The Portrayal of Teenage Mental Health: Turtles All the Way Down

“The thing about a spiral is, if you follow it inward, it never actually ends. It just keeps tightening, infinitely.”

John Green

Aza Holmes is 16 years old, she lives in Indianapolis with her mom, and she has OCD. There is a callus on her finger that she presses every time she gets anxious about a possible infection, and she’s constantly worried about microbes and pathogens. While she struggles to get through her high-school life, news break that billionaire Russell Pickett, who is under investigation for fraud, has disappeared and there’s a $100,000 reward for information about his whereabouts. Aza’s best friend Daisy decides that they will be the ones to collect the bounty and sets the both of them on a quest to find Pickett. This leads them to the door of Davis Pickett, Russell’s son and Aza’s childhood friend, who develops a romantic interest in Aza. As Aza’s life is turned upside down, she needs to learn to balance her friendship with Daisy, her relationship with Davis, her high-school life, the search for the billionaire, and her anxiety.

The Portrayal of Teenage Mental Health in Books and Media

According to the World Health Organization (WHO), at least 16% of the global teenage population suffers from a mental illness, and one out of six people around the world are teenagers. Not only that but most cases of mental illness go undetected and remain untreated (this is particularly true for teenage girls), and the consequences of this go well into adulthood and prevent people from having a fulfilling life.[1]

Despite there being so many people who suffer from a mental illness and despite suicide being the third leading cause of death among teenagers, there is still a long way to go when it comes to discussing mental health issues openly and free of stigma. But this is a topic that is being discussed more and more in media and books, especially in Young Adult fiction. Among some books that deal with mental health and trauma are Stephen Chbosky’s The Perks of Being a Wallflower, Jennifer Niven’s All the Bright Places (which I did not particularly like), Neal Shusterman’s Challenger Deep (which I found especially good), and the popularized by Netflix 13 Reasons Why, by Jay Asher (which I refuse to watch/see).

Here’s where the trouble starts. It is good that mental disorders and mental health are openly talked about, but there is always a risk in how we go about it. Back in 2017, when 13 Reasons Why debuted, many experts called out Netflix for being careless and irresponsible in their depiction of Hannah Baker’s suicide. They were accused of  doing exactly the opposite of what experts recommend when dealing with this topic (i.e. showing the suicide) sensationalizing and presenting it as a means of getting what you want, as well as of putting susceptible teens at risk. Two years later, the warnings proved to be true, as a study found out that there was “a suicide rate of 0.57 per 100,000 [teenagers]” following the release of the show.[2] Two years and two months later, Netflix deleted the infamous suicide scene.

Turtles All the Way Down does not romanticize mental illness. Aza’s anxiety is never portrayed as cute or endearing, it is something that she has to struggle with every day, it affects her relationships, her physical health, and it is taken seriously by those around her. At the same time, the book makes it clear that anxiety is not all there is to the protagonist. She is still a mostly nice person, she has her mom, her friends and Davis; she is not her anxiety, she is Aza, and she is loved and deserving of that love.

What makes this book feel so true and genuine is that, similarly to Neal Shusterman’s Challenger Deep, it comes from a personal place. In Shusterman’s case, it is his son’s experience; in John Green’s case, it’s his own:

“This is my first attempt to write directly about the kind of mental illness that has affected my life since childhood, so while the story is fictional, it is also quite personal.”

John Green

Mental disorders and illnesses are serious and need to be destigmatized and talked about freely and openly, and books and media are good ways to familiarize people with them, but they need to be approached with care. So, for anyone looking for a way to write about teenage mental issues, especially their own, this is one way to do it.

 My edition: Paperback, published in 2017 by Penguin.
My edition: Paperback, published in 2017 by Penguin.


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