The authors’ observations
It can be difficult for patients to step away from social media outlets through self-limitation. Our treatment plan comprised two parts: prevention and negotiation of recurrences. We worked with Mr. M to develop a set of Facebook rules outlining his baseline use and designed to limit potentially upsetting interactions (Table). We coached him to better identify his anxiety responses and established an agreed-on process for negotiating those feelings that involved intentional emotional and time distancing before any recourse (Figure 2).
Mr. M was discharged after 7 days of treatment and has been seen weekly as an outpatient for 3 months without need for further hospitalization.
Bottom Line
Pervasive access to social media represents a vehicle for relapse of many psychiatric conditions. Younger patients may be especially at risk because they are more likely to use social media and are in the age range for onset of psychiatric illness. Although some degree of dependence on online networks can be considered normal, patients suffering from mental illness represent a vulnerable population for maladaptive online interactions.
Related Resources
• Sandler EP. If you’re in crisis, go online. Psychology Today. www.psychologytoday.com/blog/promoting-hope-preventing-suicide/201110/if-you-re-in-crisis-go-online. Published October 26, 2011.
• Nitzan U, Shoshan E, Lev-Ran S, et al. Internet-related psychosis−a sign of the times. Isr J Psychiatry Relat Sci. 2011;48(3):207-211.
• Martin EA, Bailey DH, Cicero DC, et al. Social networking profile correlates of schizotypy. Psychiatry Res. 2012;200(2-3):641-646.
Drug Brand Names
Fluoxetine • Prozac Quetiapine • Seroquel
Risperidone • Risperdal Valproic acid • Depakote
Disclosure
The authors report no financial relationships with any company whose products are mentioned in this article or with manufacturers of competing products.