We're All Mad Here: Mental Illness in YA Fiction

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s.e. smith is a writer, agitator, and commentator based in Northern California.

Young adult literature features a number of depictions of mentally ill characters, from authors who both bother to do their homework and take the time to present their work well and authors who don’t seem to feel that research and sensitivity are necessary. In YA especially, depictions of mental illness are critical because some readers may be struggling with emotions and experiences they do not understand, or don’t have words for; some mental illnesses start to manifest during young adulthood, and can be overwhelming and alarming as people start to realize that something about their adolescence is different from that of their peers. Reading about people like them can be a reminder that no, they are not abnormal or freakish, and their experiences are not unusual.

As we plunge into these mini book reviews, please be advised that they contain some spoilers, and the comments may be spoil-y as well.

Thirteen Reasons Why, Jay Asher’s book about teen suicide, is perhaps one of my favorite books ever, and a very careful depiction of mental illness and suicide in young adult fiction. For those not familiar with the book, it starts when a character receives a set of tapes from a girl who committed suicide. Each tape features a story about an event that played into her desire and eventual decision to commit suicide. The book is a grim reminder of how easy it can be to be pushed over the edge, how difficult and lonely your teen years can be when everyone around you is tormenting you and you don’t know quite where to go for help.

The cover for Suicide Notes (crumpled notes in a trashcan) Michael Thomas Ford’s Suicide Notes is sort of a flip version; it opens with our young and depressed character in a hospital ward, receiving treatment after a suicide attempt. Over the course of the book his story unfolds in therapy and we understand what drove him to that point, and how support, or lack thereof, can make a significant difference in how a teen deals with emotions like suicidality and…well, I don’t want to spoil it for you, but there are other themes in this book that may be of interest to Bitch readers. While this narrative is a little more pat and tidy than Thirteen Reasons Why, a story with a happy ending is not necessarily a bad thing for an audience that might feel like happy endings are forever out of reach.

The cover for Will Grayson, Will Grayson (bright lights in a ray pattern) In Will Grayson, Will Grayson, one of the titular characters has depression, and he’s a well-written, and -rounded, character. The affectation of having his sections of the book entirely in lowercase is a bit trite, but the emotions behind the character are very real. Levithan captured the experience of depression well in scenes with Will Grayson, who sometimes feels like everything is futile and has trouble completing even the most basic of tasks, dragged down by the contents of his brain, an experience familiar to some people with depression.

The Summoning, by Kelley Armstrong, also explores themes of mental illness and perceptions of mentally ill characters, but it takes them in a slightly different direction. It turns out that our institutionalized character is not actually mentally ill, she has superpowers that cause symptoms similar to those associated with some mental illnesses. This is a book that could very easily fall into the trope of only condemning institution because the character is sane, and of treating disability as a superpower, but it doesn’t.

Cover for The Summoning (a pale person holding a gemstone in a raised hand)Instead, it pushes readers to think about definitions of normality and lived experience. abby jean and I had an extensive chat about this book, and we both observed how true the scenes in the institution were to actual institutional experiences, like learning to game the system to deal with people in positions of power like doctors and nurses. Even though the character’s situation ended up being quite different than what was presented at the beginning of the book, where we saw what appeared to be an outbreak of hallucinations, the themes about mental illness and who gets to define it and how were very strong, and well handled.

Cheryl Rainfield’s Scars, dealing with self-harm and survival, has also gotten a lot of recent press, and with good reason. Scars explores the role of mentors in abuse survival and recovery, constructing a more complex narrative around mental illness and emotional distress than many other books do, and it includes a lengthy and detailed resource section. Rainfield also speaks out publicly about her own history of self harm; she knows that of which she speaks, since the haunting image on the front cover features her own arm.

I deliberately selected some strong depictions of mental illness in fiction here because as we talk about how mental illness is presented in pop culture, it is important to discuss when it’s done well, as well as when it’s done poorly. These characters were carefully researched and sensitively depicted, in a way that resonated for many readers.

Criticisms of authenticity and representations in pop culture are often met with the charge that creators are not responsible for making a better world or engaging in activism with their work. And this is certainly true, but presumably creators make art because they want to bring interesting and great things to the world, and those things are so much better when they are done with care and respect for the characters. Authors of young adult fiction don’t have an obligation to send very special messages with their books—and in fact those who attempt to are rather preachy and dull—but a well-crafted story can leave the reader with something at the end. In the case of these books, readers are left with the understanding that mental illness is complex, is not necessarily inherently evil and bad, and can be a facet of someone’s personality, not an all-consuming whole.

Related Reading:

Transcontinental Disability Choir: Disability: The Human Condition
Page Turner “YA Lit Bitch”: An Interview with Novelist Laurie Halse Anderson
Page Turner “YA Lit Bitch”: An Interview with Sara Zarr


We’re All Mad Here: Going to the Loony Bin: A Brief History of the Asylum, We’re All Mad Here: Case Studies in Pop Culture Therapy

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6 Comments Have Been Posted

I enjoyed this post. As a

I enjoyed this post. As a student of psychology and a writer myself, I think it's important to do your research before writing about mental illness. Especially if the main character is dealing with suicidal thoughts. I agree that some books can border on preachy. I much prefer letting the character take me on their journey, for the real emotion to come through on the page. Everybody's experience is different and I want to hear what the character has to say about their journey, not what the writer wants the message to be. I would much rather go away with something to think about and discuss than something that's been told to me.

A great article - I've got some books to buy!

Thank you for speaking out on this topic. I've read plenty of books on depression (fiction and non-fiction) but I'd never really looked at the YA category - the only pieces of fiction I read as a teenager that dealt with any kind of mental illness tended to be anorexia or bullimia, as it was undergoing a lot of media attention at the time and seemed to be the next big problem in focus for teens and parents to deal with. Although I was grateful to understand about eating disorders, I never picked up a book that spoke to me about depression - maybe that's just the books available here in the UK.

It's great to know that young adults today have a lot more resources to look at when they're struggling with depression or know someone who is. I think that, if I had read something when I was a teenager that really discussed the issues at hand, I would have spotted my own depression a lot quicker (instead of which, I tried to ignore it and hoped it would go away - not the ideal strategy). I hope that the books you've listed can help more young adults deal with depression and read up on it.

Great Post!

Thank you to S.E. Smith for this excellent article.

Depression without Sue

As a fandom writer, I find it incredibly hard to write a character (either from canon or not) who struggles realistically with depression and depressing life circumstances, without having her labeled and vilified as a Mary Sue -- or conversely as a "whiny attention wh---". I've seen the same thing happen to other non-fan works in the real world.

This has become such a dichotomy, and I've spent so much time trying to navigate the edge of the knife, that I wonder if you have any comments on this. Do you feel that sometimes the Mary Sue/attention-wh--- labels are used to shame and dismiss valid representations of depression? Or do you feel that they represent valid, if problematically-worded, critiques of underlying problems in the representation?

One More Book to Add...

I'd be really interested in an analysis of Get Well Soon by Julie Halpern. I read it a couple years after being committed to a hospital when I was 15/16, and I really loved how similar it was to my actual experiences. The enemies aren't psychotic patients, they're nurses and doctors who chastise you for breaking a rule but don't let you know what the rules are.

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