Depression lies at the centre of some of the world’s most loved novels, from The Bell Jar by Sylvia Plath to Gail Honeyman’s Eleanor Oliphant is Completely Fine, readers can delve into the inner workings of someone else’s mind, or be hit with the realisation that the very same thing they are experiencing is being portrayed on the pages they read.
According to Champion Health, depression is one of the most prevalent mental health disorders, affecting around 1 in 6 adults in the UK. It is commonly associated with other mental health issues, including anxiety, stress and loneliness.
So can representations of depression in fiction be helpful? Or are they just harmful?
Above: Dr Janina Scarlet
Jennifer Niven’s All The Bright Places, Gayle Forman’s I Was Here and Girl in Pieces by Kathleen Glasgow have all been commended for their accurate and realistic portrayals of depression. But are they able to help someone who’s struggling?
“When people see accurate representations of the mental health issues they are experiencing, it can help them to find the right vocabulary to be able to express what they’re going through and reach out and ask for help.
“Everyone wants to be able to read something and see themselves, or something similar to what they’re going through, because it helps you feel less alone.”
Superhero Therapy, set up by Dr Scarlet, refers to incorporating characters from popular culture, including superheroes and other characters from books, movies, TV shows and video games into evidence-based therapy (such as cognitive-behavioural therapy and acceptance and commitment therapy) to help us to learn to become our own version of a superhero in real life.
Dr. Scarlet, 39, explained: “When I started working with clients in therapy, many of them would automatically refer to fictional characters.
“They would refer to Batman for loss, and Superman for strength – I saw how important it was for people to have a figure to look up to. Superhero Therapy exploded from there and now it’s used all over the world.”
“Research has shown that when people are feeling lonely, they’re more likely to turn to books or characters they can relate to,” Dr Scarlet explained.
“When people are going through a hard time, if they find another person or fictional character going through the same thing they are, then they feel significantly less lonely and it makes it easier for the individual to get the support they need or communicate what they’re going through.”
A recent survey by Mind found 20 million adults never speak about mental health, so if seeing yourself represented in fiction might help people to be more open about what they’re going through, then that’s definitely not a bad thing.
Sensitivity reader Helen Gould agrees: “I think seeing characters who act how they are expected to when they’re around people, but when they’re on their own feel completely destroyed, is something which will ring true for a lot of people experiencing depression.”
Helen, 32, from London, has been a sensitivity reader for six years and worked on over 200 projects.
Sensitivity readers read literary work, looking for perceived offensive content, stereotypes and biases. They then create a report for the author with suggested changes.
Helen explained that when a lot of authors write about mental health, they are drawing from their own experiences. “I don’t know anyone who would say they haven’t experienced some kind of mental health issue.
“A lot of the time, when authors I work with want me to look at their work, they are writing from their own personal experiences, but they want to double check that their portrayal of depression is accurate and relatable.
“This emphasises the importance of lived experience when writing about sensitive topics – whether that’s coming from the sensitivity reader or the author.”
And as Dr. Scarlet mentioned, in order for a portrayal of mental illness to be helpful, it firstly needs to be accurate because when done wrong, it can be potentially harmful.
She explained: “Inaccurate representations send out the wrong message and contribute to the negative stigma surrounding mental illness.
“For example, with murderers or criminals, when mental health is suggested to be the main motivation for their crime, it can make people reading who are experiencing the same thing feel isolated, and less likely to reach out and ask for help.”
One study found negative representations of mental illness contribute towards stigmatisation of, which in turn leads people experiencing mental health problems to avoid seeking treatment.
Helen said: “When I work with authors on books surrounding depression, it’s generally an issue surrounding accuracy.
“A lot of the time, people who don’t know a lot about mental illness or who don’t live with it, don’t really understand the impact depression can have.
“There’s an idea that it’s something that you can just be ‘cheered-up’, or ‘get over it’ – but that’s not the reality of it.
“I’m looking for accuracy in terms of the chronic nature of depression and the fact that there’s no quick fix.
“I’m also looking at how the characters with depression are being depicted in terms of the nuances. Depression can manifest itself in lots of different ways and a lot of people will try to hide it, or it will cause some people to lash out, or lose interest in things.
“There are lots of different ways that depression can evidence itself through someone’s behaviour and that’s something I’m looking for as well.”
Helen also emphasised that characters with mental illness deserve to be more than ‘the depressed one’ – their mental illness shouldn’t become their identity.
“I want to help the author to avoid stigmatisation and allow characters to be represented as a full human being,” she explained.
“All kinds of media can damage our assumptions and affect our biases about people. It’s well known now that people can, and often do, internalise the messages they receive from the media they consume – whether that’s films, TV, or books.
“I think you have to be careful with sensitive issues, such as depression, because you can end up normalising the fact that depressed people are ‘just a bit sad’, or glamorise stereotypes around it.
“The idea that you can just ‘snap out of it’, or that it’s something you’re ‘doing on purpose’ – these things can impact the audience, whether they themselves have depression or are reading about it for the first time.”
And unfortunately, some books do fall into the territory of potentially romanticising, and even glamorising depression. This is commonly done by presenting romantic relationships as a ‘cure’ for mental illness.
While we all (or at least most of us) enjoy a good love story, it’s not enough to magic away someone’s problems.
The suggestion that love is a quick fix for long term problems can become problematic when it is our only source of information on the topic.
The Fault in Our Stars by John Green has been accused of including this trope, as has We Are The Ants, where the main character’s ability to fight against his ongoing depression caused by the suicide of their previous boyfriend, is miraculously made all the better when a new love interest comes along.
People have argued that Shaun David Hutchinson’s portrayal suggests love is the cure for depression, but as many will know, that isn’t always the case.
Dr. Scarlet said: “I do think presenting love as a cure is an issue because it suggests people are depressed because they’re not in love, or that a romantic relationship can erase all struggles – that’s not true.
“I think when we feel loved and supported, whether it’s by our partner or by our community, we do feel better – but it doesn’t mean that all our issues will go away or our depression will naturally disappear.
“It’s really important that writers who are creating these books consult with mental health professionals in terms of how to depict accurate representations of mental illness and what that might look like.
“If the character is in love for instance, or the character is happy, would they not have any symptoms? Or some symptoms? What would be the healthy way for a couple to discuss mental health and for a partner to show up who might be struggling with depression, for example.”
Everyone’s experience of depression will vary slightly, but when portrayed accurately in fiction, it can help to reduce the stigma surrounding mental illness and maybe, provide someone with the confidence they need to reach out and ask for help.
Don’t forget to check out BLOT’s #ReadForYourMind campaign over on Instagram.
If you liked this post then read Escaping into fiction: The therapeutic power of listening to stories or BLOT’s interview with Clarie Alexander, author of Meridith, Alone, on why mental health representation in books is important next.
Helen is a sensitivity reader who has worked on nearly 200 projects since 2017. She specialises in issues of race, anti-blackness, and mixed heritage experiences. She has read books in many genres (including SFF, historical fiction, children’s books and YA, detective novels, and so on) as well as working on several tabletop role-playing games, video games, some scripts, and even a podcast or two.
Dr Janina Scarlet
Dr. Janina Scarlet is a Licensed Clinical Psychologist, author, TEDx speaker, and a creativity coach. A Ukrainian-born refugee, she survived Chernobyl radiation and persecution. She immigrated to the United States at the age of 12 with her family and later, inspired by the X-Men, developed Superhero Therapy to help patients with anxiety, depression, and PTSD. Dr. Scarlet is the Lead Trauma Specialist at the Trauma and PTSD Healing Center.
Yasmin is a third year journalism student at The University of Sheffield, specialising in feature writing. She has previously written for the Sheffield Tribune and women’s magazine Pick Me Up! She is particularly interested in how mental health issues are portrayed in fiction.
Favourite genres: Romance, Crime and Thrillers.