Social media consumes the attention of the majority of teens. It is a place to express yourself, flirt, intimidate, and keep them up to date with the latest happenings in the social circles. But, teens are using social media for much more.

Instagram, a social media site comprising photographs followed by comments, is one of the most common sites used by teens. They post everything from the meal they are eating to the new love in their life and everything in between.

The comment left below is usually what is known as a hashtag. A hashtag is a type of label or metadata tag used on social networks and microblogging services, which makes it easier for users to find messages with a specific theme or content. Users create hashtags by placing the hash character # (the number sign) in front of a word or unspaced phrase, either in the main text of a message or at the end. Searching for that hashtag will then present each message that has been tagged with it.1 Although teens seem to prefer simple phrases, these hashtags are used to link users to what many refer to as “Secret Society.”

For example, if a teen girl was “cutting” or interested in connecting with other teens that cut, putting #cat would link her to several social communities with the related topic. Similarly, #selfharm was the initial term used to connect to this secret society. When that was shut down by the social media site, it resurfaced as #selfharmmm2.

#MySecretFamily is a very popular hashtag that connects teens struggling with a variety of mental illnesses. Teens are instructed to put various names in their profile to identify which mental illness they are battling. For example, depression would be identified as “DEB” for a girl and “DAN” for a boy. The chart below lists various disorders.2

Nonsuicidal self-injury (NSSI) or deliberate destruction of one’s body in the absence of suicidal intent3 is most common in the middle school ages, and exposure to peer NSSI may increase the risk of engaging these behaviors.2,4 Although distinct from suicidal behaviors, there is a comorbidity between them. The normalization of these behaviors through social media and acceptance into the this “Secret Society” can only augment the risk of NSSI.

Parents not only need to be educated about the importance of monitoring their children’s social media but also about what to look for that may be a sign that something more serious is going on with them.

Although we hear so much of the negative impact of social media, it also can be a tool for early intervention.


1. Oxford English Dictionary, definition of “hashtag.”

2. J Adolesc Health. 2016 Jan;58(1):78-84 .

3. Understanding nonsuicidal self-injury: Origins, assessment, and treatment (Washington: American Psychological Association, 2009, pages 9-18.)

4. Dev Psychol. 2006 May;42(3):407-17.

Dr. Pearce is a pediatrician in Frankfort, Ill. Email her at .