Themes in Young Adult Literature: Depression, Mental Illness, and Suicide

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Last Updated on January 12, 2022, by eNotes Editorial. Word Count: 2645

Titles Discussed

Chinese Handcuffs by Chris Crutcher

Impulse by Ellen Hopkins

It's Kind of a Funny Story by Ned Vizzini

Thematic Overview

For many years, publishers and writers considered the topic of suicide to be taboo for young adult literature, fearing that open discussions of the subject would lead to...

(The entire section contains 2645 words.)

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Titles Discussed

Chinese Handcuffs by Chris Crutcher

Impulse by Ellen Hopkins

It's Kind of a Funny Story by Ned Vizzini

Thematic Overview

For many years, publishers and writers considered the topic of suicide to be taboo for young adult literature, fearing that open discussions of the subject would lead to suicidal ideation and imitations among young readers. Contributing to this belief was the lack of common knowledge about mental illness and depression, particularly among young adults. Established medical and psychiatric professionals experimented with new treatments on patients through the twentieth century, yet quite a few of the treatments were problematic, even damaging. While classic novels like Sylvia Plath's The Bell Jar (1963) and J. D. Salinger's The Catcher in the Rye (1951) featured teenage protagonists struggling with mental illness, it was not until the 1990s that the public began to have a better general understanding of mental health. This knowledge helped to create more diverse and mature young adult novels and also created a body of literature in which adolescent mental illness was regularly portrayed with nuance.

Mental illness often appears early in life, and half of the people who struggle with it first experience their illness by the age of fourteen. This means that for many people, the appearance of mental illness comes during adolescence and is complicated by confusion, rapid mental and physical changes, and increased social pressure from that time period in the person's life. One of the most common questions in all young adult literature asks what it means for an individual to form a self-identity. When mental illness enters the equation, however, a protagonist can encounter a major additional hurtle as their emerging self-identity suddenly becomes untrustworthy due to symptoms of depression and anxiety, particularly in social situations.

Of course, the definition of mental illness is incredibly broad and is regularly being updated and refined by mental health professionals. A teenager living with obsessive-compulsive disorder faces very different challenges than a teenager living with low-level depression or schizophrenia. Likewise, depression can be caused by a chemical imbalance in the brain or societal and personal factors, among them stress and trauma. Similarly, while suicide is often attributed to mental illness in teenagers, it can also be the result of physical or sexual abuse, or of societal exclusion.

Young adult literature that addresses themes of mental illness, depression, and suicide does its best when it addresses the condition on multiple levels—biological, cultural, personal, and medical. Chris Crutcher's Chinese Handcuffs (1989), for instance, explores the intersections of mental illness, suicide, and rape; while Ellen Hopkin's Impulse (2007) features three teenagers who have attempted suicide for different reasons, and must learn to live with one another in the context of a mental institution. Ned Vizzini's It's Kind of a Funny Story (2006) partially takes place in a psychiatric care facility, and his book uses the protagonist's mental illness to explore peer and academic pressure and mental illness. All three novels feature characters who experience their mental illness as one aspect of their complex lives, and who face questions of what it means to live with mental illness or depression (or the reality of the suicide of a loved one) as conditions that might well be present throughout their lives.


Chinese Handcuffs features two main characters, Dillon and Jennifer. Both characters have mental health issues rooted in traumatic violence and abuse, and both are star athletes who throw themselves into physical activity as a way to escape their own problems. Dillon's older brother, Preston, has recently committed suicide, and throughout the novel, Dillon writes him a series of letters in an attempt to process the loss. Dillon is shocked by his brother's death, and while processing his grief over the loss of his brother, Dillon becomes close friends with Jennifer. Jennifer shares her own trauma with him, revealing that she was sexually abused by her father at a young age and is now continually abused and raped by her stepfather, who is a prominent and respected community figure. Jennifer plans to flee her family with her younger sister, but when Jennifer's mother announces that she is pregnant with a baby girl (a child who will inevitably experience the same trauma and abuse), Jennifer attempts suicide instead. Dillon, unwilling to lose another person to suicide, promises Jennifer a better future and captures photographic evidence of the stepfather abusing Jennifer, and uses the evidence to drive him out of town.

The novel alternates between the first-person narration of Dillon and the wandering and omniscient third-person narration, a technique that shows the difference between the interior worlds of the characters and the external worlds of the school and the family. While mental illness can presents itself in obvious ways to the outside observer, it is also possible that depression, anxiety, and suicidal thoughts (especially those caused by trauma) can remain invisible or obscured, even to close friends and family members. We see the first clear instance of this after a third-person scene in which Dillon writes a letter to his deceased brother, after completing a triathlon. The letter from Dillon to Preston reveals that Dillon feels he cannot share his story with anyone but his deceased brother. While people expect him to crumble under the sorrow and trauma of witnessing the suicide, he instead decides to present strength, saying that to share his story would only burden those he cares about further. This letter also references an incident with a cat, which Dillon attempts to brush off. Once the novel returns to third-person narration, the cat incident is portrayed in gruesome detail through a flashback, with Dillon and Preston violently killing the animal, and with brief glimpses into Dillon's mind showing how Dillon was traumatized by this event.

For Dillon to process his brother's death, he turns outward and engages with another teenager who lives with mental illness—in this case, Jennifer. Again, the alternating narratives are used to show that the reality of Jennifer's trauma-induced mental illness is discordant with the way others perceive her. For instance, after Jennifer's basketball team wins a game, her coach observes how incredibly tough she is, yet in Jennifer's own mind, she feels weak and recalls that the last time she felt safe was when she was five years old, before the sexual abuse began. Jennifer and Dillon are both like the titular metaphor of the Chinese handcuffs, trying so hard to survive and appear normal that they only fixate further on their traumas and fall deeper in their depression and anxiety. When Jennifer and Dillon connect and share their stories with each other, they perform the “relaxing” of the Chinese handcuffs, as they are finally able to release some of that pressure. In this way, each character has affirmed the importance of sharing and overcoming the effects of mental illness. Jennifer and Dillon find happiness only when they can share their stories with others.

Craig, the protagonist of It's Kind of a Funny Story, likewise experiences mental health issues that are inseparable from other factors in his life—in his case, the stress of a high-performance high school. After earning admission into the Executive Pre-Professional High School in Brooklyn, Craig feels socially alienated while struggling with extraordinarily high expectations and daily homework. He must also watch the girl he loves, Nia, begin a relationship with his best friend. Against the advice of his psychiatrist, Craig stops taking his antidepressant medicine and manages to get by for some time before he becomes suicidal; however, before attempting to end his life he has enough clarity to call a hotline for help. He is admitted to an adult psychiatric care facility, and he forms new friendships with other patients, discovers his love of art, and even turns down Nia when she visits and tries to seduce him. At the end of his short visit to the psychiatric care facility, he is excited to begin a new life and to once more experience the world.

As with the characters in Chinese Handcuffs, Craig's mental illness is presented not as a singular issue, but rather as a challenge exacerbated by external factors, among them the social and academic pressures that many teenagers face. Craig does not have a major trauma that he must overcome, but instead he must learn to live with the ongoing reality of his depression through smaller challenges. This is made clear at the start of the novel, when the overlap of academic pressure and his choice to cease taking his medicine initiates the suicide attempt. The fact that it is possible to overcome these challenges is further emphasized by Craig's narrative voice, which finds casual humor in even the darkest moments. After sharing with his therapist that he experiences life as a nightmare he goes on to note, “Cosmic moment, I guess. Ooooh, is life really a nightmare? We need to spend like ten seconds contemplating that.” This constant levity is an obvious coping mechanism, similar to the letters Dillon writes to his deceased brother, in that both characters are able to acknowledge their deep depression without facing it directly. This humor also carries Craig through his brief stay at the psychiatric facility, where he connects with other residents and provides mutual support, often lightening other people's moods. When he emerges from his stay at the facility, it is clear that proper treatment has not only helped with his mental health, but has also improved other aspects of his life—he now has the confidence to pursue his goals of art school and to reject the shallow advances of Nia, in favor of more rewarding social and romantic connections. By facing his mental health challenges, Craig reshapes his entire life, starting himself on a healthier trajectory.

In contrast to the near-suicides in Chinese Handcuffs and It's Kind of a Funny Story, Impulse, a novel in verse, instead ends with the suicide of the main character, Conner. The novel begins when three teenagers meet in the Aspen Springs psychiatric institution, after they have all attempted suicide. Conner comes from a well-to-do family and faces constant pressure to excel in all aspects of his life; Tony spent years in juvenile detention, after killing the man who molested him as a child; and Vanessa has bipolar disorder and turns to self-mutilation when her family life starts to fall apart. Over the course of the novel, each character receives treatment and begins the long process of overcoming personal challenges, all while having flashbacks of trauma from earlier experiences. When the teens attend the final excursion of their program—a long hike up a mountain—there is both hope and further despair. Conner succumbs to his internal torment and jumps off a cliff to his death, and Tony and Vanessa turn to each other, with Tony wondering whether Vanessa would care if he, too, took his own life.

Impulse places much greater emphasis on the emotional landscape of the main characters, presenting their mental health challenges not as something that they will overcome with the help of medication, positive attitudes, and social support (as with Chinese Handcuffs and It's Kind of a Funny Story), but instead as difficulties that might overwhelm those characters, costing them their lives. The novel accomplishes this stylistically by alternating between the first-person perspectives of three main characters and by rendering their voices in verse rather than prose. The verse allows the characters' voices to linger on brief and sometimes fleeting thoughts, while also giving those thoughts heightened emphasis, with each chapter only a page or two long. When Conner finally commits suicide, for instance, the moment itself is relatively ephemeral, with Conner's internal monologue leading him to a realization, as “Suddenly it comes to me, / toes tempted to test the ledge, / that there is a way out of this.” While it might be surprising to some readers that Conner succumbs at this exact moment, it is also clear that the suicidal ideation, however fleeting, is also a recurrent and powerful aspect of his daily life.

The characters in these novels encounter a wide range of outcomes, from death and ongoing doubt in Impulse, to the optimistic, renewed conclusion of It's Kind of a Funny Story. This range of outcomes is appropriate to the range of experiences adolescents will have with mental illness. There is no singular story of mental illness or suicide—instead, there is an incredible diversity in every story. Each is shaped by social realities, personal traumas, brain chemistry, medical and therapeutic interventions, and countless other factors. What young adult readers need, and what these novels provide, are characters who encounter diverse experiences with honesty and candor, and refuse to shy away from tragedy, even as they hope for survival and happiness.


Medically and culturally, our understanding of mental illness continues to evolve at a rapid rate. The treatments for severe depression and anxiety change nearly every decade, while suicide is increasingly understood in the context of social problems (among them homophobia, racism, misogyny, poverty, and abuse) as well as biological health. Young adult literature is no exception, especially as the best writers are aware of and respondent to the most recent developments in the field of mental health. Novels from the 1970s, for instance, would likely feature characters who live with dissociative identity disorder. The characters would be forced to take medication with extremely adverse side effects and would likely struggle to function in society; however, by the late 1990s, advances in care meant that teenagers exhibiting signs of the disorder might instead take medicines with relatively minor side effects, and in turn, might expect to integrate into society.

In the twenty-first century, young adult novels must respond to rapidly changing social conditions. As novels are more likely to tackle mature subject matter, young adult literature is also more likely to feature mental illness and suicide that are linked to rape, sexual abuse, and other major traumas. Some critics take issue with this focus on a subject matter that they see as shocking or “gritty,” and argue that such novels (including those listed here) are exploitive of real life tragedies.

Other critics, however, applaud these novels for shedding light on a topic that has long been ignored by society at large. Even established classics like Plath's The Bell Jar, for instance, face criticism for their portrayals of mental illness, with the very real topic of depression seen as melodramatic or overwrought by some readers. The stigma around mental illness is fading, and more and more people are realizing that adolescents who exhibit signs of mental illness, depression, or suicidal ideation are not simply being “melodramatic teenagers,” but rather are experiencing medical conditions and signs of trauma that might well inform the rest of their lives. Although some novels certainly fall into the unfortunate category of exploiting these complex issues in order to gain readers, the subject on whole deserves urgent and repeated attention, with the best novels evolving as quickly as the medical and cultural conditions that inform them.

Further Reading

  • Campbell, Patty. “The Sand in the Oyster.” Horn Book Magazine 71.1 (1995): 94–98. Literary Reference Center. Web. 3 May 2015. <>.
  • Scrofano, Diane. “Not as Crazy as It Seems: Discussing the New YA Literature of Mental Illness in Your Classroom or Library.” Young Adult Library Services 13.2 (2015): 15–20. Literary Reference Center. Web. 3 May 2015. <>.


  • Hill, Crag. The Critical Merits of Young Adult Literature: Coming of Age. New York: Routledge, 2014. Print.
  • Jones, Jami L. “Freak Out or Melt Down: Teen Responses to Trauma and Depression.” Young Adult Library Services 7.1 (2008): 30–34. Academic Search Premier. Web. 3 May 2015. <>.
  • Porter, Roy. Madness: A Brief History. Oxford: Oxford UP, 2003. Print.
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