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Masked in code: Teens share self-harm on Instagram

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LA Post: Masked in code: Teens share self-harm on Instagram
February 16, 2024
Nahal Garakani - LA Post

A disturbing phenomenon is unfolding on Instagram largely unseen—in plain sight, teenagers struggling with self-harm are finding connection but also enabling each other's affliction through covert communities operating via secret hashtags only they recognize as alerts to graphic content.

Research out of Seattle first peeled back the veil on this practice in 2015, exposing the extensiveness of obscure keywords used by teens who cut or otherwise intentionally injure themselves. Their findings revealed a complex subculture of mutual validation but also normalization that pediatric specialists worry could spur higher rates of self-harm. Yet solutions remain murky for social platforms thrust into monitoring youth mental health.

Instagram officially prohibits hashtags deemed as glorifying self-harm, resulting in blocking those terms as searchable. But users continually manipulate new permutations once banned keywords get identified. Study author Dr. Megan Moreno, an adolescent medicine expert at Seattle Children's Hospital, tracked this sequence as teens jumped from blatant identifiers like "#selfharm" to variations like "#selfharmmm" once the initial hashtag met restriction.

Drilling further into this universe, researchers uncovered the scope of innocuous terms coopted actually to signal distress. By analyzing over 200 Instagram posts, the team compiled a glossary of coded language spanning "#blithe," "#ehtilb" (blithe spelled backward), "cat," "deb" (for depression), and "Annie" (for anxiety) among dozens more functioning as secret self-harm hashtags. But with teenagers continually generating covert keywords far faster than social platforms can trace, enforcement whack-a-mole ensues.

Instagram maintains that upon user reporting, any posts celebrating self-injury face removal. However, the Seattle team worryingly found that only about a third of the obscure self-harm hashtags they tracked displayed content warning messages. This leaves unsuspecting users, including vulnerable teenagers, at risk of unexpectedly encountering graphic imagery in their feed should they happen upon a lesser-known tag.

And the risks run in both directions. While connecting online provides a lifeline for isolated teens struggling with urges to hurt themselves, specialists express deep concern over enabling communities to normalize and even spread this behavior. Some hashtags tracked in the Seattle study revealed what researchers described as "pro-self-harm" messaging, including tips. When professional help remains out of reach for many, the support of peers facing similar battles holds undeniable appeal. But discussions can take darker turns when teenagers turn primarily to each other instead of adults.

Data on self-injury prevalence among youth tells an already troubling story. Government figures estimate that up to 20% of adolescents now actively engage in some form of intentional self-harm like cutting, burning, head banging, or picking skin compulsively. Studies consistently demonstrate that girls outnumber boys in these behaviors by more than three to one.

But those most likely to lack school support or access to clinical care also reflect some of the highest self-injury rates. LGBTQ youth living in hostile home environments self-report cutting at staggering levels up to 60%. Native American teenagers similarly top the charts for intentional injury over their peers. This suggests that existing disparities only widen the void vulnerable subgroups fall into when harming themselves in the absence of alternative coping tools.

This is why the connection can feel so critical when struggling alone. For ostracized LGBTQ kids fearing backlash or rejection at home, finding those who validate their feelings without judgment allows relief. Marginalized Native teens battling cultural losses echo this sentiment. And across groups, the common refrain focuses on finally feeling understood.

This raises the ethical tension underlying self-harm-specific hashtags. Banning them, however carefully hidden from general purview, still means eliminating connective tissue for isolated teens already experiencing social pain offline. But allowing them, however helpful as peer support portals, can also unintentionally enable harmful behaviors in youth lacking stabilizing guidance.

When clinical advisor Dr. Moreno first began encountering patients with self-inflicted injuries over a decade ago, social media had yet to saturate teenage life. Smartphones were not ubiquitous accessories. And coded cries for help on Instagram could not unfold as they now do by the second.

Over years of bearing witness to rising adolescent mental health crises that outpaced care capacity, Dr. Moreno felt compelled to quantify troubles she suspected would only mount. As youth screen time climbed parallel to her caseloads, tracking technology's potential impacts and slippery intersections with teenage well-being begged investigation.

By following where her patients already looked to in moments of distress rather than healthy outlets, Dr. Moreno aimed to illuminate unseen effects. Her team's troubling findings added numbers to a reality she hoped would spark concern— that vulnerable youth hide suffering in plain sight while enabling each other's affliction under generic keywords once meant for poetry.

In the years since, the threads connecting mental anguish and social media only wove tighter still among teenagers—today, over 90% of adolescents frequent Instagram daily. And tie-ins between excessive screen usage and depressed mood continue consolidating. One analysis of over 17,000 youth linked over 7 hours per day online with poor self-image, trust issues, and thoughts of self-harm manifesting later.

When what teens see flooding their feeds compounds vulnerability, reference groups matter deeply. And while connecting with affirming peers who "get it" offers momentary relief on hard days, relying less on stabilizing adults carries risk long-term. This worries the specialists interfacing with youth already actively in day-to-day crises.

Teenagers partitioning off distress even from adults close to them points less towards secrecy than a perceived generational disconnect, posits Dr. Moreno. The teenagers she encounters often describe deep conviction that the adults around them, including parents, simply cannot conceptualize the pressures and pace defining Gen Z's existence.

Academic futures feel in flux, and economic prospects are beyond their control. Social hierarchies get cemented on apps tapped into at all hours. Any stumble in tone, appearance, or etiquette codes is amplified across screens for all to judge. So they shoulder escalating expectations alone rather than voice cracks to those they assume cannot truly understand the modern teen experience.

This is how hidden suffering festers—youth convinced the adults meant to nurture them exist too far removed from youth reality to provide meaningful support. Marginalized teenagers already battling erasure or misunderstanding offline rarely turn to those they expect would only further invalidate struggles.

So isolation feeds distress until finding projecting strangers online feels like finding kinship finally. Hashtagging pain provides momentary relief, believing someone might recognize your unique brand of mental hurt when offline spaces rarely accommodate this. Even when enabling under dangerous mantras like "cuts for likes," feeling some sense of shared understanding eases the ache of silent suffering enough to numb rather than amplify emotional wounds further.

But reliance on reactive phrases as a collective coping strategy points back to the underlying crisis—this generation's profound loneliness and need for spaces to process mounting pressures long since normalized beyond adult awareness. What youth then build in place of meaningful connection holds power to harm when lacking balance.

Behind the secret hashtags live real teenagers voicing real struggles without healthy outlets to turn to. Banning their makeshift support circles only removes the rare sense of community many currently know to rely on in challenging moments. However, allowing distorted coping to spread unchecked also carries risks when youth urgently require care outside of peers.

Navigating this tension falls heavily on parents equally worried about struggling teens following unhealthy patterns. Moreno's studies cemented worries about teenagers finding the worst distractions rather than life-saving interventions when a crisis hits and adults remain unaware.

For parents partly severed from the online reality teenagers inhabit today, the revelation their child interacts in coded self-harm networks compounds helplessness. Upending deeply embedded support circles can destroy the trust desperately needed for healing. But standing by while destructive behaviors permeate via hashtags also terrifies caregivers worried about losing their child when self-injury carries lifelong risks.

The solutions ultimately demand societal and healthcare infrastructures geared to support youth mental health before isolated teenagers develop web habits out of sheer necessity to feel some semblance of relief. Platforms committed to user wellbeing might consider upping content warnings, advertising counseling groups, and elevating recovery stories from peers as intermediary steps while society scales intervention. But much stands in the way presently.

With psychiatry shortages nationwide, few families gain swift access to critical treatment their teenager needs. And amongst communities of color already facing medical mistrust, steering adolescents toward clinical systems can feel misguided. Marginalized youth instead turn to those who have walked parallel roads—other isolated teenagers branding pain online, believing no one else might understand.

This leaves caregivers watching their teenagers drift towards dangerous digital spaces, torn on how to intervene safely. Mandating apps get deleted destroys ties to friends enduring similar struggles. However allowing groups to enable affliction, despite best intentions, feels negligent when youth require care.

For parents shouldering blame and shame over a child they feel disconnected from, judgment from others only compounds desperation for solutions. And without societal structures adapting to meet swelling adolescent mental health needs, families weather this crisis largely adrift and alone.

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