hence, continued focus of educative efforts on this age group coupled with more in-depth examinations of their misconceptions would make sense. More extensive research on inoculating adolescents against harmful notions of mental illness is needed to make mental health education more effective. For example, educational messages that guide adolescents’ interpretation of mental illness representations could be tested to see if they could be a sufficient buffer against such media.
Appropriate support for mental illnesses. Commenters claiming to have suffered from mental illnesses shared that they often received unhelpful responses from close others that made them feel guilty or invalidated. These negative experiences of disclosure could set up readers’ own expectations of rejection or negative responses. If readers were considering disclosure or seeking professional help, such perspectives can be very discouraging and lead to continued silence. One way to alleviate this could be to provide informal and less intimidating avenues of information seeking. This could facilitate discernment of mental illness by making ‘false alarm’ experiences more acceptable. Peer workers with prior mental illness experiences have already been used to support recovery from mental illness (Holley, Gillard & Gibson, 2015). Future research can consider using social media or messaging platforms with more sophisticated gating features for privacy (e.g., Discord) to test communities that aid in the mental illness discernment process. Then, assessments can be conducted to see if these avenues are more acceptable to those seeking information about mental illness and if so, how these avenues might be scaled up for more communities.
Discouraging flippant use of mental illness descriptors. Careless use of terms meant to describe the pathological experience of mental illness was often cited as a barrier to empathic communication with others. While this might seem trivial, research has demonstrated that the labels we use do influence the way we judge people with mental illness (Granello & Gibbs, 2014). This supports the invalidating experiences described by commenters. Hence, allowing such habits to continue will only perpetuate unhelpful romantic notions of mental illness and contribute to a perceived environment of rejection for sufferers. Future efforts could consider public or school-based campaigns that promote proper understanding and respectful use of these terms.
Reduce romanticizing mental illness. We hope that engaging with the opportunities outlined here will help reduce romantic notions of mental illness and promote more helpful cognitions and interactions with mental illness sufferers. The logic model (Figure 1) detailing the motivations for romanticizing mental illness will need further study. Focus group discussions with those who have been clinically diagnosed and cross-platform or cross-content analyses of narrative material (e.g., memes, reddit, selected entertainment media) can be conducted to see if the same logic model presents itself. Other social labels such as obesity, or being LGBTQ were briefly mentioned by commenters and could be interesting domains to explore romanticizing stigmatised identities in general.
Conclusion
Our analyses of commentary surrounding romanticizing mental illness has described various interpretations and experiences as presented by this community of YouTube commenters. While the data was rich with vivid personal accounts of the impact of romanticizing mental illness, it represents only a narrow slice of the discussions surrounding romanticizing mental illness and is not generalizable to the wider discussion of mental illness. This study has organised the perspectives presented and provides a starting point for exploring this phenomenon in future research endeavours. Future research needs to take a multi-pronged approach to this phenomenon by addressing gaps from the perspectives of creators, audiences, mental health service providers, and vulnerable adolescent groups. This way, unhelpful portrayals of mental illness and its effects can be mitigated while less threatening avenues of help are provided to those who feel that they need it.
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