People have been using images to express ideas, share stories, and communicate since early history. The advent of social media has made sharing images an important part of everyday life. Among other things, social networks can be used to express psychological distress; however, research on this topic is limited. The goal of this study was to explore representations of psychological distress in the Russian-speaking segment of Instagram. The study involved contrasting images labeled with hashtags in Russian with images marked by analogous Anglophone hashtags in a data set of 1,512 images. Quantitative content analysis revealed significant differences between images labeled with Russian and Anglophone hashtags. Images containing depictions of texts were significantly less frequent among images with Russian hashtags, while inanimate object depictions were more prevalent. Hashtags for fear in both languages were related not to psychological distress but to the "scary" in popular culture. Images of alcohol were associated with stress hashtags in both languages and with hashtag for depression in Russian only. Images of food were significantly more prevalent among images with Russian hashtag for stress. Current study highlights the need for culturally and linguistically appropriate online mental health interventions.