How Letter Writing Became an Unexpected Mental Health Aid

When Diana Chao was 13 she was diagnosed with bipolar disorder. Growing up just outside LA, as a first-generation Chinese-American, she says she encountered stigma around mental health within her community at the time. Her family's limited experience of the American healthcare system in turn made her diagnosis alienating. She didn’t want to burden anyone with her problems, and so she turned inward and began to write. “Letter writing to no one, yet therefore everyone at once, became my only way to unwind. Through writing I discovered my voice and it became my way of building strength, quietly but persistently,” the 20-year-old mental health advocate and Princeton University student tells me.

Her belief in the power of letter writing grew so strong that in 2013 she started Letters To Strangers, a youth-run not for profit organisation for young people. Its premise was something that sounds fairly simple: a one-time anonymous letter exchange between peers. “Fifty percent of all lifetime cases of mental illness begin by age 14 and 75 percent by age 24," she says. "But there was, and still is, a critical lack of youth-for-youth mental health space, where peers engage with each other on a deep level without fear of condescension or dismissal from adult figures or each other." So Letters to Strangers encourages young people to form ‘Chapters’ in school student clubs and on university campuses, writing letters that share their vulnerabilities or offer support. To date, the organisation says it's impacted 30,000 people worldwide through letter exchanges, peer education and policy-based advocacy. What may have seemed like an isolated practice – Diana sat alone writing to no one – fits into a wider trend. From LGBTQIA people sharing their stories to individuals using letters to work through the tangles of their thoughts, a thread now connects a 1980s theory to thousands of people addressing their mental health with letters.

People often cite American social psychologist James W Pennebaker as the pioneer of writing therapy, based on a 1986 academic paper. Since then, the act of writing things down has been increasingly promoted as beneficial to mental wellbeing – frequently self-help books and fluffy internet articles will use journaling, gratitude diaries and list-making as examples of how to alleviate depression and anxiety. The benefits of the more archaic art of letter writing have not enjoyed the same amount of publicity. According to David Barton and Nigel Hall, who edited the book Letter Writing as a Social Practice, “While the contents of letters have always been examined and libraries are replete with published collections of the letters from famous writers, politicians, explorers, etc, far less attention has been paid to the activity of letter writing itself.” That’s changed slightly in the past two decades – see recent popular memoirs like One Million Lovely Letters and If You Find This Letter – but despite increasing attention, it’s still a less prevalently discussed form of therapy than other types of writing.

But as Barton and Hall argue, as a genre of writing, letters are perhaps most like a real human connection. “The letter can be used to mediate a huge range of human interactions; through letters one can narrate experiences, dispute points, describe situations, offer explanations, give instructions and so on,” they say. As a keen letter writer since childhood, due to long separations from my mother, I can vouch for how a letter replicates the feelings of intimacy that become lost in a text or a phone call. A person’s handwriting, the paper they use, even the way they space their words conveys so much more, and is physical like a hug or a kiss, and unlike words on a screen. Diana points to how letters can mimic conversation, and how therein lies their power as a tool for mental wellbeing: “Sometimes we have to talk things through with another person to get to the point we want to be – that's why psychotherapy exists. In my experience, letter writing, even if it's to an abstract stranger, is a simplified, more flexible approach to the same method. It helps transport our inner, nonlinear dialogue into a conversation that forces us to consider the nuances, logic and depth of our thoughts and emotions.”

Charity Letters Against Depression also recruits volunteers to write heartfelt letters to those suffering from mental health issues, but asks those requesting letters to submit a paragraph of personal information first. A volunteer then writes to them with their unique situation in mind, and the process aims to foster some longer term exchanges between participants. Florida-based founder Robert Mason explains that while it’s “definitely tougher to work with biographical information, with emphasis on having to protect sensitive data, I wanted to find ways that we could use shared experiences to help make the point that we aren't alone in this. The impact of a letter that is generic can't come close to the impact if I am writing a genuine and heartfelt letter that is specifically for you.” On average, Letters Against Depression say they receive up to 75 requests for letters per month and since their inception in 2014, they’ve sent out over 11,000 letters and cards.

Robert, who works as a financial analyst at Walt Disney World in his day job, says he started Letters Against Depression after he couldn't find a suitable treatment for depression, anxiety and borderline personality disorder. “For me, medicine and therapy did not work at all. Through many different times, I had to come off one set of meds and try a new one, which generally led to a few months of increased battling for myself.” During that time, he didn't feel able to share how he was feeling with family and co-workers. So instead, he started with journaling, but soon letter writing helped nudge him towards a more sustained sense of mental health stability. Of course, managing your mental health isn't a linear progression from 'unwell' to 'well' – most likely it's a balance of methods for managing your mood and wellbeing. As Robert says, "For some, medication provides this ‘cast’ over the wound, for others, it could be therapy. For me, my ‘cast’ was writing letters. I found that trying to help others made me feel better about myself – like I mattered.”

A similar realisation led London-based photographer Heather Glazzard to start Queer Letters in 2018, an ongoing project where photographs of members of the LGBT community are presented next to letters where they reveal their experiences, share vulnerabilities and offer advice. “When I lost my dad, it affected me quite heavily to the point of a breakdown,” Heather recounts. “Through this process of grief I started writing letters to him about his alcoholism and how that affected me growing up – things I wanted to say but felt I never could.” When Heather's mother died, their therapist recommended they go back to the letter writing that had helped when dealing with the death of their father. “She said I should start writing to my childhood self and it’s so bizarre the power it actually had on me. I instantly felt a sense of love for myself and for others. Before, I didn’t really know what that looked like. Now I see how loved I am, and that lets me love and support others even more.”

While each organisation is different, they share a catalysing spark – one person realising the power a letter can have. But as Diana explains, letter writing isn’t a replacement for treatment. “It's not going to magically make mental illness go away,” she heeds. “But what it is, especially in this digital age, is a way to reflect and meditate, a tool to make healing and wellbeing more plausible and long-lasting.” It’s true that letter writing is no quick fix, but as I recently realised when picking up letter writing again, it jolts you to attention and, through the sustained focus it requires, toward deeper emotional intelligence. Of course, real empathy isn’t easy – it calls for time and commitment. But offering it through letter writing in return gives, as Diana believes, “a safe way to practice what it's like to connect with another human being on a heart-to-heart level”. This is important, as like she points out, “If we want to change the future of mental health, first of all, we have to be there for each other.”

@kamilarymajdo