What to Read – Mental Health in Literary Fiction Classics: A Psychiatry Resident’s Perspective

One Flew Over the Cuckoo’s Nest

Ken Kesey

It spends more time exploring the struggle for power between health care professionals (Nurse Ratched) and difficult patients (Randle McMurphy). Historically, psychiatry has been practiced in a very paternalistic way. For decades, doctors and nurses often forced treatment onto patients without much in the way of checks and balances. This has changed quite a bit in recent years, at least partially due to the depictions of involuntary treatment in this book and it’s movie adaptation.

Don Quixote

Miguel de Cervantes

A Spanish nobleman reads so much chivalry literature that he goes insane, believing himself to be a knight and heading off on all kinds of ridiculous and misguided adventures. As if Don Quixote was in the throes of a manic episode as part of a bipolar disorder? Not sure if Cervantes had heard of or knew an individual who had experienced a manic episode and based his character off of the same.

Catcher in the Rye

J. D. Salinger

With our current adolescent suicide crisis, this book really seems to be ahead of its time. The internal experience of Holden Caulfield reminds us so much of what we’ve heard countless kids describe to us in emergency departments. Awesome depiction of how hard a life-phase this can be and how bad a place a person can be in, even without a clear cut ‘clinical depression’.

Catch-22

Joseph Heller

The frantic and disorganized storytelling very much reminded us of a person experiencing a dissociative episode as part of a PTSD. It comes off as lighthearted and comical in the beginning, but evolves to be much more matter-of-fact and horrific by the end. It’s almost as if the narrator’s comfort level is increasing and they slowly give up more and more of the unadulterated tale.

Slaughterhouse-Five

Kurt Vonnegut

Another really interesting exploration of PTSD in a wartime setting. Billy Pilgrim’s sensation of becoming ‘unstuck in time’ and his experience of being abducted by aliens also really closely resemble the things we’ve heard described by patients during dissociative episodes.

Infinite Jest

David Foster Wallace

A thorough exploration of addiction. Not only the more obvious drug and alcohol addictions, but also our wider cultural addiction to entertainment and materialism. David Foster Wallace was a pretty troubled guy. He himself struggled with marijuana and alcohol addiction, as well as other mental health problems. He had been hospitalized a number of times which is likely why he was able to depict interactions between healthcare professionals and their patients with such stunning accuracy. Unfortunately, he committed suicide in 2008.

The Trial

(alternatively, The Castle or The Metamorphosis)

Franz Kafka

Franz Kafka had lifelong struggles with poor sense of self, purpose, fears of abandonment, and chronic suicidality. If you read his letters, he really comes off as a guy who feels trapped in this awful, bizarre, needlessly complicated world and finds himself experiencing nonsensical emotional responses. No wonder he fathered the genre he did, and The Trial is the perfect example.

The Satanic Verses

(alternatively Midnight’s Children or The Moor’s Last Sigh)

Salman Rushdie

Taking place over multiple generations, each of these books are interesting depictions of inter-generational trauma. The use of magic realism is also very interesting. Are these strange occurrences the product of mental illness? Or just more tolerable explanations for some of the awful things these characters have experienced? (Or both).

Crime and Punishment

Fyodor Dostoevsky

An uncanny depiction of someone slipping into psychosis. There’s an interesting scene in which Raskolnikov overhears a group of people discussing exactly why he feels justified in murdering Alyona just before he decides to go through with it. You may read this scene as him attributing his own thoughts to their conversation. His paranoia and ‘mind-reading’ of Petrovich essentially causes him to turn himself in.

Ulysses

James Joyce

James Joyce had a daughter who was diagnosed with schizophrenia. One of the hallmarks of this disease is thought disorder and Ulysses definitely comes off as disorderly. While Joyce himself may not had schizophrenia, the family members of affected individuals are often odd, eccentric, and have different ways of thinking than the average person. While reading this book, you may often wonder what kind of role this phenomenon may have played.

The Bell Jar

Sylvia Plath

A historical view of mental illness and treatment. Esther is neither stimulated nor excited by either the big city or the glamorous culture and lifestyle that girls her age are expected to idolize and emulate. She instead finds her experience to be frightening and disorienting. From hereafter her mental state keeps deteriorating until she starts feeling helpless as if being kept inside a glass bell jar. It was interesting how she explained her experiences with her illness, especially as it doesn’t seem like it was well understood at the time so she’s conveying it without the technical language.

The Yellow Wallpaper

Charlotte Perkins Gilman

This book is from the perspective of a woman who has a ‘mental illness’ and leaves her home to go to a country house to get better. She ends up, well, not getting better. She gets worse by the yellow wallpaper in the nursery she and her husband are using as a bedroom. She goes what we would call crazy by it and does some pretty silly things. The author wrote this as she had the same ‘mental illness’ and was driven very close to madness by the ‘rest treatment’. It’s where you basically rest until you are better, no writing, no work and no cleaning.

Flowers for Algernon

Daniel Keyes

Born with an unusually low IQ, he has been chosen as the perfect subject for an experimental surgery that researchers hope will increase his intelligence – a procedure that has already been highly successful when tested on a lab mouse named Algernon. As the treatment takes effect, Charlie’s intelligence expands until it surpasses that of the doctors who engineered his metamorphosis. The experiment appears to be a scientific breakthrough of paramount importance, until Algernon suddenly deteriorates. Will the same happen to Charlie?

To the Lighthouse

Virginia Woolf

This simple and haunting story captures the transcience of life and its surrounding emotions. It is based on her own early experiences, and while it touches on childhood and children’s perceptions and desires, it is at its most trenchant when exploring adult relationships, marriage and the changing class-structure in the period spanning the Great War. The technique at which Woolf weaves sensory details, the perception of these details with memory, thought processes, and character relationships together is masterfully executed.

Hunger – A Memoir of (My) Body

Roxane Gay

Roxane Gay has written with intimacy and sensitivity about food and bodies, using her own emotional and psychological struggles as a means of exploring our shared anxieties over pleasure, consumption, appearance, and health. As a woman who describes her own body as ‘wildly undisciplined,’ Roxane understands the tension between desire and denial, between self-comfort and self-care. In Hunger, she casts an insightful and critical eye on her childhood, teens, and twenties-including the devastating act of violence that acted as a turning point in her young life-and brings readers into the present and the realities, pains, and joys of her daily life.

The Talented Mr. Ripley

Patricia Highsmith

Tom Ripley probably reminds all of us of Iago in Shakespeare’s Othello in the way he is able to manipulate any situation to his advantage. Tom comes from poverty and loneliness having grown up without parents. His formative years were shaped by an overbearing aunt who belittled him at every opportunity. Tom learned early on he would need to con his way through life in order to survive it. He’s not a psychopath because he has the ability to imagine the suffering of others but he thinks nothing of killing someone if it is the only way to get out of a jam.

Strangers on a Train

Patricia Highsmith

Haines is a successful architect in the midst of a divorce, Bruno a mysterious smooth-talker with a sadistic proposal. He’ll murder Haines’s wife if Haines will murder Bruno’s father. As Bruno carries out his twisted plan, Guy finds himself trapped in Highsmith’s perilous world, where, under the right circumstances, ordinary people are capable of extraordinary crimes.

The Killer Inside Me

Jim Thompson

This is a simple story of revenge when the person who feels wrong is a sociopathic killer. Jim Thompson’s Lou Ford, a silent, polite, and seemingly nice guy who is actually a simmering volcano ready to explode. In The Killer Inside Me, Thompson takes us along Lou’s trail of murder in a first person POV. Every rationale, every excuse, and every gory detail gurgles up to the surface of Lou’s mind.

The Stories of Breece DJ Pancake

Breece DJ Pancake

This is a series of stories from a writer who committed suicide early in life, so it’s his only book available. His prose does have an element of the spare, and he writes about the dark corners of his home, West Virginia – snapshots of the drain-circling days of truckers, miners, welfare addicts and general hillbilly ‘trash’. Breece is relentlessly bleak, perhaps too certain he knows the minds and souls of others.