This story was first published on May 25, 2022. It has been republished on August 19, 2022.

Research shows people with bipolar disorder are prone to risk-taking behaviour they later regret. But social media has opened up whole new avenues for manic episodes to be immortalised and shared to hundreds or thousands of people.

In 2019, Sally was admitted to hospital for a manic episode. She wasn’t much of a social media user, normally only sharing the occasional food picture and a few posts about political issues. 

But she started live streaming her hospital experience — logging onto Instagram Live for 10 minutes at a time.

Two years later she was admitted for another manic episode and began posting frequent Instagram Stories of objects and posters in the hospital surroundings.

“Sometimes the posts were really funny, and I’d add music … really quite creative,” the 25-year-old says. 

“And sometimes they were quite dark.” 

Eventually her phone was taken off her. 

Posting online during these periods meant she’d shared deeply personal details that she couldn’t take back. 

This included talking about treatment she was receiving, and asking people to call the police.

When she got out of hospital some people told her it was “entertaining”. She says this was insensitive — “I just went through something traumatic and you’re telling me it was entertaining?”

Sally says it was hard “knowing that everybody else knew about personal traumatic things”.

People with bipolar are twice as likely to regret online behaviour

A recent Danish study found people with bipolar were more than twice as likely to regret behaviour on social media or online dating sites than people without.

Research shows people with bipolar disorder are prone to risk-taking behaviour they later regret. But social media has opened up whole new avenues for manic episodes to be immortalised and shared to hundreds or thousands of people.

Bipolar is generally characterised by at least one manic episode as well as depressive episodes. Mania can include feeling elevated or ‘high’, restlessness, inability to sleep, loss of inhibition, hypersexuality, buying sprees, racing thoughts and feeling like god is talking to you. For some people mania can develop into psychosis.

These symptoms can manifest online.

Julia Rucklidge, professor of Clinical Psychology at the University of Canterbury, says for people with bipolar, displaying risky behaviours in public “certainly happened” before social media.

She recalls instances in the 1990s of people “dancing in fountains naked when in a manic episode, which is a very public display”.

But she says sharing on social media can amplify the psychological effects of bipolar symptoms by displaying them on a public platform.

“With social media, that kind of event may end up getting recorded and as such there’s a permanent record, instead of it being one brief moment in time.”

‘There are conversations I’ve had online, in a sexual way, that I wouldn’t have had if I was not ill’

Lola-Rose’s memory of being manic is patchy. It was back in 2014 when she was 19, and Tumblr and Facebook were big. She remembers posting “a lot of things that didn’t make sense” and got caught up in “God stuff and angels”.

“Being manic is like taking way too much MDMA and then you start to hallucinate,” she says.

Lola-Rose, whose name has been changed to protect her privacy, says for her, the hypersexuality aspect of mania played out online. She describes this as “strong sexual urges that are not that healthy, and cross a lot of boundaries”. 

“You want to be compulsive when you’re in that state. The more risky, and the more out there, and the more exciting, the better. You kind of seek out those things because they feed that heightened-ness”.

She says platforms like Facebook give you access to a lot of people.

“There are conversations I’ve had online, in a sexual way, that I wouldn’t have had if I was not ill.”

“And that’s uncomfortable. And it’s uncomfortable if you have to see them again when you’re not in that state anymore.” 

Lola-Rose says it’s these conversations she “regrets immensely”.

“I never slept, I’d be awake and I’d be thinking about the moon and what it was telling me, and you can see who’s online.” 

She remembers messaging her friend's boyfriend and talking about being naked in the moonlight. 

Lola-Rose says those around her didn’t think anything was wrong — she and others were experimenting with drugs at the time.

“I think it was easy to go, ‘Oh she’s probably just a little bit fucked up, or she’s taken something’, instead of being like, ‘Oh there might be something quite wrong’.”

It can be difficult to move on

Sally had to take a break from going to the gym because she needed space before facing it again. 

Some people at her gym were following her Instagram at the time she was in hospital, and a few even messaged her saying “you need to take the meds”. 

Looking back at what she posted online while manic,  Sally says she can laugh about it and jokes with her mates. 

She still has the posts and videos archived and sometimes goes on and “has a little giggle”, although there’s some stuff she doesn’t want to see anymore.

“Most of my friends were really good about it,” she says. But she also lost some friends when she got out of hospital, people who “wouldn’t bother” anymore and didn’t reply to messages.

“If there had been no social media I think I would’ve felt way better about the whole situation, no one would’ve really known, and it would’ve preserved my confidentiality. I would’ve felt a lot more confident,” she says.

“I have a couple of friends who experienced it before me, and it was really good having their support throughout.”

What can help?

The authors of the Danish study on mania recommend cautious use of social media for people with bipolar, and education about healthy and safe use of social media. 

They suggest that clinicians could make a plan for online access with patients who might be admitted to the hospital in the future. 

But there’s a long way to go to reduce the stigma around bipolar and other mental health conditions, which contributes to feelings of shame about online behaviour.

Sally says she is disappointed with portrayals of mental illness in films and the stigma that goes along with that.

“They always seem to make the villain mentally ill. At the end of the new Batman film the villain is maniacally laughing in a psychiatric hospital.” 

She says she’d like to see representations of mental illness that don’t portray it as criminal.  

For her, telling people about her diagnosis has positively changed their opinion of it because they can see she’s doing well.

Sally hopes that upcoming law changes will improve treatment and preventative options for people with bipolar.

The Mental Health (Compulsory Treatment and Assessment) Act 1992 is being repealed and replaced, and the Ministry of Health is currently developing new policy with an expert advisory panel.

This follows the results of a government inquiry into New Zealand’s mental health system, He Ara Oranga. 

The report found that the Mental Health Act does not align with a recovery and wellbeing approach to care, and does not reflect best practice. It also found that seclusion and restraint is overused.

The Mental Health Foundation of New Zealand reports that two percent of the adult population are diagnosed with bipolar at some point in their lives.

Lola-Rose says being diagnosed was helpful because “often you can’t get access to help without a diagnosis” and it also validated what was happening to her. 

She’s returned to study to do a Bachelor of Health Science and a postgrad diploma in Psychotherapy, and says the diagnosis seems like a distant part of herself.

“It forms part of who I am, and it’s something I manage, but it feels irrelevant now that I have the tools to be well.”

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