How Pop Culture Is Changing The Way We Talk About Mental Health

CONTENT WARNING: This article discusses mental health and suicide.

In the latest season of Netflix‘s animated series BoJack Horseman, the episode titled ‘Stupid Piece of Shit‘ takes you right inside the titular character’s inner thoughts.

It opens to a black screen. “Piece of shit,” thinks BoJack to himself. “Stupid piece of shit.” It cuts to a shot of BoJack in bed; he’s just woken up. “You’re a real stupid piece of shit. But I know I’m a piece of shit. That at least makes me better than all the pieces of shit that don’t know they’re pieces of shit.”

He gets up. “Breakfast,” he thinks, opening his medicine cabinet and swallowing a couple of unidentifiable pills. “Argh, I don’t deserve breakfast.” He recognises his own negative tone, and changes tact. “Hey, shut up! Don’t feel sorry for yourself. What does that do? Get breakfast you stupid fat-ass.”

This inner monologue continues throughout the episode, giving us a break only when the story jumps to another character. For the first time in four seasons, we’re taken inside the overwhelming despair BoJack – a washed-up 90s sitcom star with more issues than you can shake a fist at – feels on a daily basis.

BoJack Horseman. Source: Netflix.

In a show that’s praised for its frequent, realistic representations of mental illness, Season 4 Episode 6 hit a nerve with viewers.

“Shit. My inner dialogue is the same as BoJack’s,” one person wrote on Reddit, in a discussion about the episode.

“While not as dark as some of the stuff that’s happened on this show, BoJack’s thoughts in this episode got to me so, so much,” said another.

“Me too!” replied a third. “I teared up. This legit is my favourite episode for being so relatable/on point about anxiety and depression. This is what I’d show people so they understand how this feels. It’s a perfect mix of comedy yet also having a message behind it.”

And therein lies the power of accurate, unflinching representations of mental illness. Talking about trauma, even within the safe confines of a therapist appointment, is difficult at best and damn near impossible at worst. Being able to point to an outside text and say, that! That’s what I’m experiencing! is powerful as hell. In just four seasons, BoJack Horseman has become a cultural touchstone for how anxiety and depression are represented on the small screen.

The goal was never like, Let’s really create an expose, let’s really investigate this kind of thing, let’s diagnose BoJack in a certain way,” creator Raphael Bob-Waksberg told Bustle. “I think it was more about just trying to write this character truthfully, and taking him seriously. The idea [was to take] a character trope that is maybe a little archetypal, or that we’ve seen before, but really believing in it, and trying to be honest and respectful to it.”

BoJack Horseman might be rightly earning praise, but it’s by no means the only applauded representation in pop culture. The late and great Carrie Fisher wrote extensively about bipolar disorder; Lena Dunham‘s Girls delved into the realities of living with obsessive-compulsive disorder (OCD); and Netflix’s recent film To The Bone, about a girl woman dealing with anorexia nervosa, was one of the first films in recent history about an eating disorder that didn’t glamorise it.

The thing with giving your characters a mental illness is that you have to treat it with the full respect it deserves. A throwaway B story or an arch that serves to achieve something else (for example, a character experiencing trauma in order to further a romantic plot) is not going to cut it in 2017.

Australian series Please Like Me is a perfect example of a show that treats mental illness with the utmost care and sensitivity. The Josh Thomas-created series, which is largely based on his own life, opens with his mum’s suicide attempt.

The four-season series was widely praised for its unflinching and accurate portrayal of mental illness, which we see through the stories of several different characters (including the fantastic comedian Hannah Gadbsy). Thomas told Flavor Wire that his biggest challenge was making sure they were telling these stories truthfully.

“When you’re representing mental illness, you want it to be honest,” he said. “But it’s really varied. So I was getting worried. In Episode 10 there’s a panic attack, and we’re trying to figure out what happens when people have a panic attack. And actually everyone reacts differently. So as an actor, you can usually just do whatever you want, as long as it’s just sort of vague. But then I started to get nervous that people who have panic attacks would watch and say that’s not reality, or ‘I would never do that’.”

Josh and Rose (Debra Lawrence) in Please Like Me. Source: ABC.

While it’s this sort of storytelling that film- and television-makers should be aiming for, even those that miss the mark can be an opportunity for positive representations.

M. Night Shyamalan‘s 2016 psychological thriller Split was a lot of things: a masterclass in acting from star James McAvoy, a suspenseful story that kept you on the edge of your seat, a thoroughly enjoyable film. What it was not, however, was an accurate representation of dissociative identity disorder (DID), formerly called multiple personality disorder.

McAvoy, the villain of this thriller, flits between a number of personalities as the film progresses, each vying for control and acting to either aid or abet ‘Dennis‘, the personality who has taken three teenagers hostage. It was widely condemned for its inaccurate portrayal of the illness (people with DID are rarely violent), with mental health experts warning that the film stigmatised those suffering from it.

“You are going to upset and potentially exacerbate symptoms in thousands of people who are already suffering,” psychiatrist Dr. Garrett Marie Deckel told CNN. Widespread media coverage of the negative effects of this film offered opportunities for conversations about how DID actually presents, and while it’s irresponsible to credit the negative (the film’s portrayal) with the positive outcome (the education), it also can’t be ignored.

James McAvoy in Split. Supplied.

Of course, this isn’t always the case, and no conversation about mental health in pop culture in 2017 is complete without touching on the Selena Gomez-executive produced 13 Reasons Why, Netflix’s adaptation of the Jay Asher novel.

The inescapably popular series was widely condemned for arguably glamorising teen depression and suicide. In the books, the character Hannah Baker dies by swallowing a handful of pills, but the series depicted a graphic and incredibly confronting scene in which she cuts her wrists.

Gomez downplayed the backlash, insisting that they “stayed very true to the book” and that it was “going to come no matter what”, but that didn’t stop Australian mental health org Headspace issuing a warning that it could lead to possible suicide contagion, a well-documented phenomena where reports of suicide (and particularly methods) lead to copycat situations.

In fact, New Zealand even slapped a ban on under 18s watching it without adult supervision. We all know banning teens from watching something tends to have the opposite effect, but it was at least an acknowledgement of the dangerous portrayal of suicide in the first place. Packaged up as the hot new Netflix special? Not so much.

Katherine Langford as Hannah Baker in 13 Reasons Why. Source: Netflix.

Social media giving anyone and everyone a voice – for better or worse – has led to the rise of callout culture. Get something wrong? Someone is going to tell you about it, and loudly.

Negative depictions of mental illness in the pre-social media (practically the stone ages) were left for scrutiny in film reviews and English dissertations.

The Silence of the Lambs, which pulled in the top five gongs at the 1992 Oscars, is widely regarded as one of the best horror films ever made. And yet, it falls into the overused trope of using mental illness to explain the motivations of its main antagonist.

The main antagonist, serial killer Buffalo Bill, is portrayed as a mentally unstable, gender-questioning man using the skin of his female victims to transform himself into a woman. After backlash from gay rights groups, director Jonathan Demme took pains to insist that the character wasn’t truly a transgender person, but that trauma and various (unspecified) mental illnesses caused him to operate under the mistaken belief that he was.

Ted Levine as Buffalo Bill in Silence of the Lambs. Source: Strong Hart / Demme Productions.

Of course, rights groups still condemned the film, and today it’s wildly regarded as a transphobic work of cinema. It’s not hard to imagine that if it were released in 2017, the backlash would be significantly louder. Five Oscars? Fat chance.

That’s not to say more recent examples didn’t dangerously mishandle the depiction of mental illness. Hannibal used it as a plot device for solving crimes, for chrissake, and Monk was nothing short of hopeless in its depiction of OCD. Split proved that horror films still resort to the overused trope of mental illness as the cause of someone’s psychotic, murderous tendencies.

The more we as an audience consume and resonate with media that portrays the nuances, challenges, and sometimes absolute mundanity that is managing a mental illness, the more this type of content will be created. That’s a simple analysis of a complex supply and demand relationship, but there it is. Support the kind of content you want to see in the world.

Creators are finally being given license to tell stories about mental illness that wouldn’t have been possible 5, 10, 20 years ago. If the success of shows and films like BoJack Horseman, Please Like Me and To The Bone are anything to go by, we’re only going to be seeing more of these kind of portrayals. And honestly, we can’t wait.

If you think you need help, don’t hesitate to talk to your GP. Medibank has a range of policies that include Psychology, like Healthy Start Extras, from only $11 a fortnight. Check it HERE.

If you or someone you know is dealing with a mental illness, you can find support at BeyondBlue by calling 1300 22 4636. If you are in crisis, please call Lifeline on 13 11 14. If it is an emergency, call 000.