Anxiety support in an online forum

Anxiety is a growing, worldwide phenomenon. The World Health Organization estimates that there are 264 million people living with anxiety disorders, which are characterised by excessive fear and behavioural disturbances, and which include specific phobias, panic disorder, social anxiety disorder and generalized anxiety disorder. In this project, we investigate an online forum dedicated to providing anxiety support and hosted by Health Unlocked: the world’s largest social network for health (https://healthunlocked.com/). Like many online forums, Health Unlocked offers users a space to get the informational and emotional support they seek in relation to a range of health-related topics. By examining the contributions and interactions of the Anxiety Support forum, we set out to better understand the lived experiences of those with anxiety, including the coping strategies they adopt to mitigate the impact of anxiety disorders.

Our data comprises approximately 21 million words of text posted to the Anxiety Support forum between March 2012 and October 2020. We are using corpus-based methods to analyse this data with respect to the following areas:

Sketching Anxiety: Our analysis begins with a focus on the word anxiety, using the corpus analysis tool Sketch Engine to provide a detailed ‘Word Sketch’ of its use in the forum, e.g. looking at its occurrence in different grammatical patterns. In demonstrating how anxiety is discursively constructed, we aim to show how users perceive anxiety disorders and how they talk about strategies for coping with anxiety. We also compare anxiety to related terms such as depression, fear, panic and stress to investigate how users of the forum relate these aspects of their mental health and how they differentiate between these often co-occurring experiences.

The Lived Experience: Research has shown that the stories people tell about their illness experiences “restore a coherent self by providing a meaningful explanation for a being in the world burdened by illness” (Kleinmann, 1988, p.48). We will investigate the narratives provided by contributors to the forum as a way of understanding how anxiety operates in the context of users’ lives and how the forum functions for participants to share their stories.

Creating a Community: Online forums provide invaluable opportunities to engage with other people’s experiences in a way that facilitates relatability and empathy, ultimately fostering solidarity and a community that extends beyond geographical barriers. Our work will investigate the affordances of the online platform by looking at the ways that participants respond to each other’s posts and how users elicit informational and emotional support from others in the forum. Focusing more on interactional aspects of the forum, we consider how users reach consensus and deal with conflict, establishing the conventions for the nature and manner in which participants support each other.

Sex and gender: Diagnoses of anxiety disorders are more common among females than males (4.6% compared to 2.6% at the global level) (World Health Organization, 2017). However, researchers argue that prevalence of anxiety among men is comparable to women and that normative gender ideologies affect how individuals talk about and seek help for experiences of anxiety (Gough et al. 2021). We will explore the forum both in relation to how posts made by female and male users compare in fulfilling particular kinds of support roles, as well as how participants refer to gender stereotypes, that shape their experiences of anxiety, including how and where they find support.

Comparing cultures: The Anxiety Support forum includes contributions from participants around the globe, with 38.84% of posts made by people from the UK and 33.94% made by those from the USA. Our analysis will include a comparison of contributions from the US and the UK, highlighting cultural differences in the way that anxiety is understood (in addition to spelling (favorite) and lexical choices (vacation)). This investigation will help to highlight how the respective health services of these countries shape users’ experiences of anxiety and their interactions with support services.

Changing Times: Our corpus contains posts made over an 8-year period, offering us the opportunity to look at how language has changed over the time, focussing on changes in how anxiety discourses are conceptualised (e.g. increasingly medicalised). Research has also shown that national and global events lead to increases in the prevalence of anxiety disorders. We can, for instance, examine the impact of Brexit on how users from the UK use the forum, or how participants discuss the impacts of the Covid-19 pandemic. The timespan of the data also enables us to investigate how posting behaviour ‘evolves’ over time. As an online community, we can see how more established contributors demonstrate their expertise and negotiate the communicative practices of the forum with newer participants. The diachronic nature of the forum will also help us to understand how we can support various stakeholders in living well with anxiety.

The project will run for 2 years and through our findings, we aim to demonstrate how important online spaces like the Anxiety Support forum are for individuals experiencing mental health issues, as well as to researchers who are interested in understanding lived experiences of health and illness.

Team

Professor Paul Baker (Principal Investigator)
Dr Luke Collins (Senior Research Associate)

References

Kleinman, A. M. (1988). The Illness Narratives: Suffering, Healing, and the Human Condition. New York: Basic Books.

World Health Organization (2017). Depression and Other Common Mental Disorders: Global Health Estimates. Geneva: World Health Organization. Licence: CC BY-NC-SA.

Luke Collins
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CASS co-investigator Paul Baker is a Professor of Linguistics and English Language at Lancaster University. His research interests corpus linguistics, language and gender/sexual identities and critical discourse analysis.