In January of 2007, Skins, a British teen drama promising authentic depictions of adolescence, first aired on television. An overnight sensation, fans devoted their corners of the internet and bedroom walls to their favourite characters and couples. Specifically, young girls were reacting to Cassie Ainsworth, soon-to-be a popular culture icon of the early aughts in ways unforeseen. The “eccentric” and “dazed” Cassie, who sports a watch on her ankle and dances on park benches alone, whom we’re introduced to after an off-screen suicide attempt, has anorexia.

For many viewers, she was an idol and ideal: beautiful and ‘broken,’ misunderstood by the adults, desired by the boys. A regular fixture in pro-anorexic (pro-ana) and thinspiration (‘thinspo’) communities, Cassie’s iconic dialogues (e.g., “I didn’t eat for three days so I could be lovely,”) were mantras. Some fans eagerly noted down the tactics she demonstrated to trick weighing scales. In hindsight, the signs were obvious: fans were romanticising Cassie’s anorexia.

Characters with psychological problems, requiring either institutionalisation or exorcisms, are no longer the bogeymen of cinema. Instead, despite misunderstanding the disorders, newer storylines (e.g., Atrangi Re) have attempted to humanise characters and give them ‘happy’ endings. The conversations sparked by Skins, which still linger online, throw light on another form of misrepresentation. When romanticised, a disorder with a clinical formulation, etiology, signs and symptoms, is reduced to a pretty picture worthy of Pinterest boards. A mental illness, then, is no longer that: at the best, it’s a quirk; at the worst, desirable.

There are varying opinions about what counts as a romanticised depiction and who should be held responsible for it. But, the fundamental question remains: why is it harmful? Three interrelated reasons: one, it distorts perceptions of mental illnesses; two, it can trivialise people’s lived experiences; and three, it privileges some disorders over the rest.

While portrayals can be a few shades closer to people’s realities, the concept of ‘good’ representation hinges on the belief that there’s a monolithic experience of mental illnesses. That isn’t the case – disorders not only differ in terms of typology and intensity, but genetics, personalities, upbringing, socioeconomic and cultural backgrounds, and other factors also tend to influence how it will manifest. Therefore, romanticised depictions and interpretations complicate existing concerns regarding the authenticity of portrayals. For instance, depression, which affects nearly 3.8% of the general population, isn’t a beautiful montage of sadness; instead, it’s pervasive, results in poor function, disturbs sleep, alters appetite, is exhausting, and is the leading cause of death by suicide.

Some disorders get more screen time than others. They are used as a plot device more frequently than conditions like selective mutism, agoraphobia, depersonalisation/derealisation disorder, to name a few. Of course, certain depictions can be constrained by the medium, but, typically, disorders such as retrograde amnesia (e.g., in The Bourne Identity or Kick), schizophrenia (e.g., in Shutter Island or 15 Park Avenue), dissociative identity disorder (e.g., in Split or Bhool Bhulaiyya) are written into narratives.

For the average viewer, whose understanding of mental illnesses is derived from mass media, a range of disorders is inaccessible and even non-existent in the popular imagination. Likewise, it can limit our conception of psychological problems to the two-three symptoms that are easy to depict on-screen. Cassie, for example, is thin, preoccupied with her weight and appearance, consumes emetics, but we never see her hair fall out, limbs swell, teeth erode, or fingers discolour, all textbook symptoms of anorexia nervosa.

This preoccupation with beauty, of characters looking gorgeous even in the middle of a panic attack, of pandering to the normative gaze, glosses over the uncomfortable aspects of living with mental illnesses. It implies that there is no room for stories of rage, pain, disappointment, and hurt. This can force people with the same mental disorders to perform in ways that meet our caricatured expectations, and when they do not, we criticise them.

Similarly, when narratives present falling in love or similar ‘happy’ arcs as antidotes for our suffering, we assume that all mental illnesses can be cured or will reach a point of no return. Unfortunately, that is untrue. In reality, recovery depends upon structural factors as much as individual ones. Moreover, mental illnesses can relapse. For instance, the global relapse rate for schizophrenia ranges from 50 to 92%; for bipolar disorder, it can be up to 73%; for anorexia nervosa, it is almost 36%. While they can’t be cured, most disorders can be managed, which we never witness because the story ends before the hard work begins.

Similarly, help is always available and accessible to characters, which isn’t the case for the rest of us. There’s no discussion about the barriers to effective healthcare like the dearth of trained and sensitive practitioners, diagnostic biases, misdiagnoses, social stigma, absence of support systems, and financial difficulties, to name a few.

We might never be able to acquaint ourselves with the entire spectrum of mental illnesses, which is why it is important to be mindful of what little we can do. Cassie’s guardians misunderstood her and failed to see her for what she was: young and terrified. But, in her, her fans felt seen, heard, and understood. However, because her storyline was written around her disorder, emulating her had consequences. There were some who thought that being anorexic made them “special” and “cool,” associations which they had drawn from the show.

A romanticised depiction or interpretation has no room for reality: it presents and privileges one narrative of mental illness over the rest, thereby implying that not only does one size fit all but also that if it doesn’t, the onus is on the individual. We need sensitive and realistic portrayals, but, more than anything else, we need to listen, to ourselves and to each other. A portrayal isn’t equivalent to representation and it surely isn’t a substitute for lived experiences.

Vibhavari Desai is a writer interested in mental health and cyberspace. She is @vibhaworry on Instagram. 

Moitrayee Das is an Assistant Professor of Psychology at FLAME University, Pune. She is @dr.moitrayee on Instagram.