The difficulty of presenting mental illness in mainstream media

Recently there has been a lot of controversy on my news feed about To The Bone. For those small few of you who don’t know, it’s a depiction of a young woman’s struggle with anorexia nervosa and attempt to work within a sort of ‘halfway house’ in order to avoid being sent back to an inpatient unit or becoming fatally unwell. For many people, it seems like a ‘mental illness follow up’ to the hit Netflix series 13 Reasons Why, which explored different elements of mental health: depression, self-harm and suicide.

People have subsequently accused Netflix of capitalizing on the romanticization of mental illnesses so commonly seen on sites such as Tumblr. The site has been accused of putting vulnerable lives at risk by portraying such sensitive and ‘triggering’ issues. It seems to be virtually impossible for Netflix, or any other label, to ‘get mental illness right’.

The unfortunate truth is that those who are most affected by these issues are the ones most likely to become upset or outraged. Having suffered with issues seen in these shows myself, I found myself getting annoyed because ‘that wasn’t like my experience’ or ‘I don’t want people to think that’s what depression is’. I was worried that these films would cause more issues. That they would make suicide seem romantic, or anorexia seem beautiful.

This isn’t the right way to look at it. We have to face these issues. We can’t hide away mental illnesses. They can’t carry on being ignored, shoved into the back of people’s minds. We need people to understand the scope of suffering that rushes through someone when they are dealing with these things. We need to get people talking about mental health, we need to get people showing support to others, we need to get the conservation started. And this is what these TV shows are doing.

  • It is always going to be an imitation. 

What we see in shows is never, ever going to be the real thing. It doesn’t matter if the actor has struggled with this issue in the past: they are putting on a performance. They are being directed and no matter how much emotion goes into it, it’s always going to be artificial. That is the case with all TV series and films, over all issues. But with mental illness, it’s hard to get it right without it being ‘real’. This has to be accepted.

  • Mental illness affects everyone in different ways. 

No one person has the same experience with mental illness. Even with the same illness, people experience different symptoms. You might not understand how sexual harassment, bullying and loneliness could push someone to commit suicide and lash out at everyone else (because you know, mental illness isn’t always sweet and nice), because that wasn’t how you felt. Maybe you were pushed to the edge by something else. But that doesn’t disqualify other people relating to Hannah Baker.

Similarly, no two of my friends or family members with anorexia are the same. People have different triggers, different perceptions, and different attitudes to their illness. Some people do use humour to lighten a shitty situation. Some people are angry and bitter. Some people seem happy on the outside but are actually keeping a harrowing storm within.

  • People also have different experiences with treatment. 

This is especially true with services in different parts of the world. Many people from the UK have kicked off about these two series, complaining that the depiction of treatment ‘wasn’t realistic’. However, this is assuming that everyone in the world has the same healthcare as those of us who live in the UK. This is obviously wrong. When money is so much more closely involved with health services in the US, things are bound to be different. The section system that exists here is not the same as there. In some ways, you can’t be forced to get better.

  • It’s impossible to go into complete depth. 

The presentation of mental illness at any one point is only the tip of an iceberg. A whole life full of events and thoughts can contribute to an illness, which would clearly impossible to present in a film or even in a long TV series. It would be time-consuming and boring to go through every single factor of a complex illness. This is therefore up to the viewer to understand what could have possibly contributed, and to get that all characters in TV shows are to some extent, simplified.

  • To sugar coat is to reduce, to present realistically is inevitably to trigger.  

It’s a lose-lose situation. If you don’t show the triggering and unpleasant elements of mental illness, people say that it’s not realistic and that it’s romanticized mental illness. That it’s not offering a rounded view of an illness, and is belittling those who struggle.

On the other hand, if you show the illness completely unfiltered, you may then be accused of triggering viewers, or blowing things out of proportion. This may be seen as detrimental to viewers.

Most TV series and films depicting mental illness come somewhere between these two extremes, and are thus condemned both for sugar-coating and for triggering.


I know a few years ago I would have found 13 Reasons Why unbearable. I would have fuelled my depression and urge to self-harm on it. It would have validated me. But that was a projection of my illness. And I didn’t have 13 Reasons Why so I ‘fuelled’ my self-hatred and despair on other things. And unfortunately, there are always going to be other things. We can’t stop talking about mental illness in case it ‘gives people ideas’. That’s not how it works.

But please, Netflix.

  • Please put detailed trigger warnings on films and episodes.

It’s not that difficult to simply alert people of the nature of what they are about to watch. This doesn’t mean putting ‘This episode/film may be upsetting for some viewers’. TV shows and films, specifically those revolving around mental illness (and are hence more likely to attract vulnerable people), need to have more detailed trigger warnings.

It wouldn’t take much to have at the start of the episode ‘This episode/film contains… (insert list of the most common triggers)’. They could even put the timings on so people can still watch.

  • Please show us that people can get better. 

The reality of mental illness is that people do die. People do die of complications, people do take their own lives. But please give people some hope to hold onto. Show us characters who battle through and come out the other end. Show us that not everyone is a sad story and that we can get better. Stop this love story nonsense, and give us characters with real inner courage. Give us male characters battling the emotional conditioning of our society, give us characters who aren’t conventionally attractive. Give us people, as real and as hopeful and as you can.

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