Participants in the study were emailed surveys and depression screenings at the beginning of the study and after two months. The authors of the study found that overall, 33.8 percent had resolved their depression symptoms, though "a causal relationship cannot be determined."

Among frequent users (more than five hours a week), the success rate was 42.9 percent compared to 20.7 percent for infrequent users.

After 12 months, 72.6 percent of the survey's responders still participated in their online group, and 81 percent were receiving face-to-face care. Sixty-two percent said their support group experience influenced them to "ask their health care provider a question," and 26 percent indicated they had made a change in their meds because of their group. Nearly all (95 percent) said participating in their support groups helped with their symptoms.

Seventy-eight percent of the online participants were women (a figure that almost exactly matches my Newsletter subscribers and website visitors, by the way), aged 40. Forty-five percent had completed college, but 42 percent were unemployed and only 44 percent were married As a group, they were chronically depressed and socially isolated, ranking low on such measures as tangible support (eg someone to help you with chores if sick), positive social interaction, emotional support (eg someone to talk to), and affectionate support. This social isolation did not appear to be the result of frequent internet activity, as there was no worsening over 12 months.

Forty percent of the participants in the study came from Walkers Web (AKA Walkers in Darkness), which started a decade ago as a group of people sending email to each other. Walkers now hosts 16 message boards (including one each for depression, bipolar, PTSD, panic, teens, and spirituality), four chat rooms, and six mailing lists that serve 14,000 registered users. Volunteers put in 400 hours a week moderating discussions.

Walkers is run by Mark Oberg, 44, who ten years ago went from vice-president of a hi-tech firm to sleeping in a shelter. Mark's first suicide attempt and subsequent hospitalization resulted in an outpouring of good wishes from fellow list members. "You have no idea how that changed my life," he confides. A year or two later, in 1996, when founder David Harmon decided to step down, Mark assumed full-time responsibility "as a way of repaying the debt which gave my life back." (Mark is quick to add Walkers is not a suicide crisis group.) Since then, Walkers has become his "life's work and passion."

"It was like all of a sudden I am not alone," says Kathleen, a Walkers regular. "Others out there know how I am feeling." She adds that there is almost always another member of the Walkers community available to chat, from any part of the world. Participation puts one on both sides of the advisor/advisee equation, she notes, one day "helping someone share what you can when you can, then having your whole world cave in and crying for help the next getting what you need from what others have to share."

Says Anita, who has bipolar and PTSD: "I can't begin to tell you how comforting it is to just log in and talk to others like me day or night. I am now a staff member of Walkers chat and I can't tell you how much it means to me. I have a reason to live."

And from Carmen: "There were several moments where the people and support here helped get me through the day. Walkers has always been a glimmer of hope surrounded at times by overwhelming darkness." Carmen's depression has improved, and her new career hardly allows time for much email, but she stays connected to Walkers knowing "support, love, and acceptance are only an email away."

And it took psychiatry 12, 13, 14, 15 years to find this out?

More

The authors of the online support study note that an estimated 33 million Americans have used the internet as a health resource. By 2000, 41.5 percent of American households had internet access.

Online Support

Walkers is not an isolated phenomenon. Entering "depression support" or "bipolar support" into Google turns up hundreds of choices, though most of these are outdoor stalls compared to Walkers' Wal-Mart (see selections under Support Links). The only other comparable online organization, serving a different constituency, is the Child and Adolescent Bipolar Foundation, comprising parents who find it difficult to leave their homes to attend a live support group, with 19 message boards, 20 mailing lists, and state-of-the-art articles on early onset bipolar. The Depression and Bipolar Support Alliance, whose strength is its hundreds of face-to-face support groups nationwide, has recently made a virtual outreach, adding three message boards to its revamped website.

My Experience

My experience with online support was very briefly recounted as part of a June 2001 Newsweek cover story, The New Patient Power, on health and the internet. Following my diagnosis of bipolar in early 1999 after a series of crushing depressions, I dragged myself to the computer to find out what I could. I checked out several message boards and gravitated to one in particular, run by Colleen Sullivan at Bipolar World. Someone had posted a list of ten ways you know you have bipolar. One of them was, you know you have bipolar if you think Robin Williams should stop being so laid back. I knew then I had found a home away from home. Colleen encouraged me to write on depression for the website Suite101.com, and most of you know what happened from there. These days, my emails back and forth from readers have replaced my participation on message boards, but the principle and the practice remain the same - we are all part of a community helping each other and we are not alone.