Teenage mental health is explored in HBO's Euphoria — but is it helpful? (HBO)

April 29, 2022   7 mins

Marianne Eloise wants the world to know that she does not “have a regular brain at all”. That’s her declaration, on the very first page of her new memoir, Obsessive, Intrusive, Magical Thinking. The book catalogues her experience of a dizzying variety of psychiatric conditions: OCD, anxiety, autism, ADHD, alcohol abuse, seasonal affective disorder, an eating disorder, night terrors, depression. By her own telling, Eloise has suffered a great deal from these ailments; I believe her, and wish better for her. But she would prefer we not think of them as ailments at all. And that combination of self-pity and self-aggrandisement is emblematic of our contemporary understanding of mental health.

Eloise is a champion of neurodivergence, an omnibus term that’s recently ballooned in popularity, which can include autism, anxiety, borderline personality disorder, or indeed any other psychiatric condition that’s hot right now. The term is designed for making sweeping pronouncements. Forget the fact that, say, autism and schizophrenia are so different that they have at times been described as opposite conditions. Forget the fact that saying you’re neurodivergent has as much medical meaning as saying you have a disorder of the body. The idea is that there’s a group of people whose brain chemistry differs, in some beautiful way, from some Platonic norm. And it’s an idea that’s taken on great symbolic power in contemporary liberal culture.

There is, for example, a thriving ADHD community on TikTok and Tumblr: people who view their attentional difficulties not as an annoyance to be managed with medical treatment but as an adorable character trait that makes them sharper and more interesting than others around them. (They still demand extra time to take tests, naturally.) It’s also easy to come across social media users who declare how proud they are to be autistic; I’m glad they’re proud, but their repetitive insistence makes me wonder who exactly they’re trying to convince, us or them.

Darker, there’s the world of “DID TikTok”. DID, dissociative identity disorder, is a profoundly controversial condition, once known as multiple personality disorder. Many serious experts question whether it exists at all; at the very least it’s incredibly rare. And yet thousands of adolescents have diagnosed themselves with the condition, and happily perform their various personalities for their social media followers, typically in ways that defy all established psychological understandings of the disorder.

Against this backdrop, Eloise is a marketing department’s dream come true: hers is a story of the young, beautiful, dysfunctional — and successful. Eloise is the perfect 21st-century woman, from a certain internet-enabled philosophy of human affairs. She is an admirer of witchcraft and believes that women have a mythical connection to water. She does a lot of drugs and becomes bisexual. She uses Tumblr and travels the world, vacationing in Lisbon and the south of France, and moves to Los Angeles to be an actor, taking care to embed that period of her life in a self-defensive patina of irony. She lives an enviable life of obvious socioeconomic privilege, which she does not have time to recognise, as she’s too busy cataloging her psychiatric maladies.

She crams them into every last anecdote: apparently nothing happens to her that she does not ultimately attribute to those maladies. Eloise’s love of swimming as a child is, for instance, laboriously explained in terms of her neurodivergence. I’m talking thousands of words. It seems never to have occurred to her that a love of swimming is not exactly rare among children, or that she doesn’t have to justify her joy at being in the ocean by making it “deeper”. Again and again, she holds perfectly mundane attitudes and behaviours up to the reader and says “Isn’t this special?”

The label of neurodivergence is so vague and capacious, pretty much anything can be pulled into its orbit and made “diverse”. There’s a meme that crops upon Tumblr, TikTok and Twitter that starts with “the neurodivergent urge to…” and is immediately followed by, well, just about anything a person does. Common examples include the neurodivergent urge not to reply to an email or to order food in rather than cooking what’s in the fridge.

Take Eloise’s nightmares. She has, at times in her life, suffered from debilitatingly bad dreams that made sleep a constant source of fear and pain. This sounds like an awful condition, and she deserves sympathy. But she gives the game away when she writes: “Maybe my relationship with dreaming wasn’t like everyone else’s.” Not like everyone else’s, no. But certainly like that of many people who suffer from recurring and terrifying nightmares. Eloise writes that, according to the Mayo Clinic, nightmare disorder “only affects around 4-5% of adults, which shocked me: did adults really not have nightmares?” It’s as if she genuinely does not know the difference between 4% and zero.

It is perhaps comforting to see every last detail of one’s life as the product of some uncontrollable force. “I am this way because I was born this way,” Eloise writes, in a remarkably bald denial of personal responsibility. As a pawn of the various interior forces that do combat in her brain, she is adamant that there is nothing wrong with her, that her suffering is all in service to some deeper way to live, and that she is proud of the very conditions she asks us to treat as a perpetual get-out-of-jail-free card for her behaviour.

The implication is that the neurodivergent might just be better than other people. As with introverts, social media users have developed a discourse around neurodivergence that is nakedly self-celebratory, a bragger’s genre. Eloise has clearly endured a great deal of hardship, but like her culture she seems to feel that this hardship can only be given meaning by being woven into a journey of self-actualisation. Eloise writes that her life is “underpinned and ultimately made whole by obsession”. Can you imagine a sadder statement: an adult telling you that there is nothing to distinguish her or give her value but her psychiatric conditions, conditions she shares with millions of others?

Diagnosis is the Holy Grail of the neurodivergence narrative. Eloise fixates on hers and its quasi-mystical powers. No reader could doubt that her problems are real, but she seems to have treated getting diagnoses like a consumer on Amazon. She states flat out, on several occasions, that she went shopping for an autism diagnosis, went to doctors with the express intent of wringing one out of them. There was a time when self-diagnosis was understood to be unhealthy, and perhaps embarrassing, but this is a brave new world we’re living in now.

Once enough people insist on mental illnesses as upbeat and fashionable lifestyle brands, then any of us who oppose it are guilty of the most grave sin of all, the sin of perpetuating stigma. It’s stigma to call autism a disorder, despite the fact that it renders some completely nonverbal and unable to care for themselves; it’s stigma to suggest that someone with ADHD bears any responsibility at all for problems at school or work; it’s stigma to speak the plain fact that people with psychotic disorders sometimes commit acts of violence under the influence of their conditions. It’s stigma, in other words, to treat those of us with mental illnesses as anything else than wayward children.

Stigma, that cartoon monster, has never been in the top 100 of my problems in 20 years of managing a psychotic disorder, but never mind; stigma is the ox to be gored in contemporary pop culture, and so we must fixate on it to the point that we sideline the health, safety and treatment of those with mental disorders.

What I find tragic about those who buy into the neurodivergence narrative is that they become their illnesses. And yes, there are alternatives. Eloise and people like her seem never to consider one of the possible ways that they could have dealt with their myriad disorders: to suffer. Only to suffer. To suffer, and to feel no pressure to make suffering an identity, to not feel compelled to wrap suffering up in an Instagram-friendly manner. To accept that there is no sense in which her pain makes her deeper or more real or more beautiful than others, that in fact the pain of mental illness reliably makes us more selfish, more self-pitying, more destructive, and more pathetic. To understand that and to accept it and to quietly go about life trying to maintain peace and dignity is, I think, the best possible path for those with mental illness to walk.

But in this culture, all must be monetised, all must be aspirational, anything can be marketed. Eloise lacks the self-awareness to ask whether there’s something exploitative and ugly about turning psychological illness into fodder for soap opera and motivational posters. Again and again in this book, Eloise gins up the kind of statement on mental health that you might find in an Instagram meme, wedges it awkwardly into some prosaic story about her youth, and then skips away. At one point she mocks “Airbnb-style Live Laugh Love signage”, and I could only think, you’re writing a book filled with it.

The most real, most human, most honest, and most humane part of Eloise’s book is something she wrote in a journal in 2009, when she was a teenager:

I fear my mind, as one single assembly by one fireman on fire safety in primary school caused this deep-seated fear. That shows the true extent of my mind’s power over me. Although these things are unlikely to happen, just yet, I fear every one of them one day. I don’t need a doctor to tell me that is a problem. But I want, so badly, to get better.

This is what it’s actually like to have a mental illness: no desire to justify or celebrate or honor the disease, only the desire to be rid of it. But the modern conception of neurodivergence (and disability activism generally) wants to have it both ways. Sometimes, people would prefer for you to think of their conditions as debilitating hindrances for which they may demand special dispensation. And sometimes they would like them to be seen as positive personality quirks that make them unique.

It is hard to witness the damage that has been done to this young woman, by a culture that insists she views her suffering as part of a beautiful journey. Today’s activists never seem to consider that there is something between terrible stigma and witless celebration, that we are not in fact bound to either ignore mental illness or treat it as an identity.

Were we wiser and more serious, we might be able to see psychiatric disorders as both natural and lamentable, as beyond the control of the individual but still within their responsibility. We would have sympathy for those who suffer from them, but recognise that sympathy only accrues to those whose conditions are unfortunate, unhealthy. We might be honest and say that, yes, it’s bad to be afflicted with psychiatric disorders.

We might, then, have the courage to say that mental illness sucks, that there’s nothing good about it, that the efforts to bend it into some superpower of greater creativity or deeper living is sour grapes from those who can’t escape. We might help people like Eloise, rather than celebrating them as self-actualised girlbosses. We might have the wisdom to ease her suffering, while we patiently tell her that there’s nothing beautiful about it.

Freddie deBoer is a writer and academic. His newsletter can be found at freddiedeboer.substack.com.