What to hear of stories from a psychiatric ward? Or learn about the life of a 33 year old diagnosed with personality disorder? Or a father's perspective of caring for a son diagnosed with schizophrenia? Adam James examines mental health blogs.

September 15, 2006

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There?s reflections, anecdotes from daily life and debate?as well as pain. Welcome to mental health blogs, online journals (or web logs) where anyone with access to a computer can upload their thoughts - be they insightful, distressing or plain drivel ? for the world's billions to read.

Blogging began in earnest in 1999. Now it?s a self-publishing phenomenon and the internet is rife with blogs, whose quality and purpose varies. There's the excruciatingly banal (such as a woman posting pictures of daffodils blooming in her back yard at willa.com) and there?s the heavyweight (such as BBC political editor Nick Robinson discussing Gordon Brown at bbc.co.uk/blogs/nickrobinson). Eager not to miss a trick, brands, such as Nike, have launched corporate blogs.

As for mental health blogs, they are as varied. There?s the torturous despair of an American woman ?trapped within the dark, surreal realm of mental illness? who?s considering having a form of brain nerve stimulation to treat her depression (themassdefective.blogspot.com). Of a contrasting genre is university professor Peter Beresford?s blog (bizbuzzmedia.com/blogs/peter_beresford). Beresford reflects on social policy and, for example, criticises the Disability Rights Commission for its use of the phrase ?you must be crazy? in one of its campaigns). One polemical blog, psychwatch.blogspot.com, regularly posts a collection of ?stories about psychiatric screwups?, such as that of a forensic psychiatrist at Strangeways Prison, Manchester, who in May allegedly dumped hundreds of confidential statements from victims of sex attacks and child abuse in a public rubbish bin in Bradford.

Each blogger has their own reason for sending out that first online ?post?. But, of the hundreds of blogs by people struggling with a mental health diagnosis, one prevalent reason is that blogging helps achieve catharsis. Blogging allows the sharing of thoughts and experiences while residing in the comfort of anonymity. Many bloggers are, therefore, startlingly candid. ?All I've done for the last 20 years is to let people down, to let myself down," blogs ?Scott? a nurse from Florida in America at butterflies-and-bruises.blogspot.com.

?I thought that I was really making headway with progressing from those awful, destructive behaviors. Now, I don't know. After talking I can't shake this feeling of failure. I will pray on it and sleep on it. I will surrender these feelings of doom and gloom to my Higher Power. I can't handle it. I can't handle it. I can't handle it?I can't handle it. I can't handle it. I can't handle it.? Hard words to read, hard words to write. But Beresford, who has himself experienced depression and anxiety, recognises this therapeutic benefit of blogging : ?The more things are out in the open, the better it often is. One of the most awful things about distress is that you may feel [because of stigma] that you can not talk about it,? he says.

A New Zealand 33-year-old blogger diagnosed with personality disorder (http://polarbearblog.blogspot.com) explains that she started to blog after a suicide attempt. ?I needed to express myself, and I needed to let people know about the despair I often felt. I had few friends and support in real life, and so I turned to the online community.?

Likewise, Mike, the father of a 26-year-old man diagnosed with schizophrenia, started blogging (mindriddles.blogspot.com) following his own ?nervous breakdown?. ?For me my blog was intentional therapy to get out some of the emotion,? he says.

As for blogs by mental health professionals, these are conspicuously sparse. This is largely likely to be due to the fact that employers ? private or public sector - would object. However, such blogs do exist. One of the longest running is mentalnurse.org.uk, a humorous and sometimes irreverent blog by a mental health nurse. It details his life, from the mundane to the upsetting. In one post ?Mentalnurse? described when John, a patient, committed suicide by hanging himself on a ward. Mentalnurse was actually John?s key nurse and so shares his feelings over the tragedy. But Mentalnurse remains attentive not to give too much away. For example, he describes the suicide as occurring in a ?busy acute ward in a distant part of the country.? In a similar bid to disguise his employers, when in another job, he named the ward in which he worked as ?Swamplands? and his not-for-profit employers ?The Brotherhood?

Those bloggers who do use real names have to be careful over what they write. In theory, anyone who publishes a blog could be sued for libel. This is something that the bigger media companies (such as Emap which hosts Beresford?s blog) will be all to aware of. In March, Michael Keith-Smith, a Ukip candidate in Portsmouth North at the last election sued a woman who, on a Yahoo message board, falsely labeled him a "Nazi", a "racist bigot" and a "nonce". Tracy Williams, a college lecturer from Oldham, was ordered to pay £10,000 in damages. It?s warning shot for any mental health blogger pondering about whether to publish derogatory or insulting words aimed at a professional, colleague or service user.

Nevertheless, because blogs allow readers to post their own comments, they can quickly generate close-knit online communities. For example, one reader of mindriddles.blogspot.com ended up interviewing Mike and his family for a book she was writing. She also offered them use of her house in Spain for four months. Another introduced the family to how the new direct payments system of healthcare might benefit Mike?s son. ?We?ve met some wonderful other carers from the blog. It?s also been useful because readers have helped us to find out what is available in the [mental health] service,? says Mike.

And, even if a blogger is anonymous, the more detail a blogger provides the higher the risk they?ll be identified. For example, although Mike decided to conceal his identity when he started blogging in February 2004, word soon got about that he was blogging. First his extended family knew and then his son?s key care worker, and they all tracked down Mike?s blog. Mike now as to bear in mind such readers when blogging.

Finally, for those who start blogging for cathartic reasons may find that, if their blog?s popularity grows, so a sense of ?duty? to keeping posting entries increases. This applies especially if a blog is well read. Mike, for example, admits his blog as ?kind of become a job?. ?This is because I know other people read it readily. It?s less of a therapeutic thing now.?

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Want to blog?
If you want free and easy, there?s (part of the google empire). It takes all of five minutes to set up your own blog using a choice of six or so design templates. Just give yourself a username, password and the name of your blog. You can upload pictures, delete comments, posts, add links etc. Your blog, hosted by blogger.com, will automatically be included in google?s ever more popular blog search. For the more tech-savvy http://wordpress.org enables you to design your own blog and host it on your own website. For a tailor-made blog, expect to pay a professional web designer up to £600.

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Blogger profile:

Blog name: ?Up the Down Escalator: Life of a husband caring for his schizophrenic wife? (http://downescalator.blogspot.com)
Profile. Works with learning disabled. Wife, ?S?, is a welfare rights worker ?when her illness allows?. Both mid 40s with three children. Active in mental health charities and local mental health groups.
Why did you set up Up the Down Escalator? I didn't feel I could really talk to family and friends about my fears and concerns, particularly when my wife's symptoms were bad . At the same time there was an immense need to 'let things out'?. Writing down my experiences helped in this regard.It's a cliche but it really was cathartic and it helped me deal with some of my frustrations.
How many visitors? No official counter. I know from emails I receive that it is being read by a lot of people in the same situation as myself.
Are comments you receive useful? Some are very useful, life-savers almost. One person sent me the book Phone at Nine Just to Say you're Alive by Linda Hart. It was my bible for weeks and gave me hope when I thought I'd lost everything. I'll be forever indebted to that person for his comments and encouragement.
How do you conceal your identity? I don't use names and locations and I talk about feelings, thoughts and medication. These things are universal to people who care for someone with mental illness. Anonymity is more a concern of mine than my wife's. She is quite happy to talk about her illness openly.
Which blogging software and why? Blogger.com was the most simple. I didn't want any ?bells and whistles?. I just wanted to be able to write. I had no idea how long I'd be blogging. I just wanted to set it up and get going.
Other recommended blogs? http://mindriddles.blogspot.com/

* This article first appeared in Openmind, published by Mind

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