Exploring self-presentation posts of people with depression: themes, stigma, and identity construction

Introduction: Social media plays an increasingly influential role in shaping mental health communication. However, individual expressions related to self-presentation, particularly among people with depression, remain relatively understudied. This study aims to examine how individuals with depression construct and present their identities on Xiaohongshu (RED), a prominent Chinese social media platform. Methods: We employed semantic network analysis and content analysis to investigate depression-related self-presentation narratives on Xiaohongshu. User posts were systematically analyzed to identify key themes and patterns in identity construction. Results: Three primary themes driving self-presentation narratives were identified: Mental Health & Treatment, Life Stress & Emotion Management, and Self-awareness & Emotional Experience. These themes are intertwined with experiences of stigma and personal challenges, fostering a narrative shift toward optimism and resilience. This shift supports the formation of three distinct identity types: the Depressed Self, the Optimistic Self, and the Resilient Self. Cognitive biases such as negative filtering, overgeneralization, and catastrophizing were found to influence identity formation. Discussion: The findings reveal the complex interplay between thematic narratives, cognitive biases, and stigma in online self-presentation among individuals with depression. The study highlights the pivotal role of social media in redefining mental health narratives and shaping online identity construction.