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These New Novels Face The Complicated Reality Of Mental Illness

Fiction has long had a history of using mental illness as a plot device or symbolism, but some recent novels are depicting mental illness in refreshingly nuanced ways.

Posted on May 31, 2018, at 10:43 a.m. ET

Calum Heath for BuzzFeed News

In Melissa Broder’s just-released debut novel, The Pisces, narrator Lucy wakes up one day in her car on the side of the road, surrounded by doughnuts, including the jelly kind, which she doesn’t even like. She has fallen asleep in her car after taking far too many Ambien the night before, sleeping for 15 hours, waking up ravenous, and attempting to go get breakfast. She’s confused and can’t think of anyone to phone to get her, and the police officer called to the scene ends up giving her a ride home. He’s the same officer who came to investigate her just days before, after she broke her ex-boyfriend’s nose in a fit of jealous rage over his new squeeze. It isn’t until later, when Lucy is living in LA and comes to the aid of a suicidal friend, that Lucy realizes driving while still stoned on the Ambien was a suicide attempt. She realizes, startled, that depression is a real disease. She goes on to say: “I’d had depression my whole life too but more of a dysthymia — a general malaise.”

That sentence marks one of the greatest things about the novel: its frank admission of mental illness. This naming of mental illness and the attempt to describe its nuance is still incredibly rare to find in contemporary novels. Though there are quite a few contemporary memoirs, such as 2012’s Agorafabulous! by Sara Benincasa, 2018’s Defying the Verdict by Charita Cole Brown, and, coming out in 2019, The Collected Schizophrenias by Esmé Weijun Wang, that have dealt with the experience of mental illness in astonishing and beautiful ways, it’s been harder to find contemporary novels that approach mental illness with the same care. Fiction has also had such a long, exhausting history of using mental illnesses as symbols and plot devices that seeing more books like Broder’s is a welcome relief.

“Madness” in one form or another has seemingly always been around — ancient Chinese medical texts discuss mental disorders, as do some of the Greek philosophers — but the modern scientific roots of our understanding of it are not so old. It is a rather modern construct, to separate mental illnesses into different categories and symptoms with the names we’re familiar with now, like schizophrenia, depression, or anxiety, as opposed to vague and ableist words like “insanity” or “madness.” We’ve come to view mental illness as an identity marker as well as a biological fact. How, then, do we include our modern understanding of it in literature, and how do we integrate it in fictional narratives?

Fiction has had such a long, exhausting history of using mental illnesses as symbols and plot devices.

Back in 1979, professors and feminist critics Sandra Gilbert and Susan Gubar published The Madwoman in the Attic, in which they identified the trope exemplified by Bertha Mason, the titular madwoman, locked in Mr. Rochester’s attic in Jane Eyre by Charlotte Brontë. Gilbert and Gubar use a feminist lens to view how madness is utilized in the texts of various Victorian authors, and for them, madness is always symbolic of something: repressed sexuality, for example, and women writers’ lack of independence. Which isn’t to say that there hasn’t been literature directly addressing madness as well — there is suicide in Mrs. Dalloway by Virginia Woolf, depression pretty clearly depicted in The Bell Jar by Sylvia Plath, and germophobia and hallucinations portrayed in One Flew Over the Cuckoo’s Nest by Ken Kesey.

Yet mental illness is still used as a plot device, whether it’s in the twists of a psychological thriller where a woman is actually a psychopath all along (think Gone Girl by Gillian Flynn), or whether it’s as an attempted humorous character whose crrrazy! antics are the punchline (think of the narrator’s mom in Jonathan Tropper’s This Is Where I Leave You). To be fair, there’s a fine line between demonstrating what mental illness is actually like and pathologizing every experience of pain so that it fits into a diagnosis. It’s all too alluring, especially for people with mental illness ourselves, to worry we’re exaggerating our experiences and making a big deal out of nothing, or pathologizing ourselves for some nefarious reason. The very nature of so many mental illnesses is conflict between the awareness that our illness can feed us wrong information and the inability to ignore its persuasive, if often rather fucked, logic.

That’s exactly why some recent books like The Pisces; Everything Here Is Beautiful by Mira T. Lee, which came out in January; and John Green’s 2017 novel Turtles All the Way Down are worth celebrating. They manage to show that tension between the denial and doubt many people with mental illness experience regarding their conditions and the points at which they’re convinced of their reality and effects. According to the National Alliance on Mental Illness, 1 in 5 adults in the US deal with mental illness in any given year; the same statistic holds true for teenagers. That’s a large swath of our population, and an incredibly diverse one at that. And yet many if not most people with mental illness are also not defined by it, though it is an inextricable part of their lives. Finding books examining the reality of mental illness, naming it, facing it, but not making it the be-all and end-all of a person’s identity and character can help readers feel like their experiences are valid and real.


Young adult literature has been somewhat of a pioneer in the realm of representing mental illness because in so many ways, the YA genre was built around the idea of the “issue” book. One of the best recent examples is John Green’s book Turtles All the Way Down, which deals with anxiety and possible obsessive-compulsive disorder, though it’s only the former that’s explicitly diagnosed. The novel’s protagonist and narrator is Aza, a 16-year-old whose father died some years ago, and the plot revolves around her anxiety, but also doesn’t; it’s triggered into motion by something entirely unrelated — the disappearance of a millionaire who fled a raid on his house. Aza once knew the millionaire’s son, and they reconnect when her best friend becomes fixated on getting the reward money for finding the missing man.

Aza’s anxiety is central to her character because it’s a part of her. She’s on medication, but she doesn’t take it regularly. She continually reopens a wound on her hand as a coping mechanism, a reassurance that she is rid of infection. The wound is a metaphor, as ancient as Greek myths involving never-healing wounds. But for Aza, the wound is real. It’s connected to her obsession around her gut biome, the thousands upon thousands of bacteria that live inside us and help make our bodies work; Aza keeps wondering about those bacteria, and how she can be real if she’s only making a small percentage of her decisions. The bacteria are also a useful metaphor for her intrusive thoughts themselves. How does a person with mental illness know she is making her own decisions rather than feel like her illness is making them for her? This is the kind of question people with mental illness grapple with on a daily basis, and John Green manages to show this through Aza’s internal monologue, which sometimes gets dense and all-too-familiar:

You lie there, not even thinking really, except to try to consider how to describe

the hurt, as if finding the language for it might bring it up out of you. If you can

make something real, if you can see it and smell it and touch it, then you can kill

it. You think, it’s like a brain fire. Like a rodent gnawing at you from the inside. A knife in your gut. A spiral. Whirlpool. Black hole.

YA has been somewhat of a pioneer in the realm of representing mental illness.

Aza’s self-awareness is one of the strong points of the book. She’s always questioning her perceptions, knowing that her obsessions make no “real” sense, but also aware that she can only control them so much. There are quite a few YA novels that deal with mental illness, from 2009’s Wintergirls by Laurie Halse Anderson, about girls with eating disorders, to 2017’s Little & Lion by Brandy Colbert, which involves a character diagnosed with bipolar disorder. I’ve found that, until recently, many literary adult novels have tended to refer to mental illness obliquely, though of course there are so many books out there that imply them, whether it’s classics like many of Virginia Woolf’s books or more recent and whimsical examples like Amy Bender’s 2010 book The Particular Sadness of Lemon Cake.

But recently, I’ve noticed a shift in adult novels, a willingness to name mental illness and examine it closely, simultaneously allowing characters to have motivations and feelings outside of their diagnoses. In 2016, for instance, the indie Unnamed Press published The Border of Paradise by Esmé Weijun Wang, which was praised for its depiction of mental illness. While Wang doesn’t diagnose the protagonist, David, with a specific illness, though this may be in part because the novel is set in the early days of the Diagnostic and Statistical Manual of Mental Disorders, which still used diagnoses like “neurosis.” But David clearly has a mental illness, and his family knows it too, referring to his “sickness.” David himself explains: “My options have been psychoanalysis, electroshock, or medication with more side effects than treatment functions. There is no taught method of coping. What the doctors never told me is that a percentage of the crazy are also living a crazy lifestyle. The doctors don’t give you much in the way of options, which is why so many of us madmen choose to go full stop.” Wang shows the world through David’s lens as he attempts to grapple with what’s felt wrong and off to him since his youth. He lives more often in fantasies than in the realities of his life, and his suicide, which opens the novel, touches everyone around him in the lasting ways that trauma often does.

More recently, there is Mira T. Lee’s debut novel, Everything Here Is Beautiful, which came out in January. It’s a gorgeous examination of life within a serious and hard-to-define mental illness and the way the people around deal with and mis/understand it. Lucia Bok, daughter and sister to Chinese immigrants, the first of her family born in the US, has schizoaffective disorder. Early in the novel, Miranda, Lucia’s older sister, has to educate Lucia’s new husband, Yonah, about her illness; Yonah objects to the hospital, thinks Lucia merely needs rest, when in fact she’s in a paranoid spiral, believing she’s being watched and observed by the serpents who participate in many of her delusions. Miranda becomes incensed with Yonah’s inability to see her sister’s illness: “I pulled out a folder full of pamphlets and notes and clinical papers, which I’d save for three years. FAQs 4 Caregivers, Bipolar Symptoms and Signs. 25 Tips for Coping with Schizophrenia. ‘She has a mental illness,’ I said. I brandished the folder like a weapon of proof. ‘This hospital is to help her. She needs help. Can’t you see?’” Yonah wins this fight, but Miranda spends her life worrying about Lucia, because she’s seen Lucia at her lowest.

Until recently, many literary adult novels have tended to refer to mental illness obliquely.

On the flip side, though, we get to see the world from Lucia’s perspective, and she is so much more than her mental illness, though it is undeniably part of her. She is smart and vivacious and passionate, imaginative and absolutely capable of being a responsible grown-up, with training and much experience as a journalist. She and Manny, an undocumented Ecuadorian immigrant to the US, have a baby together, and after an initial incredibly difficult period, Lucia returns to her child and moves with Manny back to Ecuador to live near his family. She has good years and bad years, times when she finds the world a gorgeous, wondrous place, and times when it seems like it and she are both poisonous. But she is, understandably, incredibly resentful of the medical establishment. During her first hospital stay at age 26, she narrates: “I was a compliant patient, a Sweet Asian Doll, and for this I was branded with a Severe Lifelong Mental Illness. Later, I would be told I had a twenty percent chance of maintaining a full-time job, a twenty-five percent chance of living independently, a forty percent chance of attempting suicide, a ten percent chance of succeeding.”

Lee manages to observe the difficult and heartbreaking reality of one kind of disease, but she doesn’t pretend to be describing a monolithic or typical experience. It is one woman’s story, and the stories of her family and loved ones, and it is about so much more than her mental illness. It’s about change and fear and family and what it means to be a caretaker and what it means to be taken care of.

Another writer making great strides in how literature involving mental illness works is Melissa Broder, the voice behind the @sosadtoday Twitter account. In The Pisces, Broder examines depression in an incredibly honest way that, I suspect, will be incredibly familiar to almost anyone who suffers from it. Her narrator, Lucy, has recently been through a breakup, and though she has long suffered from depression, she experiences it in a new way this time around: “I had always thought of depression as having no shape. But this was something new, like a thicker, gooey sludge. It had its own shape. It could not be contained. It was a terror. Of what I was terrified I couldn’t exactly say, but it was sitting on me.” Lucy’s summer in her sister’s Venice Beach house is full of anonymous sex and group therapy for people with sex and love addictions and a love affair with a mythical creature, but more than anything, the book manages to capture the logic that fills the minds of people with depression. It also shows Lucy’s growing understanding of her own illness, as she begins to recognize it in others around her. When her new friend Claire threatens suicide, Lucy narrates:

Suicide was one of those things that, having been suicidal, in retrospect, I felt like I could talk about without being judgmental. But at the same time, there was no rational reason I could see giving her to live. But what kind of person didn’t try to talk their friend out of killing herself?

It’s startling to read such candor, to see an internal monologue you’ve had with yourself splayed across the page of a published book. This is why representation matters in so many ways — knowing that your experience is not yours alone can be incredibly liberating and validating.

These recent novels are a big deal because they still feel incredibly rare.

These recent novels are a big deal because they still feel incredibly rare, perhaps because in comparison to nonfiction that confronts mental illness, the fictional offerings are few and far between. They manage to capture the realities of mental illnesses while also telling gripping, moving, and often beautiful stories. They provide a place where readers of fiction can recognize aspects of themselves and feel seen. Two recent YA novels — An Na’s The Place Between Breaths, which came out in March, about a girl grappling with early symptoms of schizophrenia, and another March release, The Astonishing Color of After by Emily X.R. Pan, about a parental suicide — also deal with mental health issues. Plus, there’s hope yet for more: Ottessa Moshfegh’s My Year of Rest and Relaxation is coming in July, and deals with the pharmacology aspect of coping with mental illness; YA debut Darius the Great Is Not Okay by Adib Khorram is coming in August, and looks at clinical depression and how meaningful connections can help get through the tough times; and there’s also Ayana Mathis’s next book, A Violent Woman, which is described as the story of a mother with a shadowy past and a daughter with mental illness who gets recruited into a radical political group, and which doesn’t have a publication date. Just like all identity markers, mental illness is nuanced and often means different things to different people, so it’s good to see that we’re beginning to see a variety of experiences with mental illness depicted in fiction as well. ●


Ilana Masad is an Israeli-American writer whose fiction, nonfiction, and criticism have appeared in The New Yorker, the New York Times, the Washington Post, the Guardian, Catapult, Joyland Magazine, the LA Times, and many more. She is the founder and host of The Other Stories, a podcast featuring new, emerging, and established fiction writers.

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