Historically, mental health–especially women with mental health issues–haven’t had the best representation in literature. However, as society’s attitudes towards mental illness is starting to change, so are the books dealing with the very same problems people are now starting to talk about.
Beth* first became interested in reading Ottessa Moshfegh’s My Year of Rest and Relaxation after coming across multiple clips of the book’s cover on TikTok, displayed alongside hyper-feminine items such as dainty pearl necklaces, bottles of perfume and lip gloss.
“I loved reading My Year of Rest and Relaxation because I see myself in characters that don’t have their life together,” Beth admitted. “It makes you feel validated and understood, like it’s okay to be struggling. I think most people who read ‘sad girl’ books feel like this too. It’s so important for people to be able to see their own experiences reflected in novels, and it’s beneficial to be able to see all the ugly parts that come with having a mental illness too, because it’s so easy to feel alone in your struggle.”
Beth, 22, was diagnosed with post-traumatic stress disorder after witnessing a horrific car crash in her early teens. For her, the limited access she had to mental health representation growing up played a significant role in shaping her initial reaction to her diagnosis.
“I couldn’t accept that I had PTSD because it wasn’t like anything I’d ever seen in books or movies. That was the only exposure I had to people with mental illnesses,” she said. “I always thought PTSD was a disorder that war veterans or people who had been abused in their childhood got, but it wasn’t like that for me. For a long time, this stopped me from getting treatment, because I was so scared the therapist would think I was making things up.”
While many books have been written about mental illness in the past, the theme has grown increasingly popular on BookTok, especially post-covid. This, in turn, has led to the sales of fiction about mental illness rising, with a market analysis of Kindle ebooks in 2020 showing that books falling under the category of Mental Illness are more in demand than 70% of all categories on Amazon.
Manchester-based psychotherapist, Sarah Lee, believes the demand in books dealing with mental illness has grown as a result of the reduced stigma surrounding mental health and therapy, allowing more conversations about these topics. “Mental health affects most people so it has a wide reaching appeal, and in the past it’s been quite a secretive and shameful issue,” she said. “Many people will have grown up with family members who had problems but it wasn’t spoken about. I think people are curious to know how they and others work and interact.”
This has only grown since the Covid-19 pandemic. Rethink Mental Illness, a UK-based mental health charity, has seen a 175% rise in demand for mental health advice since the announcement of the first national lockdown, and according to the World Health Organisation, the prevalence of anxiety and depression worldwide has increased by 25% post-covid.
Celina Pan, 20, an avid reader and university student, said: “People are a lot more open about mental health issues now than in the past, so I think that’s also making people feel more comfortable writing such content and also reading it.”
Books help us understand the world around us, and for Celina, who has been living with anxiety and depression since high school, this statement is one she wholeheartedly agrees with. She told me understanding her own mental health through books was something that happened in two phases for her.
She first started reading books that touch on themes of mental illness when she was in middle school, but at the time, the lack of education she’d had on these disorders had made it difficult for her to identify these themes.
“I didn’t have much of a concept about mental illness at the time, indeed I didn’t really know what they were, so I didn’t even realise I was reading about them, and specifically, depression,” she said. “I remember just feeling sorry for the characters and hoping they would be happier soon.
“But by high school, I was able to recognise that I was reading about mental illness, and while I still felt bad for the characters, I was able to empathise with them and relate to them a lot more. I could recognise myself in the pages and in the characters a lot more.”
Overall, Celina feels that representations of neurodivergent characters in novels has been getting better, especially in recent years. “Ten years back, I couldn’t find many books that had a character that was canonically suffering from mental health issues [because it wasn’t popularised] and if I did, there wasn’t much to the characters except their mental illness. More recently, however, I’ve been able to find some writers who write about mental illness pretty spot on based on my personal experiences.”
While the rising popularity of neurodivergent books and characters on TikTok have raised awareness about mental health and given many readers a sense of belonging, it’s also propelling older books with potentially damaging tropes back into the spotlight. “I’ve definitely seen books that I think border on romanticising mental health, and I think that’s problematic,” Beth says. “Mental health is often messy, and when you aestheticise trauma and stuff like suicide, I think younger readers might start to aspire to be these characters, who sometimes do things that are self-destructive.”
Sarah agrees, telling me that it’s inevitable for authors’ portrayals of mental illness to be inaccurate if they don’t have professional or personal experience with the disorder they’re writing about. “Often issues are oversimplified and misunderstood,” Sarah explained. “I read a book where someone with very severe traumas has brief therapy and recovers quickly. Severe trauma stays with people for life. It isn’t that people can’t change or feel better but the speed and trajectory of recovery is often unrealistic because the author doesn’t understand how trauma and recovery work.
“I think it’s invalidating and dismissive. For many people, they’ve grown up having their feelings ignored or hearing they were wrong, they shouldn’t feel that way, it wasn’t a big deal, they should just forget and move on. So when they read these inaccurate portrayals, they might feel shame, or anger towards themselves that they’re stuck or don’t know how to change or that they can’t live their life the way that they would like to.”
Discussing some of the more harmful tropes she’s seen in books, Celina said: “I think a really problematic trope is someone’s mental illness getting ‘cured’ by a romantic relationship. It makes me quite angry to be honest, because that’s just not how it works, it’s highly unrealistic, and it seems to be saying that to be happy, you need a significant other, which is just not true.
“With mental illnesses, the healing process is long and complicated, and it’s never really complete in my opinion. The illness itself will come and go as your life progresses, and you can’t just suddenly cure it in one day.”
Sarah explains that misrepresentation of mental health in books can also have a negative impact on readers who don’t personally experience mental illness, impacting the way they interact with the people in their lives who may suffer from a mental health disorder. “I think it could cause people to be less empathic, or to feel like they understand mental health better than they do if they’ve read a particular depiction in a book. Experiences are not the same, and one person with trauma won’t necessarily have the same symptoms or reaction as another.”
So, which books about mental health should you read?
When trying to understand mental health through books, it’s important to find ones with accurate representations of what mental illness looks like. While not everyone will have the same experiences with mental health or identify with the same characters, here’s some books my interviewees recommended for people wishing to learn more about the issue.
Lying on the Couch by Irvin Yalom
Sarah said: “It’s a fictional book written by a real psychiatrist. Yalom has the advantage of being a therapist, which makes his description of therapists all the more substantial.”
A Court of Silver Flames by Sarah J. Maas
Celina said: “A good example of a book with good mental health representation would be Sarah J. Maas's very realistic portrayal of PTSD and depression with her character Nesta in the ACOTAR series. Although a significant other is there, they are simply there to teach Nesta the skills they picked up for dealing with mental illness. What she does with them is ultimately up to her, and she heals through her platonic relationships more than her romantic ones.
“It's also said pretty much explicitly, that sometimes it gets better, and sometimes it gets worse, but not giving up on recovering from mental illness is the key. Her journey with mental illness is also very different from other characters in the same series who also deal with mental illness, which I think shows how nuanced mental illness can be.”
A Semi-Definitive List of Worst Nightmares by Krystal Sutherland
Beth said: “I like that issues such as mental health and addiction aren't romanticised or sugar coated in this book. Each character is suffering from a mental health issue that impacts their daily life in one way or another, but it’s nice to see that they’re never defined by their mental illness. I don’t personally struggle with the mental health issues in this book, but the depth of these characters makes me think that the author has really done her research.”
If you liked this post then read The power of bibliotherapy: how reading can make you healthier and happier or Think piece: is discrimination necessary in works of fiction? next.
Shani is a journalism student obsessed with books, dance, and all things true crime. When she’s not stuck in the middle of a good book, she’s listening to podcasts or watching hour-long video essays on YouTube.
Favourite genre: Crime.