The world treated Britney Spears’ mental health as a punchline. Things have changed for celebrities, but not for the better.

• Britney Spears became an overnight success, then faced years of constant harassment.
• When the scrutiny became too overwhelming, Spears and her mental state became a worldwide joke.
• These days we’re better at acknowledging mental health stigma, but we still pick at stars, and round-the-clock social media has replaced Spears’ swarming paparazzi.
• Visit Insider’s homepage for more stories.

I have a vivid memory of going to the grocery store with my mom when I was 13, and just staring.

It was 2007, and tabloid covers of a tired-looking, stressed-out, and bald-headed Britney Spears dominated the checkout aisle magazine stands.

Spears is 13 years my senior and as a child, I’d always seen her as the woman I wanted to become: Gorgeous, talented, and beloved. Those paparazzi photos, burned into my head forever, portrayed the opposite.

I felt sad, and pitied Spears when she was the butt of primetime TV jokes, but I couldn’t explain why it felt wrong. Last week, when the New York Times and Hulu released the documentary “Framing Britney Spears,” it clicked.

The film is a look at her rise to fame, the media bombardment she endured, and how she ended up in a 12-year conservatorship meaning that, to this day, her father controls her money and life.

It put so perfectly what we all had trouble expressing at the time: Britney Spears, at 26 years old, was in shambles and needed compassion and help. Instead, she got abuse and scrutiny.

It's been over a decade and a lot has changed. If Spears rose to fame today, we'd have language to identify the bullying that put her mental health at risk. But that doesn't mean we're better at shutting down harassment and treating celebrities as real people.

Celebrities today have as fraught a relationship with their social media followers as the stars of 2007 had with paparazzi and magazines. Take Spears herself: she barely goes out, isn't working, and famously does not post anything of note on her Instagram. And yet every photo, video, and caption is the subject of scrutiny. There's even a weekly podcast analyzing her posts, seen by 27.7 million followers.

Whether we've got the language for it or not, we just don't know how to leave famous people alone, and that's what sends people like Spears into a spiral.

Two events pushed us to take mental health more seriously: Sandy Hook and Robin Williams' death

It wasn't until recently that Americans had the vocabulary to discuss mental health.

In 2006, a year before Spears' breakdown made national headlines, the National Alliance on Mental Illness released its first report in 15 years examining the state of healthcare for those struggling with anxiety, depression, and other mind-related issues.

The report concluded the United States deserved a D-rating for its lack of mental-health infrastructure and information access.

Siri Sat Nam, a licensed marriage and family therapist who's worked with stars like Katy Perry and Waka Flocka Flame, remembers a turning point in 2013. The Sandy Hook elementary school shooting, where 20-year-old Adam Lanza opened fire and killed 20 children and then himself, was a pivotal moment for America's mental-health reckoning. The New York Times later reported Lanza had a history of untreated mental health issues.

"I think this is stuff that's in the underbelly of consciousness and it rises at particular times when a culture is ready. When traditions are really shook up, it calls us to get the term mental health," and the horror of Sandy Hook did just that, Sat Nam told Insider.

That year, state funding for mental health services increased. Months later, the rollout of the Affordable Care Act began, giving 2.65 million Americans with mental health needs access to care.

Another shift came in 2014, when the beloved actor Robin Williams died of suicide, shocking fans who knew little of his behind-the-scenes struggle with Lewy body dementia and depression. Moments after the news broke, Twitter and Instagram were flooded with images of Williams.

His death "served as a reminder that mental illness affects everyone regardless of age or socioeconomic status," Gregory Dalack, chair of the Michigan Medicine Department of Psychiatry, told HuffPost reporter Lindsay Holmes.

Over the next few years, our vocabulary built. As a society we discussed mental health in the wake of the deaths of famed fashion designer Kate Spade and chef Anthony Bourdain, also by suicide.

We also saw mental health creep into pop culture, with positive portrayals of therapists on television shows like "13 Reasons Why," "This Is Us," and "The Real Housewives of Potomac."

But more conversations and positive portrayals haven't led to actionable change, as rates of anxiety and depression continue to rise. 6.7% of Americans, or 17.3 million people, said they suffered from depression in 2017, according to the Anxiety and Depression Association of America. 18.1% or 40 million suffer from anxiety every year.

Relentless social media makes it difficult for the famous to catch a break

"Framing Britney Spears" illustrates how the paparazzi hounded the star for years, to the point she went on TV to say her biggest wish was for them to leave her alone.

But, as the documentary lays out, her tearful request wasn't enough. Daniel Ramos, a former paparazzo who followed Spears and took the famous shot of her bashing his car with an umbrella, still sees his relationship with her in a positive light.

"It was like she needed us and we needed her. We both needed each other. It was a great kind of a relationship," Ramos said in the film. "There were times when she [was] like, 'Can you leave me alone for the day?'" Ramos said. "But it wasn't like, 'Leave me alone forever.' You know what I mean?"

Today fans can like, comment, and directly message their favorite stars on social media, actions that give a false sense of closeness, a term researchers call "parasocial interaction."

America's fixation on celebrities as quasi-royals is a "double-edged sword," Sat Nam said.

These one-sided relationships that can feel two-sided to fans have existed since the advent of TV, but have become more commonplace on oversaturated social media channels.

"The issue that that then creates is that sometimes viewers will feel some sort of ownership over the creator and the content," Arienne Ferchaud, an assistant professor in the School of Communication at Florida State University who studies the relationships between online personalities and the public, told The Verge's Megan Farokhmanesh.

When celebrities give into their fandom's pull, the aftermath can be devastating for their mental health because their public and private lives become blurred and they can lose their sense of self, according to Sat Nam. Though the #FreeBritney movement has a positive bend, with global marches and constant messages of support on her Instagram, the level of surveillance can be suffocating.

"The public makes a star. They choose, gather around them, support them, and buy their records or whatever. Not saying they're not talented and great, but we make them. And then we also can destroy them," Sat Nam said.

"That's a lot for anybody to go through, being under scrutiny all the time. It's exciting at one point when you first start with, but if you haven't prepared for that, there's no privacy," said Sat Nam.

Cyberbullying can be more insidious than in-person hate

If social media users band together to scrutinize someone behind the safety of a computer screen, the feedback can be too overwhelming for one person to handle.

It's something Dr. Samantha Saltz, a board-certified child, adolescent, and adult psychiatrist in Boca Raton, Florida, sees often with her adolescent patients who've experienced cyberbullying.

"The victims of bullying are unable to separate themselves from anywhere where they have access to the internet, so they get bullied over and over and over again. They literally cannot separate themselves," Saltz told Insider. "It used to be where we could separate ourselves from any kind of bad situation. We go home versus being at work where something bad is happening."

It's also a reality for social-media-present celebrities today.

15-year-old TikTok star Charli D'Amelio said she gets hundreds of thousands of hate comments every week about her appearance. British reality TV star Caroline Flack died by suicide in February 2020 after her personal life became months-long tabloid and social media gossip. This month, singer Chloe Bailey was shamed for being too sexy on TikTok after she posted a video to a viral dancing trend on the app.

We just can't leave celebrities alone

I wish I could tell my 13-year-old self the world has become a kinder to place to people struggling with mental health issues big and small, but that would be a lie.

Spears remains under her conservatorship with her father keeping partial control over her $60 million net worth. Despite a record-breaking Vegas residency and hit songs and music videos in recent years, 39-year-old Spears is still fighting to prove she's fit to be independent.

Her Instagram, the only way fans can communicate with Spears, has become just as scrutinized as her every move the paparazzi documented and hosts called out on national television.

On Monday, Spears shared a selfie on Instagram with a simple caption of three mango emojis and no words.

"We're listening," one follower commented. Another said they were googling the "spiritual meaning of mangoes" as a clue into the potential hidden meaning behind the pop star's post. Another thought "mango" could really mean "Man, go," a reference to Britney's father and his power over her.

Despite Spears' disappearance from the public eye, we're still scrapping for anything she does. We mean well, but hundreds of thousands of well-meaning remarks can be overwhelming, just like a swarm of camera-clad paparazzi.