This article originally appeared on VICE Alps
Ana, Annie, Bella, Deb, Mia, Perry, Sue and Sophie aren't real girls. They're abbreviations for mental health issues and eating disorders used by teenagers looking to band together through personal stories on Instagram. Ana, for example, appears to stand for 'Anorexia'. Annie means 'Anxiety' and Bella 'Borderline', while Sophie is 'Schizophrenia'. Yet, there is one hashtag that seems to be cropping up more and more often on social media in recent months: #Sue for "Suicidal".
While Anas (anorexics) and Mias (bulimics) seem to basically interact on forums and WhatsApp groups, Sues mostly connect on Instagram. Instead of fighting against their depression, these teenage girls have managed to turn the disorder into a fundamental part of their identity.
According to youth worker Patrizia Castelli, "the rampant flow of information and the unlimited possibilities for consumption on the internet pose a large problem for people with such preconditions." This is supported by a number of studies examining the dangers and risks that come with joining an online community.
Personifying their illness seems to not only bring these young women together but to also validate and glorify the condition in the process. It's only among their fellow sufferers that these girls get a sense of community. Suddenly, being at odds with the world becomes revered; In their minds, the teens are not sick – they are special.
In our eyes, everyone who commits suicide becomes an angel. If your whole life was spent in hell, you belong in heaven. We envy those girls for having the courage to do what we all want to do, but we also respect them for bearing so many years before ending it all.
Looking up #sue on Instagram generates countless posts that relate to suicide – and Instagram is aware of the problem. If you type #sue into the search box, you'll be confronted with the warning: "Please be advised: These posts may contain graphic content. For information and support with suicide or self-harm please tap on learn more." Clicking on that link takes you to suicide prevention website, Befrienders Worldwide.
In early December 2015, images of the word 'Angel' written on the wrists of young Sues made the rounds of German-speaking Instagram, under the hashtag #respektvorsuizidengeln (#respectforsuicideangels). Apparently, one Instagram user had started the hashtag to pay homage to all those Sues who had already killed themselves.
Frank Köhnlein, a youth psychiatrist at the University Clinic in Basel, explains the dangers posed by such movements: "Young people who are already fragile and perhaps already have experience with self-harm could be massively stimulated by this sort of thing and encouraged to self-harm again. When self-harm is glorified or – as in this case – put into an almost religious context, so that it is evaluated positively, the risk is particularly high."
When I contact the psychological support service for young people in Zurich (where I am from) and ask them about the issue, I'm told they have never heard of the Sue hashtag. That makes the danger of online communities all the more clear; The hidden meanings and regularity of these hashtags is hard to chart, so it's equally hard to develop an effective course of action against them.
UK mental health charity Mind, on the other hand, are aware of the issue: "We know that lots of people find online forums helpful, particularly if they are unable to confide in friends or don't have strong social networks. We would encourage those people to visit online peer support networks like Mind's Elefriends website where people can discuss their problems with others who are going through similar experiences and talk about potential solutions," says Eve Critchley, Digital Community Manager at Mind.
Of course, the worship of psychological crisis is at the centre of this phenomenon. I first encountered the symbol of the angel in a pro-Ana WhatsApp chat I infiltrated for the purposes of an earlier article. The members of the group told me they believed they had been angels in a former life. Apparently, their shoulder blades are the place where their wings once were – the bonier the shoulder blades, the closer one is to turning into an angel again. Quite literally, as Anorexia Nervosa has the highest mortality rate of any psychiatric disorder in adolescence.
Moreover, approximately 20 to 40 percent of those deaths are thought to result from suicide. In my attempt to understand even the tiniest fraction of their reality, this time around I spoke to a Sue who asked to remain anonymous – so let's call her, Leandra.
This dynamic bares a lot of similarities to that of a sect: The concept serves the group, but damages the individual members.
Leandra started by explaining what #respectforsuicideangel means: "In our eyes, everyone who commits suicide becomes an angel. If your whole life was spent in hell, you belong in heaven. We envy those girls for having the courage to do what we all want to do, but we also respect them for bearing so many years before ending it all."
This dynamic, naturally, bares a lot of similarities to that of a sect. According to Susanne Schaaf from the Swiss Office for Sect Issues what's sect-like in this case is "this internal logic that blocks out aspects of reality. These 'Sues' have developed an almost ideological structure, within which young people who have committed suicide are called angels. Their 'act of bravery' is admired and they are 'honoured' by having the word 'Angel' scrawled over the patently symbolic wrist."
But Schaaf recognises another dangerous pattern here: "Killing oneself is re-imagined as freeing oneself. We don't classify this movement as a religious phenomenon, but images used in an ideological context are instrumental in reinforcing, justifying and promoting these thoughts, feelings and actions in young people. The concept serves the group, but damages the individual members."
For Leandra, "being a part of the community is wonderful. You feel understood. Everyone has the same or at least similar problems – no-one is judged because everyone knows what it's like to be judged. No-one has to pretend they are someone else. You're accepted just as you are."
Fear of judgment is a focal reason why teens suffering from mental health issues don't confide in anyone else. Rather than being offered the help they sorely need, many Sues are met with incomprehension and spite in their close environment. So, ironically, they look for stability in the supposedly safe anonymity of the web.
Frank Köhnlein also notes that those teenagers should not be accused of being attention-seekers. "Even if someone appears to 'only' want attention, it's worth a closer look. After all, we all more or less want attention. The question is: Why does someone choose such a self-destructive path to get it?"
If you are concerned about someone you know, it is important to avoid passing judgment and seek a conversation instead: "Such behaviour should always be addressed," says Köhnlein. "If they respond evasively and you have grounds for concern – for example because the child shows other signs of depression – I would recommend seeing an expert: A paediatrician, a child and youth psychiatrist or a psychologist."
When it comes to measures one can take if they start spotting warning signs in their own behaviour, Mind's Eve Critchley adds: "I would encourage people to be aware of how they are feeling when they are online and, if they are feeling vulnerable, to take a break from their computer or phone. We would also ask people to consider whether the things they post online could be triggering for others and to use a trigger warning if necessary, so that others can make an informed decision about whether they want to look or not."