The dangerous aesthetic of psych-ward TikTok Mental illness is becoming an accessory

What is particularly alarming about the TikTok psych-ward trend is its vibe of cossetted childishness. A common theme among “grippy socks” creators is the aesthetics of infantilism; grown women sit in teddy-bear-print onesies colouring in Mr Men books, surrounded by cuddly toys and watching cartoons as their “comfort shows”. Where the imagery of ED (eating-disorder) Twitter is all skeletal legs, cigarettes and accounts with “ugw” (ultimate goal weights) in the bios, psych-ward TikTok is equally faddish about teddy bears and felt-tip pens. Their places of confinement function as trend-pits: one fascinating TikTok of a unit in Italy shows a wall graffitied with the phrase “ACAB” showing, in the most uncharitable interpretation, how damningly fad-based a lot of this is, so that an imported American political curio joins the other more predictable adolescent causes of the inpatients (there is also an anarchy symbol and less probably, the Nietzschean howl “god is dead”). But at the cutting edge of mental-health content creation, in the UK and US, it’s less about raging against the machine than cleaving to an extended adolescence: healing by collecting sheets of shiny stickers.

This psych-ward aesthetic has now so utterly invaded feminine youth culture that “fashion girlies” are lip-syncing a quote from 1999’s Girl Interrupted: “Maybe I was just crazy, maybe it was the Sixties,” they murmur in the middle of a smokey-eye tutorial. The film, starring Winona Ryder and based on the bestselling 1993 memoir by Susanna Kaysen, is the iconographic homeland of the modern mental-health influencer. Ryder, admitted to an institution with a diagnosis of borderline personality disorder, meets Angelina Jolie’s character Lisa, a diagnosed sociopath and long-term inpatient — who also happens to be a cigarette-puffing model/rock chick. And we meet a host of characters including Janet the anorexic, Polly the pyromaniac, Georgina the pathological liar, and Daisy with OCD and sexual trauma.  The novel, which The Boston Globe claimed “threatened to replace Sylvia Plath’s The Bell Jar ‘as a must-read for young women”. It equivalenced middle-class femininity and “psychological risk”, and the subsequent Hollywood film became an unstoppable draw as a template of tortured “cool”.

In her Washington Post review from 1993, Diane Middlebrook described Kaysen’s memoir as a consummate “girl’s story” because of its “preoccupation with confinement in a pink-and-white-body”. The imagery of pink and white speaks to something broader that is still true of the fantasy of the psych ward today: that it is a locus of suspended adolescence, of somatic and social liminality, whose inhabitants cower between the twin poles of protected asexual girlhood and frenzied, freighted womanhood. In 1994’s Reviving Ophelia, the therapist Mary Pipher lamented a generation of “lovely and promising” girls falling prey to “depression, eating disorders, suicide attempts, and crushingly low self-esteem”; she cited a “developmental Bermuda Triangle” caused by a “girl-poisoning” culture which had traumatised the young women floating through her office with sexualisation and body complexes. Her namechecking of Hamlet’s tragic waif nails the critical character of the suffering of teenage girls: that it is spectacular. That is not to say that it is not real — anyone who has ever been a teenage girl will know exactly how real it is — but it has a peculiarly performative inflection which affects the way it is experienced by girls and misunderstood by baffled adults.

These TikTok psych-ward influencers, then, alien and faddish as they may seem, are simply the latest embodiment of an ancient tradition. The theorist Michele Aaron has studied the cinematic archetype of female mental suffering, anchoring her in another weapons-grade source of sad-girl iconography, Sofia Coppola’s 1999 The Virgin Suicides (the Air soundtrack of which, in no coincidence, plays in the background of those Girl, Interrupted TikTok videos above). This film depicts the deaths of five sisters as watched by the infatuated boys who live across the street; though the aesthetics of girlish delirium seem disconnected from men (that pink-and-whiteness, or Ophelia’s flower-strewn watery grave, suggest this is, if anything, about a toxic excess of femininity) it is important to remember the tension between the young woman and her male spectators, and the curiously gendered inflection this produces. What began with Giotto’s 14th-century feminisation of the suicidal vice of Despair, continues throughout the Renaissance with death-struck heroines such as Lucretia (Raphael) and Dido, Queen of Carthage (in Marlowe’s 1594 play, then Purcell’s gorgeous 1689 opera). The academic Heidi S. Kosonen says the staging of these tragic women, “cogitating their suicides while holding weapons in their hands, in a state of bodily sanctity and mental resolution”, affords them the status of “masculine heroism”. In her analysis, women die for love and men for glory; we must understand the atmosphere of feminine mental illness, if not the reality, as steeped in its associations with ancient tragedy. Only then can we attempt to process the weirdness of the present-day psych ward: in drawing on shared symbols — the forehead wound, the teddies, the Girl, Interrupted quotes — these teens can ennoble their suffering.

Emily Dickinson was the ultimate American shut-in poet and muse, clad in white and known, not unlike the plushie-hugging creators of today, for her strange, confected childishness. The feminist critics Gilbert and Gubar write of Dickinson that her shunning of adult, maternal and marital society meant the “price of her salvation was her agoraphobic imprisonment in her father’s household, along with a concomitant exclusion from the passionate drama of adult sexuality”. How hauntingly familiar in the context of the suspended adolescents of today, shut away from the world of employment and responsibility and left to shuffle around corridors in socks, broken by intervals of colouring-in.

Dickinson’s own curation of this purgatorial lifestyle might help explain the strange lure of PICU life: the isolated girl, a font of meaningful suffering, can shield herself from a cruel and intimidating public existence and spend her time instead creating doleful poems or, indeed, videos, about herself. Teen girls have always, always done this — and they always will, not understanding that this “traumatic passage” really is just that, not realising that stable, if less keenly felt, adulthood is probably just around the corner.

The modern mental-health martyr of social media is engaged in the same search for meaning as every tragic teenager before her; what’s changed is that for the first time these girls can communicate and compete, instantly and constantly. The resultant arms race to extreme and conspicuous suffering means that what might ultimately have amounted to a tricky couple of years threatens to become an extended stay in a secure unit, and an interrupted journey into adulthood.

In 2023, Susanna Kaysen gave a fascinating interview to The Cut to mark 30 years of her Girl, Interrupted; in it, she laments the “label soup” of modern psychiatric culture which, she says, can prevent “an acceptance of the variety of human emotions”. “Stowing people away” in wards is not the answer, she says — though the girls who quote her own memoir idealise just that. One senses that this is a writer who has watched her own story become cannibalised by a generation of fans, ravenous for identity and meaning. Her solution? “‘I have ADD, I have OCD, I’m depressed.’ Come on! You’re a teenager, This is what it’s like. It’s terrible. That much, I remember.”

There is a difference, though, between life-ruining psychological conditions and the transient unease of being a young woman; neither is easy, and both deserve sympathy. The danger is that teens building their fragile identities around the aesthetics of torment they see on TikTok undermines both the suffering of the gravely ill and the truth that all former teenagers learn in time: that sometimes, the only way out is through.

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Poppy Sowerby is an UnHerd columnist

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