Helping others online may ease depression symptoms

“To ease another’s heartache is to forget one’s own.”

I’m told Abraham Lincoln said this, some 150 years ago. If you’re like me, you might initially dismiss this as just an empty cliche, another quote for a high school yearbook. Sure, maybe there’s some transient benefit to helping others. Maybe you feel a glow for a moment or two, but the effect is likely fleeting — a kind of high-fructose corn syrup for the soul.

Researchers at Columbia University and MIT, myself included, recently published new findings that suggest otherwise.

Under the right circumstances, it seems that helping others can be an incredibly powerful and profound way to help yourself. Depression symptoms can go down, while well-being scores can improve. These new findings, published in Personality and Social Psychology Bulletin this month, describe the psychological effects of helping others on an online platform for emotional well-being. Now called Koko, the service is available on Facebook Messenger, Twitter, Kik, and iOS.

Koko is something I originally developed at MIT, as a way to manage my own depression. The platform offers a simple, communal way to build emotional resilience. Think of it as a crowdsourced form of cognitive therapy.

How it works

Users first compose short descriptions of stressful situations and negative thoughts. Here’s one I wrote a while back, as I prepared for my dissertation defense:

I’m about to give a talk and I’m so nervous. My hands are shaking. People will see how nervous I am and think I’m stupid.

After a few minutes, my phone lit up and I started getting a host of positive, yet realistic, reinterpretations (aka ‘reframes’) from the Koko community. Here’s one that was particularly helpful:

I’ve been there, it sucks. But your nerves are your body’s way of preparing you for action. If anyone sees you’re nervous, they might just think you care a lot about your talk and that you’re taking it seriously.

Responses like these are generally returned within a few minutes and they’re always reviewed, by either human or machine. Users in severe distress get sent to crisis resources, while malicious types get the silent treatment. (Trolls can drip as much venom as they like into our network, but it doesn’t go anywhere and it’s never seen).

Importantly, Koko doesn’t rely upon clinicians or counsellors; rather, it coordinates the collective efforts of all users in the network, each of whom is trained on demand, as needed.

Though general use of the platform has previously been shown to convey benefits, the new analyses show that helping others, specifically, leads to the most dramatic improvements.

There’s something really beautiful and heartwarming about this basic social formula: Help others to help yourself. Aside from reminding us about the power of human kindness (something we could really use right now), this idea has immediate practical value for most large-scale social networks.

A safety net for social networks

Cries for help aren’t hard to find online. Search for ‘depression’ on Instagram and you’ll get well over 10 million results. Search for “I feel hopeless” on Twitter and you’ll see an endless, heartbreaking stream of sadness. Similar patterns exist on just about any large social network (Reddit, Tumblr, you name it). Sadly, millions and millions of people cry out for help on these platforms every day.

In the past two years, my colleagues and I have interviewed hundreds of these users. These individuals aren’t downloading mental health apps; they’re not picking up meditation or signing up for 12-week cognitive therapy programs. Rather, they’re using the platforms they visit every day — they’re hacking them, in a sense — to seek emotional support and validation. But these systems were never designed for this. Many of these individuals get shunned or bullied or, even worse, preyed upon. Peer support, if it comes at all, is unstructured and unlikely to help in any enduring way.

Some platforms, like Facebook, offer links to crisis resources and ways to reach out for friends. But friends aren’t always available or capable of providing support. Crisis resources, meanwhile, can’t accommodate everyone and they can be off-putting, particularly for people experiencing mild or moderate distress. What’s needed is a stepped model of care. To really address mental health concerns, we must deliver evidence-based care well before an individual reaches a state of crisis. And since the demand for in-person services will always outpace supply, online interventions that scale are sorely needed.

In his recent manifesto, even Mark Zuckerberg himself admits ‘‘we must find a way to do more.” But how? How might we address a problem of such magnitude, at the scale of large social networks (millions and millions of people)? The answer is simply this: empower people to help each other.

The power of helping others

This basic idea completely eluded me when I first developed Koko. The platform started as solely a place to get help (not to give it). I actually thought I might even have to pay people to help each other on the service. Indeed, when the service went live, back in 2012, I wasn’t sure anyone would actually sign on, let alone help each other for free. But within a few minutes, a handful of people started using the service.

One user, a participant in one of my research studies, had previously reported extremely high depression symptoms, including significant withdrawal from social activities. And yet as soon as she joined the platform, she immediately started composing the most beautiful responses for others. They were well-written and artful and full of hope. They didn’t seem like they could possibly come from someone with such severe depression. Watching this happen, in real time, was extraordinary to observe.

Bruce Doré, now a post-doc at UPenn and the lead author of the upcoming paper, tried the platform himself. Like many other Koko users, he immediately developed an intuition that helping others was perhaps the most therapeutic part of the experience. His analyses, reported in the upcoming article, lend support to this hypothesis: people who helped others on the platform tended to show the biggest reductions in depression symptoms.

What accounts for this effect? One possibility is that the act of helping others rethink their experiences has therapeutic benefit in itself. Our early analyses suggest that this behavior strengthens a faculty known as ‘cognitive reappraisal’, a way of ‘looking on the bright side.’ By helping others think more optimistically, over and over, this mindset may become automatic, almost like a reflex. One research participant wrote:

After doing more and more reframes that mindset started to permeate into my thinking process and when I faced a difficult scenario I started thinking, ‘how would I reframe that if I read it on the app?’

In addition to its possible therapeutic value, helping others on Koko is also fun. No one interaction takes more than a few minutes. In fact, the vast majority of people who seek help go on to help multiple other people in return. This creates a rare network dynamic, where supply and demand are continually in balance. For every post that goes out to our network, about four replies get returned (often in just a few minutes). Even at extreme surges in volume (say 10,000 requests a minute), our platform continues to flourish. This makes it an ideal complement to social networks that have millions crying out for help on any given day. For these reasons, we’ve started integrating Koko into large social networks, often through the private direct messaging channels.

My co-founders Fraser Kelton and Kareem Kouddous have led this effort with me, bringing Koko to over 200,000 people in the past year. In the past 6 months alone, 26 million messages have been exchanged on our platform.

All this being said, it’s important to remember that there’s no one tool to address the global mental health crisis. Be skeptical of anyone who tells you otherwise. But empowering people to help each other is a powerful place to start. It solves the problem of scale; for every person in need there are always people available to help. It also suggests an exciting new approach to mental health treatment. By helping others, we help ourselves.