The Vlogging Cure

Every morning, Martina Stawski wakes up in pain, her every joint, from jaw to knuckles, screaming its complaint. There is no cure for Ehlers-Danlos Syndrome, the chronic connective tissue disorder she lives with, and at 33, she is starting to have trouble walking. Fans of Martina's YouTube channel, "Simon and Martina," know that her condition is as much a part of her as her trademark enthusiasm, pink hair, and Wolverine sleeve tattoo. But while Ehlers-Danlos has been a recurring topic on her nine-year-old channel, it wasn't until February that she decided to tell her 1.1 million subscribers about the other condition she's been living with—chronic depression.

"I was really, really scared to put out this video because I was embarrassed to begin with. I felt shameful about it because it's totally not talked about," Stawski says. "But depression is not a choice you make, and I think this video will probably help out and reach a lot of people who have been doing what I was doing and not telling their family and friends."

Stawski isn't the only popular YouTube video creator (or "vlogger") to post candid testimonials about personal experiences with mental illness and treatments. Thousands have used the platform to discuss depression, OCD, trichotillomania, eating disorders, bipolar disorder, panic attacks, severe social anxiety, and more. Some include their confessionals among other video offerings in which they sing, perform sketches, cook, shop, or chat about different topics. Others have launched second channels dedicated to providing their own brand of education and information about how they deal with their condition, perhaps most famously Beckie Brown, whose time-lapse video, "She Takes a Photo: 6.5 Years," details the highs and lows of her struggles with trichotillomania through daily photos. The video has been viewed more than 15 million times and is widely credited with showing the world what a person who experiences compulsive hair pulling and skin picking endures.

YouTube is the web's second-most-visited site, behind only Google (with which it shares a corporate parent, Alphabet). It has evolved from a bare-bones video archiving site to a social space where people can make a living posting high-quality, innovative content—in some cases, a very good living. But while anyone can upload a video, gaining a large following is not easy. Without agents, studios, or a Hollywood promotion machine to support them, individual creators must rely on their distinct personality, perspective, or subject to set them apart from the enormous pack. It's this authenticity that has turned some of these people into stars.

But mental illness is more challenging to put onscreen than pranks, celebrity commentary, fashion tips, or crafty how-tos. It comes with a level of vulnerability as well: What if viewers don't believe creators' claims of depression or, worse, attack them through their comments for not being grateful enough for their relative health or success?

When the videos work, though, "suddenly mental illness is not this abstract idea," says clinical psychologist Ben Michaelis, who is interested in the intersection of psychology and media. "Face-to-face is the way evolution has shaped us to interact with one another; it's how we know one another and how we build empathy for one another."

On YouTube, individuals generate "face-to-face" connection through the screen. "It provides a space for people to have a more empathetic experience with those who are suffering," Michaelis says. "People who are in the middle of a crisis can be connected with little effort."

For months, Stawski and her husband debated whether she should upload her depression video. They ultimately decided that it was in her and her fans' best interest to show a realistic portrait of the condition. "I think people hear the word and expect somebody to be wearing gothic clothing and sitting in a basement. To get a message from someone who says she's a totally active person, super outgoing with all her friends, and that she still struggles with depression, with no understanding of how to explain it—I hope my video will show people they're a lot like me," she says.

The typical format of a YouTube video, with a speaker sitting close to and looking directly at the camera, creates an air of intimacy for raw and candid disclosure. In "An Open Talk About My Depression," Stawski told viewers: "I want to show you what I do to help myself on these really, really low days....I don't want to paint an inaccurate or unattainable way of living with chronic pain or depression....what I want to do today is open up to you guys and talk to you very honestly."

Speaking about her efforts to live with her condition, she explained that tiny steps propelled improvement. "And with each accomplishment and with each goal and each tiny adventure, I slowly started to add rungs to this ladder. And I started to see meaning in life again." After going on the internet to start learning to knit, she said, "then the next thing I do is go out to actually get thread, and that's a big step. And then from there I start to join forums and look things up online and then the next thing I know, I'm going to a cafe and I'm meeting real people and having conversations with them, and all these little tiny goals were just taking me out a little further away from this total pit of complete hopelessness."

The World's Biggest Network

People around the world view more than 1 billion hours of YouTube videos per day—more than any major television network or streaming service can deliver. Millennials view an average of 12.1 hours of YouTube videos per week. This potentially massive audience gives popular creators a real opportunity to engage peer-to-peer with fans about previously taboo topics.

After filmmaker Anna Akana lost her younger sister to suicide, she began using her channel to speak out about mental illness, becoming one of the first highly followed vloggers to address her own depression publicly. In a 2013 video, "Please Don't Kill Yourself," she said, "I've been pretty open about the fact that my sister committed suicide in 2007, and I've been getting a lot of questions from people, like, 'I want to kill myself. What should I do?' If you commit suicide, I don't even know, I don't even know what would happen to you. All I really know is what happens to the people around you after you die."

As an Asian-American vlogger with 1.7 million subscribers, Akana hopes to give public discourse about depression a different face and enable a discussion about how culture and race affect notions of mental illness. "Mental health was never really discussed in my family," she says. "It still isn't, even though we lost someone to suicide. I decided to finally talk about it because so much of the internet is about being open and honest. I really wonder if my sister would have gone through with her suicide if she had had a personality she watched or an influencer she looked up to who talked about these issues."

When lifestyle vlogger Alayna Fender had her first panic attack in junior high school, she had no idea what was happening to her body. In 2015, after getting a handle on her anxiety through a daily practice of mindfulness, she uploaded her first video describing her years of unpredictable attacks. "I decided to start talking about it because I'm from a small town and when I was growing up I didn't know anyone who had anxiety," Fender says. "Being able to go on the internet and see other people who were going through this was so helpful for me. I've done my job if someone who is younger and doesn't know anyone with anxiety, or doesn't understand what's happening to them, can watch one of my videos and go: That. There it is. That is what I'm experiencing. I'm not alone. I'm not the only one."

A vlogger's ability to build community through the shared experience of mental illness can have broad impact, says psychologist Denise Sloan of the U.S. Department of Veteran Affairs, who cites social support, real or virtual, as one of the biggest factors in the healing of veterans suffering from PTSD. "It's easy for a therapist to tell a veteran, 'These treatments really work,' but they believe it more when they hear it from another veteran," she says. A social media community has the power not only to normalize symptoms for sufferers but "to help people understand how effective treatment can be."

Each successive YouTube star who has come out seems to have inspired others to reveal their own realities to audiences. When vlogging pioneer and best-selling author John Green (The Fault in Our Stars) began speaking out about his severe anxiety and OCD on his channel, he paved the way for others, such as comedian, chef, and vlogger Hannah Hart, who has posted about her depression and her experience growing up with a schizophrenic parent. And at the 2015 Streamy Awards honoring video creators, prankster Yousef Erakat, whose videos have been viewed 1.4 billion times, used his acceptance speech to reach out to others who, like him, live with bipolar disorder.

The Power of Disclosure

The idea that confessional videos bring psychological benefits to their creators is based on foundational research on the power of expressive writing to help people come to grips with traumatic experiences. In 1997, James Pennebaker of the University of Texas asked a group of students to write for 20 minutes at a time over the course of several days in response to a prompt about traumatic experiences; other students were told to write in the same fashion about a neutral topic. Those who responded in writing to the prompt about traumatic experiences reported better psychological health months later and had made fewer visits to the campus health center. The "Pennebaker paradigm" has since been confirmed by other studies, including a number evaluating individuals who blogged about their experiences. The exercise enables people to build a structure around their difficult experiences and regain a sense of control—much as the vloggers have.

Years later, a University of Michigan undergraduate, Sonia Doshi, launched a series of confessional performances on her campus called "The Mental Health Monologues," to help peers explore the link between speaking out and healing. Doshi guided participants over the course of three months to create stories, videos, and, eventually, live performances describing their experience with mental illness. "It was incredibly cathartic to go through the process of writing, creating, and sharing these stories. It was a way for them to reflect on what they had been through in a safe space," says Doshi, now a Stanford graduate student, whose master's thesis examines the positive power of technology on mental health activism.

"People are going to use social media no matter what," Doshi says. "We're in this culture of communicating and consuming constantly; why not capitalize on that? The power to have that impact on a wider, more global scale is huge."

While research confirms the personal benefits of mental-health vlogging, many creators cite helping others as their prime motivation, and that can be more challenging to pull off. There may be pressure to offer fans an "I'm OK now!" catharsis even when that's not one's reality. This can send a inaccurate message about one's condition and do more harm than good.

"On one hand," Fender says, "it's important to talk about mental health, but on the other hand, people want to see you overcoming. They don't necessarily want to hear about your anxiety and then hear about it again and again. That's the messy truth of life: Anxiety, depression, mental illness—they don't just go away. As scary and as intimidating as it might be, it's important for us to talk about them over and over and over again."

Whether consciously or not, vloggers discussing mental health become de facto spokespeople for their conditions. Those who have embraced that role say that support, professional and otherwise, outside the closed universe of YouTube, is vital to enable them to continue in that role. "YouTubers are worldwide, and people are online at all times," says marriage and family therapist Kati Morton, a vlogger based in Santa Monica, California, whose videos explaining mental illness and related issues have been viewed 15 million times. "When people put themselves online and are being vulnerable, it can be a recipe for disaster if they don't take proper precautions."

Psychologist Seth Gillihan often recommends social apps and YouTube channels to his young clients, and credits responsible video creators with providing resources that viewers might otherwise have difficulty accessing because of cost or their location. Ideally, such videos offer awareness and destigmatization and make effective treatments more widely known. "That's something that I think people in academia are not great at doing," he says.

As open conversations about treatment gain momentum across social media, there's also been an increasingly frank public discussion about the link between identity and mental health. For British lifestyle vlogger and mental health advocate Grace F Victory, talking with her 215,000 subscribers about her experiences with depression, self-harm, and eating disorders has been vital not only to her own healing, but also to addressing the stigma around mental illness she has seen among peers in the black community. "When one person is honest and open," she says, "others tend to follow. I don't want to paint a fake picture of my life, because it's important that people see every side of me. Suicide and self-harm are epidemics, and I can't sit back and watch. This is my way of doing my part."

As performers, vloggers, and others have led the movement toward greater openness about mental health on YouTube, the professionals have followed suit. Morton launched her channel five years ago to provide tips and counseling to individuals her practice otherwise could never have reached. She's since produced nearly 800 short videos. "I hear from many viewers that they've been in therapy for three or four years and no one knows," she says. "They've kept it a secret, as though it's something embarrassing, and I think putting it on a public platform really helps people realize: I'm not alone, this isn't weird, and it can get better."

Such interactions, even if they're hesitant, anonymous first steps, shouldn't be dismissed just because they are virtual in nature, says Pamela Rutledge, director of the Media Psychology Research Center at Fielding Graduate University. "The ability to interact over social media normalizes mental illness to some degree, but it doesn't change what people's daily realities are—if their mothers are embarrassed by them, or they can't tell their friends," she says. "But social media gives them an outlet, a place to go for support where they're recognized and understood, and the more practice you have being authentic, the more likely you are, at a certain point, to transfer those behaviors into your offline world."

The Parasocial Paradox

Viewers can get strongly attached to YouTube stars, who must walk a fine line when it comes to interacting with fans in their Comments section and other forums. As a vlogger gains in popularity, their relationship with their audience can transform from peer-to-peer to a deeper but one-sided emotional attachment.

One risk, Morton says, is that viewers may commit "emotional blackmail" in a channel's Comments section through claims like, "If you don't get back to me, I'm going to kill myself." "This can be so hard for a creator to see, and many don't know how to handle it. They'll stumble across a comment from six days ago and think, Oh my god, did they...?" she says. "Creators need to know that they are in no way responsible for that person and that most people who send these messages are not actually suicidal. They are simply reaching out to anyone they can for connection."

Fans may also have an expectation of support from a vlogger that can be provided only by a professional. "Sharing intimate information such as personal struggles can increase the sense of connection and emotional closeness felt by a fan. 'Seeing' someone in videos can create the sense that you actually know the blogger—a parasocial relationship," Rutledge says. "I would recommend that every vlogger talking about mental distress have information about outside resources handy and easily shareable."

Many creators launched their channels to help others, but as the most popular have become online celebrities, the pressures of dealing with fans—without the resources and gatekeepers from which traditional celebrities benefit—has only risen. Akana says that, to preserve her own mental health, she no longer responds to comments on her page. Fender responds to fans demanding more with information about professional resources that she hopes will inspire them to take the next tangible step to getting help.

Jamison Monroe, the founder of Newport Academy, a residential rehabilitation center for teens, sees in his work how young people can easily confuse "the unrealistic highs, and no lows" of social media with the ups and downs of real life. For a teen already living with mental illness, constant social media consumption invites comparison to other people's carefully crafted "perfect" public personas, which can heighten feelings of isolation, anxiety, and a fear of being less than everyone else. He welcomes responsible vloggers' contributions because "anytime a public persona speaks out about his or her personal struggles, it only makes it easier for others to do the same."

"Social media is not going to fix someone's depression," Monroe says. "What it can do is reduce stigma and increase the likelihood of someone asking for help. That's how they're going to get from dark to light."

Michaelis, who posts One Minute Diagnosis videos on his own YouTube channel, praises the platform as a place to satisfy curiosity about mental illness. But he acknowledges the potential downsides, such as overidentification and the spread of misinformation. "The videos are mostly a positive because if you're curious enough to be watching and thinking along these lines, you're probably going to get help for yourself," he says. "But if you then attach a diagnosis to someone else, that's concerning to me. And in some ways, these videos can provide ammunition to people to diagnose others."

If vloggers can't cure mental illness, they can set someone on the path to recovery by offering true-life examples of people battling the same demons and doing their best to live a full life. Creators whose output also includes performance, comedy, or discussion of a range of topics besides their mental health model the idea that mental illness does not have to define one's identity. While elsewhere on the YouTube platform, creators are embracing cinematic techniques, the mental-health corner largely remains simple, personal, and direct. Viewers get invested, and as they encounter stories they've never heard, taboos break down and greater understanding may emerge.

"Traditional media is airbrushed," Morton says. "This is, 'I'm in my apartment in my sweatpants and I've just been crying all day, but I want you to know I'm still fighting.'"

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